Lithium from breast‐milk inhibits thyroid iodine uptake and hormone production, which are remedied by maternal iodine supplementation

Abstract

Background: Lithium is especially taken as a maintenance medication for Bipolar Disorder. In women with bipolar disorder, lithium is often effective during postpartum period, but breast-feeding for medicated mothers is controversial because of harmful effects for her child. At present, the biological mechanisms of lithium are not wellunderstood, affecting its usage and overall health implications.Procedure: We developed a rat lithium and breast-feeding model at human therapeutic levels to study the effects of lithium exposure through breast-milk on pups' thyroid function. Novel laser analytical spectroscopy, along with traditional blood and immunohistochemical tests, were applied to further investigate the mechanisms behind the thyroid dysfunction. Maternal iodine supplementation was evaluated as a therapeutic method to address the pups' thyroid dysfunction.Results: Pups exposed to lithium via breastmilk, even with the dam on a subtherapeutic level, experienced weight gain, reduced blood thyroxine (T 4 ), and elevated blood urea nitrogen, indicating effects on thyroid and kidney function. We show that lithium inhibited iodine uptake by thyroid follicles, initiating a mechanism that reduced

Lithium in breast milk transiently affects the renal electrolytic balance of infants

“…In the case of hypothyroidism independent of lithium, creatinine is increased resulting in decreased urea to creatinine ratio significantly [37][38][39] and the renal tubular ion transporters are decreased. 38 However, in our case of hypothyroidism caused by lithium, 21 elevated urea nitrogen and increased renal tubular ion transporters such as Na + -K+ ATPase and Na + −sulfate exchanger (suggested by the monitored elements such as Na, K, and S) 38 are observed.…”

“…35 In this study, at P18 in lithium group, along with the elevated urea nitrogen, the subjects were observed with reduced total T4 (p = 0.04), and increased weight gain from the study. 21 Reduced T4 and enhanced weight are typically signs of hypothyroidism. In the case of hypothyroidism independent of lithium, creatinine is increased resulting in decreased urea to creatinine ratio significantly [37][38][39] and the renal tubular ion transporters are decreased.…”

“…The continuation of significant reduction in thyroid hormones, increased weight of subject, and decreased renal tubular ion transporters in the kidneys are signs of hypothyroidism. 21,[37][38][39] In humans, lithium is highly effective in preventing postpartum psychosis (mania, psychotic depression, mixed state or non-affective psychosis) in the first months after delivery and is therefore given prophylactically in women at high risk. 40 Women at extremely high risk for postpartum relapse include women with a prior history of postpartum psychosis and/or women with bipolar disorder, with a documented relapse risk in meta-analysis of 31% and 37%, respectively.…”

“…LIBS is well-suited to multi-elemental analysis 19 due to its unique feature of rapid in situ analysis of biomedical organs. [20][21][22][23][24][25] Multivariate chemometrics combined with LIBS characteristics spectrum has facilitated a sharp growth of LIBS. Data analysis methods such as partial least-squares regression, artificial neural network, support vector machine, random forest regression, multi-linear regression, principal component regression, standard addition methods were widely applied to LIBS data in predicting the concentration of elements and classification.…”

“…Previously, we detected lithium traces in the breast milk of mother (rat) administered on lithium 22 and found the inhibition of thyroid hormones of their babies. 21 In this article, we employ LIBS and energy dispersive energy dispersive X-ray fluorescence (XRF) to perform multi-variate analysis to conduct characterization and discrimination of the presence of lithium in the kidneys of the animal model. We applied principal component analysis on LIBS and XRF-measured spectra to classify the control and lithium groups followed by a supervised linear discriminant analysis (LDA).…”