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Adverse Effects of Iodine Deficiency and its Eradication by Iodine Supplementation

  • John T. Dunn
Part of the Contemporary Endocrinology book series (COE, volume 2)

Abstract

Iodine is an essential component of the thyroid hormones, thyroxine (T4) and 3, 5, 3 ′-triiodothyronine (T, ). Its deficiency leads to inadequate production of these hormones, which in turn produces a number of consequences, the so-called iodine deficiency disorders (IDD). This article reviews iodine metabolism by the thyroid, and the metabolic, clinical, and public health consequences of iodine deficiency and its correction. Aspects of these topics have already been reviewed extensively during the past decade (1–5).Here we build on previous summaries, point out new developments, and try to relate physiology to public health.

Keywords

Thyroid Hormone Iodine Deficiency Urinary Iodine Thyroid Volume Urinary Iodine Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Dunn JT, van der Haar F. A Practical Guide to the Correction of Iodine Deficiency. International Council for Control of Iodine Deficiency Disorders, The Netherlands, 1990.Google Scholar
  2. 2.
    Hetzel BS, Dunn JT.The iodine deficiency disorders: their nature and prevention. Ann Rev Nutr 1989; 9: 21–38.CrossRefGoogle Scholar
  3. 3.
    Dunn JT, Pretell EA, Daza GH, Viteri FE, eds. Towards the eradication of endemic goiter, cretinism, and iodine deficiency. Pan American Health Organization, Washington, DC, 1986.Google Scholar
  4. 4.
    Hetzel BS, Dunn JT, Stanbury JB. The Prevention and Control of Iodine Deficiency Disorders. Elsevier, Amsterdam, 1987.Google Scholar
  5. 5.
    Delange FM, Ermans A-M. Iodine deficiency. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid. A Fundamental and Clinical Text. Lippincott-Raven, Philadelphia, 1996, pp. 296–316.Google Scholar
  6. 6.
    Taurog A. Hormone synthesis. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid. A Fundamental and Clinical Text. Lippincott-Raven, Philadelphia, 1996, pp. 47–81.Google Scholar
  7. 7.
    Dunn AD. Thyroglobulin retrieval and the endocytic pathway. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid. A Fundamental and Clinical Text, Lippincott-Raven, Philadelphia, 1996, pp. 81–84.Google Scholar
  8. 8.
    Dunn JT. Thyroglobulin: chemistry and biosynthesis. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid. A Fundamental and Clinical Text, Lippincott-Raven, Philadelphia, 1996, pp. 85–95.Google Scholar
  9. 9.
    Dai G, Levy O, Carrasco N. Cloning and characterization of the thyroid iodide transporter. Nature 1996; 379: 458–460.PubMedCrossRefGoogle Scholar
  10. 10.
    Gavaret J-M, Nunez J, Cahnmann HJ. Formation of dehydroalanine residues during thyroid hormone synthesis in thyroglobulin. J Biol Chem 1980; 255: 5281–5285.PubMedGoogle Scholar
  11. 11.
    Dunn JT, Anderson PC, Fox JW, Fassler CA, Dunn AD, Hite LA, Moore RC. The sites of thyroid hormone formation in rabbit thyroglobulin. J Biol Chem 1987; 262:16, 948–16, 952.Google Scholar
  12. 12.
    Fassler CA, Dunn JT, Anderson PC, Fox JW, Dunn AD, Hite LA, Moore RC, Kim PS. Thyrotropin alters the utilization of thyroglobulin’s hormonogenic sites. J Biol Chem 1988; 263: 17, 366–17371.Google Scholar
  13. 13.
