Özlem Kuman Tunçel1, Fisun Akdeniz2, Süha Süreyya Özbek3, Gülgün Kavukçu3, Gökçen Ünal Kocabaş4. 1. Department of Psychiatry, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey. 2. Psychiatrist, Private Practice, İzmir, Turkey. 3. Department of Radiology, Ege University School of Medicine, İzmir, Turkey. 4. Department of Endocrinology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
Abstract
INTRODUCTION: Lithium has many effects on thyroid physiology. Although these side effects have been known for a long time, large sample studies of lithium-treated patients using ultrasonography are lacking. The aim of this study is to investigate the detailed thyroid morphologies, hormone levels, and antibodies of lithium-treated patients compared with healthy controls. METHODS: This cross-sectional study involved 84 lithium-treated patients with bipolar disorder and 65 gender and age similar controls who had never been exposed to lithium. Subjects between 18 and 65 years of age were eligible for the study. Venous blood samples were acquired to determine the levels of free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroid antibodies; also, ultrasonographic examinations of the patients' thyroid glands were performed. RESULTS: There were no statistically significant differences in smoking habits, known thyroid disease, thyroid medication use, familial thyroid disease, fT4 level, autoimmunity, thyroid nodule presence, or Hashimoto's thyroiditis between the lithium and control groups. The median TSH level and thyroid volume were significantly higher in the lithium group. In the lithium group, 14 cases (16.7%) of hypothyroidism, seven cases (8.3%) of subclinical hypothyroidism, and one case (1.2%) of subclinical hyperthyroidism were defined; in the control group, seven cases (10.8%) of hypothyroidism and two cases (3.1%) of subclinical hyperthyroidism were defined. Thyroid dysfunction, goiter, parenchymal abnormality, ultrasonographically defined thyroid abnormality, and thyroid disorder were found to be more prevalent in the lithium group. 90% of patients with goiter and 74.3% of patients with ultrasonographic pathologies were euthyroid. CONCLUSION: It is important to note that 90% of the patients with goiter were euthyroid. This indicates that monitoring by blood test alone is insufficient. The prevalence rates of 47.6% for goiter and 83.3% for ultrasonographic pathology demonstrate that ultasonographic follow-up may be useful in lithium-treated patients. To determine whether routine ultrasonographic examination is necessary, large sample prospective studies are necessary due to the limitations of this study.
INTRODUCTION:Lithium has many effects on thyroid physiology. Although these side effects have been known for a long time, large sample studies of lithium-treated patients using ultrasonography are lacking. The aim of this study is to investigate the detailed thyroid morphologies, hormone levels, and antibodies of lithium-treated patients compared with healthy controls. METHODS: This cross-sectional study involved 84 lithium-treated patients with bipolar disorder and 65 gender and age similar controls who had never been exposed to lithium. Subjects between 18 and 65 years of age were eligible for the study. Venous blood samples were acquired to determine the levels of free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroid antibodies; also, ultrasonographic examinations of the patients' thyroid glands were performed. RESULTS: There were no statistically significant differences in smoking habits, known thyroid disease, thyroid medication use, familial thyroid disease, fT4 level, autoimmunity, thyroid nodule presence, or Hashimoto's thyroiditis between the lithium and control groups. The median TSH level and thyroid volume were significantly higher in the lithium group. In the lithium group, 14 cases (16.7%) of hypothyroidism, seven cases (8.3%) of subclinical hypothyroidism, and one case (1.2%) of subclinical hyperthyroidism were defined; in the control group, seven cases (10.8%) of hypothyroidism and two cases (3.1%) of subclinical hyperthyroidism were defined. Thyroid dysfunction, goiter, parenchymal abnormality, ultrasonographically defined thyroid abnormality, and thyroid disorder were found to be more prevalent in the lithium group. 90% of patients with goiter and 74.3% of patients with ultrasonographic pathologies were euthyroid. CONCLUSION: It is important to note that 90% of the patients with goiter were euthyroid. This indicates that monitoring by blood test alone is insufficient. The prevalence rates of 47.6% for goiter and 83.3% for ultrasonographic pathology demonstrate that ultasonographic follow-up may be useful in lithium-treated patients. To determine whether routine ultrasonographic examination is necessary, large sample prospective studies are necessary due to the limitations of this study.
Authors: A Bocchetta; A Cherchi; A Loviselli; P Mossa; F Velluzzi; R Derai; M Del Zompo Journal: Acta Psychiatr Scand Date: 1996-07 Impact factor: 6.392
Authors: A Loviselli; A Bocchetta; P Mossa; F Velluzzi; F Bernardi; M del Zompo; S Mariotti Journal: Neuropsychobiology Date: 1997 Impact factor: 2.328
Authors: Michael Bauer; Holger Blumentritt; Reinhard Finke; Peter Schlattmann; Mazda Adli; Christopher Baethge; Tom Bschor; Bruno Müller-Oerlinghausen; Anne Berghöfer Journal: J Affect Disord Date: 2007-03-07 Impact factor: 4.839
Authors: Ingrid Lieber; Michael Ott; Louise Öhlund; Robert Lundqvist; Mats Eliasson; Mikael Sandlund; Ursula Werneke Journal: J Psychopharmacol Date: 2019-10-31 Impact factor: 4.153