OUTCOME OF LONG-TERM ANTITHYROID TREATMENT OF GRAVES' DISEASE IN RELATION TO IODINE INTAKE

1977 ◽  
Vol 84 (3) ◽  
pp. 538-541 ◽  
Author(s):  
I. B. Lumholtz ◽  
D. Loldrup Poulsen ◽  
K. Siersbœk-Nielsen ◽  
Th. Friis ◽  
P. Rogowski ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Iodine Intake ◽  
Term Treatment ◽  
Urinary Iodine Excretion ◽  
Graves Disease ◽  
High Relapse Rate ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Iodine Excretion

ABSTRACT Seventy-seven patients with Graves' disease, with an average of 56 years of age were treated with carbimazole in the period 1968–1975. The duration of therapy was on an average, 17.9 months and the follow-up on an average, 28.5 months. Remission was found only in 32 % of the patients. Data on the urinary iodine excretion from a total of 127 euthyroid controls and 15 patients with Graves' disease living in the same area were collected during the periods: 1962–1964, 1965–1968, 1971–1973 and 1972–1974. No significant difference was found in the urinary iodine excretion in the period 1962–1973 and no significant difference was found in the urinary iodine excretion between the patients with Graves' disease and the euthyroid controls. Our data demonstrate a high relapse rate following long-term treatment with anti-thyroid drugs in an area with relative low iodine intake.

scholarly journals Medical therapy of Graves' disease: effect on remission rates of methimazole alone and in combination with triiodothyronine

2000 ◽  
pp. 117-124 ◽  
Author(s):  
W Raber ◽  
E Kmen ◽  
W Waldhausl ◽  
H Vierhapper
Keyword(s):  
Randomized Study ◽  
Urinary Iodine ◽  
Antithyroid Drug ◽  
Iodine Intake ◽  
Fixed Dose ◽  
Urinary Iodine Excretion ◽  
Graves Disease ◽  
Significant Difference ◽  
Remission Rates ◽  
Iodine Excretion

In a prospective, randomized study of 135 newly diagnosed patients with hyperthyroidism due to Graves' disease we compared the effect on remission rates of additional triiodothyronine (T3) with conventional antithyroid drug therapy. To this end 114 patients were followed for at least 12 months (15.7+/-4.9, mean+/-s.d.) after the discontinuation of any therapy. After return of thyroid function to normal (8.5+/-7.4 weeks, mean+/-s.d.) patients were maintained on antithyroid medication for 9.0+/-2.5 months. They were then randomly assigned to one of three groups: group 1 (n=44) stopped methimazole, groups 2 (n=39) and 3 (n=31) continued with exogenous T3 (not exceeding 75 microgram/day in any patient) for a further 6 months either with (group 2) or without (group 3) a fixed dose of 10mg methimazole daily. The T3 dose was kept variable to keep TSH suppressed (<0. 1mU/l), which could be achieved in 82% of patients on 100% of their monthly visits. No serious side-effect requiring the discontinuation of the study occurred in any patient. Total T3, TSH-receptor antibodies and some previously suggested potential predictors of relapse including thyroid size by ultrasound, 24h urinary iodine excretion, history of cigarette smoking and ophthalmopathy were determined at the outset of the study and subsequently every 6 months (and total T3 every 4 weeks). No significant difference (P>0.05, Chi square) was seen in relapse of hyperthyroidism after a mean follow-up of 16 months (range: 12-31 months; groups 1:52%, 2:44% and 3:42%) in an area of low-to-moderate iodine intake (prevalence of 24h urinary iodine excretion <100 microgram/24h: 17 and 25% at two different measurements respectively). Concomitantly, no predictor of recurrence of disease could be identified, irrespective of treatment modality.

