Advertisement

Iodine-Induced Thyroid Dysfunction

  • Simone De Leo
  • Lewis E. BravermanEmail author
Chapter

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.

Keywords

Iodine Thyroid hyperthyroidism Thyroid hypothyroidism 

References

  1. 1.
    Du Y, Gao Y, Meng F, Liu S, Fan Z, Wu J, et al. Iodine deficiency and excess coexist in china and induce thyroid dysfunction and disease: a cross-sectional study. PLoS One. 2014;9:e111937.  https://doi.org/10.1371/journal.pone.0111937.CrossRefPubMedCentralPubMedGoogle Scholar
  2. 2.
    Zhao H, Tian Y, Liu Z, Li X, Feng M, Huang T. Correlation between iodine intake and thyroid disorders: a cross-sectional study from the South of China. Biol Trace Elem Res. 2014;162:87–94.  https://doi.org/10.1007/s12011-014-0102-9.CrossRefGoogle Scholar
  3. 3.
    Kotwal A, Kotwal J, Prakash R, Kotwal N. Does iodine excess lead to hypothyroidism? Evidence from a case-control study in India. Arch Med Res. 2015;46:490–4.  https://doi.org/10.1016/j.arcmed.2015.07.005.CrossRefGoogle Scholar
  4. 4.
    Zimmermann MB. Iodine deficiency and excess in children: worldwide status in 2013. Endocr Pract. 2013;19:839–46.  https://doi.org/10.4158/EP13180.RA.CrossRefGoogle Scholar
  5. 5.
    Shi X, Han C, Li C, Mao J, Wang W, Xie X, et al. Optimal and safe upper limits of iodine intake for early pregnancy in iodine-sufficient regions: a cross-sectional study of 7190 pregnant women in China. J Clin Endocrinol Metab. 2015;100:1630–8.  https://doi.org/10.1210/jc.2014-3704.CrossRefGoogle Scholar
  6. 6.
    Food and Nutrition Board, Institute of Medicine. Dietary reference intakes. Washington, DC: National Academy Press; 2006. p. 320–7.Google Scholar
  7. 7.
    WHO, UN Children’s Fund, International Council for the Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers. 3rd ed. Geneva: World Health Organization; 2007.Google Scholar
  8. 8.
    European Food Safety Authority. Scientific opinion on dietary reference values for iodine EFSA Panel on Dietetic Products, Nutrition and Allergies. EFSA J. 2014;12:3660.  https://doi.org/10.2903/j.efsa.2014.3660.CrossRefGoogle Scholar
  9. 9.
    European Commission. Health & Consumer Protection Directorate-General. Scientific Committee on Food. Opinion of the Scientific Committee on Food on the Tolerable Upper Intake Level of Iodine. 2002. http://ec.europa.eu/food/fs/sc/scf/out146_en.pdf. Accessed 16 May 2016.
  10. 10.
    De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:2543–65.  https://doi.org/10.1210/jc.2011-2803.CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Zimmermann MB, Andersson M. Assessment of iodine nutrition in populations: past, present, and future. Nutr Rev. 2012;70:553–70.  https://doi.org/10.1111/j.1753-4887.2012.00528.x.CrossRefPubMedGoogle Scholar
  12. 12.
    Nath SK, Moinier B, Thuillier F, Rongier M, Desjeux JF. Urinary excretion of iodide and fluoride from supplemented food grade salt. Int J Vitam Nutr Res. 1992;62:66–72.Google Scholar
  13. 13.
    Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Andersen S, Rasmussen LB, et al. Estimation of iodine intake from various urinary iodine measurements in population studies. Thyroid. 2009;19:1281–6.  https://doi.org/10.1089/thy.2009.0094.CrossRefGoogle Scholar
  14. 14.
    Rasmussen LB, Ovesen L, Christiansen E. Day-to-day and within-day variation in urinary iodine excretion. Eur J Clin Nutr. 1999;53:401–7.CrossRefGoogle Scholar
  15. 15.
    Als C, Helbling A, Peter K, Haldimann M, Zimmerli B, Gerber H. Urinary iodine concentration follows a circadian rhythm: a study with 3023 spot urine samples in adults and children. J Clin Endocrinol Metab. 2000;85:1367–9.Google Scholar
  16. 16.
    König F, Andersson M, Hotz K, Aeberli I, Zimmermann MB. Ten repeat collections for urinary iodine from spot samples or 24-hour samples are needed to reliably estimate individual iodine status in women. J Nutr. 2011;141:2049–54.  https://doi.org/10.3945/jn.111.144071.CrossRefGoogle Scholar
  17. 17.
    Andersen S, Karmisholt J, Pedersen KM, Laurberg P. Reliability of studies of iodine intake and recommendations for number of samples in groups and in individuals. Br J Nutr. 2008;99:813–8.Google Scholar
  18. 18.
    Chen W, Wu Y, Lin L, Tan L, Shen J, Pearce EN, et al. 24-Hour urine samples are more reproducible than spot urine samples for evaluation of iodine status in school-age children. J Nutr. 2016;146:142–6.  https://doi.org/10.3945/jn.115.215806.CrossRefGoogle Scholar
  19. 19.
