alexa Lithium-associated clinical hypothyroidism. Prevalence and risk factors.
Diabetes & Endocrinology

Diabetes & Endocrinology

Journal of Thyroid Disorders & Therapy

Author(s): Johnston AM, Eagles JM

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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.
This article was published in Br J Psychiatry and referenced in Journal of Thyroid Disorders & Therapy

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