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Association of Iodine and Iron with Thyroid Function

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Abstract

Iodine and iron are essential elements for healthy thyroid function. However, little is known about the association of iron and iodine with thyroid function in the general US population. We investigated iron and iodine status in relation to concentrations of thyroid hormones. We included 7672 participants aged 20 and older from three surveys (2007–2008, 2009–2010, and 2011–2012) of the National Health and Nutrition Examination Survey. Serum thyroid measures (including free and total T3 and T4, and TSH), serum iron concentration, and urinary iodine concentrations were measured. Multivariate linear regression models were conducted with serum thyroid measures as dependent variables and combinations of serum iron concentration and urinary iodine concentration as predictors with covariate adjustment. Logistic regression models were performed with TSH levels (low, normal, and high) and combinations of serum iron concentration and urinary iodine concentration. Overall, 10.9% of the study population had low iron; 32.2 and 18.8% had low or high iodine levels, respectively. Compared with normal levels of iron and iodine, normal iron and high iodine were associated with reduced free T3 and increased risk of abnormal high TSH. Combined low iron and low iodine was associated with reduced free T3 and increased TSH. In addition, high iodine was associated with increased risk of abnormal high TSH in females but not in males. Thyroid function may be disrupted by low levels of iron or abnormal iodine, and relationships are complex and sex-specific. Large prospective studies are needed to understand the mechanisms by which iron interacts with iodine on thyroid function.

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References

  1. La Vecchia C, Malvezzi M, Bosetti C, Garavello W, Bertuccio P, Levi F, Negri E (2015) Thyroid cancer mortality and incidence: a global overview. Int J Cancer 136:2187–2195

    Article  CAS  PubMed  Google Scholar 

  2. Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal ML (2016) Worldwide thyroid-cancer epidemic? The increasing impact of Overdiagnosis. N Engl J Med 375:614–617

    Article  PubMed  Google Scholar 

  3. Enewold L, Zhu KM, Ron E, Marrogi AJ, Stojadinovic A, Peoples GE, Devesa SS (2009) Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980-2005. Cancer Epidemiol Biomark Prev 18:784–791

    Article  Google Scholar 

  4. Franceschi S, Preston-Martin S, Dal Maso L, Negri E, La Vecchia C, Mack WJ, McTiernan A, Kolonel L, Mark SD, Mabuchi K, Jin F, Wingren G, Galanti R, Hallquist A, Glattre E, Lund E, Levi F, Linos D, Ron E (1999) A pooled analysis of case-control studies of thyroid cancer. IV. Benign thyroid diseases. Cancer Causes Control 10:583–595

    Article  CAS  PubMed  Google Scholar 

  5. Zimmermann MB, Boelaert K (2015) Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol 3:286–295

    Article  CAS  PubMed  Google Scholar 

  6. Zimmermann MB, Galetti V (2015) Iodine intake as a risk factor for thyroid cancer: a comprehensive review of animal and human studies. Thyroid Res 8:8

    Article  PubMed  PubMed Central  Google Scholar 

  7. Zhao W, Han C, Shi XG, Xiong CH, Sun J, Shan ZY, Teng WP (2014) Prevalence of goiter and thyroid nodules before and after implementation of the universal salt iodization program in mainland China from 1985 to 2014: a systematic review and meta-analysis. PLoS One 9:e109549

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kohrle J (2005) Selenium and the control of thyroid hormone metabolism. Thyroid 15:841–853

    Article  PubMed  Google Scholar 

  9. Zimmermann MB (2006) The influence of iron status on iodine utilization and thyroid function. Annu Rev Nutr 26:367–389

    Article  CAS  PubMed  Google Scholar 

  10. Jain RB (2014) Thyroid function and serum copper, selenium, and zinc in general U.S. population. Biol Trace Elem Res 159:87–98

    Article  CAS  PubMed  Google Scholar 

  11. Zimmermann MB, Kohrle J (2002) The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid 12:867–878

    Article  CAS  PubMed  Google Scholar 

  12. Hess SY, Zimmermann MB (2004) The effect of micronutrient deficiencies on iodine nutrition and thyroid metabolism. Int J Vitam Nutr Res 74:103–115

    Article  CAS  PubMed  Google Scholar 

  13. Hess SY (2010) The impact of common micronutrient deficiencies on iodine and thyroid metabolism: the evidence from human studies. Best Pract Res Clin Endocrinol Metab 24:117–132

    Article  CAS  PubMed  Google Scholar 

  14. McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B (2009) Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993-2005. Public Health Nutr 12:444–454

    Article  PubMed  Google Scholar 

  15. Beard JL, Brigham DE, Kelley SK, Green MH (1998) Plasma thyroid hormone kinetics are altered in iron-deficient rats. J Nutr 128:1401–1408

    CAS  PubMed  Google Scholar 

  16. Kandhro GA, Kazi TG, Afridi HI, Kazi N, Arain MB, Sarfraz RA, Sirajuddin SN, Baig JA, Shah AQ (2008) Evaluation of iron in serum and urine and their relation with thyroid function in female goitrous patients. Biol Trace Elem Res 125:203–212