    Perrine CG, Cogswell ME, Swanson CA, Sullivan KM, Chen TC, Carriquiry AL, et al. Comparison of population iodine estimates from 24-hour urine and timed-spot urine samples. Thyroid. 2014;24:748–57.  https://doi.org/10.1089/thy.2013.0404.CrossRefPubMedCentralPubMedGoogle Scholar
  20. 20.
    Ji C, Lu T, Dary O, Legetic B, Campbell NR, Cappuccio FP. Systematic review of studies evaluating urinary iodine concentration as a predictor of 24-hour urinary iodine excretion for estimating population iodine intake. Rev Panam Salud Publica. 2015;38:73–81.Google Scholar
  21. 21.
    Johner SA, Thamm M, Schmitz R, Remer T. Examination of iodine status in the German population: an example for methodological pitfalls of the current approach of iodine status assessment. Eur J Nutr. 2016;55:1275–82.  https://doi.org/10.1007/s00394-015-0941-y.CrossRefGoogle Scholar
  22. 22.
    Montenegro-Bethancourt G, Johner SA, Stehle P, Neubert A, Remer T. Iodine status assessment in children: spot urine iodine concentration reasonably reflects true twenty-four-hour iodine excretion only when scaled to creatinine. Thyroid. 2015;25:688–97.  https://doi.org/10.1089/thy.2015.0006.CrossRefGoogle Scholar
  23. 23.
    Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Carlé A, Pedersen IB, et al. Thyroglobulin as a marker of iodine nutrition status in the general population. Eur J Endocrinol. 2009;161:475–81.  https://doi.org/10.1530/EJE-09-0262.CrossRefPubMedGoogle Scholar
  24. 24.
    Ma ZF, Venn BJ, Manning PJ, Cameron CM, Skeaff SA. Iodine supplementation of mildly iodine-deficient adults lowers thyroglobulin: a randomized controlled trial. J Clin Endocrinol Metab. 2016;101:1737–44.  https://doi.org/10.1210/jc.2015-3591.CrossRefGoogle Scholar
  25. 25.
    Zimmermann MB, Ito Y, Hess SY, Fujieda K, Molinari L. High thyroid volume in children with excess dietary iodine intakes. Am J Clin Nutr. 2005;81(4):840.CrossRefPubMedGoogle Scholar
  26. 26.
    Zimmermann MB, de Benoist B, Corigliano S, Jooste PL, Molinari L, Moosa K, et al. Assessment of iodine status using dried blood spot thyroglobulin: development of reference material and establishment of an international reference range in iodine-sufficient children. J Clin Endocrinol Metab. 2006;91:4881–7.CrossRefGoogle Scholar
  27. 27.
    Zimmermann MB, Aeberli I, Andersson M, Assey V, Yorg JA, Jooste P, et al. Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100-299 μg/L: a UNICEF/ICCIDD study group report. J Clin Endocrinol Metab. 2013;98:1271–80.  https://doi.org/10.1210/jc.2012-3952.CrossRefPubMedGoogle Scholar
  28. 28.
    Wolff J, Chaikoff IL. Plasma inorganic iodide as a homeostatic regulator of thyroid function. J Biol Chem. 1948;174:555–64.PubMedCentralPubMedGoogle Scholar
  29. 29.
    Markou K, Georgopoulos N, Kyriazopoulou V, Vagenakis AG. Iodine-Induced hypothyroidism. Thyroid. 2001;11:501–10.CrossRefGoogle Scholar
  30. 30.
    Dugrillon A. Iodolactones and iodoaldehydes—mediators of iodine in thyroid autoregulation. Exp Clin Endocrinol Diabetes. 1996;104(Suppl 4):41–5.Google Scholar
  31. 31.
    Thomasz L, Oglio R, Rivandeira DT, Dagrosa MA, Jahn G, Pignataro OP, et al. Inhibition of goiter growth and of cyclic AMP formation in rat thyroid by 2-iodohexadecanal. Mol Cell Endocrinol. 2010;317:141–7.  https://doi.org/10.1016/j.mce.2009.12.026.CrossRefGoogle Scholar
  32. 32.
    de Souza EC, Dias GR, Cardoso RC, Lima LP, Fortunato RS, Visser TJ, et al. MCT8 is downregulated by short time iodine overload in the thyroid gland of rats. Horm Metab Res. 2015;47:910–5.  https://doi.org/10.1055/s-0035-1550008.CrossRefGoogle Scholar
  33. 33.
    Braverman LE, Iingbar SH. Changes in thyroidal function during adaptation to large doses of iodide. J Clin Invest. 1963;42:1216–31.CrossRefPubMedGoogle Scholar
  34. 34.
    Dai G, Levy O, Carrasco N. Cloning and characterization of the thyroid iodide transporter. Nature. 1996;379:458–60.CrossRefGoogle Scholar
  35. 35.
    Darrouzet E, Lindenthal S, Marcellin D, Pellequer JL, Pourcher T. The sodium/iodide symporter: state of the art of its molecular characterization. Biochim Biophys Acta. 1838;2014:244–53.  https://doi.org/10.1016/j.bbamem.2013.08.013.CrossRefGoogle Scholar
  36. 36.
