No Connection between Long-Term Lithium Treatment and Antithyroid Antibodies

2019 ◽  
Vol 52 (05) ◽  
pp. 232-236 ◽  
Author(s):  
Agnieszka Kraszewska ◽  
Katarzyna Ziemnicka ◽  
Jerzy Sowiński ◽  
Ewa Ferensztajn-Rochowiak ◽  
Janusz K. Rybakowski
Keyword(s):  
Filtration Rate ◽  
Lithium Treatment ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Antithyroid Antibodies ◽  
Female Patients ◽  
Bipolar Patients

Abstract Introduction The studies on the effect of lithium treatment on antithyroid antibodies showed either a higher concentration of these antibodies in patients receiving lithium compared to those lithium-naive or no difference between these groups. In lithium-treated bipolar patients, some researchers pointed to an association between antithyroid antibodies and other features of thyroid dysfunction such as hypothyroidism and decrease of glomerular filtration rate. Methods We compared antithyroid antibodies in 98 patients (30 male, 68 female) with bipolar disorder, aged 62±13 years, who received lithium for 19±10 years to 39 patients (12 male, 27 female), aged 57±10 years, who were never treated with lithium. The antibodies against thyroid peroxidase (TPOAb), against thyroglobulin (TGAb), and thyroid-stimulating hormone (TSH) receptors (TSHRAb) were estimated. Results No difference in the percentages of antibodies occurrence was found between groups, although the concentrations of TGAb were higher in patients receiving lithium. In lithium-treated patients, the presence of TPOAb was associated with lower concentrations of free triiodothyronine and the presence of TGAb, with higher concentrations of TSH. In females, the levels of TGAb were associated with lower thyroid volume. The concentrations of TPOAb correlated positively with the duration of lithium therapy in males, and those of TPOAb and TGAb negatively, with such duration, in female patients. Conclusion The results obtained showed no significant connection between long-term lithium treatment and antithyroid antibodies. In bipolar patients receiving lithium longitudinally, antithyroid antibodies can be associated with some indexes of thyroid function. However, they behave differently in male and female patients.

The effect of including other psychotropic medications into a long-term bipolar disorder lithium treatment on thyroid function

2019 ◽  
Vol 35 (2) ◽  
pp. 111-119
Author(s):  
Agnieszka Kraszewska ◽  
Ewa Ferensztajn-Rochowiak ◽  
Janusz Rybakowski
Keyword(s):  
Bipolar Disorder ◽  
Lithium Treatment ◽  
Antidepressant Drugs ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Structure And Function ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
And Function

Background/Aims. Long-term bipolar disorder (BD) treatment with lithium exerts a significant effect on thyroid structure and function. Compared with BD patients who do not take lithium, patients treated with lithium have higher concentrations of thyroid-stimulating hormone (TSH) and free thyroxine (FT4), lower concentrations of free triiodothyronine (FT3), higher thyroid volume and higher occurrence of goitre. The aim of the study was to compare thyroid structure and function in relation to the inclusion of other mood stabilisers and antidepressants into a lithium treatment. Method. The studied group consisted of eighty BD patients (27 male, 53 female) aged 24–85 years, receiving a prophylactic lithium treatment for the average of 19 ± 9 years. Fifteen patients underwent lithium monotherapy; in 17, lithium was administered concurrently with carbamazepine; in 17, concurrently with quetiapine; and in 11, concurrently with valproate. In 20 subjects, lithium was administered concurrently with antidepressants. Results. In comparison with patients on lithium monotherapy, in patients who took lithium and antidepressant drugs, the concentrations of TSH were significantly higher, while in patients who took lithium and carbamazepine the concentrations of FT4 were lower. The concentrations of thyroid peroxidase antibodies (TPOAb) were significantly higher in patients who took lithium concurrently with antidepressants and concurrently with valproate. The highest frequency of goitre (70%) was observed in patients who took lithium concurrently with antidepressants. Conclusions. The obtained results may suggest a significant effect of including other mood stabilisers and antidepressants into a long-term lithium treatment on thyroid structure and function. A limitation of the study is the small size of the groups.

