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On the Prevalence, Diagnosis and Management of Lithium-Induced Hypothyroidism in Psychiatric Patients

Published online by Cambridge University Press:  29 January 2018

Göran Lindstedt ,
Lars-Åke Nilsson ,
Jan Walinder ,
Annika Skott  and
Rolf Öhman
Göran Lindstedt
Affiliation:
University of Göteborg, Department of Clinical Chemistry, Sahlgren's Hospital, S-413 45 Göteborg, Sweden
Lars-Åke Nilsson
Affiliation:
University of Göteborg, Institute of Medical Microbiology, S-413 46 Göteborg, Sweden
Jan Walinder
Affiliation:
University of Göteborg, Psychiatric Research Centre, St. Jörgen's Hospital, S-422 03 Hisings Backa, Sweden
Annika Skott
Affiliation:
University of Göteborg, Psychiatric Research Centre, St. Jörgen's Hospital, S-422 03 Hisings Backa, Sweden
Rolf Öhman
Affiliation:
University of Göteborg, Lillhagen's Hospital, S-422 03 Hisings Backa, Sweden
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Summary

Fifty-three psychiatric patients who had been receiving treatment with lithium continuously for more than two years were examined to estimate the prevalence of lithium-induced hypothyroidism. It was found to be 20 per cent among women. No men were affected among these patients. In order to study the characteristics of the disorder further cases were drawn from another population. One third of the patients developed hypothyroidism during their first year of treatment, others not until after 9 years. About two thirds of the female patients with hypothyroidism had thyroid antibodies. All cases with lithium-induced hypothyroidism showed elevated levels of serum thyrotropin, which in our experience is the laboratory examination of choice in these as well as other cases of ‘primary’ hypothyroidism. Since the probability of detecting these cases at a given control visit was found to be low, we feel that such visits need not include extensive laboratory investigations. Hypothyroid patients responding well to lithium treatment should continue their medication combined with appropriate thyroxine substitution.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 130 , Issue 5 , May 1977 , pp. 452 - 458
Copyright
Copyright © Royal College of Psychiatrists, 1977 

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References

Beutner, E. H., Sepulveda, M. R. & Barnett, E. V. (1968) Quantitative studies of immunofluorescent staining. Bulletin of the World Health Organization, 39, 587–606.Google Scholar
Biberfeld, G. & Jonsson, J. (1968) Autoantikroppar i diagnostiken. Läkartidningen, 65, 3925–31.Google Scholar
Carlson, H. E., Temple, R. & Robbins, J. (1973) Effect of lithium on thyroxine disappearance in man. Journal of Clinical Endocrinology and Metabolism, 36, 1251–4.Google Scholar
Crowe, M. J., Lloyd, G. G., Bloch, S. & Rosser, R. M. (1973) Hypothyroidism in patients treated with lithium: a review and two case reports. Psychological Medicine, 3, 337–42.Google Scholar
Emerson, Ch. H., Dyson, W. L. & Utiger, R. D. (1973) Serum thyrotropin and thyroxine concentrations in patients receiving lithium carbonate. Journal of Clinical Endocrinology and Metabolism, 36, 338–46.Google Scholar
Fyrö, B., Pettersson, U. & Sedvall, G. (1973) Time course for the effect of lithium on thyroid function in men and women. Acta Psychiatrica Scandinavica, 49, 230–6.Google Scholar
Lindstedt, G., Lundberg, P.-A., Toft, M., Åkesson, H. O. & Öhman, R. (1973) Serum thyrotropin and hypothyroidism during lithium treatment. Clinica Chimica Acta, 48, 127–33.Google Scholar
Maletzky, B. & Blackly, P. H. (1971) The Use of Lithium in Psychiatry. London: Butterworths.Google Scholar
Nosslin, B. (1965) A simplified technique for the triiodothyronine test (T3 test) with Sephadex. Scandinavian Journal of Clinical and Laboratory Investigation, Suppl 86, 177.Google Scholar
Ploem, J. S. (1967) The use of a vertical illuminator with interchangeable dichroic mirrors for fluorescence microscopy with incident light. Zeitschrift für wissenschaftliche Mikroskopie und mikroskopische Technik, 68, 129–42.Google Scholar
Rifkin, A., Quitkin, F., Blumberg, A. G. & Klein, D. F. (1974) The effect of lithium on thyroid functioning: a controlled study. Journal of Psychiatric Research, 10, 115–20.Google Scholar
Schou, M., Amdisen, A., Eskjaer Jansen, S. & Olsen, T. (1968) Occurrence of goitre during lithium treatment. British Medical Journal, iii, 710–13.Google Scholar
Sedvall, G., Jönsson, B., Pettersson, U. & Levin, K. (1968) Effects of lithium salts on plasma protein bound iodine and uptake of I181 in thyroid gland of man and rat. Life Sciences, 7, 1257–64.Google Scholar
Sedvall, G., Jönsson, B., Pettersson, U. (1969) Evidence of an altered thyroid function in man during treatment with lithium carbonate. Acta Psychiatrica Scandinavica, Suppl 207, 59–67.Google Scholar
Shopsin, B. (1970) Effects of lithium on thyroid function. Diseases of the Nervous System, 31, 204–11.Google Scholar
Shopsin, B., Blum, M. & Gershon, S. (1969) Lithium-induced thyroid disturbance: case report and reviews. Comprehensive Psychiatry, 10, 215–23.Google Scholar
Spaulding, S. W., Barrow, G. N., Bermundez, F. G. & Himmelhoch, J. M. (1972) The inhibitory effect of lithium on thyroid hormone release in both euthyroid and thyrotoxic patients. Journal of Clinical Endocrinology, 35, 905–11.Google Scholar
Temple, R., Berman, M., Carlson, H. E., Robbins, J. & Wolf, J. (1972) The use of lithium in Graves' disease. Mayo Clinic Proceedings, 47, 872–8.Google Scholar
Villeneuve, A., Gautier, J., Jus, A. & Perron, D. (1974) The effect of lithium on thyroid in man. International Journal of Clinical Pharmacology, 9, 75–80.Google Scholar
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