    Lamas L, Anderson PC, Fox JW, Dunn JT. Consensus sequences for early iodination and hormonogenesis in human thyroglobulin. J Biol Chem 1989; 264:13, 541–13, 545.Google Scholar
  14. 14.
    Dunn JT, Kim PS, Dunn AD. Favored sites for thyroid hormone formation on the peptide chains of human thyroglobulin. J Biol Chem 1982; 257: 88–94.PubMedGoogle Scholar
  15. 15.
    Roe MT, Anderson PC, Dunn AD, Dunn JT. The hormonogenic sites of turtle thyroglobulin and their homology with those of mammals. Endocrinology 1989; 124: 1327–1332.PubMedCrossRefGoogle Scholar
  16. 16.
    Dunn AD, Crutchfield HE, Dunn JT. Tg processing by thyroidal proteases: major sites of cleavage by cathepsins B, D, and L. J Biol Chem 1991; 266:20, 198–20, 204.Google Scholar
  17. 17.
    Dunn AD, Myers HE, Dunn JT. The combined action of two thyroidal proteases releases T4 from the dominant hormone-forming site of thyroglobulin. Endocrinology 1996; 137: 3279–3285.PubMedCrossRefGoogle Scholar
  18. 18.
    Medeiros-Neto G, Stanbury JB. Inherited Disorders of the Thyroid System. CRC, Boca Raton, 1994, pp. 139–159.Google Scholar
  19. 19.
    Delange F. Requirements of iodine in humans. In: Delange F, Dunn JT, Glinoer D, eds. Iodine Deficiency in Europe. A Continuing Concern. Plenum, New York, 1993, pp. 5–13.Google Scholar
  20. 20.
    Stanbury JB, ed. The damaged brain of iodine deficiency. Cognizant Communication Corporation, New York, 1994.Google Scholar
  21. 21.
    Bleichrodt N, Born MP. A metaanalysis of research on iodine and its relationship to cognitive development. In: Stanbury JB, ed. The damaged brain of iodine deficiency. Cognizant Communication Corporation, New York, 1994, pp. 195–200.Google Scholar
  22. 22.
    DeLong GR. The effect of iodine deficiency on neuromuscular development. IDD Newsletter 1990; 6 (3): 1–9.Google Scholar
  23. 23.
    Thilly C, Lagasse R, Roger G, Bourdoux P, Ermans AM. Impaired fetal and postnatal development and high perinatal death-rate in a severe iodine deficient area. In: Stockigt JR, Nagataki S, eds. Thyroid Research VIII. Proceedings of the Eighth International Thyroid Congress. Australian Academy of Science, Canberra, 1980, pp. 20–23.Google Scholar
  24. 24.
    Chaouki ML, Benmiloud M. Prevention of iodine deficiency disorders by oral administration of Lipiodol during pregnancy. Eur J Endocr 1994; 130: 547–551.CrossRefGoogle Scholar
  25. 25.
    Pharoah POD, Connolly KJ. A controlled trial of iodinated oil for the prevention of endemic cretinism: a long-term follow-up. Int J Epidemiol 1987; 16: 68–73.PubMedCrossRefGoogle Scholar
  26. 26.
    Li J, Wang X. Jixian: a success story in IDD control. IDD Newsletter 1987; 3 (1): 4–5.Google Scholar
  27. 27.
    Dunn JT. Societal implications of iodine deficiency and the value of its prevention. In: Stanbury JB, ed. The damaged brain of iodine deficiency. Cognizant Communication Corporation, New York, 1994, pp. 309–314.Google Scholar
  28. 28.
    Gutekunst R. Iodine deficiency costs Germany over one billion dollars per year. IDD Newsletter 1993; 9 (3): 29–31.Google Scholar
  29. 29.
    Aghini-Lombardi F, Antonangeli L, Vitti P, Pinchera A. Status of iodine nutrition in Italy. In: Delange F, Dunn JT, Glinoer D, eds. Iodine Deficiency in Europe. A Continuing Concern. Plenum, New York, 1993, pp. 403–408.Google Scholar
  30. 30.