The effect of long-term lithium administration on thyroid function and structure as compared with monotherapy by other mood stabilising drugs – a preliminary study

2020 ◽  
Vol 35 (3-4) ◽  
pp. 169-176
Author(s):  
Agnieszka Kraszewska ◽  
Ewa Ferensztajn-Rochowiak ◽  
Janusz Rybakowski
Keyword(s):  
Antidepressant Drugs ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Structure And Function ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Long Term Treatment ◽  
Preliminary Study ◽  
And Function

Aims: Long-term treatment with lithium in patients with bipolar disorder (BD) exerts a significant effect on thyroid structure and function. Previously, it was found that adding to lithium other mood stabilising or antidepressant drugs can also be important. The aim of this preliminary study was to compare thyroid structure and function in patients with BD receiving long-term lithium monotherapy with monotherapy using other mood stabilising drugs, such as carbamazepine, valproates or quetiapine. Method: Forty-one BD patients were studied (13 male, 28 female) aged 28–80 years. In 15, monotherapy with lithium was given; in 10 – with carbamazepine; and in 8 – with valproate and quetiapine. In all patients, the thyroid-stimulating hormone (TSH), free thyroxine (fT3) free triiodothyronine (fT4), and the antibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb) and TSH receptors (TSHRAb) were estimated. Goiter was diagnosed when the thyroid volume exceeded 18 cm3 in women and 25 cm3 in men. Results: The groups were of similar age; however, the duration of quetiapine therapy was shorter than lithium or carbamazepine. Comparing to patients on lithium monotherapy, the median of TSH concentration was lower in patients on quetiapine, and the median of TPOAB lower in patients on valproates. The highest frequency of goiter (47%) was observed in patients receiving lithium. Conclusions: The results obtained may suggest that among the studied mood stabilisers, lithium exerts the biggest goiter-inducing effect. The differences between groups as to thyroid hormones and antibodies were not significant. The limitation of the study was a small number of studied patients.

scholarly journals Thyroid Functions in Bamboo-Shoots Consuming Children of Tripura, North-east India

2021 ◽  
Author(s):  
Indrajit Ray ◽  
A. K. Chandra ◽  
Saru Kumar Debbarma ◽  
Sekhar Kumar Mookerjee ◽  
Ajoy Datta ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Consumption Pattern ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Cross Sectional ◽  
North East ◽  
Bamboo Shoots ◽  
The Village

Abstract PurposeInformation on thyroid functions in populations consuming potent antithyroidal bamboo-shoots (BS) was found scanty. Therefore, to assess thyroid function in BS consuming children was found relevant.MethodsThis cross-sectional study included 127 children from 3 villages. Thyroid volume (TV), free thyroxine (FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH), thyroglobulin antibody (Tg-Ab), thyroid peroxidase antibody (TPO-Ab), urinary iodine (UI), urinary thiocyanate (USCN), salt iodine (SI), water iodine (WI), and BS consumption pattern were assessed. ResultsVariable-wise overall mean±SDs/medians/interquartile ranges (IQR) were - age: 8.69±1.69/8.77/7.22-9.74 y, TVol: 0.82±0.27/0.82/0.67-0.96 ml, FT4: 19.5+5.6/20.1/16.9-22.0 pmol/L, FT3: 4.27+1.24/4.22/3.35-4.96 pmol/L, TSH: 2.44+1.39/2.33/1.60-3.15 mIU/L, Tg-Ab: 15.2+10.0/12.5/11.1-14.5 IU/ml, TPO-Ab: 5.58+12.25/3.89/2.90-5.11 IU/ml, UI: 117.4±58.5/108/73-160.5 µg/L, USCN: 0.99+0.67/0.8/0.5-1.2 mg/dl, WI: 4 .69±4.56/3.0/1.35–7µg/L, and BS consumption: 153.8±01.4/119/71.4–214.3 g/person/day respectively. Only 80.3% salt samples had ≥15 ppm iodine. Thyroid dysfunction prevalence was 6.3%. There were positive correlations between TV and FT4 (r=0.2466, p=0.005), UI and TSH (r=0.2633, p=0.003), TSH and FT4 (r=0.2135, p=0.016), TSH and FT3 (r=0.1898, p=0.033), USCN and FT4 (r=0.2477, p=0.005), Tg-Ab and TPO-Ab (r=0.3768, p=<0.001), and negative correlations between Tg-Ab and TSH (r=-0.2024, p=0.023), Tg-Ab and FT4 (r=-0.1869, p=0.035). In boys, USCN had a positive correlation with TPO-Ab (r=0.3069, p=0.018). The village having highest levels of BS consumption (p=0.037) and median UI showed higher TSH levels (p=0.037) and higher FT3 level (p=0.001) compared to the village of lowest BS consumption.ConclusionsThe BS consuming children appear at risk of developing hypothyroidism by Tg-Ab, which may partly be diminished by reducing BS consumption.

