ArticleFrontiers in endocrinology2026
Lithium carbonate bridging and outcomes of radioiodine therapy in severe Graves' disease: a retrospective cohort study.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study evaluated whether a short-term lithium carbonate bridging therapy was associated with improved outcomes of subsequent radioiodine (RAI) therapy in patients with severe Graves' disease during the high-risk interval after antithyroid drug (ATD) cessation. Methods: In this single-center retrospective cohort, adults with severe Graves' disease undergoing RAI were included. The lithium group (n=46) received lithium (serum target 0.6-1.0 mmol/L) from ATD withdrawal until 7 days post-RAI, while the standard-care 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). Results: Lithium bridging was associated with a higher euthyroidism rate (30.4% vs. 13.0%, Conclusion: Pre-RAI lithium carbonate bridging may be associated with improved therapeutic outcomes in severe Graves' 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-risk patients.
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