    WHO, UNICEF, International Council for the Control of Iodine Deficiency Disorders. Indicators for assessing iodine deficiency disorders and their control through salt iodization. Geneva: WHO, 1994.Google Scholar
  31. 31.
    Perez C, Scrimshaw NS, Munoz JA. Technique of endemic goitre surveys. In: Endemic Goitre. World Health Organization, Geneva, 1960, pp. 369–383.Google Scholar
  32. 32.
    Gutekunst R. The value and application of ultrasonography in goiter surveys. IDD Newsletter 1990; 6 (4): 3–5.Google Scholar
  33. 33.
    Vitti P, Martino E, Aghini-Lombardi F, et al. Thyroid volume measurement by ultrasound in children as a tool for the assessment of mild iodine deficiency. J Clin Endocrinol Metab 1994; 79: 600–603.PubMedCrossRefGoogle Scholar
  34. 34.
    Ueda D. Normal volume of the thyroid gland in children. J Clin Ultrasound 1990; 18: 455–462.PubMedCrossRefGoogle Scholar
  35. 35.
    Dunn JT, Crutchfield HE, Gutekunst R, Dunn AD. Two simple methods for measuring iodine in urine. Thyroid 1993; 3: 119–123.PubMedCrossRefGoogle Scholar
  36. 36.
    Dunn JT, Crutchfield HE, Gutekunst R, Dunn AD. Methods for measuring iodine in urine. International Council for the Control of Iodine Deficiency Disorders, Wageningen, 1993.Google Scholar
  37. 37.
    Bourdoux P, Thilly C, Delange C, Ermans AM. A new look at old concepts in laboratory evaluation of endemic goiter. In: Dunn JT, Pretell EA, Daza CH, Viteri FE, eds. Towards the eradication of endemic goiter, cretinism, and iodine deficiency. Scientific Publication No. 502, Pan American Health Organization, Washington, 1986, pp. 115–128.Google Scholar
  38. 38.
    Benmiloud M, Chaouki ML, Gutekunst R, Teichert H-M, Wood WG, Dunn JT. Oral iodized oil for correcting iodine deficiency: optimal dosing and outcome indicator selection. J Clin Endocrinol Metab 1994; 79: 20–24.PubMedCrossRefGoogle Scholar
  39. 39.
    Delange F, Heidemann P, Bourdoux P, Larsson A, Vigneri R, Klett M, Beckers C, Stubbe P. Regional variations of iodine nutrition and thyroid function during the neonatal period in Europe. Biol Neonat 1986; 49: 322–330.CrossRefGoogle Scholar
  40. 40.
    Missler U, Gutekunst R, Wood WG. Thyroglobulin is a more sensitive indicator of iodine deficiency than thyrotropin: development and evaluation of dry blood spot assays for thyrotropin and thyroglobulin in iodine-deficient geographical areas. Eur J Clin Chem Clin Biochem 1994; 32: 137–143.PubMedGoogle Scholar
  41. 41.
    Venkatesh Mannar MG, Dunn JT. Salt iodization for the elimination of iodine deficiency. International Council for the Control of Iodine Deficiency Disorders, Wageningen, 1995.Google Scholar
  42. 42.
    Dunn JT. Iodized oil in the treatment and prophylaxis of IDD. In: Hetzel BS, Dunn JT, Stanbury JB, eds. The Prevention and Control of Iodine Deficiency Disorders. Elsevier, 1987, pp. 127–134.Google Scholar
  43. 43.
    Dunn JT 1987 Alternatives to salt and oil for iodine supplementation. In: Hetzel BS, Dunn JT, Stanbury JB, eds. The Prevention and Control of Iodine Deficiency Disorders. Elsevier, 1987, pp. 135–138.Google Scholar
  44. 44.
    Suwanik R, Pleehachinda R, Pattanachak C, Pattanachak S, Chongchirasiri S, Tojinda N, Jaipetch T, Ingbar SH. Simple technology provides effective IDD control at the village level in Thailand. IDD Newsletter 1989; 5 (3): 1–6.Google Scholar
  45. 45.
