Use of lithium in the treatment of thyrotoxicosis

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


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.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Lithium Compounds / adverse effects
  • Lithium Compounds / blood
  • Lithium Compounds / therapeutic use*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thyrotoxicosis / drug therapy*
  • Thyroxine / blood


  • Iodine Radioisotopes
  • Lithium Compounds
  • Thyroxine