{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:13:33Z","timestamp":1778130813251,"version":"3.51.4"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated whether a short\u2212term lithium carbonate bridging therapy was associated with improved outcomes of subsequent radioiodine (RAI) therapy in patients with severe Graves\u2019 disease during the high\u2212risk interval after antithyroid drug (ATD) cessation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2212center retrospective cohort, adults with severe Graves\u2019 disease undergoing RAI were included. The lithium group (n=46) received lithium (serum target 0.6\u20131.0 mmol\/L) from ATD withdrawal until 7 days post\u2212RAI, while the standard\u2212care group (n=100) received routine management without lithium bridging. The primary outcome was thyroid function status at 6 months, defined biochemically: euthyroidism (normal TSH, FT3, FT4 within reference ranges), hypothyroidism (elevated TSH with low FT4), or treatment failure (persistent hyperthyroidism or need for repeat RAI\/surgery within 6 months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Lithium bridging was associated with a higher euthyroidism rate (30.4% vs. 13.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.009) and a lower hypothyroidism rate (54.3% vs. 77.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.005) compared to standard care. This was preceded by a significant reduction in serum FT3 and FT4 following lithium initiation (P &amp;lt; 0.001). Treatment was well tolerated, with mild gastrointestinal side effects in 8.7% and no cases of thyroid storm (0% vs. 3.0% in standard\u2212care group). Multivariate analysis confirmed pre\u2212RAI FT3 as a key modifiable risk factor for treatment failure (adjusted OR 1.55 per 5 pmol\/L increase, 95% CI 1.15\u20132.09,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.004). Within the lithium group, the magnitude of FT3 reduction (\u0394FT3) was independently associated with treatment success (adjusted OR 0.45 per 5 pmol\/L decrease, 95% CI 0.22\u20130.92,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre\u2212RAI lithium carbonate bridging may be associated with improved therapeutic outcomes in severe Graves\u2019 disease, potentially mediated through reduction in serum FT3. These findings support the need for prospective randomized studies to confirm the role of lithium as a bridging strategy in high\u2212risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1770772","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:50:24Z","timestamp":1778129424000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lithium carbonate bridging and outcomes of radioiodine therapy in severe Graves\u2019 disease: a retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xuemei","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiao","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingmin","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruihua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00278-6","article-title":"Hyperthyroidism","volume":"388","author":"De Leo","year":"2016","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra042972","article-title":"Antithyroid drugs","volume":"352","author":"Cooper","year":"2005","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association guidelines for diagnosis and 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