Interrelations between Lithium Therapy, Auto-Immune Thyroiditis and TSH

The case of a 30-year old female patient treated with lithium for bipolar disorder, who developed an autoimmune thyroiditis resulting in thyroid failure, is presented. Although she was kept on lithium, the patient relapsed into three subsequent manic episodes. Blood tests finally revealed high TSH (Thyroid Stimulating Hormone) level and satisfying lithium plasma level, but intra-cellular lithium concentration was close to zero. The authors present a review of the related literature and discuss the implication of the lithium therapy in the onset of autoimmune thyroiditis and the influence of thyroid failure and TSH level on the lithium cellular concentration.

References

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