Lithium in Drinking Water and Thyroid Function

Abstract

BackgroundHigh concentrations of lithium in drinking water were previously discovered in the Argentinean Andes Mountains. Lithium is used worldwide for treatment of bipolar disorder and treatment-resistant depression. One known side effect is altered thyroid function.ObjectivesWe assessed associations between exposure to lithium from drinking water and other environmental sources and thyroid function.MethodsWomen (n = 202) were recruited in four Andean villages in northern Argentina. Lithium exposure was assessed based on concentrations in spot urine samples, measured by inductively coupled plasma mass spectrometry. Thyroid function was evaluated by plasma free thyroxine (T4) and pituitary gland thyroid-stimulating hormone (TSH), analyzed by routine immunometric methods.ResultsThe median urinary lithium concentration was 3,910 μg/L (5th, 95th percentiles, 270 μg/L, 10,400 μg/L). Median plasma concentrations (5th, 95th percentiles) of T4 and TSH were 17 pmol/L (13 pmol/L, 21 pmol/L) and 1.9 mIU/L, (0.68 mIU/L, 4.9 mIU/L), respectively. Urine lithium was inversely associated with T4 [β for a 1,000-μg/L increase = −0.19; 95% confidence interval (CI), −0.31 to −0.068; p = 0.002] and positively associated with TSH (β = 0.096; 95% CI, 0.033 to 0.16; p = 0.003). Both associations persisted after adjustment (for T4, β = −0.17; 95% CI, −0.32 to −0.015; p = 0.032; for TSH: β = 0.089; 95% CI, 0.024 to 0.15; p = 0.007). Urine selenium was positively associated with T4 (adjusted T4 for a 1 μg/L increase: β = 0.041; 95% CI, 0.012 to 0.071; p = 0.006).ConclusionsExposure to lithium via drinking water and other environmental sources may affect thyroid function, consistent with known side effects of medical treatment with lithium. This stresses the need to screen for lithium in all drinking water sources.

Selenium metabolism to the trimethylselenonium ion (TMSe) varies markedly because of polymorphisms in the indolethylamine N-methyltransferase gene

“…The Argentinian cohort consisted of female inhabitants of the arid Puna region in the northern Argentinian Andes who had previously been studied for exposure to arsenic and lithium through drinking water and related effects on thyroid function and the cardiovascular system (17,18). The main village, San Antonio de los Cobres, is located 3800 m above sea level and has w6000 inhabitants, mainly of indigenous origin (predominantly Colla).…”

Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes

“…Lithium, from both therapy and drinking water, crosses freely the placenta (Harari et al, 2012;Newport et al, 2005) and is known to impair the thyroid hormones (Broberg et al, 2011;Grandjean and Aubry, 2009c). Like most of the hormones, the thyroid hormones play a critical role in fetal growth and development (Forhead and Fowden, 2014).…”

Variation of Lithium Contents in Scalp Hair Samples of Different Male Psychiatric Patients Before and After Treatment with its Pharmaceutical Supplements

“…Treatment with Li salts has also been affect the thyroid function [9], where as its contribution in reducing neuroglial inflammation, increasing pre and postsynaptic protein, and reducing stress which causes structural and functional damage to the dendrites (segments of the neuron cells that receive stimulation to become active) [7,11].…”

“…Lithium, a very effective agent for the prevention of mania and depression, has also been shown to have considerable neuroprotective effects, far more in extent and human relevance than any other psychotropic agent [7][8][9][10][11]. It was immensely investigated about the positive effects of Li therapy for different neurodegenerative illnesses [12][13][14].…”