    Eng PH, Cardona GR, Fang SL, Previti M, Alex S, Carrasco N, et al. Escape from the acute Wolff-Chaikoff effect is associated with a decrease in thyroid sodium/iodide symporter messenger ribonucleic acid and protein. Endocrinology. 1999;140:3404–10.CrossRefGoogle Scholar
  37. 37.
    Leoni SG, Kimura ET, Santisteban P, De la Vieja A. Regulation of thyroid oxidative state by thioredoxin reductase has a crucial role in thyroid responses to iodide excess. Mol Endocrinol. 2011;25:1924–35.  https://doi.org/10.1210/me.2011-0038.CrossRefPubMedCentralPubMedGoogle Scholar
  38. 38.
    Arriagada AA, Albornoz E, Opazo MC, Becerra A, Vidal G, Fardella C, et al. Excess iodide induces an acute inhibition of the sodium/iodide symporter in thyroid male rat cells by increasing reactive oxygen species. Endocrinology. 2015;156:1540–51.  https://doi.org/10.1210/en.2014-1371.CrossRefPubMedCentralPubMedGoogle Scholar
  39. 39.
    Serrano-Nascimento C, da Silva Teixeira S, Nicola JP, Nachbar RT, Masini-Repiso AM, Nunes MT. The acute inhibitory effect of iodide excess on sodium/iodide symporter expression and activity involves the PI3K/Akt signaling pathway. Endocrinology. 2014;155:1145–56.  https://doi.org/10.1210/en.2013-1665.CrossRefGoogle Scholar
  40. 40.
    Serrano-Nascimento C, Nicola JP, Teixeira Sda S, Poyares LL, Lellis-Santos C, Bordin S, et al. Excess iodide downregulates Na(+)/I(−) symporter gene transcription through activation of PI3K/Akt pathway. Mol Cell Endocrinol. 2016;426:73–90.  https://doi.org/10.1016/j.mce.2016.02.006.CrossRefGoogle Scholar
  41. 41.
    JC S-S, Villalobos P, Orozco A, Delgado G, Quintanar-Stephano A, Garcia-Solis P, et al. Inhibition of intrathyroidal dehalogenation by iodide. J Endocrinol. 2011;208:89–96.  https://doi.org/10.1677/JOE-10-0300.CrossRefGoogle Scholar
  42. 42.
    Calil-Silveira J, Serrano-Nascimento C, Kopp PA, Nunes MT. Iodide excess regulates its own efflux: a possible involvement of pendrin. Am J Physiol Cell Physiol. 2016;310:C576–82.  https://doi.org/10.1152/ajpcell.00210.2015.CrossRefPubMedCentralPubMedGoogle Scholar
  43. 43.
    Calil-Silveira J, Serrano-Nascimento C, Nunes MT. Iodide treatment acutely increases pendrin (SLC26A4) mRNA expression in the rat thyroid and the PCCl3 thyroid cell line by transcriptional mechanisms. Mol Cell Endocrinol. 2012;350:118–24.  https://doi.org/10.1016/j.mce.2011.12.002.CrossRefGoogle Scholar
  44. 44.
    Iglehart JK. Health insurers and medical-imaging policy—a work in progress. N Engl J Med. 2009;360:1030–7.  https://doi.org/10.1056/NEJMhpr0808703.CrossRefGoogle Scholar
  45. 45.
    Medicare Payment Advisory Commission. A data book: health care spending and the medicare program. 2013. http://www.medpac.gov/documents/publications/jun14databookentirereport.pdf. Accessed 16 May 2016.
  46. 46.
    Lee SY, Rhee CM, Leung AM, Braverman LE, Brent GA, Pearce EN. A review: radiographic iodinated contrast media-induced thyroid dysfunction. J Clin Endocrinol Metab. 2015;100:376–83.  https://doi.org/10.1210/jc.2014-3292.CrossRefGoogle Scholar
  47. 47.
    American College of Radiology. ACR manual on contrast media. Version 10.1. ACR Committee on Drugs and Contrast Media. 2015. http://www.acr.org/~/media/37D84428BF1D4E1B9A3A2918DA9E27A3.pdf. Accessed 16 May 2016.
  48. 48.
    van der Molen AJ, Thomsen HS, Morcos SK. Contrast Media Safety Committee European Society of Urogenital Radiology (ESUR). Effect of iodinated contrast media on thyroid function in adults. Eur Radiol. 2004;14:902–7.CrossRefGoogle Scholar
  49. 49.
    Barr ML, Chiu HK, Li N, Yeh MW, Rhee CM, Casillas J, et al. Thyroid dysfunction in children exposed to iodinated contrast media. J Clin Endocrinol Metab. 2016;101(6):2366–70.  https://doi.org/10.1210/jc.2016-1330.CrossRefPubMedCentralPubMedGoogle Scholar
  50. 50.
    Rhee CM, Bhan I, Alexander EK, Brunelli S. Association between iodinated contrast media exposure and incident hyperthyroidism and hypothyroidism. Arch Intern Med. 2012;172:153–9.  https://doi.org/10.1001/archinternmed.2011.677.CrossRefGoogle Scholar
  51. 51.
