Iodine-Induced Thyroid Dysfunction

  • Simone De Leo
  • Lewis E. BravermanEmail author


Iodine is required for the synthesis of the thyroid hormones. Recommended daily iodine intake in adults is 150 μg daily, except in pregnant and lactating women who require higher amounts of iodine. The primary source of iodine is the diet, where iodine intake is predominantly obtained from dairy products, grains, and iodized salt. However, seaweed and other sources of iodine, including iodinated contrast media, nutritional supplements, and some medications, such as amiodarone and povidone-iodine, can be responsible for iodine excess. A healthy thyroid is able to adapt to iodine excess due to escape from the acute Wolff-Chaikoff effect. However, iodine excess can induce hypothyroidism, hyperthyroidism, and thyroid autoimmunity. Iodine-induced hypothyroidism is due to failure to escape from the acute Wolff-Chaikoff effect; it is typically transient and may not require treatment. Levothyroxine replacement therapy is necessary in some patients. Iodine-induced hyperthyroidism develops in patients with underlying autonomy of the thyroid, in which the iodine load acts as a substrate for the thyroid to produce excess amounts of thyroid hormones (Jod-Basedow phenomenon). It is usually transient and requires only treatment with β-blockers. Patients with severe or persistent hyperthyroidism require treatment with antithyroid drugs. Prophylactic treatment to avoid the onset of thyroid dysfunction after exposure to iodine excess is generally not recommended.


Iodine Thyroid hyperthyroidism Thyroid hypothyroidism 


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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Endocrine UnitFondazione IRCCS Cà GrandaMilanItaly
  2. 2.Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
  3. 3.Section of Endocrinology, Diabetes and NutritionBoston University School of MedicineBostonUSA

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