Thyroid abnormalities in lithium-treated patients

Özpoyraz, Nurgül; Tamam, Lut; Kulan, Emel

doi:10.1007/bf02848693

Cited by 35 publications

(33 citation statements)

References 22 publications

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“…It has also been shown to inhibit iodotyrosine coupling, alter thyroglobulin structure, and inhibit thyroid hormone secretion (21). Our results are in accordance with the findings of Ozpoyraz et al, who reported hypothyroidism in only 14% of the subjects on lithium therapy (22). We have strived to provide baseline orientation regarding the prevalence of thyroid disorders in the representative north Indian population.…”

Section: Resultssupporting

confidence: 92%

Prevalence of Thyroid Disorders in Patients Visiting a Tertiary Care Center in New Delhi: A Three-Year Study

et al. 2013

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Background: Thyroid disorders constitute the most prevalent endocrine disorder in our country. Thyroid disorders are classified broadly as hyperthyroidism and hypothyroidism depending on the functional capacity of the thyroid gland. These two entities are further segregated as sub clinical and overt dysfunction. The present study attempts to evaluate the prevalence of thyroid disorders in north Indian population which is more prone to hypothyroidism due to iodine deficiency observed in the Himalayan belt. Materials and Methods:A total of 7474 patients presenting to the department of Biochemistry, G B Pant hospital, Delhi, were enrolled in the study. The patients were examined and asked to report after overnight fast for sample collection on a prescribed date. Thyroid hormone estimation was done with commercially available ELISA kits supplied by Cal biotech, USA. Statistical Analysis was done using Microsoft Office "Excel" with Windows 2007 Operating System and multiple comparisons were made using SPSS 12.0 statistical software package. Results:The majority of the patients (approximately 85%) were Euthyroid. Only 1.22% of the total number of referred patients turned out to be hyperthyroid. Hypothyroidism was more prevalent with the number of patients diagnosed with both sub clinical and overt hypothyroidism being 987 (13.2%). Conclusions:We have strived to provide a baseline orientation regarding the prevalence of thyroid disorders in the representative north Indian population in the post iodine fortification era.

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Section: Resultssupporting

confidence: 92%

Prevalence of Thyroid Disorders in Patients Visiting a Tertiary Care Center in New Delhi: A Three-Year Study

et al. 2013

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“…22 An association was not found between thyroid volumes and hypothyroidism in lithiumtreated bipolar patients in a study. 31 In our study, the final TSH value and initial thyroid diameters, duration of lithium therapy and total duration of disease were not associated. Significance of thyroid diameter increases may be understood with follow-up studies with longer duration.…”

Section: Discussioncontrasting

confidence: 46%

“…fT4 level was found to be lower in lithium-treated bipolar patients compared to healthy controls in a study. 31 In a 15-year follow-up study of Bocchetta et al, yearly hypothyroidism ratio was found at 1.5% in lithium-treated bipolar patients. 32 No patients devel- Under the light of our findings, it may be suggested that lithium treatment is safe in patients who stayed euthyroid when using lithium and treatment may be continued by doing required tests.…”

Section: Discussionmentioning

confidence: 95%

Thyroid status in lithium-treated bipolar disorder patients: An one-year follow-up study - Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio)