    Hsieh MS, Chiu CS, Chen WC, Chiang JH, Lin SY, Lin MY, et al. Iodinated contrast medium exposure during computed tomography increase the risk of subsequent development of thyroid disorders in patients without known thyroid disease: a nationwide population-based, propensity score-matched, longitudinal follow-up study. Medicine (Baltimore). 2015;94:e2279.  https://doi.org/10.1097/MD.0000000000002279.CrossRefGoogle Scholar
  52. 52.
    Kornelius E, Chiou JY, Yang YS, Peng CH, Lai YR, Huang CN. Iodinated contrast media increased the risk of thyroid dysfunction: a 6-year retrospective cohort study. J Clin Endocrinol Metab. 2015;100(9):3372.  https://doi.org/10.1210/JC.2015-2329.CrossRefGoogle Scholar
  53. 53.
    Marraccini P, Bianchi M, Bottoni A, Mazzarisi A, Coceani M, Molinaro S, et al. Prevalence of thyroid dysfunction and effect of contrast medium on thyroid metabolism in cardiac patients undergoing coronary angiography. Acta Radiol. 2013;54:42–7.  https://doi.org/10.1258/ar.2012.120326.CrossRefGoogle Scholar
  54. 54.
    Özkan S, Oysu AS, Kayataş K, Demirtunç R, Eren M, Uslu H, et al. Thyroid functions after contrast agent administration for coronary angiography: a prospective observational study in euthyroid patients. Anadolu Kardiyol Derg. 2013;13:363–9.  https://doi.org/10.5152/akd.2013.134.CrossRefGoogle Scholar
  55. 55.
    Jarvis C, Simcox K, Tamatea JA, McAnulty K, Meyer-Rochow GY, Conaglen JV, et al. A low incidence of iodine-induced hyperthyroidism following administration of iodinated contrast in an iodine-deficient region. Clin Endocrinol (Oxf). 2016;84:558–63.  https://doi.org/10.1111/cen.12818.CrossRefGoogle Scholar
  56. 56.
    Kaneshige T, Arata N, Harada S, Ohashi T, Sato S, Umehara N, et al. Changes in serum iodine concentration, urinary iodine excretion and thyroid function after hysterosalpingography using an oil-soluble iodinated contrast medium (lipiodol). J Clin Endocrinol Metab. 2015;100:E469–72.  https://doi.org/10.1210/jc.2014-2731.CrossRefGoogle Scholar
  57. 57.
    Lee SY, Chang DL, He X, Pearce EN, Braverman LE, Leung AM. Urinary iodine excretion and serum thyroid function in adults after iodinated contrast administration. Thyroid. 2015;25:471–7.  https://doi.org/10.1089/thy.2015.0024.CrossRefPubMedCentralPubMedGoogle Scholar
  58. 58.
    Nimmons GL, Funk GF, Graham MM, Pagedar NA. Urinary iodine excretion after contrast computed tomography scan: implications for radioactive iodine use. JAMA Otolaryngol Head Neck Surg. 2013;139:479–82.  https://doi.org/10.1001/jamaoto.2013.2552.CrossRefGoogle Scholar
  59. 59.
    Padovani RP, Kasamatsu TS, Nakabashi CC, Camacho CP, Andreoni DM, Malouf EZ, et al. One month is sufficient for urinary iodine to return to its baseline value after the use of water-soluble iodinated contrast agents in post-thyroidectomy patients requiring radioiodine therapy. Thyroid. 2012;22:926–30.  https://doi.org/10.1089/thy.2012.0099.CrossRefPubMedCentralPubMedGoogle Scholar
  60. 60.
    Ho JD, Tsang JF, Scoggan KA, Leslie WD. Urinary iodine clearance following iodinated contrast administration: a comparison of euthyroid and postthyroidectomy subjects. J Thyroid Res. 2014;2014:580569.  https://doi.org/10.1155/2014/580569.CrossRefPubMedCentralPubMedGoogle Scholar
  61. 61.
    Sohn SY, Choi JH, Kim NK, Joung JY, Cho YY, Park SM, et al. The impact of iodinated contrast agent administered during preoperative computed tomography scan on body iodine pool in patients with differentiated thyroid cancer preparing for radioactive iodine treatment. Thyroid. 2014;24:872–7.  https://doi.org/10.1089/thy.2013.0238.CrossRefPubMedGoogle Scholar
  62. 62.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1–133.  https://doi.org/10.1089/thy.2015.0020.CrossRefPubMedCentralPubMedGoogle Scholar
  63. 63.
    Thomsen HS, Faber J. Iodine-based contrast media cause hyperthyroidism—another important adverse reaction to contrast media? Acta Radiol. 2012;53:1079–80.  https://doi.org/10.1258/ar.2012.12A013.CrossRefGoogle Scholar
  64. 64.
    Pearce EN. Iodine-induced thyroid dysfunction: comment on “association between iodinated contrast media exposure and incident hyperthyroidism and hypothyroidism”. Arch Intern Med. 2012;172:159–61.  https://doi.org/10.1001/archinternmed.2011.1396.CrossRefGoogle Scholar
  65. 65.
