Posted by Larry Hoover on July 29, 2007, at 11:29:18
In reply to Re: Should all drugs be generic? » Larry Hoover, posted by Squiggles on July 28, 2007, at 12:06:04
> > Your beloved lithium could not pass current clinical trial requirements, IMHO. Just be thankful it got approved before the lawyers could sue the makers for thyroid toxicosis and kidney damage. Just consider how we accept *these* toxic effects without batting an eye, but we howl if one of the mose effective anti-inflammatory drugs in existence shows a correlation with heart attack. The causative link has never been demonstrated (unlike with lithium salts), as there are a number of possible alternative explanations for the statistical finding (e.g. subject selection bias), yet Vioxx is toast. And the lawyers get rich.
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> I don't understand the thyrotoxicosis point-- lithium lowers the thyroid hormone not elevates it. Infact, lithium is used to thyrotoxicosis.Here we go again, with the jargon issue. I apologize for not being 100% rigorous with my semantics, but I did not ever mention thyrotoxicosis. I mentioned thyroid toxicosis, whereby what I meant was "lithium-induced toxicosis of the thyroid", i.e. that the thyroid was the specific organ affected by toxic lithium exposure.
Thyrotoxicosis is a specific effect of hyperthyroidism. That is not what I meant at all, and I apologize for opening the door on that misinterpretation of my words.
Lithium influences iodine uptake and storage in the thyroid. Goiter is a common result of lithium therapy (about 1 in 4 users). Frank hypothyroidism is far more common among lithium users than in the broader population. I dispute that TSH influences the thyroid, but that TSH is a result of thyroid defects caused by lithium. In the end, the argument is moot, IMHO, as I intended the broadest possible interpretation of the thyro-toxic effects of lithium. Mechanisms were not my concern.
Lar
poster:Larry Hoover
thread:772306
URL: http://www.dr-bob.org/babble/20070719/msgs/772701.html