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Lithium-Induced Goiter Follow-up

  • Author: Nicholas J Sarlis, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
Updated: Feb 27, 2015

Further Outpatient Care

A review of patient history, a physical examination, and an evaluation of thyrotropin levels are indicated within 6 months immediately after the initiation of lithium therapy and annually thereafter.

The treating physician must be aware that rare cases of thyrotoxicosis have been reported following discontinuation of lithium therapy.


Further Inpatient Care

No further inpatient care is usually required.



All care is typically performed in an ambulatory clinic setting; thus, no specific transfer requirements are applicable.



For all patients on long-term lithium therapy, regular follow-up with an endocrinologist is indicated, starting within 6 months immediately after the initiation of lithium therapy and continuing annually thereafter (with thyrotropin levels and neck palpation).



Potential complications include the following:



The long-term prognosis ranges from very good to excellent.


Patient Education

Regularly educate patients with regard to the possibility of thyroid dysfunction with long-term lithium treatment.

For excellent patient education resources, visit eMedicineHealth's Thyroid and Metabolism Center. Also, see eMedicineHealth's patient education article Thyroid Problems.

Contributor Information and Disclosures

Nicholas J Sarlis, MD, PhD, FACP Vice President, Head of Medical Affairs, Incyte Corporation

Nicholas J Sarlis, MD, PhD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American Association for Cancer Research, American Association of Clinical Endocrinologists, American College of Physicians, American Federation for Medical Research, American Head and Neck Society, American Medical Association, American Society for Radiation Oncology, American Thyroid Association, Endocrine Society, New York Academy of Sciences, Royal Society of Medicine, Association for Psychological Science, American College of Endocrinology, European Society for Medical Oncology, American Society of Clinical Oncology

Disclosure: Received salary from Incyte Corporation for employment; Received ownership interest from Sanofi-Aventis for previous employment; Received ownership interest/ stock & stock option (incl. rsu) holder from Incyte Corporation for employment.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Don S Schalch, MD Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics

Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Additional Contributors

Steven R Gambert, MD Professor of Medicine, Johns Hopkins University School of Medicine; Director of Geriatric Medicine, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center

Steven R Gambert, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Physician Leadership, American College of Physicians, American Geriatrics Society, Endocrine Society, Gerontological Society of America, Association of Professors of Medicine

Disclosure: Nothing to disclose.


Boaz Hirshberg, MD Associate Director, CVMD, Pfizer

Boaz Hirshberg, MD is a member of the following medical societies: American Dietetic Association

Disclosure: Nothing to disclose.


The author wishes to dedicate this article to the late Jacob Robbins, MD (1922-2008), a leading figure in international thyroidology and a force majeure within the Clinical Endocrinology Branch of NIDDK, National Institutes of Health. His legacy lives on.

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