Thyrotoxicosis treatment with lithium corbanate. Cases reported
https://doi.org/10.14341/ket12709
Abstract
Treatment of thyrotoxicosis caused by Graves’ disease or multinodular toxic goiter, is not difficult, in most cases, since the prescription of thionamides allows to normalize the level of thyroid hormones quickly and safety. But in a number of cases this therapy might be associated with serious side effects (agranulocytosis, toxic hepatitis, cholestasis), severe allergic reactions and also individual intolerance on thionamides. In such cases lithium carbonate is used, especially in severe thyrotoxic syndrome. It is known, that lithium can accumulate in the thyroid gland at a concentration 3–4 times higher than in the plasma. Perhaps, lithium uses Na+/I- ions. It can inhibit the synthesis and secretion thyroid hormones of thyroid gland. The article presents the cases reported the use of lithium carbonate in thyrotoxicosis treatment before thyroidectomy. Administering low doses of carbonate lithium (900 mg/ per day) renders significant decrease or normalization of thyroid hormones concentration within 7–14 days, thus it let perform thyroidectomy on the patients. No side effects have been identified with such a short course of lithium carbonate treatment.
About the Authors
I. A. MatsuevaRussian Federation
Irina A. Matsueva, student
6-8 L’va Tolstogo street, 197022 Saint Petersburg
eLibrary SPIN: 9628-0458
A. B. Dalmatova
Anna B. Dalmatova, MD, PhD
Saint Petersburg
eLibrary SPIN: 5995-0259
T. V. Andreychenko
Tatiana V. Andreychenko, MD
Saint Petersburg
E. N. Grineva
Elena N. Grineva, MD, PhD, Professor
Saint Petersburg
eLibrary SPIN: 2703-0841
References
1. Cooper DS. Antithyroid Drugs. N Engl J Med. 2005;352(9):905-917. doi: https://doi.org/10.1056/NEJMra042972
2. Czarnywojtek A, Zgorzalewicz-Stachowiak M, Czarnocka B, et al. Effect of lithium carbonate on the function of the thyroid gland: Mechanism of action and clinical implications. J Physiol Pharmacol. 2020;71(2). doi: https://doi.org/10.26402/jpp.2020.2.03
3. Lazarus JH. Lithium and thyroid. Best Pract Res Clin Endocrinol Metab. 2009;23(6):723-733. doi: https://doi.org/10.1016/j.beem.2009.06.002
4. Licht RW, Vestergaard P, Brodersen A. Long-term outcome of patients with bipolar disorder commenced on lithium prophylaxis during hospitalization: a complete 15-year register-based follow-up. Bipolar Disord. 2008;10(1):79-86. doi: https://doi.org/10.1111/j.1399-5618.2008.00499.x
5. Mosolov SN, Kostyukova EG, Kuzavkova MV. Bipolar affective disorder: diagnosis and therapy. Mosolova SN, editor. Moscow: MEDpress-inform; 2008. P. 15. (In Russ.)
6. Schou M, Amdisen A, Jensen SE, Olsen T. Occurrence of Goitre during Lithium Treatment. BMJ. 1968;3(5620):710-713. doi: https://doi.org/10.1136/bmj.3.5620.710
7. Kibirige D, Luzinda K, Ssekitoleko R. Spectrum of lithium induced thyroid abnormalities: a current perspective. Thyroid Res. 2013;6(1):3. doi: https://doi.org/10.1186/1756-6614-6-3
8. Lazarus JH. The effects of lithium therapy on thyroid and thyrotropin-releasing hormone. Thyroid. 1998;8(10):909-913. doi: https://doi.org/10.1089/thy.1998.8.909
9. Hahn CG, Pawlyk AC, Whybrow PC, et al. Lithium administration affects gene expression of thyroid hormone receptors in rat brain. Life Sci. 1999;64(20):1793-1802. doi: https://doi.org/10.1016/s0024-3205(99)00121-6
10. Temple R, Berman M, Carlson HE, et al. The use of lithium in Graves’ disease. Mayo Clin Proc. 1972;47:872-878.
11. Lazarus JH, Richards AR, Addison GM, Owen GM. Treatment of thyrotoxicosis with lithium carbonate. Lancet. 1974;2(7890):1160-1163. doi: https://doi.org/10.1016s0140-6736(74)90808-3
12. Kristensen O, Andersen HH, Pallisgaard G. Lithium carbonate in the treatment of thyrotoxicosis. Lancet. 1976;307(7960):603-605. doi: https://doi.org/10.1016/S0140-6736(76)90414-1
13. Troshina EA, Sviridenko NYu, Belovalova IM, et al. The clinical recommendation on diagnostics and treatment of thyrotoxicosis with diffuse goiter (Graves’ disease), nodular/multinodular goiter. RAE; 2021. 50 p. (In Russ.)
14. Bistriceanu M, et al. Effect of short-term lithium carbonate administration in hyperthyroidism, with or without associated ophthalmopathy. Endocrinologie. 1986;24(2):109-113.
15. Nayakand B, Burman KD. Thyrotoxicosis and thyroidstorm. Endocrinology and Metabolism Clinics of North America. 2006;35(4):663-686.
