lithium induced thyroid dysfunction

Last reviewed 01/2018

  • lithium inhibits the secretion of T4 and T3 by poorly understood mechanisms
  • lithium is associated with thyroiditis, goitre, hypothyroidism and possibly hyperthyroidism
    • goitre - the incidence of goitre in patients on treatment with lithium approaches 50%; generally it presents as a smooth enlargement of the thyroid gland and requires no further intervention
    • hypothyroidism - occurs in 20-30% of patients on lithium treatment; responds to treatment with thyroxine; generally not necessary to stop lithium treatment
  • prior to commencing treatment with lithium patients should have a neck examination and thyroid function tests; thyroid function should then be checked every 6-12 months whilst on lithium treatment

Reference:

  1. Prescriber (2002), 13 (10), 50-68.