INFLUENCE OF THIAZIDES ON THYROID PARAMETERS IN MAN

1978 ◽  
Vol 89 (4) ◽  
pp. 673-678 ◽  
Author(s):  
Karine Bech ◽  
Lis Skovsted ◽  
Kaj Siersbæk-Nielsen ◽  
Jens Mølholm Hansen
Keyword(s):  
Arterial Hypertension ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Term Treatment ◽  
Distribution Volume ◽  
Long Term Treatment ◽  
Thyroid Uptake ◽  
Iodine Metabolism ◽  
Normal Controls

ABSTRACT Iodine metabolism and thyroid hormones in blood were studied in 19 men and 11 women who had been treated with thiazides for arterial hypertension from 1 month to 15 years. The results were compared with the findings from age-matched normal controls. No differences were found regarding 24-h 131I-thyroid uptake, thyroid iodide clearance, renal iodide clearance, plasma inorganic iodide, absolute iodine uptake (AIU), serum thyroxine (T4 (D)), resin T3 test (T3U) and TSH after TRH. Twenty-four-hour urinary iodine was higher in the patients treated with diuretics which could be explained by increased iodine intake. The findings of increased serum triiodothyronine (T3 (RIA)) and reverse T3 (rT3) might be due to changes in distribution volume in the thiazide-treated patients. Long-term treatment with thiazides in man do not lead to iodine depletion.

scholarly journals Iodine deficiency among Italian children and adolescents assessed through 24-hour urinary iodine excretion

2019 ◽  
Vol 109 (4) ◽  
pp. 1080-1087 ◽  
Author(s):  
Angelo Campanozzi ◽  
Irene Rutigliano ◽  
Paolo E Macchia ◽  
Gianpaolo De Filippo ◽  
Antonio Barbato ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Age Related ◽  
Italian Regions ◽  
Significant Difference ◽  
Iodine Excretion

ABSTRACTBackgroundIodine is an essential micronutrient for intellectual development in children. Information on iodine intakes based on 24-h urinary iodine excretion (UIE) is scant, because iodine status is only assessed by the measurement of urinary iodine concentration (UIC) in spot urine samples.ObjectivesThe aim of our study was to evaluate the iodine intake of school-age children and adolescents, using UIE measurement in 24-h urine collections.MethodsThe study population included 1270 healthy subjects (677 boys, 593 girls) aged 6–18 y (mean age ± SD: 10.3 ± 2.9) from 10 Italian regions. Daily iodine intake was estimated as UIE/0.92, based on the notion that $\sim$92% of the dietary iodine intake is absorbed. The adequacy of intakes was assessed according to the Dietary Reference Values for iodine of the European Food Safety Authority (EFSA). Body mass index (BMI) and UIC were also measured for each subject.ResultsBased on the scientific opinion of EFSA, 600 of 1270 subjects (47.2%) had a lower than adequate iodine intake, with a higher prevalence among girls (54.6%) compared with boys (40.2%) (P < 0.001). Although UIE and 24-h urinary volumes increased with age (P < 0.001), a progressive decrease in the percentage of subjects with iodine excretion <100 µg/24 h (P < 0.001) was observed, without any significant difference in the percentage of subjects with UIC <100 µg/L. No significant association was detected between BMI z-score and UIE (P = 0.603) or UIC (P = 0.869).ConclusionsA sizable proportion of our population, especially girls, appeared to be at risk of iodine inadequacy. The simple measurement of UIC could lead to underestimation of the occurrence of iodine deficiency in younger children, because of the age-related smaller urine volumes producing spuriously higher iodine concentrations.

scholarly journals Excess dietary iodine intake in long-term African refugees

2006 ◽  
Vol 9 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Andrew J Seal ◽  
Paul I Creeke ◽  
Daniella Gnat ◽  
Fathia Abdalla ◽  
Zahra Mirghani
Keyword(s):  
Urinary Iodine ◽  
Iodine Intake ◽  
Humanitarian Assistance ◽  
World Health ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Cross Sectional ◽  
Excessive Iodine ◽  
Iodine Excretion

