Skip to main content
Log in

Increased incidence of thyrotoxicosis after iodine supplementation in an iodine sufficient area

  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

The aim of this study was to determine the incidence rate of thyrotoxicosis (TT) before and during dietary-iodine supplementation in an iodine-sufficient area. Population: the study was carried out in Vigo, South Galicia (northwest of Spain), from January 1977 to December 1989. The mean population throughout the study period was 267,330 inhabitants (47% males and 53% females). From January 1985, a mandatory consumption of iodinized salt on the whole population started in Galicia. This region was considered as an iodine-deficient area but Vigo is an iodine-sufficient area. Measurements: all newly diagnosed TT cases in Vigo city within the study period were included in this study. Diagnosis of TT was based on the clinical manifestations, an elevated level of T4 and suppressed TSH values. The difference between diffuse and nodular forms of goiter was assessed by scintigraphy. The average incidence rate (AIR) was determined in two periods, before (period A, 1977–1984) and during (period B, 1985–1989) iodine supplementation. Results: the AIR throughout the whole study period was 4.89 new cases per 100,000 population, 95% confidence limits 4.16 to 5.63; AIR was 1.34 for males and 8.03 for females. AIR in period B was significantly higher with respect to period A, 7.68 and 3.10 per 100,000 respectively. The confidence interval for the difference was from −20.4 to 30.1, p<0.05. The increase of the incidence of TT was comprised of both nodular and diffuse goiters. Conclusions: dietary iodinesupplementation in iodine-sufficient areas may induce an increase of the incidence of TT. This could be explained by the fact that individuals and populations differ widely in terms of optimal daily requirements as well as adverse responses to both deficiency and excess of iodine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Tunbridge W.M.G., Calwell G. The epidemiology of thyroid diseases. In: Braverman L.E., Utiger R.D. (Eds.), The Thyroid: a Fundamental and Clinical Text, ed. 6. Lippincott Co., Philadelphia, 1991, p. 578.

    Google Scholar 

  2. Furszyfer J., Kurland L.T., McConahey W.M., Elveback L.R. Graves’ disease in Olmsted Country, Minnesota 1935 through 1967. Mayo Clin. Proc. 45: 636, 1970.

    PubMed  CAS  Google Scholar 

  3. Barker D.J.P., Phillips D.I.W. Current incidence of thyrotoxicosis and past prevalence in 12 British towns. Lancet 2: 567, 1984.

    Article  PubMed  CAS  Google Scholar 

  4. Thommesen N., Nirrel I., Kristensen H.P.O. A fine year study of hyperthyroidism in a Central hospital. Ugeskr. Laeger 133: 1663, 1971.

    PubMed  CAS  Google Scholar 

  5. Brownlie B.E.W., Wells J.E. The epidemiology of thyrotoxicosis in New Zealand: incidence and geographical distribution in North Canterbury, 1983–1985. Clin. Endocrinol. (Oxf.) 33: 249, 1990.

    Article  CAS  Google Scholar 

  6. Haraldson A., Gudmundsson S.T., Larusson G., Sugurdsson G. Thyrotoxicosis in Iceland 1980–1982. Acta Med. Scand. 217: 253, 1985.

    Article  Google Scholar 

  7. Mogensen E.F., Green A. The epidemiology of thyrotoxicosis in Denmark: incidence and geographical variation in the funen region 1972–1974. Acta Med. Scand. 108: 183, 1980.

    Google Scholar 

  8. Connolly R.J. The changing age incidence of jodbasedow in Tasmania. Med. J. Aust. 2: 171, 1973.

    PubMed  CAS  Google Scholar 

  9. Kiceić M. Problemi hypertireoze u toku uvedenja jodne profilakse endemske tireopatske distrofige. Vojnosanit. Pregl. 34: 409, 1977.

    Google Scholar 

  10. Riccabona G. Hyperthyroidism and thyroid causes in an endemic goiter area. In: Dunn J.T., Medeiros-Neto G. (Eds.), Endemic goiter and cretinism continuing threats to world health. P.A.H.O. Sci. Pub. N°292, Washington DC, 1974 p. 156.

    Google Scholar 

  11. Van Leeuwen E. Een vorm vangenuine hyperthyreose (M. Basedow zondes exophthalmus) nagebruik van gejodeerd brood. Ned. Tijdschr. Geneeskd 98: 81, 1954.

    Google Scholar 

  12. Escobar del Rey F., Morreale de Escobar G. Iodine deficiency in Spain: a continuing concern. Endocrinologia 39: 171, 1992.

    Google Scholar 

  13. Ríos Santomé M., García-Mayor R.V.G., Fernández Garcia M., Lago Lustres Y., Blanco Herrero V., Vázquez Fernández E. El bocio endémico en el sur de Galicia: estudio epidemiolögico. An. Med. Intern. (Madrid) 4: 379, 1987.

