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Lithium-associated clinical hypothyroidism

Prevalence and risk factors

Published online by Cambridge University Press:  31 January 2018

Ann M. Johnston  and
John M. Eagles
Ann M. Johnston*
Affiliation:
Psychiatric Unit, Hairmyres Hospital, East Kilbride, Lanarkshire
John M. Eagles
Affiliation:
Royal Cornhill Hospital, Aberdeen
*
Ann M. Johnston, Consultant Psychiatrist. Psychiatric Unit, Hairmyres Hospital, Eaglesham Road, East Kilbride, Lanarkshire G75 8RG
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Abstract

Background

Rates of, and risk factors for, lithium-associated clinical hypothyroidism are uncertain.

Aims

To determine prevalence of and risk factors for clinical hypothyroidism in patients treated with lithium carbonate.

Method

Retrospective case-note review of 718 patients who had undergone serum lithium estimation during a 15-month period. Patients on thyroxine had a more detailed review.

Results

The prevalence of clinical hypothyroidism during lithium treatment was 10.4%. The main risk factor was female gender (women 14% v. men 4.5%). Women were at highest risk during the first two years of lithium treatment, and women starting lithium aged 40–59 years had the greatest prevalence (> 20%). No equivalent risk factors emerged in men, although, like women, their prevalence of hypothyroidism was substantially higher than community rates.

Conclusions

The high rates of clinical hypothyroidism identified may call for a review of the drug information given to women, particularly to those starting lithium in middle age. Consideration should be given to screening for thyroid antibodies before treatment in high-risk cases. Monitoring of thyroid function should take into account gender, age and stage of lithium treatment.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 4 , October 1999 , pp. 336 - 339
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

None.

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