AbstractObjectiveTo assess the iodine status of long-term refugees dependent on international food aid and humanitarian assistance.DesignA series of cross-sectional two-stage cluster or systematic random sample surveys which assessed urinary iodine excretion and the prevalence of visible goitre. Salt samples were also collected and tested for iodine content by titration.SettingSix refugee camps in East, North and Southern Africa.SubjectsMale and female adolescents aged 10–19 years.Main resultsThe median urinary iodine concentration (UIC) ranged from 254 to 1200 μg l−1 and in five of the camps exceeded the recommended maximum limit of 300 μg l−1, indicating excessive iodine intake. Visible goitre was assessed in four surveys where it ranged from 0.0 to 7.1%. The camp with the highest UIC also had the highest prevalence of visible goitre. The iodine concentrations in 11 salt samples from three camps were measured by titration and six of these exceeded the production-level concentration of 20 to 40 ppm recommended by the World Health Organization (WHO), but were all less than 100 ppm.ConclusionsExcessive consumption of iodine is occurring in most of the surveyed populations. Urgent revision of the level of salt iodisation is required to meet current WHO recommendations. However, the full cause of excessive iodine excretion remains unknown and further investigation is required urgently to identify the cause, assess any health impact and identify remedial action.

Sodium ipodate and methimazole in the long-term treatment of hyperthyroid Graves' disease

Metabolism ◽  
1993 ◽  
Vol 42 (4) ◽  
pp. 403-408 ◽  
Author(s):  
Elio Roti ◽  
Eliana Gardini ◽  
Roberta Minelli ◽  
Lina Bianconi ◽  
Lewis E. Braverman
Keyword(s):  
Term Treatment ◽  
Graves Disease ◽  
Long Term Treatment ◽  
Sodium Ipodate

scholarly journals Nationwide Representative Survey of Dietary Iodine Intake and Urinary Excretion in Postpartum Korean Women

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3955
Author(s):  
Do-Kyung Lee ◽  
Hunjoo Lee ◽  
Hyeyoung Lee ◽  
Taehyung Yoon ◽  
Seon-Joo Park ◽  
...  
Keyword(s):  
Large Scale ◽  
Urinary Iodine ◽  
Brown Seaweed ◽  
Nationwide Survey ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Korean Women ◽  
Spot Urine ◽  
Before And After ◽  
Iodine Excretion

Iodine is an essential component of thyroid hormones, but excessive iodine intake can lead to thyroid dysfunction. Traditionally, Korean mothers consume brown seaweed soup (miyeokguk), a high source of iodine, after childbirth. There is controversy regarding the effects of excessive postpartum iodine intake on the health of mothers and infants. Thus far, there have been no nationwide large-scale surveys regarding the status of iodine intake among postpartum women in Korea. Therefore, we conducted a nationwide survey of postpartum dietary iodine intake among Korean women. In total, 1054 Korean women aged ≥19 years, at less than 8 weeks postpartum, participated in this survey. Dietary data were collected using self-reported 2-day dietary records, along with before-and-after meal photos. To evaluate the correlation between dietary iodine and urinary iodine excretion (UIE), spot urine, and 24 h urine samples were collected from 98 and 29 participants, respectively. The mean daily iodine intake among all participants was 2945.6 μg, and it gradually decreased over time after childbirth. Dietary iodine intake was significantly correlated with 24 h UIE (r = 0.396, p < 0.05) and spot urine UIE (r = 0.312, p < 0.05). Follow-up studies are required to examine the influence of excessive postpartum iodine intake on thyroid health in mothers and their infants.

scholarly journals Preserved activation of thyrotropin receptor antibody to stimulate thyroid function despite long-term treatment in euthyroid patients with Graves' disease

1998 ◽  
pp. 281-285 ◽  
Author(s):  
M Akuzawa ◽  
M Murakami ◽  
M Yamada ◽  
T Satoh ◽  
H Shimizu ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Normal Subjects ◽  
Term Treatment ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Receptor Antibody ◽  
Thyrotropin Receptor Antibody ◽  
Long Term Treatment ◽  
Tsh Levels

