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The Thyroid and Its Diseases pp 435–452Cite as

Iodine-Induced Thyroid Dysfunction

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Abstract

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.

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Authors and Affiliations

  1. Endocrine Unit, Fondazione IRCCS Cà Granda, Milan, Italy

    Simone De Leo

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Simone De Leo

  3. Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, MA, USA

    Simone De Leo & Lewis E. Braverman

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  1. Simone De Leo
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  2. Lewis E. Braverman
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Correspondence to Lewis E. Braverman .

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  1. Department of Nuclear Medicine, Philipps University Marburg, Marburg, Germany

    Markus Luster

  2. Unit of Endocrinology Diabetes and Metabolism, Evgenidion Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Leonidas H. Duntas

  3. Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

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De Leo, S., Braverman, L.E. (2019). Iodine-Induced Thyroid Dysfunction. In: Luster, M., Duntas, L., Wartofsky, L. (eds) The Thyroid and Its Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-72102-6_31

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