{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:35:42Z","timestamp":1791974142327,"version":"4.4.0"},"reference-count":16,"publisher":"American Chemical Society (ACS)","issue":"6","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":2535,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We assessed associations between exposure to lithium from drinking water and other environmental sources and thyroid function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women (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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median urinary lithium concentration was 3,910 \u03bcg\/L (5th, 95th percentiles, 270 \u03bcg\/L, 10,400 \u03bcg\/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 [\u03b2 for a 1,000-\u03bcg\/L increase = \u22120.19; 95% confidence interval (CI), \u22120.31 to \u22120.068; p = 0.002] and positively associated with TSH (\u03b2 = 0.096; 95% CI, 0.033 to 0.16; p = 0.003). Both associations persisted after adjustment (for T4, \u03b2 = \u22120.17; 95% CI, \u22120.32 to \u22120.015; p = 0.032; for TSH: \u03b2 = 0.089; 95% CI, 0.024 to 0.15; p = 0.007). Urine selenium was positively associated with T4 (adjusted T4 for a 1 \u03bcg\/L increase: \u03b2 = 0.041; 95% CI, 0.012 to 0.071; p = 0.006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exposure 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1289\/ehp.1002678","type":"journal-article","created":{"date-parts":[[2011,1,20]],"date-time":"2011-01-20T14:36:14Z","timestamp":1295534174000},"page":"827-830","source":"Crossref","is-referenced-by-count":86,"title":["Lithium in Drinking Water and Thyroid Function"],"prefix":"10.1021","volume":"119","author":[{"given":"Karin","family":"Broberg","sequence":"first","affiliation":[{"name":"Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Concha","sequence":"additional","affiliation":[{"name":"Division of Toxicology, Swedish National Food Administration, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Lindvall","sequence":"additional","affiliation":[{"name":"Department of Child and Youth Psychiatry, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Grand\u00e9r","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Vahter","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2011,1,20]]},"reference":[{"key":"2026080314023380000_micit1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.ecoenv.2008.02.026","article-title":"Toxicity of lithium to humans and the environment\u2014a literature review","volume":"70","author":"Aral","year":"2008","journal-title":"Ecotoxicol Environ Saf"},{"key":"2026080314023380000_micit2","doi-asserted-by":"crossref","first-page":"488","DOI":"10.4414\/smw.2003.10226","article-title":"Chronic Cs-137 incorporation in children\u2019s organs","volume":"35\u201336","author":"Bandazhevsky","year":"2003","journal-title":"Swiss Med Wkly"},{"key":"2026080314023380000_micit3","first-page":"614","article-title":"Regulation of lithium and boron levels in normal human blood: environmental and genetic considerations","volume":"121","author":"Barr","year":"1993","journal-title":"J Lab Clin Med"},{"key":"2026080314023380000_micit4","doi-asserted-by":"crossref","first-page":"6875","DOI":"10.1021\/es1010384","article-title":"High-level exposure to lithium, rubidium, cesium, boron and arsenic via drinking water in the Puna region of northern Argentina","volume":"44","author":"Concha","year":"2010","journal-title":"Environ Sci Technol"},{"key":"2026080314023380000_micit5","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1192\/bjp.195.3.271","article-title":"Lithium in drinking water and food, and risk of suicide","volume":"195","author":"Desai","year":"2009","journal-title":"Br J Psychiatry"},{"key":"2026080314023380000_micit6","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/j.1442-200X.2010.03101.x","article-title":"Long term stability of thyroid hormones and DNA in blood spots kept under varying storage conditions","volume":"52","author":"El Ezzi","year":"2010","journal-title":"Pediatr Int"},{"key":"2026080314023380000_micit7","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2165\/00023210-200923030-00004","article-title":"Lithium: updated human knowledge using an evidence-based approach: part I: clinical efficacy in bipolar 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