LITHIUM-INDUCED THYROID DISTURBANCE - CASE REPORT AND REVIEW

The appearance of goiter and hypothyroidism was observed in a 41-year-old female maintained on lithium carbonate for approximately two years as a prophylaxis against recurrent manic-depressive illness. After lithium was discontinued, the patient became euthyroid, and the goiter decreased in size. Chemical evidence of hypothyroidism reappeared when treatment with lithium was resumed. Moderately elevated levels of antithyroglobulin antibody were present throughout the investigation, independent of lithium ingestion. Various pathways by which lithium may interfere with thyroid functioning are explored and discussed with reference to pertinent literature. The findings suggest that lithium interferes with thyroxin production resulting in deficiency of the circulating hormone. Our patient was unable to adequately compensate for this deficit because of an underlying chronic thyroiditis, probably Hashimoto's Disease. The authors propose that a damaged thyroid gland is prerequisite for uncovering the defect produced by chronic lithium ingestion, in the absence of which, patients usually remain euthyroid albeit some show goiter. © 1969.