Clinical evaluation was conducted to ascertain whether thyrotropin receptor antibody (TRAb) in the normal range may still be involved in the regulation of thyroid function after prolonged treatment for Graves' disease. All patients (n = 33) were treated with antithyroid drugs for an average of 10.6 years and were under euthyroid conditions in which normal blood levels of tri-iodothyronine (T3) were significantly correlated with blood thyrotropin (TSH) levels, but not with titers of TRAb. A significant correlation was observed between TRAb titer and thyroid-stimulating antibody (TSAb) activity. In contrast, this correlation was not found in normal subjects. After administration of T3 (75 microg daily for 8 days), the patients showed increased levels of T3 with concomitant suppression of TSH levels. Under these conditions, linear regression analysis showed significant correlations of TRAb titer and TSAb activity with 24-h thyroid radioiodine uptake (r = 0.641 and 0.621 respectively, P < 0.01), in contrast to declining blood thyroxine levels. Moreover, the immunoglobulin G (IgG) of the patients precipitated to a greater extent than IgG from normal subjects a peptide consisting of the amino acid sequence near the terminus of the human TSH receptor. These findings indicated that TRAb at normal levels possessed significant unremitting activities on thyroid function despite long-term treatment in euthyroid patients with Graves' disease.

Iodine and Goiter in Children

PEDIATRICS ◽  
1975 ◽  
Vol 56 (1) ◽  
pp. 82-90
Author(s):  
Frederick L. Trowbridge ◽  
Josip Matovinovic ◽  
Gordon D. McLaren ◽  
Milton Z. Nichaman
Keyword(s):  
United States ◽  
Urinary Iodine ◽  
The United States ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
High Iodine ◽  
Goiter Prevalence ◽  
Iodine Excretion ◽  
American Children

Goiter examination was performed on 7,785 children aged 9 to 16 years in four areas of the United States—Michigan, Kentucky, Texas, and Georgia. Urinary iodine and creatinine, thyroxine, protein-bound iodine, and plasma inorganic iodide determinations were made on 377 matched pairs of goitrous and nongoitrous control children. The overall prevalence of goiter was 6.8%. Most children with goiter had palpably but not visibly enlarged thyroids and showed no evidence of clinical or biochemical thyroid abnormality. Mean urinary iodine excretion was 452µg/gm of creatinine, many times the 50µg/gm of creatinine level used to define deficiency. Children with goiter and areas with high goiter prevalence tended to have higher rather than lower iodine excretion. These findings are consistent with other data indicating high iodine intakes in the United States and suggest that goiter in American children cannot be assumed to be related to iodine deficiency. The possible role of high iodine intake in the causation of goiter is discussed.

scholarly journals Chronic iodine excess does not increase the incidence of hyperthyroidism: a prospective community-based epidemiological survey in China

2007 ◽  
Vol 156 (4) ◽  
pp. 403-408 ◽  
Author(s):  
Fan Yang ◽  
Zhongyan Shan ◽  
Xiaochun Teng ◽  
Yushu Li ◽  
Haixia Guan ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase ◽  
Community Based ◽  
Iodine Excess ◽  
Iodine Supplementation ◽  
Excessive Iodine ◽  
Iodine Excretion ◽  
Excessive Iodine Intake