scholarly journals Correlations between Biochemical Markers in Thyroid Pathology with those in Carbohydrates Metabolism

2020 ◽  
Vol 26 (2) ◽  
pp. 100-104
Author(s):  
Voiculescu Anne-Lise Mihaela ◽  
Anghel Andreea ◽  
Gurgas Leonard ◽  
Petcu Lucian ◽  
Rosoiu Natalia
Keyword(s):  
Thyroid Dysfunction ◽  
Glycated Haemoglobin ◽  
Serum Glucose ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Female Patients ◽  
Patients With Diabetes ◽  
Male Patients ◽  
Thyroid Profile

Abstract Thyroid dysfunction is increasingly found in patients with diabetes. Diabetes can affect thyroid function to a variable extent and unrecognized thyroid dysfunction, not only worsens metabolic control, but also prevents the management of diabetes. The aim of this study was to screen the incidence of thyroid disease in Constanta County, Romania in patients diagnosed with type II diabetes, in order to assess the tendency to associate thyroid hormone dysfunction with the diabetic process by correlating glycemic parameters and thyroid profile in serum. The study included a number of 153 patients who presented within 3 months for blood tests, in compliance with GDPR rules. The following parameters were processed from these patients: FT3 - free triiodothyronine, FT4 - free thyroxine, TSH - thyroid stimulating hormone, Anti-TPO - thyroid peroxidase antibodies (anti-thyroid peroxidase), Serum glucose, Glycosylated haemoglobin - HbA1C. In patients of both sexes studied, the mean TSH was 3.15 IU / ml, males’ TSH mean being 2.82 IU / ml and higher, but not above the maximum limit. Blood glucose ranged from an average of 92.11 mg / dl in the 153 patients, 92.41 mg / dl in male patients and 93.82 mg / dl in female patients. Glycated haemoglobin (%) ranged from 6.79% in female patients to 6.21% in male patients, with a mean of 6.5%. Pathology derived from disorders of carbohydrate metabolism may be present in patients with thyroid changes.

Evaluation of long-term follow-up and methimazole therapy outcomes of pediatric Graves’ disease: a single-center experience

2019 ◽  
Vol 32 (4) ◽  
pp. 341-346 ◽  
Author(s):  
Elvan Bayramoğlu ◽  
Selin Elmaogulları ◽  
Elif Sagsak ◽  
Zehra Aycan
Keyword(s):  
Remission Rate ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Free Triiodothyronine ◽  
Management Options ◽  
Single Center Experience ◽  
Male Sex

