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Iodine-induced thyrotoxicosis after ingestion of kelp-containing tea

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Abstract

Complementary medication is en vogue and an increasing number of patients consume herbal medicine without reporting their use to physicians. We report a case of iodine-induced hyperthyroidism due to the ingestion of a kelp-containing tea. A 39-year-old woman with multi-nodular goiter presented with typical signs of hyperthyroidism, which was confirmed by endocrine tests. She was not exposed to iodinated radiocontrast media and did not take medications containing iodine, such as amiodarone. However, a detailed medical history revealed that she had been treated for a period of 4 weeks by a Chinese alternative practitioner with a herbal tea containing kelp because of her enlarged thyroid. The consumption of the tea was discontinued and an antithyroid drug therapy was initiated. Physicians should advise patients with underlying thyroid disease to avoid all complementary or alternative medications containing iodine.

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References

  1. Braverman LE. Iodine and the thyroid: 33 years of study. Thyroid. 1994;4:351–6.

    Article  CAS  Google Scholar 

  2. Wolff J, Chaikoff IL. Plasma inorganic iodide as homeostatic regulator of thyroid function. J Biol Chem. 1948;174:555–64.

    Article  CAS  Google Scholar 

  3. Wolff J, Chaikoff IL, Goldberg, Meier JR. The temporary nature of the inhibitory action of excess iodine on organic iodine synthesis in the normal thyroid. Endocrinology. 1949;45:504–13.

    Article  CAS  Google Scholar 

  4. Galton VA, Pitt-Rivers R. The effect of excessive iodine on the thyroid of the rat. Endocrinology. 1959;64:835–9.

    Article  CAS  Google Scholar 

  5. Braverman LE, Ingbar SH. Changes in thyroidal function during adaptation to large doses of iodide. J Clin Invest. 1963;42:1216–31.

    Article  CAS  Google Scholar 

  6. Fradkin JE, Wolff J. Iodide-induced thyrotoxicosis. Medicine (Baltimore). 1983;62:1–20.

    Article  CAS  Google Scholar 

  7. Roti E, Uberti ED. Iodine excess and hyperthyroidism. Thyroid. 2001;11:493–500.

    Article  CAS  Google Scholar 

  8. Lee SM, Lewis J, Buss DH, Holcombe GD, Lawrance PR. Iodine in British foods and diets. Br J Nutr. 1994;72:435–46.

    Article  CAS  Google Scholar 

  9. Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158:2200–11.

    Article  CAS  Google Scholar 

  10. Johnston BA. One-third of nation’s adults use herbal remedies. Herbalgram. 1997;40:49.

    Google Scholar 

  11. NBJ Herbal and Botanical U.S. Consumer Sales 1999. San Diego, CA: Nutrition Business Journal 2000; 1–3.

  12. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993;328:246–52.

    Article  CAS  Google Scholar 

  13. Ernst E. Harmless herbs? A review of the recent literature. Am J Med. 1998;104:170–8.

    Article  CAS  Google Scholar 

  14. Bent S, Ko R. Commonly used herbal medicines in the United States: a review. Am J Med. 2004;116:478–85.

    Article  Google Scholar 

  15. Vagenakis AG, Wang CA, Burger A, Maloof F, Braverman LE, Ingbar SH. Iodide-induced thyrotoxicosis in Boston. N Engl J Med. 1972;287:523–7.

    Article  CAS  Google Scholar 

  16. Rajatanavin R, Safran M, Stoller WA, Mordes JP, Braverman LE. Five patients with iodine-induced hyperthyroidism. Am J Med. 1984;77:378–84.

    Article  CAS  Google Scholar 

  17. Martin FI, Deam DR. Hyperthyroidism in elderly hospitalised patients. Clinical features and treatment outcomes. Med J Aust. 1996;164:200–3.

    Article  CAS  Google Scholar 

  18. Harjai KJ, Licata AA. Effects of amiodarone on thyroid function. Ann Intern Med. 1997;126:63–73.

    Article  CAS  Google Scholar 

  19. Martin FI, Tress BW, Colman PG, Deam DR. Jodine-induced hyperthyroidism due to nonionic contrast radiography in the elderly. Am J Med. 1993;95:78–82.

    Article  CAS  Google Scholar 

  20. Shilo S, Hirsch HJ. Iodine-induced hyperthyroidism in a patient with a normal thyroid gland. Postgrad Med J. 1986;62:661–2.

    Article  CAS  Google Scholar 

  21. Hartman AA. Hyperthyroidism during administration of kelp tablets. Ned Tijdschr Geneesk. 1990;134:1373.

    CAS  Google Scholar 

  22. de Smet PA, Stricker BH, Wilderink F, Wiersinga WM. Hyperthyroidism during treatment with kelp tablets. Ned Tijdschr Geneesk. 1990;134:1373.

    Google Scholar 

  23. Eliason BC. Transient hyperthyroidism in a patient taking dietary supplements containing kelp. J Am Board Fam Pract. 1998;11:478–80.

    Article  CAS  Google Scholar 

  24. Salas Coronas J, Cruz Caparros G, Laynez Bretones F, Diez Garcia F. Hyperthyroidism secondary to kelp tablets ingestias. Med Clin (Barc). 2002;118:797–8.

    Google Scholar 

  25. Teas J, Pino S, Critchley A, Braverman LE. Variability of iodine content in common commercially available edible seaweeds. Thyroid. 2004;14:836–41.

    Article  CAS  Google Scholar 

  26. Dahl L, Johansson L, Julshamn K, Meltzer HM. The iodine content of Norwegian foods and diets. Public Health Nutr. 2004;7:569–76.

    Article  Google Scholar 

  27. Pennington JA, Young BE. Total diet study nutritional elements, 1982–1989. J Am Diet Assoc. 1991;91:179–83.

    Article  CAS  Google Scholar 

  28. Henzen C, Buess M, Brander L. Iodine-induced hyperthyroidism (iodine-induced Basedow’s disease): a current disease picture. Schweiz Med Wochenschr. 1999;129:658–64.

    CAS  Google Scholar 

  29. Ishizuki Y, Yamauchi K, Miura Y. Transient thyrotoxicosis induced by Japanese kombu. Nippon Naibunpi Gakkai Zasshi. 1989;65:91–8.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Endocrinology, Metabolism and Pathobiochemistry, Department of Internal Medicine, University Hospital of Tübingen, Germany

    Karsten Müssig MD, Claus Thamer MD, Hans-Ulrich Häring MD & Baptist Gallwitz MD

  2. Department of Nuclear Medicine, University Hospital of Tübingen, Germany

    Roland Bares MD

  3. Department of Pharmacy, University Hospital of Tübingen, Germany

    Hans-Peter Lipp PhD

  4. Medizinische Klinik IV, Universitätsklinikum Tübingen, Otfried-Müller-Strasse 10, D-72076, Tübingen, Germany

    Karsten Müssig MD

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  1. Karsten Müssig MD
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  2. Claus Thamer MD
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  3. Roland Bares MD
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  4. Hans-Peter Lipp PhD
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  5. Hans-Ulrich Häring MD
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  6. Baptist Gallwitz MD
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Corresponding author

Correspondence to Karsten Müssig MD.

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The authors contributed equally to this manuscript.

The authors have no conflicts of interest to declare.

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Müssig, K., Thamer, C., Bares, R. et al. Iodine-induced thyrotoxicosis after ingestion of kelp-containing tea. J Gen Intern Med 21, C11–C14 (2006). https://doi.org/10.1111/j.1525-1497.2006.0344.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.0344.x

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