ArticleCureus2025
Endocrine and Metabolic Challenges of Long-Term Lithium Therapy: Diagnostic and Management Considerations.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Lithium-associated hyperparathyroidism: a systematic review of prevalence and surgical outcomes.Langenbeck's archives of surgery · 2026Pooled it
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Lithium is a key treatment for bipolar disorder but is associated with significant endocrine and metabolic side effects, particularly lithium-induced hyperparathyroidism (LIH). Characterized by hypercalcemia and inappropriately normal or elevated parathyroid hormone (PTH) levels, LIH can lead to skeletal complications such as osteoporosis. Managing this condition is particularly challenging in psychiatric patients due to adherence issues with follow-up care. We describe the case of a 56-year-old Caucasian female patient with bipolar disorder on long-term lithium therapy (16 years), presenting with recurrent hypercalcemia, hyperparathyroidism, and osteoporosis. Symptoms included fatigue, depression, and cognitive difficulties. Laboratory tests confirmed hypercalcemia (2.8 mmol/L), normal PTH (47.5 pg/mL), and vitamin D deficiency (11.8 ng/mL). Imaging identified a parathyroid adenoma and osteoporosis. Parathyroidectomy failed to resolve hypercalcemia, which persisted at 2.6 mmol/L. Lithium discontinuation led to calcium normalization and improved bone density (8.2% increase in lumbar spine measurements). However, follow-up imaging revealed a small epithelial adenoma, raising concerns about further surgical intervention. Management was complicated by poor adherence to follow-up care. This case highlights the complexities of diagnosing and managing LIH, particularly in patients with psychiatric comorbidities. A multidisciplinary approach involving endocrinology and psychiatry is essential to optimize treatment while balancing lithium's therapeutic benefits against its risks. Further research is needed to refine surgical strategies, calcimimetic therapy, and long-term follow-up protocols for effective management.
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Registered trials
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