16. Wang MT, Lee WJ, Huang TY, et al. Antithyroid drug-related hepatotoxicity in hyperthyroidism patients: a populationbased cohort study. Br J Clin Pharmacol. 2014;78(3):619-629. doi: https://doi.org/10.1111/bcp.12336
17. Bhuyan AK, Sarma D, Kaimal Saikia U, Choudhury BK. Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge. Case Rep Med. 2014;2014:1-5. doi: https://doi.org/10.1155/2014/790458
18. Gallicchio V, Chen M. Modulation of murine pluripotential stem cell proliferation in vivo by lithium carbonate. Blood. 1980;56(6):1150-1152. doi: https://doi.org/10.1182/blood.V56.6.1150.1150
19. Petrini M, Azzarà A. Lithium in the treatment of neutropenia. Curr Opin Hematol. 2012;19(1):52-57. doi: https://doi.org/10.1097/MOH.0b013e32834da93b
20. Cooper DS. Antithyroid Drugs. N Engl J Med. 2005;352(9):905-917. doi: https://doi.org/10.1056/NEJMra042972
21. Turner J, Brownlie BE, Rogers TG. Lithium as an adjunct to radioiodine therapy for thyrotoxicosis. Lancet. 1976;307(7960):614-615. doi: https://doi.org/10.1016/S0140-6736(76)90419-0
22. Suwansaksri N, Preechasuk L, Kunavisarut T. Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future. Int J Endocrinol. 2018;2018:1-10. doi: https://doi.org/10.1155/2018/5794054
23. Wang MT, Lee WJ, Huang TY, et al. Antithyroid drug-related hepatotoxicity in hyperthyroidism patients: a populationbased cohort study. Br J Clin Pharmacol. 2014;78(3):619-629. doi: https://doi.org/10.1111/bcp.12336
24. Ng YW, Tiu SC, Choi KL, et al. Use of lithium in the treatment of thyrotoxicosis. Hong Kong Medical Journal. 2006;12(4):254-259.
25. Saleem T, Sheikh A, Masood Q. Resistant Thyrotoxicosis in a Patient with Graves Disease: A Case Report. J Thyroid Res. 2011;2011:1-4. doi: https://doi.org/10.4061/2011/649084
26. Nair G, C. Babu M, Menon R, Jacob P. Preoperative preparation of hyperthyroidism for thyroidectomy – Role of supersaturated iodine and lithium carbonate. Indian J Endocrinol Metab. 2018;22(3):392. doi: https://doi.org/10.4103/ijem.IJEM_3_18
27. Tsunoda T, Mochinaga N, Eto T, et al. Lithium carbonate in the preoperative preparation of Graves’ disease. Jpn J Surg. 1991;21(3):292-296. doi: https://doi.org/10.1007/BF02470949
28. Prakash I, Nylen ES, Sen S. Lithium as an Alternative Option in Graves Thyrotoxicosis. Case Rep Endocrinol. 2015;2015:1-4. doi: https://doi.org/10.1155/2015/869343
29. Burman KD, Dimond RC, Earll JM, et al. Sensitivity to Lithium in Treated Graves’ Disease: Effects on Serum T4, T3 and Reverse T3. J Clin Endocrinol Metab. 1976;43(3):606-613. doi: https://doi.org/10.1210/jcem-43-3-606
30. Davis TF, Laurberg P, Bahn RS. Hyperthyroid disorders. Williams Textbook of Endocrinology. Philadephia, PA, USA: Elsevier; 2016. P. 369-415.
31. Spaulding SW, Burrow GN, Bermudez F, Himmelhoch JM. The inhibitory effect of lithium on thyroid hormone release in both euthyroid and thyrotoxic patients. J Clin Endocrinol Metab. 1972;35(6):905-911. doi: https://doi.org/10.1210/jcem-35-6-905
32. Fairbrother F, Petzl N, Scott JG, Kisely S. Lithium can cause hyperthyroidism as well as hypothyroidism: A systematic review of an under-recognised association. Aust N Z J Psychiatry. 2019;53(5):384-402. doi: https://doi.org/10.1177/0004867419833171
33. de Sousa Gurgel W, Dutra PE, Higa RA, et al. Hyperthyroid rage: when bipolar disorder hides the real disorder. Clin Neuropharmacol. 2015;38(1):38-39. doi: https://doi.org/10.1097/WNF.0000000000000059
34. Shapiro HI, Davis KA. Hypercalcemia and «primary» hyperparathyroidism during lithium therapy. Am J Psychiatry. 2015;172(1):12-15. doi: https://doi.org/10.1176/appi.ajp.2013.13081057
Supplementary files
|
1. Figure 1. The serum concentration dynamics of thyroid hormones (FT4, FT3) during the lithium carbonate treatment of a 69 years old patient GNA. | |
Subject | ||
Type | Исследовательские инструменты | |
View
(108KB)
|
Indexing metadata ▾ |
|
2. Figure 2. The serum concentration dynamics of thyroid hormones (FT4, FT3) during the lithium carbonate treatment of a 19 years old patient AMA. | |
Subject | ||
Type | Исследовательские инструменты | |
View
(95KB)
|
Indexing metadata ▾ |
Review
For citations:
Matsueva I.A., Dalmatova A.B., Andreychenko T.V., Grineva E.N. Thyrotoxicosis treatment with lithium corbanate. Cases reported. Clinical and experimental thyroidology. 2021;17(3):22-26. (In Russ.) https://doi.org/10.14341/ket12709

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).