    Braverman LE. Effects of iodine on thyroid function in man. Trans Am Clin Climatol Assoc. 1991;102:143–51.PubMedCentralPubMedGoogle Scholar
  66. 66.
    Atwell TD, Lteif AN, Brown DL, McCann M, Townsend JE, Leroy AJ. Neonatal thyroid function after administration of IV iodinated contrast agent to 21 pregnant patients. AJR Am J Roentgenol. 2008;191:268–71.  https://doi.org/10.2214/AJR.07.3336.CrossRefGoogle Scholar
  67. 67.
    Bourjeily G, Chalhoub M, Phornphutkul C, Alleyne TC, Woodfield CA, Chen KK. Neonatal thyroid function: effect of a single exposure to iodinated contrast medium in utero. Radiology. 2010;256:744–50.  https://doi.org/10.1148/radiol.10100163.CrossRefGoogle Scholar
  68. 68.
    Rajaram S, Exley CE, Fairlie F, Matthews S. Effect of antenatal iodinated contrast agent on neonatal thyroid function. Br J Radiol. 2012;85:e238–42.  https://doi.org/10.1259/bjr/29806327.CrossRefPubMedCentralPubMedGoogle Scholar
  69. 69.
    Kochi MH, Kaloudis EV, Ahmed W, Moore WH. Effect of in utero exposure of iodinated intravenous contrast on neonatal thyroid function. J Comput Assist Tomogr. 2012;36:165–9.  https://doi.org/10.1097/RCT.0b013e31824cc048.CrossRefGoogle Scholar
  70. 70.
    Webb JA, Thomsen HS, Morcos SK. Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 2005;15:1234–40.CrossRefGoogle Scholar
  71. 71.
    Ahmet A, Lawson ML, Babyn P, Tricco AC. Hypothyroidism in neonates post-iodinated contrast media: a systematic review. Acta Paediatr. 2009;98:1568–74.  https://doi.org/10.1111/j.1651-2227.2009.01412.x.CrossRefGoogle Scholar
  72. 72.
    Thaker VV, Leung AM, Braverman LE, Brown RS, Levine B. Iodine-induced hypothyroidism in full-term infants with congenital heart disease: more common than currently appreciated? J Clin Endocrinol Metab. 2014;99:3521–6.  https://doi.org/10.1210/jc.2014-1956.CrossRefPubMedCentralPubMedGoogle Scholar
  73. 73.
    Leung AM, Braverman LE. Consequences of excess iodine. Nat Rev Endocrinol. 2014;10:136–42.  https://doi.org/10.1038/nrendo.2013.251.CrossRefGoogle Scholar
  74. 74.
    Pearce EN, Pino S, He X, Bazrafshan HR, Lee SL, Braverman LE. Sources of dietary iodine: bread, cows’ milk, and infant formula in the Boston area. J Clin Endocrinol Metab. 2004;89:3421–4.CrossRefGoogle Scholar
  75. 75.
    Perrine CG, Sullivan KM, Flores R, Caldwell KL, Grummer-Strawn LM. Intakes of dairy products and dietary supplements are positively associated with iodine status among U.S. children. J Nutr. 2013;143:1155–60.  https://doi.org/10.3945/jn.113.176289.CrossRefPubMedCentralPubMedGoogle Scholar
  76. 76.
    Murray CW, Egan SK, Kim H, Beru N, Bolger PM. US Food and Drug Administration’s Total Diet Study: dietary intake of perchlorate and iodine. J Expo Sci Environ Epidemiol. 2008;18:571–80.  https://doi.org/10.1038/sj.jes.7500648.CrossRefGoogle Scholar
  77. 77.
    Zava TT, Zava DT. Assessment of Japanese iodine intake based on seaweed consumption in Japan: a literature-based analysis. Thyroid Res. 2011;4:14.  https://doi.org/10.1186/1756-6614-4-14.CrossRefPubMedCentralPubMedGoogle Scholar
  78. 78.
    Teas J, Pino S, Critchley A, Braverman LE. Variability of iodine content in common commercially available edible seaweeds. Thyroid. 2004;14:836–41.CrossRefGoogle Scholar
  79. 79.
    Teas J, Braverman LE, Kurzer MS, Pino S, Hurley TG, Hebert JR. Seaweed and soy: companion foods in Asian cuisine and their effects on thyroid function in American women. J Med Food. 2007;10:90–100.CrossRefGoogle Scholar
  80. 80.
    Miyai K, Tokushige T, Kondo M, Iodine Research Group. Suppression of thyroid function during ingestion of seaweed “Kombu” (Laminaria japonica) in normal Japanese adults. Endocr J. 2008;55:1103–8.CrossRefGoogle Scholar
  81. 81.
    Rhee SS, Braverman LE, Pino S, He X, Pearce EN. High iodine content of Korean seaweed soup: a health risk for lactating women and their infants? Thyroid. 2011;21(8):927.  https://doi.org/10.1089/thy.2011.0084.CrossRefGoogle Scholar
  82. 82.
    Chung HR, Shin CH, Yang SW, Choi CW, Kim BI. Subclinical hypothyroidism in Korean preterm infants associated with high levels of iodine in breast milk. J Clin Endocrinol Metab. 2009;94:4444–7.  https://doi.org/10.1210/jc.2009-0632.CrossRefGoogle Scholar
  83. 83.
