Hypothyroidism in patients treated with lithium: a review and two case reports

Crowe, Morgan; Lloyd, G. E. R.; Bloch, S; Rosser, Rachel

doi:10.1017/s0033291700049631

Cited by 36 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are compatible with evidence of a direct inhibitory action of lithium on the thyroid gland [Bhattacharya and Wolff, 1976;Bagchi et al, 1978]. Crowe et al [1973] suggested that lithium might induce two types of hypothyroidism, one with thyroiditis, one without. Our results may sup port this hypothesis; lithium acts directly on the thyroid gland, causing an impairment of hormone production and/or release in most patients, whereas a minority of patients, females as a rule [Villeneuve et al, 1974], develop antithyroid antibodies and thyroiditis.…”

Section: Discussionsupporting

confidence: 91%

Lithium Therapy and Thyroid Function Tests

et al. 1984

View full text Add to dashboard Cite

Thyroid function tests including thyroxine (T₄), T₃ test, thyroid-stimulating hormone (TSH), free T4 index and antithyroid antibodies were studied in 51 patients before the start of long-term lithium therapy and after 4 and 12 months on lithium. After 4 months on lithium, changes occurred in all laboratory parameters – T4 and T3 test levels decreased and TSH increased. After 12 months T₄ and T₃ test increased to pretreatment levels and TSH remained higher than before the start of lithium. During 1 year of lithium treatment only 1 patient developed clinical signs of hypothyroidism and started levo-thyroxine substitution therapy.

show abstract

Section: Discussionsupporting

confidence: 91%

Lithium Therapy and Thyroid Function Tests

et al. 1984

View full text Add to dashboard Cite

show abstract

“…A similar iendency towards over-representaiion of hypothyroidism in female patients was been noted during the initial phase of treatment (Fyrö et al 1973;Villeneuve et al 1973) and in two groups of case reports representing altogefher 26 female and 4 male cases of hypoihyroidism (Crowe et al 1973;Lindstedt et al 1973). These 56 females accounted for 19 cases of hypothy¬ roidism, while just one case occurred in the remaining 30 patienis (P < 0.001).…”

supporting

confidence: 64%

“…Most subjects, however, escape from this general action, while some remain hypothyroid as long as treatment is continued (Emerson et al 1973;Fyrö et al 1973). A survey of the case reports including 26 females and 4 males with persistent hypothyroidism suggests that female patients have an increased susceptibility to develop this complication (Crowe et al 1973;Lindstedt et al 1973). A few large-scale, cross-sectional studies have been con¬ ducted using the measurement of serum thyrotrophin (TSH) as a sensitive indicator of hypothyroidism (Emerson et al 1973;Lindstedt et al 1973).…”

mentioning

confidence: 99%

Endocrine Effects of Lithium

Transbøl

Christiansen

Baastrup

1978

Acta Endocrinologica

View full text Add to dashboard Cite

The purpose of this study was to evaluate the prevalence of hypothyroidism in a sample of lithium-treated manic-depressive outpatients who had been under treatment for several years. The sample included 86 patients, 70 females and 16 males, who had been treated for an average of 80 months. One-hundred-and-five blood donors, 58 females and 47 males, aged from 21 to 70 years, served as a reference population for the determinations of serum triiodothyronine (T3), thyroxine (T4), triiodothyronine-resin uptake (T3RU), the free T3 and T4 indices (FT3I and FT4I) and thyroid-stimulating hormone (TSH).Raised TSH levels occurred in 20 patients (23 %), all females, and all but one being over the age of 40 years. This prevalence of 19 cases of hypothyroidism among 56 females over 40 years of age (34 %) contrasted sharply with one single case in the remaining 30 patients (P < 0.001). Highly significant reductions (P < 0.001) of FT3I3I and FT4I were observed in the 20 patients with raised TSH levels, in whom log TSH also correlated very closely with FT3I and FT4I (r=\m=-\0.73and \m=-\0.86,respectively, P <0. 001). The remaining patients had average normal values of T4, FT4I and TSH, but slightly depressed levels of T3 (P < 0.05) and FT3I (P <0.01), possibly reflecting decreased peripheral deiodination of thyroxine.Our data suggest, that cases of hypothyroidism continue to appear as treatment continues. Determination of TSH is recommended at 6 to 12 months intervals in manic-depressive patients undergoing long-term lithium therapy. 759

show abstract

“…For instance, lithiumtreated patients show increased prevalences of goitre (1)(2)(3)(4) and, to a lower extent, increased incidences of clinical hypothyroidism (5,6). Thyroid function tests are modified in lithium-treated patients and volunteers within a few months of treatment (7)(8)(9)(10).…”

mentioning

confidence: 99%

Thyroid abnormalities during lithium treatment

Bocchetta

Bernardi

Pedditzi

et al. 1991

Acta Psychiatr Scand

View full text Add to dashboard Cite

Thyroid function was evaluated in 150 Sardinian outpatients at different stages of lithium treatment. A visible and/or palpable goitre was found in 51% of patients, and there was no apparent correlation with the duration of treatment. No cases of symptomatic hypothyroidism were observed, but subclinical hypothyroidism was present in 19% of patients. The prevalence of specific antithyroid antibodies was positively correlated with age and duration of lithium treatment, and was higher in women. Subclinical hypothyroidism was observed in 53% of antibody-positive lithium-treated patients. Carbamazepine in combination with lithium was associated with significantly lower levels of total T4 and T3 than with lithium alone, and the ratios between total and free hormones were also decreased.

show abstract

Hypothyroidism in patients treated with lithium: a review and two case reports

Cited by 36 publications

References 19 publications

Lithium Therapy and Thyroid Function Tests

Lithium Therapy and Thyroid Function Tests

Endocrine Effects of Lithium

Thyroid abnormalities during lithium treatment

Contact Info

Product

Resources

About