    Article  CAS  PubMed  Google Scholar 

  17. Yu X, Shan Z, Li C, Mao J, Wang W, Xie X, Liu A, Teng X, Zhou W, Li C, Xu B, Bi L, Meng T, Du J, Zhang S, Gao Z, Zhang X, Yang L, Fan C, Teng W (2015) Iron deficiency, an independent risk factor for isolated hypothyroxinemia in pregnant and nonpregnant women of childbearing age in China. J Clin Endocrinol Metab 100:1594–1601

    Article  CAS  PubMed  Google Scholar 

  18. Zimmermann M, Adou P, Torresani T, Zeder C, Hurrell R (2000) Persistence of goiter despite oral iodine supplementation in goitrous children with iron deficiency anemia in cote d’Ivoire. Am J Clin Nutr 71:88–93

    CAS  PubMed  Google Scholar 

  19. Hess SY, Zimmermann MB, Adou P, Torresani T, Hurrell RF (2002) Treatment of iron deficiency in goitrous children improves the efficacy of iodized salt in cote d’Ivoire. Am J Clin Nutr 75:743–748

    CAS  PubMed  Google Scholar 

  20. Zimmermann MB, Zeder C, Chaouki N, Torresani T, Saad A, Hurrell RF (2002) Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous, iron-deficient children: a randomized, double-blind, controlled trial. Eur J Endocrinol 147:747–753

    Article  CAS  PubMed  Google Scholar 

  21. Zimmermann MB, Zeder C, Chaouki N, Saad A, Torresani T, Hurrell RF (2003) Dual fortification of salt with iodine and microencapsulated iron: a randomized, double-blind, controlled trial in Moroccan schoolchildren. Am J Clin Nutr 77:425–432

    CAS  PubMed  Google Scholar 

  22. Zimmermann MB, Wegmueller R, Zeder C, Chaouki N, Rohner F, Saissi M, Torresani T, Hurrell RF (2004) Dual fortification of salt with iodine and micronized ferric pyrophosphate: a randomized, double-blind, controlled trial. Am J Clin Nutr 80:952–959

    CAS  PubMed  Google Scholar 

  23. Eftekhari MH, Simondon KB, Jalali M, Keshavarz SA, Elguero E, Eshraghian MR, Saadat N (2006) Effects of administration of iron, iodine and simultaneous iron-plus-iodine on the thyroid hormone profile in iron-deficient adolescent Iranian girls. Eur J Clin Nutr 60:545–552

    Article  CAS  PubMed  Google Scholar 

  24. NHANES. (2016) National Health and Nutrition Examination Survey. http://www.cdc.gov/nchs/nhanes/index.htm. CDC

  25. Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM, Segal RL, American Association of Clinical E (2002) American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract 8:457–469

    Article  Google Scholar 

  26. Gomella LG, Haist SA (2007) Laboratory diagnosis: chemistry, immunology, serology. McGraw-Hill, New York

  27. WHO. (2016) Urinary Iodine concentrations for determining iodine status in populations. http://apps.who.int/iris/bitstream/10665/85972/1/WHO_NMH_NHD_EPG_13.1_eng.pdf. World Health Organization.

  28. Association AAT. Thyroid function tests. http://www.thyroid.org/wp-content/uploads/patients/brochures/nTests_brochure.pdf. American Thyroid Association

  29. Wolff J, Chaikoff IL (1948) Plasma inorganic iodide as a homeostatic regulator of thyroid function. J Biol Chem 174:555–564

    CAS  PubMed  Google Scholar 

  30. Leung AM, Braverman LE (2014) Consequences of excess iodine. Nat Rev Endocrinol 10:136–142

    Article  CAS  PubMed  Google Scholar 

  31. Paul T, Meyers B, Witorsch RJ, Pino S, Chipkin S, Ingbar SH, Braverman LE (1988) The effect of small increases in dietary iodine on thyroid function in euthyroid subjects. Metabolism 37:121–124

    Article  CAS  PubMed  Google Scholar 

  32. Haymart MR, Repplinger DJ, Leverson GE, Elson DF, Sippel RS, Jaume JC, Chen H (2008) Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocr Metab 93:809–814

    Article  CAS  PubMed  Google Scholar 

  33. Smith SM, Johnson PE, Lukaski HC (1993) In vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of dietary fat. Life Sci 53:603–609

    Article  CAS  PubMed  Google Scholar 

  34. Surks MI (1969) Effect of thyrotropin on thyroidal iodine metabolism during hypoxia. Am J Phys 216:436–439

    CAS  Google Scholar 

  35. Hess SY, Zimmermann MB, Arnold M, Langhans W, Hurrell RF (2002) Iron deficiency anemia reduces thyroid peroxidase activity in rats. J Nutr 132:1951–1955

    CAS  PubMed  Google Scholar 

  36. Bauer M, Glenn T, Pilhatsch M, Pfennig A, Whybrow PC (2014) Gender differences in thyroid system function: relevance to bipolar disorder and its treatment. Bipolar Disord 16:58–71

    Article  PubMed  Google Scholar 

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Correspondence to Juhua Luo.

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There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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Luo, J., Hendryx, M., Dinh, P. et al. Association of Iodine and Iron with Thyroid Function. Biol Trace Elem Res 179, 38–44 (2017). https://doi.org/10.1007/s12011-017-0954-x

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  • DOI: https://doi.org/10.1007/s12011-017-0954-x

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