    Michikawa T, Inoue M, Shimazu T, Sawada N, Iwasaki M, Sasazuki S, et al. Seaweed consumption and the risk of thyroid cancer in women: the Japan Public Health Center-based Prospective Study. Eur J Cancer Prev. 2012;21:254–60.  https://doi.org/10.1097/CEJ.0b013e32834a8042.CrossRefGoogle Scholar
  84. 84.
    Wang C, Yatsuya H, Li Y, Ota A, Tamakoshi K, Fujino Y, et al. Prospective study of seaweed consumption and thyroid cancer incidence in women: the Japan collaborative cohort study. Eur J Cancer Prev. 2016;25:239–45.  https://doi.org/10.1097/CEJ.0000000000000168.CrossRefGoogle Scholar
  85. 85.
    Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015;3:286–95.  https://doi.org/10.1016/S2213-8587(14)70225-6.CrossRefPubMedCentralPubMedGoogle Scholar
  86. 86.
    Zimmermann MB, Jooste PL, Pandav CS. Iodine-deficiency disorders. Lancet. 2008;372:1251–62.  https://doi.org/10.1016/S0140-6736(08)61005-3.CrossRefPubMedGoogle Scholar
  87. 87.
    Carvalho AL, Meirelles CJ, Oliveira LA, Costa TM, Navarro AM. Excessive iodine intake in schoolchildren. Eur J Nutr. 2012;51:557–62.  https://doi.org/10.1007/s00394-011-0239-7.CrossRefGoogle Scholar
  88. 88.
    Sehnishvili Z, Suchdev P. Gerasimov G. IDD Newsletter: Elimination of iodine deficiency in the Republic of Georgia; 2007. http://www.ign.org/newsletter/idd_nl_may07_georgia.pdf. Accessed 16 May 2016Google Scholar
  89. 89.
    Watts MJ, Joy EJ, Young SD, Broadley MR, Chilimba AD, Gibson RS, et al. Iodine source apportionment in the Malawian diet. Sci Rep. 2015;5:15251.  https://doi.org/10.1038/srep15251.CrossRefPubMedCentralPubMedGoogle Scholar
  90. 90.
    Dasgupta PK, Liu Y, Dyke JV. Iodine nutrition: iodine content of iodized salt in the United States. Environ Sci Technol. 2008;42:1315–23.CrossRefGoogle Scholar
  91. 91.
    Hussein IS, Min Y, Ghebremeskel K, Gaffar AM. Iodine status and fish intake of Sudanese schoolchildren living in the Red Sea and White Nile regions. Public Health Nutr. 2012;15:2265–71.  https://doi.org/10.1017/S1368980012000833.CrossRefGoogle Scholar
  92. 92.
    Lv S, Zhao J, Xu D, Chong Z, Jia L, Du Y, et al. An epidemiological survey of children’s iodine nutrition and goitre status in regions with mildly excessive iodine in drinking water in Hebei Province, China. Public Health Nutr. 2012;15:1168–73.  https://doi.org/10.1017/S1368980012000146.CrossRefGoogle Scholar
  93. 93.
    Laurberg P, Jørgensen T, Perrild H, Ovesen L, Knudsen N, Pedersen IB, et al. The Danish investigation on iodine intake and thyroid disease, DanThyr: status and perspectives. Eur J Endocrinol. 2006;155:219–28.CrossRefPubMedGoogle Scholar
  94. 94.
    Rasmussen LB, Carlé A, Jørgensen T, Knudsen N, Laurberg P, Pedersen IB, et al. Iodine intake before and after mandatory iodization in Denmark: results from the Danish Investigation of Iodine Intake and Thyroid Diseases (DanThyr) study. Br J Nutr. 2008;100:166–73.  https://doi.org/10.1017/S0007114507886387.CrossRefGoogle Scholar
  95. 95.
    Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Carlé A, Pedersen IB, et al. Lower prevalence of mild hyperthyroidism related to a higher iodine intake in the population: prospective study of a mandatory iodization programme. Clin Endocrinol (Oxf). 2009;71:440–5.  https://doi.org/10.1111/j.1365-2265.2008.03493.x.CrossRefGoogle Scholar
  96. 96.
    Krejbjerg A, Bjergved L, Pedersen IB, Knudsen N, Jørgensen T, Perrild H, et al. Thyroid nodules in an 11-year DanThyr follow-up study. J Clin Endocrinol Metab. 2014;99:4749–57.  https://doi.org/10.1210/jc.2014-2438.CrossRefGoogle Scholar
  97. 97.
    Blomberg M, Feldt-Rasmussen U, Andersen KK, Kjaer SK. Thyroid cancer in Denmark 1943-2008, before and after iodine supplementation. Int J Cancer. 2012;131:2360–6.  https://doi.org/10.1002/ijc.27497.CrossRefPubMedGoogle Scholar
  98. 98.
    Dong W, Zhang H, Zhang P, Li X, He L, Wang Z, et al. The changing incidence of thyroid carcinoma in Shenyang, China before and after universal salt iodization. Med Sci Monit. 2013;19:49–53.CrossRefPubMedGoogle Scholar
  99. 99.
