Abstract
BackgroundLithium-induced thyroid abnormalities have been documented in many studies. They may occur despite normal plasma lithium levels. The objectives of this study were: 1) to determine possible relationship between lithium ratio, defined as erythrocyte lithium concentrations divided by plasma lithium concentrations, and thyroid abnormalities in bipolar patients receiving lithium and 2) to find other possible risk factors for developing thyroid abnormalities in the subjects.MethodsSixty-eight bipolar patients receiving lithium therapy were enrolled in a cross-sectional evaluation of thyroid function test and thyroid size. Patients were divided into two groups based on their thyroid function tests and thyroid sizes. Erythrocyte and plasma lithium concentrations were determined by atomic absorption spectrometry for each patient. Lithium ratio was then calculated.ResultsNo significant differences were found between age, positive family history of affective disorder, plasma lithium concentration, erythrocyte lithium concentration, and lithium ratio comparing the two groups. Thyroid abnormalities was significantly higher in women than in men (p < 0.05).ConclusionsLithium ratio does not appear to have a predictive role for thyroidal side effects of lithium therapy. Female gender was the main risk factor. We suggest more frequent thyroid evaluation of bipolar women who are treated with lithium.
Highlights
Lithium-induced thyroid abnormalities have been documented in many studies
There was Sampling Blood samples for lithium determination were taken at 9 a.m. (12 ± 1 hours after the last dose), since lithium ratio and plasma lithium concentration change only minimally after this interval [9]
Data collection Data regarding age of patients, number of hospital admission for psychiatric reasons, lithium dose, duration of lithium therapy, plasma lithium concentration (PLC), erythrocyte lithium concentration (ELC), Lithium ratio (LR), family history for affective disorder, and sex are shown in table 1
Summary
Lithium-induced thyroid abnormalities have been documented in many studies. They may occur despite normal plasma lithium levels. The objectives of this study were: 1) to determine possible relationship between lithium ratio, defined as erythrocyte lithium concentrations divided by plasma lithium concentrations, and thyroid abnormalities in bipolar patients receiving lithium and 2) to find other possible risk factors for developing thyroid abnormalities in the subjects. Lithium therapy is an established treatment in patients with bipolar disorders. This agent has a narrow therapeutic window. Alteration in thyroid status induced by lithium treatment is important in the clinical evaluation of neuropsychiatric effects [1] including fatigue, memory impairment, and anhedonia. Patients who fulfilled criteria for entry into the study were reassessed for diagnosis of bipolar disorder according to DSM IV criteria. The study protocol was approved by the Institutional Review Board
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