Abstract Background The management options for Graves’ disease in children are limited and there is controversy regarding optimal treatment. Remission rate with anti-thyroid drug (ATD) treatment in children is said to be lower than in adults. Definitive treatments are effective, but they often result in permanent hypothyroidism. The objective of this study was to investigate the outcome of methimazole treatment, identify significant predictors of a remission and evaluate the adverse effects of methimazole in a pediatric population of GD patients. Methods Medical records of the patients who had been diagnosed with Graves’ disease were screened retrospectively. Diagnostic criteria included elevated free thyroxine (fT4) and total triiodothyronine (T3), suppressed thyroid-stimulating hormone (TSH) and either positive thyroid-stimulating immunoglobulin (TSI) or thyroid receptor antibodies (TRABs) or clinical signs suggestive of Graves’ disease, for example, exophthalmos. Remission was defined as maintenance of euthyroidism for more than 12 months after discontinuing methimazole treatment. Results Of the 48 patients, provisional remission was achieved in 21 patients. Of the 21 patients, 14 experienced a relapse (66.6%). Remission was achieved in seven (24.1%) of 29 patients who received methimazole treatment for more than 2 years. In patients who achieved long-term remission, the male sex ratio and fT4 levels at diagnosis were significantly lower than the relapsed and non-remission groups, whereas the free triiodothyronine (fT3)/fT4 ratio and duration of methimazole treatment were significantly higher than the relapse group. Conclusions Long-term methimazole treatment in pediatric Graves’ disease would be appropriate. High fT4 levels at the time of diagnosis and male sex were associated with a risk of relapse.

Glomerular Filtration Rate and Calcium Metabolism in Long-Term Lithium Treatment

1981 ◽  
Vol 7 (2) ◽  
pp. 105-111 ◽  
Author(s):  
H. Thysell ◽  
G. Brante ◽  
L. Sjöstedt ◽  
B. Lindergård ◽  
T. Lindholm ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Calcium Metabolism ◽  
Filtration Rate ◽  
Lithium Treatment

Monitoring of Patients in Prophylactic Lithium Treatment

1982 ◽  
Vol 140 (2) ◽  
pp. 185-187 ◽  
Author(s):  
P. Vestergaard ◽  
Mogens Schou ◽  
Klaus Thomsen
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Kidney Biopsy ◽  
Lithium Treatment ◽  
Serum Tsh

The effect of long-term lithium treatment on the kidneys has generated concern among psychiatrists, and proposals have been made that routine determinations of serum lithium and serum TSH should be supplemented with control of the kidney function through regular determinations of serum creatinine, glomerular filtration rate, and renal concentrating ability, as well as through kidney biopsy in certain circumstances.

Iodine nutrition status of women after 10 years of Lipiodol supplementation: a cross-sectional study in Xinjiang, China

2020 ◽  
pp. 1-13
Author(s):  
Lixiang Liu ◽  
Peng Liu ◽  
Qin Lin ◽  
Xiaohui Su ◽  
Jia Huang ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Nutrition Status ◽  
Thyroid Peroxidase ◽  
Urinary Iodine Concentration ◽  
Free Triiodothyronine ◽  
Iodine Nutrition ◽  
Detection Rates ◽  
Status Of Women

Abstract This study examined the contribution of long-term use of Lipiodol capsules, as a supplement to iodised salt to the control of iodine deficiency disorders among women in Xinjiang of China. A total of 1220 women across Kashgar, Aksu, Turpan and Yili Prefectures were surveyed in 2017. Lipiodol capsules were administered twice yearly in Kashgar and once yearly in Aksu and Turpan, but not in Yili. Urinary iodine concentration (UIC), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody, thyroid peroxidase antibody and thyroid volume values were assessed. All the women in the four areas were in a state of non-iodine deficiency by UIC. The UIC were higher than adequate in Kashgar and Aksu (619·4 v. 278·6 μg/l). Thyroid hormone levels differed significantly in Turpan and Yili (FT3: 4·4 v. 4·6 pmol/l, FT4: 13·8 v. 14·2 pmol/l, TSH: 2·0 v. 2·7 mIU/l), but did not differ significantly in Kashgar, Aksu and Yili. The four areas did not differ significantly with regard to thyroid nodules, autoimmune thyroiditis or goitre. However, the detection rates of subclinical hypothyroidism (16·6 %) and total thyroid dysfunction (25·4 %) were higher among women in Yili. The supplementation with Lipiodol capsules had improved the iodine nutrition status of women in iodine-deficient areas of Xinjiang since 2006. To avoid negative effects of excess iodine, we suggest a gradual discontinuation of Lipiodol capsules in women with special needs based on the existing iodine nutrition level of local women.