    O’Grady TJ, Gates MA, Boscoe FP. Thyroid cancer incidence attributable to overdiagnosis in the United States 1981-2011. Int J Cancer. 2015;137:2664–73.  https://doi.org/10.1002/ijc.29634.CrossRefGoogle Scholar
  100. 100.
    Henjum S, Barikmo I, Strand TA, Oshaug A, Torheim LE. Iodine-induced goitre and high prevalence of anaemia among Saharawi refugee women. Public Health Nutr. 2012;15:1512–8.  https://doi.org/10.1017/S1368980011002886.CrossRefGoogle Scholar
  101. 101.
    Henjum S, Barikmo I, Gjerlaug AK, Mohamed-Lehabib A, Oshaug A, Strand TA, et al. Endemic goitre and excessive iodine in urine and drinking water among Saharawi refugee children. Public Health Nutr. 2010;13:1472–7.  https://doi.org/10.1017/S1368980010000650.CrossRefGoogle Scholar
  102. 102.
    Medani AM, Elnour AA, Saeed AM. Excessive iodine intake, water chemicals and endemic goitre in a Sudanese coastal area. Public Health Nutr. 2013;16:1586–92.  https://doi.org/10.1017/S1368980012004685.CrossRefGoogle Scholar
  103. 103.
    Liu L, Wang D, Liu P, Meng F, Wen D, Jia Q, et al. The relationship between iodine nutrition and thyroid disease in lactating women with different iodine intakes. Br J Nutr. 2015;114:1487–95.  https://doi.org/10.1017/S0007114515003128.CrossRefGoogle Scholar
  104. 104.
    Aakre I, Bjøro T, Norheim I, Strand TA, Barikmo I, Henjum S. Excessive iodine intake and thyroid dysfunction among lactating Saharawi women. J Trace Elem Med Biol. 2015;31:279–84.  https://doi.org/10.1016/j.jtemb.2014.09.009.CrossRefGoogle Scholar
  105. 105.
    Aakre I, Bjøro T, Norheim I, Strand TA, Barikmo I, Henjum S. Development of thyroid dysfunction among women with excessive iodine intake—a 3-year follow-up. J Trace Elem Med Biol. 2015;31:61–6.  https://doi.org/10.1016/j.jtemb.2015.03.004.CrossRefGoogle Scholar
  106. 106.
    Leung AM, Braverman LE, He X, Heeren T, Pearce EN. Breastmilk iodine concentrations following acute dietary iodine intake. Thyroid. 2012;22:1176–80.  https://doi.org/10.1089/thy.2012.0294.CrossRefPubMedCentralPubMedGoogle Scholar
  107. 107.
    Li WH, Dong BS, Li P, Li YF. Benefits and risks from the national strategy for improvement of iodine nutrition: a community-based epidemiologic survey in Chinese schoolchildren. Nutrition. 2012;28:1142–5.  https://doi.org/10.1016/j.nut.2012.04.014.CrossRefGoogle Scholar
  108. 108.
    Sang Z, Chen W, Shen J, Tan L, Zhao N, Liu H, et al. Long-term exposure to excessive iodine from water is associated with thyroid dysfunction in children. J Nutr. 2013;143:2038–43.  https://doi.org/10.3945/jn.113.179135.CrossRefGoogle Scholar
  109. 109.
    Sang Z, Wei W, Zhao N, Zhang G, Chen W, Liu H, et al. Thyroid dysfunction during late gestation is associated with excessive iodine intake in pregnant women. J Clin Endocrinol Metab. 2012;97:E1363–9.  https://doi.org/10.1210/jc.2011-3438.CrossRefGoogle Scholar
  110. 110.
    Kassim IA, Moloney G, Busili A, Nur AY, Paron P, Jooste P, et al. Iodine intake in Somalia is excessive and associated with the source of household drinking water. J Nutr. 2014;144:375–81.  https://doi.org/10.3945/jn.113.176693.CrossRefPubMedCentralPubMedGoogle Scholar
  111. 111.
    Kassim IA, Ruth LJ, Creeke PI, Gnat D, Abdalla F, Seal AJ. Excessive iodine intake during pregnancy in Somali refugees. Matern Child Nutr. 2012;8:49–56.CrossRefGoogle Scholar
  112. 112.
    Liu P, Liu L, Shen H, Jia Q, Wang J, Zheng H, et al. The standard, intervention measures and health risk for high water iodine areas. PLoS One. 2014;9:e89608.  https://doi.org/10.1371/journal.pone.0089608.CrossRefPubMedCentralPubMedGoogle Scholar
  113. 113.
    Leung AM, Pearce EN, Braverman LE. Iodine content of prenatal multivitamins in the United States. N Engl J Med. 2009;360:939–40.  https://doi.org/10.1056/NEJMc0807851.CrossRefGoogle Scholar
  114. 114.
    Sang Z, Wang PP, Yao Z, Shen J, Halfyard B, Tan L, et al. Exploration of the safe upper level of iodine intake in euthyroid Chinese adults: a randomized double-blind trial. Am J Clin Nutr. 2012;95:367–73.  https://doi.org/10.3945/ajcn.111.028001.CrossRefGoogle Scholar
  115. 115.
