High rate of autoimmune thyroiditis in bipolar disorder: Lack of association with lithium exposure

Ralph W. Kupka, Willem A. Nolen, Robert M. Post, Susan L. McElroy, Lori L. Altshuler, Kirk D. Denicoff, Mark A. Frye, Paul E. Keck, Gabriele S. Leverich, A. John Rush, Trisha Suppes, Chad Pollio, Hemmo A. Drexhage

Research output: Contribution to journalArticlepeer-review

187 Scopus citations


Background: We assessed the prevalence of thyroperoxidase antibodies (TPO-Abs) and thyroid failure in outpatients with bipolar disorder compared with two control groups. Methods: The TPO-Abs of outpatients with DSM-IV bipolar disorder (n = 226), a population control group (n = 252), and psychiatric inpatients of any diagnosis (n = 3190) were measured. Thyroid failure was defined as a raised thyroid stimulating hormone level, previously diagnosed hypothyroidism, or both. Subjects were compared with attention to age, gender, and exposure to lithium. Results: The TPO-Abs were more prevalent in bipolar patients (28%) than population and psychiatric controls (3-18%). The presence of TPO-Abs in bipolar patients was associated with thyroid failure, but not with age, gender, mood state, rapid cycling, or lithium exposure. Thyroid failure was present in 17% of bipolar patients and more prevalent in women. It was associated with lithium exposure, especially in the presence of TPO-Abs, but not with current rapid cycling, although an association may have been masked by thyroid hormone replacement. Conclusions: Thyroid autoimmunity was highly prevalent in this sample of outpatients with bipolar disorder and not associated with lithium treatment. These variables appear to be independent risk factors for the development of hypothyroidism, especially in women with bipolar disorder.

Original languageEnglish (US)
Pages (from-to)305-311
Number of pages7
JournalBiological psychiatry
Issue number4
StatePublished - Feb 15 2002


  • Bipolar disorder
  • Hypothyroidism
  • Lithium
  • Thyroid antibodies

ASJC Scopus subject areas

  • Biological Psychiatry


Dive into the research topics of 'High rate of autoimmune thyroiditis in bipolar disorder: Lack of association with lithium exposure'. Together they form a unique fingerprint.

Cite this