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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by TonyZ on March 1, 2008, at 10:47:15
Anyone taking lithium and concerned about developing a goiter. According to some articles I've read about 20% can develop this condition in iodine deficient/deplete diets. Anyone out there who is taking lithium and some type of iodine supplement to protect the thyroid from absorbing the lithium instead. This can be a bit tricky as too much iodine can be toxic. I'm very concerned with this as doc has put me on lithium recently? Appreciate any advice
Posted by Larry Hoover on March 1, 2008, at 11:02:45
In reply to Lithium and Iodine supplementation, posted by TonyZ on March 1, 2008, at 10:47:15
> Anyone taking lithium and concerned about developing a goiter. According to some articles I've read about 20% can develop this condition in iodine deficient/deplete diets. Anyone out there who is taking lithium and some type of iodine supplement to protect the thyroid from absorbing the lithium instead. This can be a bit tricky as too much iodine can be toxic. I'm very concerned with this as doc has put me on lithium recently? Appreciate any advice
If you use iodized table salt (stay clear of sea salt, as it has little iodide), then you should be fine. If you're on a salt restricted diet, then a kelp supplement will cover the iodide requirement.
Iodide toxicity is really quite rare, and is really an idiosyncratic (individual) sensitivity, rather than a general toxic effect. Some people can't excrete iodide efficiently, due to the way their kidneys (don't) work.
Lithium goiter is most often benign, in any case. Although lithium reduces thyroid hormone release, the goiter (if it occurs) is a compensatory effect. In most cases, thyroid hormone output remains normal.
Lar
Posted by Phillipa on March 1, 2008, at 12:17:39
In reply to Re: Lithium and Iodine supplementation » TonyZ, posted by Larry Hoover on March 1, 2008, at 11:02:45
So a person can take lithium even with thyroid disorder and not fear more destruction of the gland. I think this is a subject a lot of people don't understand. I know I don't. Love Phillipa
Posted by yxibow on March 1, 2008, at 15:59:25
In reply to Re: Lithium and Iodine supplementation » TonyZ, posted by Larry Hoover on March 1, 2008, at 11:02:45
> > Anyone taking lithium and concerned about developing a goiter. According to some articles I've read about 20% can develop this condition in iodine deficient/deplete diets. Anyone out there who is taking lithium and some type of iodine supplement to protect the thyroid from absorbing the lithium instead. This can be a bit tricky as too much iodine can be toxic. I'm very concerned with this as doc has put me on lithium recently? Appreciate any advice
>
> If you use iodized table salt (stay clear of sea salt, as it has little iodide), then you should be fine. If you're on a salt restricted diet, then a kelp supplement will cover the iodide requirement.
>
> Iodide toxicity is really quite rare, and is really an idiosyncratic (individual) sensitivity, rather than a general toxic effect. Some people can't excrete iodide efficiently, due to the way their kidneys (don't) work.
>
> Lithium goiter is most often benign, in any case. Although lithium reduces thyroid hormone release, the goiter (if it occurs) is a compensatory effect. In most cases, thyroid hormone output remains normal.
>
> Lar
>
Its rare in the western world, but is a problem in underdeveloped countries, as you say, hence iodized salt.
Seaweed can be quite tasty too, just have a little bit of sliced handrolls every now and then.
Posted by Larry Hoover on March 1, 2008, at 17:04:39
In reply to Re: Lithium and Iodine supplementation » Larry Hoover, posted by Phillipa on March 1, 2008, at 12:17:39
> So a person can take lithium even with thyroid disorder and not fear more destruction of the gland. I think this is a subject a lot of people don't understand. I know I don't. Love Phillipa
Uhh, that's not what I said. I assumed an otherwise healthy person. Prior or subclinical autoimmune thyroid disease predisposes to goiter and hypothyroidism, with the risk increasing with lithium therapy.
Lar
Posted by Phillipa on March 1, 2008, at 18:50:22
In reply to Re: Lithium and Iodine supplementation » Phillipa, posted by Larry Hoover on March 1, 2008, at 17:04:39
Lar thanks understood that time. Phillipa
Posted by brooke484 on March 1, 2008, at 23:16:06
In reply to Re: Lithium and Iodine supplementation » TonyZ, posted by Larry Hoover on March 1, 2008, at 11:02:45
I have hypothyroidism and am adding a small amount of Lithium to Marplan. Do you think that would make me more hypothyroid or would I stay the same? I'll talk to my doctor next week, but wanted your opinion also.
Thanks,
brooke
Posted by Larry Hoover on March 3, 2008, at 17:37:17
In reply to Re: Lithium and Iodine supplementation - Larry, posted by brooke484 on March 1, 2008, at 23:16:06
> I have hypothyroidism and am adding a small amount of Lithium to Marplan. Do you think that would make me more hypothyroid or would I stay the same? I'll talk to my doctor next week, but wanted your opinion also.
>
> Thanks,
>
> brookeLithium is preferentially taken up by the thyroid gland; the concentration within it is much higher than the blood concentration. The lithium ions inhibit the thyroid response to TSH, resulting in reduced T4/T3 release. Over time, the pituitary would increase TSH, and the thyroid would adjust upwards to restore normal output. In some cases, that upregulation increases the volume of the thyroid tissue, a trait we call goiter. However, if someone is already hypothyroid, lithium could increase the need for supplementation, as the gland may be unable to fully compensate for the lithium inhibition effect.
So, yes, lithium will reduce your own thyroid output. It may be able to bounce back, or it may not. You should have your thyroid hormones monitored once you restabilize, and potentially adjust your supplemental hormone intake. Your TSH will likely remain higher than it is now, so you'll need a thyroid panel to tell the full tale.
Lar
Posted by brooke484 on March 3, 2008, at 22:27:49
In reply to Re: Lithium and Iodine supplementation - Larry » brooke484, posted by Larry Hoover on March 3, 2008, at 17:37:17
.
This is the end of the thread.
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