lithium and hypothyroidism

6 Jan

LITHIUM & THE THYROID:
–not always best friends

–multiple mechanisms by which Lithium causes hypothyroidism:

  • inhibits thyroid hormone release and increases TRH-stimulated TSH. 
  • concentrated by the thyroid gland and inhibits iodine uptake.
  • interferes with the deiodination of T4 to T3
  • may have an immunostimulant effect, either by inducing or exacerbating a preexisting autoimmune disease.

–Rates of overt hypothyroidism can vary from 0 – 47% (average 10%) in people on long term lithium treatment.  

BOTTOM LINE:
–if you have a patient who is taking lithium, and you’re sending off labs (lithium level, sodium/lytes, etc) for some [presumably good] reason, might be worth adding a TSH to the mix

Submitted by J. Gullo.

Reference(s): a review, another source, picture

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