A historical cohort study of kidney damage in long-term lithium patients: continued surveillance needed

2001 ◽  
Vol 16 (4) ◽  
pp. 199-206 ◽  
Author(s):  
H. Bendz ◽  
M. Aurell ◽  
J. Lanke
Keyword(s):  
Renal Function ◽  
Treatment Duration ◽  
Filtration Rate ◽  
Lithium Treatment ◽  
Initial Study ◽  
Historical Cohort ◽  
Record Review ◽  
Insufficient Knowledge

SummaryBackgroundInsufficient knowledge on the longitudinal fate of renal function in lithium patients incited this retrospective study of 149 patients.MethodMedical record review of a lithium cohort (N = 149), 8–12 years after an initial renal function study.ResultsTwenty-one patients had died, one from uremia probably not caused by lithium, and 42 had discontinued lithium. Reduced urinary concentrating capacity (Umax) or glomerular filtration rate (GFR) was not more frequent among deceased or off-lithium patients than among the 86 patients who were on lithium at follow-up. In 63 of the latter patients, Umax had been re-examined after the initial study, and GFR in 29 patients. Reduced Umax and GFR had become twice as common, and average Umax and GFR had decreased significantly. The reduction of GFR was associated with lithium treatment duration and age, and reduced Umax with treatment duration only.ConclusionsReduced renal function is not a major cause of treatment discontinuation but becomes increasingly common with treatment duration.

scholarly journals THYROID STATUS OF ATHLETES IN VARIOUS DISCIPLINES

2020 ◽  
Vol 20 (S1) ◽  
pp. 5-12
Author(s):  
R Radzhabkadiev ◽  
K Vybornaya ◽  
C Lavrinenko ◽  
A Vasilev
Keyword(s):  
Female Athletes ◽  
Elite Athletes ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Thyroid Peroxidase ◽  
Thyroid Status ◽  
Free Triiodothyronine ◽  
Male Athletes ◽  
Normal Limits

Aim. The article deals with the assessment of the thyroid status of athletes engaged in physical activity of varying intensity. Materials ant methods. 146 elite athletes involved in bobsleigh, biathlon, shooting and snowboarding participated in the study. We determined the serum concentration of thyroid stimulating hormone (TSH), free triiodothyronine (f.T3), free thyroxin (f.T4) and thyroid peroxidase antibodies (TPO-ab) with the COBAS e411 immunochemistry analyzer (Roche, Germany). The integral thyroid index ((f.T3 + f.T4)/TSH) was used for the assessment of the level of function of the thyroid proper. The conversion index of thyroxin to triiodothyronine (f.T4/ f.T3) was also studied. Results. 40 % of the bobsleigh athletes examined and 29 % of the snowboarders had high serum f.T3. The concentration of f.T4 in all examined athletes both male and female was within normal limits. Approximately 25 % of the male athletes examined had low II values. Among female athletes, 25 % of shooters and 33 % of bobsleigh athletes had low II values. In male biathletes and bobsleigh athletes, TPO-ab was 56 % higher than in shooters and snowboarders. In 43 % of bobsleigh athletes, 19 % of shooters, 10 % of biathletes and snowboarders, the content of TSH in males exceeded the reference intervals. Among females, TSH was high in 25 % of shooters and bobsleigh athletes. Conclusion. There were no statistically significant differences in the content of thyroid hormones in the compared sports groups, which can probably be explained by the activity of deiodinases at the local, intracellular level. At the same time, in a large number of respondents surveyed, the indicators of II and TPO-ab were outside the physiological norm.

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