    Google Scholar 

  14. Ríos Santomé M., San Luis A., Parrondo Muiños C., García-Mayor R.V.G. Valoración de la ingesta de iodo en la población del Sur de Galicia. Endocrinologia 34(Suppl. 1): 16, 1987.

    Google Scholar 

  15. Tunbridge W.M.G., Evered D.C., Hall R., Appleton D., Brewis M., Clark F., Grimley Evans J., Young E., Bird T., Smith P.A. The spectrum of thyroid disease in a community: the wickhan survey. Clin. Endocrinol. (Oxf.) 7: 481, 1977.

    Article  CAS  Google Scholar 

  16. Adams D.O., Kennedy T.H., Stewart J.C., Utiger R.D., Vidor G.I. Hyperthyroidism in Tasmania following iodine supplementation: measurements of thyroid-stimulating autoantibodies and thyrotropin. J. Clin. Endocrinol. Metab. 47: 221, 1975.

    Article  Google Scholar 

  17. Fradkin J.E., Wolff J. Iodide-induced thyrotoxicosis. Medicine 62: 1, 1983.

    Article  PubMed  CAS  Google Scholar 

  18. Matovinovic J. Complications of goiter prophylaxis. In: Stanbury J.B., Hetzel B.S. (Eds.), Endemic goiter and endemic cretinism. Wiley Medical Publication, New York, 1980, p. 533.

    Google Scholar 

  19. Williams I., Ankrett V.O., Lazarus J.H., Volpe R. Aetiology of hyperthyroidism in Canada and Wales. J. Epidemiol. Community Health 37: 245, 1983.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  20. García-Mayor R.V.G., Páramo C, Luna Cano R., Pérez Méndez L.F., Galofré J.C., Andrade A. Antithyroid drug and Graves’ hyperthyroidism. Significance of treatment duration and TRab determination on lasting remission. J. Endocrinol. Invest. 15: 815, 1992.

    Google Scholar 

  21. Solomon B.L., Evaul J.E., Burman K.D., Wartofsky L. Remission rates with antithyroid drug therapy: continuing inference of iodine intake? Ann. Intern. Med. 107: 510, 1987.

    CAS  Google Scholar 

  22. Roti F., Vagenakis A.G. Effect of excess iodide: clinical aspects. In: Braverman L.E., Utiger R.D. (Eds.), The Thyroid: a Fundamental and Clinical Text. ed. 6. Lippincott Co., Philadelphia, 1991, p. 390.

    Google Scholar 

  23. Allen E.M., Appel M.C., Braverman L.E. The effect of iodine ingestion on the development of spontaneous lymphocytic thyroiditis in the diabetes prone BB/W rat. Endocrinology 118: 1977, 1986

    Article  PubMed  CAS  Google Scholar 

  24. Cohen S.B., Weetman A.P. The effect of iodine depletion and supplemantation in the Buffalo strain rat. J. Endocrinol. Invest. 11: 625, 1988.

    Article  PubMed  CAS  Google Scholar 

  25. Schatz H., Schleusener H. Hyperthyroidism in Europe: clinical and laboratory data of a prospective multicentre survey. J. Endocrinol. Invest. 9(Suppl. 2): 1, 1986.

    PubMed  Google Scholar 

  26. Safran M., Paul T.L., Roti E., Braverman L.E. Environmental factors affecting autoimmune thyroid disease. Endocrinol. Metab. Clin. North Am. 16: 327, 1987.

    PubMed  CAS  Google Scholar 

  27. Volpé R. Immunology of thyroid disease. In: Volpé R. (Ed.), Autoimmunity in Endocrine Disease. CRC press, Boca Raton 1990, p. 73.

    Google Scholar 

  28. Martino E., Safran M., Aghini-Lombardi F., Rajatanavin R., Lenziardi M., Fay M., Pacchiartti A., Aronin N., Macchia E., Haffajee C, Odoguardi L., Love J., Bigalli A., Baschieri L., Pinchera A., Braverman L. Environmental iodine intake and thyroid dysfunction during amiodarone therapy. Ann. Intern. Med. 707: 28, 1984.

    Article  Google Scholar 

  29. García-Mayor R.V.G., Gómez Sobreira M., Batista J., Moreiras M., Lázaro Enguis J., Alvarez Gándara D. Disfunción tiroidea clínica en pacientes tratados crónicamente con amiodarona. Rev. Esp. Cardiol. 43: 227, 1990.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported by Grant FISss 89/127 from Spanish Ministry of Health and “Valgrande“ Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Galofré, J.C., Fernández-Calvet, L., Ríos, M. et al. Increased incidence of thyrotoxicosis after iodine supplementation in an iodine sufficient area. J Endocrinol Invest 17, 23–27 (1994). https://doi.org/10.1007/BF03344958

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03344958

Key-words

Navigation