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Lithium-associated clinical hypothyroidism: Prevalence and risk factors

  • Ann M. Johnston (a1) and John M. Eagles (a2)



Rates of, and risk factors for, lithium-associated clinical hypothyroidism are uncertain.


To determine prevalence of and risk factors for clinical hypothyroidism in patients treated with lithium carbonate.


Retrospective case-note review of 718 patients who had undergone serum lithium estimation during a 15-month period. Patients on thyroxine had a more detailed review.


The prevalence of clinical hypothyroidism during lithium treatment was 10.4%. The main risk factor was female gender (women 14% v. men 4.5%). Women were at highest risk during the first two years of lithium treatment, and women starting lithium aged 40–59 years had the greatest prevalence (> 20%). No equivalent risk factors emerged in men, although, like women, their prevalence of hypothyroidism was substantially higher than community rates.


The high rates of clinical hypothyroidism identified may call for a review of the drug information given to women, particularly to those starting lithium in middle age. Consideration should be given to screening for thyroid antibodies before treatment in high-risk cases. Monitoring of thyroid function should take into account gender, age and stage of lithium treatment.


Corresponding author

Ann M. Johnston, Consultant Psychiatrist. Psychiatric Unit, Hairmyres Hospital, Eaglesham Road, East Kilbride, Lanarkshire G75 8RG


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Lithium-associated clinical hypothyroidism: Prevalence and risk factors

  • Ann M. Johnston (a1) and John M. Eagles (a2)


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