Fifteen-year follow-up of thyroid function in lithium patients
Abstract
Objective To study prospectively the course of clinically relevant thyroid dysfunction in a cohort of patients on long-term lithium treatment.Method Patients (no.=150) who had undergone a cross-sectional evaluation of their thyroid function in 1989, when they were at different stages of lithium treatment, were followed up for thyroid circulating thyroid antibodies, hypothyroidism, hyperthyroidism, and thyroidectomy, during a further period of lithium exposure of up to 15 yr.Results Annual rates of newly developed circulating thyroid antibodies and hypothyroidism were 1.7 and 1.5%, respectively. Subjects with thyroid antibodies had a higher chance of requiring substitution treatment with levothyroxine for hypothyroidism compared with subjects with no evidence of thyroid antibodies (6.4% annual rate compared to 0.8%; relative risk: 8.4; 95% confidence interval: 2.9-24.0). One case of hyperthyroidism was observed over 976 patient-yr. Three patients underwent thyroidectomy during followup (two for multinodular goiter and one for multicentric papillary carcinoma).Conclusions Lithium may be associated with hypothyroidism in particular in the presence of circulating thyroid antibodies. Incidence of thyroid antibodies is comparable with that reported for the general population. Hyperthyroidism and thyroid cancer are rare.
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Overt or subclinical hypothyroidism develops in up to 15% or 34% of lithium-treated patients, with an annual rate of developing primary hypothyroidism of 1.5% (6.4% in thyroid antibody-positive and 0.8% in thyroid antibody-negative individuals).
“OH or SCH develop in up to 15 or 34% of lithum-treated patients (20), the annual rate of developing PH being 1.5%, (6.4% in thyroid antibody-positive and 0.8% in thyroid antibody-negative individuals) (70).”
From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [70]
Two published series have identified the development of thyrotoxicosis in 0.6% and 3.0% of patients taking lithium, respectively.
“Two published series have identified the development of thyrotoxicosis in 0.6% and 3.0% of patients, respectively (653,654).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [653]
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- Authors
- Bocchetta, A., Cocco, F., Velluzzi, F., Del Zompo, M., Mariotti, S., & Loviselli, A.
- Affiliations
- University of Cagliari (IT)
- Corresponding author
- Bocchetta, A.
- Venue
- Journal of Endocrinological Investigation
- Published
- 2007-05
- Volume
- 30
- Issue
- 5
- Pages
- 363-366
- ISSN
- 0391-4097 (ISSN-L)
- 1720-8386
- OpenAlex
- W1997904823
- Cited by
- 76
- References
- 21
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 6 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 9 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 2 · 2014: 7 · 2013: 5 · 2012: 4
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Endocrinological Investigation (publishedVersion)
- PubMed (publishedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- lithium, thyroid dysfunction, hypothyroidism, hyperthyroidism, thyroid autoantibodies, thyroidectomy, multinodular goiter, levothyroxine, long-term lithium therapy, drug-induced thyroid dysfunction
- MeSH terms
- Aged, Autoantibodies, Carcinoma, Papillary, Female, Follow-Up Studies, Humans, Hyperthyroidism, Hypothyroidism, Male, Middle Aged, Prospective Studies, Risk Factors, Thyroid Gland, Thyroid Neoplasms, Thyroidectomy, Thyroxine, Incidence, Seroepidemiologic Studies, Lithium Carbonate, Antimanic Agents, Immunoglobulins, Thyroid-Stimulating
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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