Objective: An increasing incidence of hyperthyroidism has been observed when iodine supplementation has been introduced to an iodine-deficient population. Moreover, the influence of chronic more than adequate or excessive iodine intake on the epidemiological features of hyperthyroidism has not been widely and thoroughly described. To investigate the influences of different iodine intake levels on the incidence of hyperthyroidism, we conducted a prospective community-based survey in three communities with mild-deficient, more than adequate (previously mild deficient iodine intake), and excessive iodine intake. Subjects and methods: In three rural Chinese communities, a total of 3761 unselected inhabitants aged above 13 years participated in the original investigation and 3018 of them received identical examinations after 5 years. Thyroid function, levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody and urinary iodine excretion were measured and thyroid ultrasound examination was also performed. Results: In three communities, median urinary iodine excretion was 88, 214, and 634 μg/l (P<0.05) respectively. The cumulative incidence of hyperthyroidism was 1.4, 0.9, and 0.8% (P>0.05) respectively. Autoimmune hyperthyroidism was predominant in thyroid hyperfunction in all the three cohorts. Either positive TPOAb (>50 U/ml) or goiter in original healthy participants was associated with the occurrence of unsuspected hyperthyroidism in 5 years (logistic regression, OR=4.2 (95% CI 1.7–8.8) for positive TPOAb, OR=3.1 (95% CI 1.4–6.8) for goiter). Conclusion: Iodine supplementation may not induce an increase in hyperthyroidism in a previously mildly iodine-deficient population. Chronic iodine excess does not apparently increase the risk of autoimmune hyperthyroidism, suggesting that excessive iodine intake may not be an environmental factor involved in the occurrence of autoimmune hyperthyroidism.

scholarly journals Iodine bioavailability from cow milk: a randomized, crossover balance study in healthy iodine-replete adults

2019 ◽  
Vol 110 (1) ◽  
pp. 102-110 ◽  
Author(s):  
Olivia L van der Reijden ◽  
Valeria Galetti ◽  
Sarah Bürki ◽  
Christophe Zeder ◽  
Adam Krzystek ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Iodine Intake ◽  
Cow Milk ◽  
Urinary Iodine Excretion ◽  
High Concentration ◽  
Total Iodine ◽  
Balance Study ◽  
Iodine Absorption ◽  
Iodine Excretion ◽  
Potential Matrix

ABSTRACTBackgroundMilk and dairy products are considered important dietary sources of iodine in many countries. However, to our knowledge, iodine bioavailability from milk has not been directly measured in humans.ObjectiveThe aim of this study was to compare iodine bioavailability in iodine-replete adults from: 1) cow milk containing a high concentration of native iodine; 2) milk containing a low concentration of native iodine, with the addition of potassium iodide (KI) to assess a potential matrix effect; and 3) an aqueous solution of KI as a comparator; with all 3 containing equal amounts of total iodine (263 µg/250 mL). We also speciated iodine in milk.DesignWe conducted a 3-wk, randomized, crossover balance study in adults (n = 12) consuming directly analyzed, standardized diets. During the 3 test conditions — high intrinsic iodine milk (IIM), extrinsically added iodine in milk (EIM), and aqueous iodine solution (AIS) — subjects collected 24-h urine over 3 d and consumed the test drink on the second day, with 3- or 4-d wash-out periods prior to each treatment. Iodine absorption was calculated as the ratio of urinary iodine excretion (UIE) to total iodine intake. Milk iodine speciation was performed using ion chromatography-mass spectrometry.ResultsIodine intake from the standardized diet was 195 ± 6 µg/d for males and 107 ± 6 µg/d for females; the test drinks provided an additional 263 µg. Eleven subjects completed the protocol. There was a linear relation between iodine intake and UIE (β = 0.89, SE = 0.04, P < 0.001). There were no significant differences in UIE among the 3 conditions (P = 0.24). Median (range) fractional iodine absorption across the 3 conditions was 91 (51–145), 72 (48–95), and 98 (51–143)% on days 1, 2, and 3, respectively, with day 2 significantly lower compared with days 1 and 3 (P < 0.001). In milk, 80–93% of the total iodine was inorganic iodide.ConclusionNearly all of the iodine in cow milk is iodide and although fractional iodine absorption from milk decreases with increasing dose, its bioavailability is high. The trial was registered at clinicaltrials.gov as NCT03590431.

Sign in / Sign up

Export Citation Format

Share Document