et al. 2014

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SUMMARY ObjectiveIn this follow-up study, the hormonal changes were determined in bipolar euthyroid patients who were treated with lithium for the duration of one year. MethodFor the study, 23 bipolar I disorder patients without any axis I comorbidity were consecutively selected and followed up for one year. All patients were compared with 25 age-and sex-matched healthy controls in terms of thyroid hormone levels and thyroid volumes. The Sociodemographic and Clinical Characteristics Data Form, Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I and SCID-I/NP) were administered. Initial thyroid hormone levels and thyroid volumes were measured in the patients and controls. Patient and control groups were compared at baseline for thyroid volumes. Patients' lithium levels were measured at baseline, they were re-examined at six months for thyroid hormones, and at the first year for thyroid hormones and lithium levels. ResultsThyroid hormone levels changed in no patients during the follow-up period. Thyroid hormone levels were measured within the normal range. No correlation was found between the final TSH levels and duration of illness, duration of lithium treatment, initial thyroid volumes, and the initial TSH levels. ConclusionsLithium can safely be used in bipolar patients who were already receiving this treatment before and not developed any thyroid problem for a substantial period.Key words: Lithium, thyroid gland, bipolar disorder. RESUMEN ObjetivoEn este estudio de seguimiento se determinarán los cambios hormonales que se producen en pacientes eutiroideos con trastorno bipolar en tratamiento con litio durante un periodo de un año. MétodoPara el estudio se seleccionaron de forma consecutiva 23 pacientes con trastorno bipolar tipo I sin prevalencia concomitante de otros trastornos del eje I, y fueron seguidos durante un año. En todos los pacientes se compararon los niveles de las hormonas tiroideas y el volumen de la glándula tiroides con las del grupo control sano pareado por sexo y compuesto de sujetos de 25 años de edad. La evaluación se hizo por medio de: una hoja de datos de las características sociodemográficas y clínicas, la Escala de Valoración de Hamilton para la Evaluación de la Depresión (HDRS), la Escala de Young para la Evaluación de la Manía (YMRS), Entrevistas clínicas estructuradas para los trastornos del eje I del DSM-IV (SCID-I y SCID-I/NP). A los pacientes y al grupo control se les midieron los niveles iniciales de las hormonas tiroideas y el volumen de la glándula tiroides, a la vez que se les comparó la línea base del volumen de la glándula tiroides. Al inicio del estudio se determinó la línea base de los niveles de litio en los pacientes. Al sexto mes, se reexaminaron las hormonas tiroideas y, al cabo del primer año, los niveles hormonales tiroideos y de litio. ResultadosLos niveles de las hormonas tiroideas no sufrieron cambios en ningún paciente durante todo el seguimiento. Dichos niveles se midieron ...

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“…As a side-effect lithium causes nodular growth and goitre in a subset of patients even when euthyroidism is maintained by L-thyroxine treatment (1,2). The underlying mechanism is unclear but may be based on a direct effect as in vitro studies by Gaberscek et al (3) in FRTL-5 cells indicate an increased proliferation with low-dose lithium.…”

Section: Introductionmentioning

confidence: 99%

Lithium stimulates proliferation in cultured thyrocytes by activating Wnt/β-catenin signalling

Rao¹,

Kremenevskaja²,

Resch³

et al. 2005

eur j endocrinol

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Background: Lithium, clinically used in the treatment of bipolar disorders, is well known to induce thyroid growth. However, the mechanism involved is only incompletely characterized. Although it is conventionally believed that thyroid proliferation depends on the thyroid-stimulating hormone (TSH)/cAMP/cAMPresponseelementbinding protein (CREB) pathway, recent data indicate that Wnt/b-catenin signalling may be of critical importance. In other cell types lithium activates canonical Wnt signalling by GSK-3b inhibition, which in turn stabilizes cytosolic free b-catenin. Here we investigated the potential modulation of Wnt/b-catenin signalling under lithium treatment in primary and neoplastic human thyrocytes. Methods: Primary (S18) and neoplastic (NPA, FTC133) thyrocytes treated with and without LiCl were analysed using Western blotting, immunoprecipitation, reporter-gene assay, MTT proliferation assay and transfection studies. Results: LiCl dose-dependently inhibited GSK-3b, stabilized free b-catenin and inhibited b-catenin degradation. Furthermore, LiCl altered the assembly of adherens junction by upregulating the E-cadherin repressor, Snail, and downregulated E-cadherin expression. At a dose of 5 mM, LiCl significantly increased the proliferative potency of thyrocytes, which appeared to be mediated by b-catenin, since nuclear b-catenin stimulated T-cell factor/lymphoid enhancer factor (TCF/LEF)-mediated transcription and upregulated downstream targets like cyclin D1. To characterize the specificity of Wnt/b-catenin-driven thyrocyte proliferation, we transfected primary thyrocytes and FTC133 cells with dominant negative TCF4 to block Wnt-dependent pathways or with dominant negative CREB to inhibit the TSH/cAMP cascade. In cells transfected with dominant negative CREB lithium-stimulated proliferation was unchanged whereas blocking Wnt/b-catenin by dominant negative TCF4 reduced proliferation by approx. 50%. Conclusion: Our data indicate that Wnt/b-catenin signalling is of major importance in the control of lithium-dependent thyrocyte proliferation.

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Thyroid abnormalities in lithium-treated patients

Cited by 35 publications

References 22 publications

Prevalence of Thyroid Disorders in Patients Visiting a Tertiary Care Center in New Delhi: A Three-Year Study

Prevalence of Thyroid Disorders in Patients Visiting a Tertiary Care Center in New Delhi: A Three-Year Study

Lithium stimulates proliferation in cultured thyrocytes by activating Wnt/β-catenin signalling

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