No Connection between Long-Term Lithium Treatment and Antithyroid Antibodies

Abstract

Introduction The studies on the effect of lithium treatment on antithyroid antibodies showed either a higher concentration of these antibodies in patients receiving lithium compared to those lithium-naive or no difference between these groups. In lithium-treated bipolar patients, some researchers pointed to an association between antithyroid antibodies and other features of thyroid dysfunction such as hypothyroidism and decrease of glomerular filtration rate. Methods We compared antithyroid antibodies in 98 patients (30 male, 68 female) with bipolar disorder, aged 62±13 years, who received lithium for 19±10 years to 39 patients (12 male, 27 female), aged 57±10 years, who were never treated with lithium. The antibodies against thyroid peroxidase (TPOAb), against thyroglobulin (TGAb), and thyroid-stimulating hormone (TSH) receptors (TSHRAb) were estimated. Results No difference in the percentages of antibodies occurrence was found between groups, although the concentrations of TGAb were higher in patients receiving lithium. In lithium-treated patients, the presence of TPOAb was associated with lower concentrations of free triiodothyronine and the presence of TGAb, with higher concentrations of TSH. In females, the levels of TGAb were associated with lower thyroid volume. The concentrations of TPOAb correlated positively with the duration of lithium therapy in males, and those of TPOAb and TGAb negatively, with such duration, in female patients. Conclusion The results obtained showed no significant connection between long-term lithium treatment and antithyroid antibodies. In bipolar patients receiving lithium longitudinally, antithyroid antibodies can be associated with some indexes of thyroid function. However, they behave differently in male and female patients.

Ultra-long-term lithium therapy: all-important matters and a case of successful 50-year lithium treatment

“…29 No connection was found between long-term lithium treatment and antithyroid antibodies. 30 We also observed similar indexes of thyroid function in bipolar patients who had used lithium for 10-20 years and in those who had used it for 20 years or more. 31 The most common renal adverse effect of lithium is decreased renal concentrating capacity, which can appear after a few weeks of lithium use.…”

“… 29 No connection was found between long-term lithium treatment and antithyroid antibodies. 30 We also observed similar indexes of thyroid function in bipolar patients who had used lithium for 10-20 years and in those who had used it for 20 years or more. 31 …”

Thyroid structure and function in long‐term lithium‐treated and lithium‐naïve bipolar patients

“…Furthermore, in both lithium and nonlithium groups, there were other mood stabilizers such as valproate, carbamazepine, or quetiapine that make frequent modalities of BD prophylaxis (Musetti et al, ) and could exert an effect on thyroid function. We also did not correlate our results with those of antithyroid antibodies as it has been described elsewhere (Kraszewska et al, ). Another limitation can be a lack of a healthy comparison group.…”

“…The second aim of the study was to investigate a relationship between lithium effect on hormonal function and the structure of the thyroid gland. The assessment of antithyroid antibodies in these groups of patients has been a subject of a separate paper (Kraszewska, Ziemnicka, Sowinski, Ferensztajn‐Rochowiak, & Rybakowski, ).…”

The effect of long-term lithium administration on thyroid function and structure as compared with monotherapy by other mood stabilising drugs – a preliminary study

“…The thyroid structure showed a higher thyroid volume and a higher incidence of goiter (Kraszewska et al 2019a). No significant differences were found between the groups of antithyroid antibodies (Kraszewska et al 2019b). A recent study also found that the effect on function and structure may be modified by adding other mood stabilisers and antidepressant drugs to lithium (Kraszewska et al 2019c).…”