{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:16:09Z","timestamp":1787318169868,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,12,16]],"date-time":"2013-12-16T00:00:00Z","timestamp":1387152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies have provided evidence of subtle thyroid hormone metabolism abnormalities in patients with mood disorders. Although these studies are informative, the precise role of the hypothalamic\u2010pituitary\u2010thyroid axis in bipolar disorder, especially in women, remains unclear. We sought to further corroborate thyroid function in patients with bipolar disorder in comparison to patients with other psychiatric, as well as non\u2010psychiatric, diagnoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, cross\u2010sectional, naturalistic study, serum thyroid\u2010stimulating hormone (TSH) levels in a total sample of 3,204 patients were compared. The study sample included patients with bipolar disorder (n\u00a0=\u00a0469), unipolar depression (n\u00a0=\u00a0615), and other psychiatric diagnoses (n\u00a0=\u00a0999), patients from endocrinology clinics (n\u00a0=\u00a0645), and patients from dermatology clinics (n\u00a0=\u00a0476). Analyses were completed using two different normal ranges for TDH: a high normal range (0.4\u20135.0 \u03bcIU\/mL) and a low normal range (0.3\u20133.0 \u03bcIU\/mL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with bipolar disorder showed significantly higher serum TSH levels compared to all other groups. In women, the rate of above normal range TSH was highest in patients with bipolar disorder for both high (5.0\u00a0\u03bcIU\/mL; 12.1%) and low (3.0\u00a0\u03bcIU\/mL; 30.4%) upper normal limits. In patients with bipolar disorder, serum TSH levels did not differ significantly between different mood states. In the lithium\u2010treated patients (n\u00a0=\u00a0240), a significantly lower percentage of women (55.9%) compared to men (71.2%) fell within the 0.3\u20133.0\u00a0\u03bcIU\/mL normal TSH window (p\u00a0=\u00a00.016). For the high normal range (0.4\u20135.0\u00a0\u03bcIU\/mL), serum lithium levels above 0.8\u00a0mmol\/L were associated with a significantly lower proportion of female patients (59.2%) falling within the normal range than male patients (88.9%). Non\u2010lithium treatment was not associated with a gender difference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our findings show a higher rate of TSH abnormality in patients with bipolar disorder, particularly those taking lithium, compared to those with other psychiatric and medical conditions. Lithium\u2010associated thyroid dysregulation occurs more frequently in female patients. Using the low normal range\n                      <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>\n                      values at follow\u2010up can increase sensitivity in recognizing hyperthyroidism in lithium\u2010treated female patients, and help in preventing the development of subclinical hypothyroidism and an adverse course of illness.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.12163","type":"journal-article","created":{"date-parts":[[2013,12,16]],"date-time":"2013-12-16T06:40:29Z","timestamp":1387176029000},"page":"72-82","source":"Crossref","is-referenced-by-count":48,"title":["Female vulnerability for thyroid function abnormality in bipolar disorder: role of lithium treatment"],"prefix":"10.1111","volume":"16","author":[{"given":"Ay\u015feg\u00fcl","family":"\u00d6zerdem","sequence":"first","affiliation":[{"name":"Department of Psychiatry Faculty of Medicine Izmir Turkey"},{"name":"Department of Neuroscience 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