Seventy-three patients who had been continuously receiving lithium carbonate for 6 months or more had their thyroid function evaluated clinically and biochemically. Goitre was found in 37%, exophthalmos in 23%, positive thyroid auto-antibodies in 24% and abnormal TRH tests in 49%. It would appear that thyroid failure due to lithium is usually dependent on antibody mediated damage. It is unlikely that lithium has a direct effect on the hypothalamic-pituitary axis.
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Lazarus et al. (1981) studied this question.
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