    Squatrito S, Vigneri R, Runello F, Ermans AM, Polley RD, Ingbar SH. Prevention and treatment of endemic iodine-deficiency goiter by iodination of a municipal water supply. J Clin Endocrinol Metab 1986; 63: 368–375.PubMedCrossRefGoogle Scholar
  46. 46.
    Fisch A, Pichard E, Prazuck T, Sebbag R, Torres G, Gernez G, Gentilini M. A new approach to combatting iodine deficiency in developing countries: the controlled release of iodine in water by a silicone elastomer. Am J Public Health 1993; 83: 540–545.PubMedCrossRefGoogle Scholar
  47. 47.
    Cao X-Y, Jiang X-M, Kareem A, Dou Z-H, Rakeman MA, Zhang M-L, Ma T, O’Donnell K, DeLong N, DeLong GR. Iodination of irrigation water as a method of supplying iodine to a severely iodine-deficient population in Xinjiang, China. Lancet 1994; 344: 107–110.PubMedCrossRefGoogle Scholar
  48. 48.
    Pardo A. (personal communication), 1986.Google Scholar
  49. 49.
    Simescu M, Popescu R, Ionitiu D, Zbranca E, Grecu E, Marinescu E, Tintea L, Nicolaescu E, Purice M, Popa M, Gutekunst R. The status of iodine nutrition in Romania. In: Delange F, Dunn JT, Glinoer D, eds. Iodine Deficiency in Europe. A Continuing Concern. Plenum, New York, 1993, pp. 383–388.Google Scholar
  50. 50.
    Elnagar B. Iodine Supplementation in a Goitre Endemic Area. Uppsala University, 1996.Google Scholar
  51. 51.
    Glinoer D. Thyroid regulation during pregnancy In: Delange F, Dunn JT, Glinoer D, eds. Iodine Deficiency in Europe. A Continuing Concern. Plenum, New York, 1993, pp. 181–188.Google Scholar
  52. 52.
    Li J, Xin Z, Shu L, Yin B. Survey on the results of prevention and treatment of endemic goiter with iodized brick tea. IDD Newsletter 1989; 5 (4): 11.Google Scholar
  53. 53.
    Eltom M, Elnagar B, Sulieman A, Karlsson FA, Van Thi HV, Bourdoux P, Gebre-Medhin M. The use of iodised sugar as a vehicle for iodine fortification in endemic iodine deficiency. Int J Food Sci Nutr 1995; 46: 281–289.PubMedCrossRefGoogle Scholar
  54. 54.
    Gerasimov G, Nazarov A, Mayorova N, Schischkina A, Arbusova M, Mischenko B, Dedov I. Bread iodization for micronutrient supplementation in iodine deficient region of Russia. Program of the 11th International Thyroid Congress, Toronto, Ontario, 1995, p. S-40 (Abstract).Google Scholar
  55. 55.
    Dunn JT. Seven deadly sins in confronting endemic iodine deficiency, and how to avoid them. J Clin Endocrinol Metab 1996; 81: 1332–1335.PubMedCrossRefGoogle Scholar
  56. 56.
    Dunn JT. Monitoring of programs of iodine prophylaxis in industrialized countries. In: Delange F, Dunn JT, Glinoer D, eds. Iodine Deficiency in Europe: A Continuing Concern. Plenum, New York, 1993, pp. 285–289.Google Scholar
  57. 57.
    Bürgi H, Supersaxo Z, Selz B. Iodine deficiency diseases in Switzerland one hundred years after Theodor Kocher’s survey: a historical review with some new goitre prevalence data. Acta Endocrinologica (Copenh) 1990; 123: 577–590.Google Scholar
  58. 58.
    Markel H. “When it rains it pours”: endemic goiter, iodized salt, and David Murray Cowie, M.D. Am J Public Health 1987; 77:219–229.CrossRefGoogle Scholar
  59. 59.
    Todd CH, Allain T, Gomo ZAR, Hasler JA, Ndiweni M, Oken E. Increase in thyrotoxicosis associated with iodine supplements in Zimbabwe. Lancet 1995; 345: 1563–1564.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • John T. Dunn

There are no affiliations available

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