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Hong Kong Med J. 2006 Aug;12(4):254-9.

Use of lithium in the treatment of thyrotoxicosis.

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1
Department of Medicine, Queen Elizabeth Hospital, Hong Kong.

Abstract

OBJECTIVES:

To evaluate the efficacy and safety of lithium in the treatment of thyrotoxicosis, and to study the dose and serum levels at which therapeutic response occurs.

DESIGN:

Retrospective study.

SETTING:

Thyroid clinic of a regional hospital in Hong Kong.

PATIENTS:

Thirteen patients with thyrotoxicosis pending therapy with radioiodine or surgery, in whom thionamides were contra-indicated due to adverse reactions or failure of treatment.

MAIN OUTCOME MEASURES:

Free thyroxine levels, time to euthyroidism, and side-effects of lithium.

RESULTS:

A satisfactory response, defined as a fall by 40% or more in free thyroxine levels and clinical improvement, was achieved in eight patients within 1 to 2 weeks of lithium therapy. In four others, response occurred in 3 to 5 weeks. Response was slow and inadequate in one patient due to 'escape'. The median dosage of lithium was 750 mg daily, with a range of 500 to 1500 mg daily. The median serum lithium level was 0.63 mmol/L. Lithium toxicity was observed in one patient.

CONCLUSIONS:

A relatively low dose of lithium offers a safe and effective alternative means of controlling thyrotoxicosis in patients who cannot tolerate or do not respond to thionamides.

Comment in

PMID:
16912350
[Indexed for MEDLINE]
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