    Thomson CD, Campbell JM, Miller J, Skeaff SA. Minimal impact of excess iodate intake on thyroid hormones and selenium status in older New Zealanders. Eur J Endocrinol. 2011;165:745–52.  https://doi.org/10.1530/EJE-11-0575.CrossRefGoogle Scholar
  116. 116.
    Stagi S, Manoni C, Chiarelli F, de Martino M. Congenital hypothyroidism due to unexpected iodine sources. Horm Res Paediatr. 2010;74:76.  https://doi.org/10.1159/000295697.CrossRefGoogle Scholar
  117. 117.
    de Vasconcellos Thomas J, Collett-Solberg P. Perinatal goiter with increased iodine uptake and hypothyroidism due to excess maternal iodine ingestion. Horm Res. 2009;72:344–7.  https://doi.org/10.1159/000249162.CrossRefGoogle Scholar
  118. 118.
    Connelly KJ, Boston BA, Pearce EN, Sesser D, Snyder D, Braverman LE, et al. Congenital hypothyroidism caused by excess prenatal maternal iodine ingestion. J Pediatr. 2012;161:760–2.  https://doi.org/10.1016/j.jpeds.2012.05.057.CrossRefPubMedCentralPubMedGoogle Scholar
  119. 119.
    Leung AM, Avram AM, Brenner AV, Duntas LH, Ehrenkranz J, Hennessey JV, et al. Potential risks of excess iodine ingestion and exposure: statement by the American Thyroid Association Public Health Committee. Thyroid. 2015;25:145–6.  https://doi.org/10.1089/thy.2014.0331.CrossRefPubMedCentralPubMedGoogle Scholar
  120. 120.
    Nesvadbova M, Crosera M, Maina G, Larese Filon F. Povidone iodine skin absorption: an ex-vivo study. Toxicol Lett. 2015;235:155–60.  https://doi.org/10.1016/j.toxlet.2015.04.004.CrossRefGoogle Scholar
  121. 121.
    Erdoğan MF, Tatar FA, Unlütürk U, Cin N, Uysal AR. The effect of scrubbing hands with iodine-containing solutions on urinary iodine concentrations of the operating room staff. Thyroid. 2013;23:342–5.  https://doi.org/10.1089/thy.2012.0325.CrossRefGoogle Scholar
  122. 122.
    Below H, Behrens-Baumann W, Bernhardt C, Völzke H, Kramer A, Rudolph P. Systemic iodine absorption after preoperative antisepsis using povidone-iodine in cataract surgery—an open controlled study. Dermatology. 2006;212(Suppl 1):41–6.CrossRefGoogle Scholar
  123. 123.
    Velasco I, Naranjo S, López-Pedrera C, Garriga MJ, García-Fuentes E, Soriguer F. Use of povidone-iodine during the first trimester of pregnancy: a correct practice? BJOG. 2009;116:452–5.  https://doi.org/10.1111/j.1471-0528.2008.02059.x.CrossRefGoogle Scholar
  124. 124.
    Findik RB, Yilmaz G, Celik HT, Yilmaz FM, Hamurcu U, Karakaya J. Effect of povidone iodine on thyroid functions and urine iodine levels in caesarean operations. J Matern Fetal Neonatal Med. 2014;27:1020–2.  https://doi.org/10.3109/14767058.2013.847417.CrossRefGoogle Scholar
  125. 125.
    Razavi B, Zollinger R, Kramer A, Fricke C, Völzke H, Jäger B, et al. Systemic iodine absorption associated with the use of preoperative ophthalmic antiseptics containing iodine. Cutan Ocul Toxicol. 2013;32:279–82.  https://doi.org/10.3109/15569527.2013.776574.CrossRefGoogle Scholar
  126. 126.
    Safran M, Braverman LE. Effect of chronic douching with polyvinylpyrrolidone-iodine on iodine absorption and thyroid function. Obstet Gynecol. 1982;60:35–40.Google Scholar
  127. 127.
    Pramyothin P, Leung AM, Pearce EN, Malabanan AO, Braverman LE. Clinical problem-solving. A hidden solution. N Engl J Med. 2011;365:2123–7.  https://doi.org/10.1056/NEJMcps1008908.CrossRefPubMedCentralPubMedGoogle Scholar
  128. 128.
    Kurtoglu S, Bastug O, Daar G, Halis H, Korkmaz L, Memur S, et al. Effect of iodine loading on the thyroid hormone level of newborns living in Kayseri province. Am J Perinatol. 2014;31:1087–92.  https://doi.org/10.1055/s-0034-1371701.CrossRefGoogle Scholar
  129. 129.
    Linder N, Davidovitch N, Reichman B, Kuint J, Lubin D, Meyerovitch J, et al. Topical iodine-containing antiseptics and subclinical hypothyroidism in preterm infants. J Pediatr. 1997;131:434–9.CrossRefGoogle Scholar
  130. 130.
    Aitken J, Williams FL. A systematic review of thyroid dysfunction in preterm neonates exposed to topical iodine. Arch Dis Child Fetal Neonatal Ed. 2014;99:F21–8.  https://doi.org/10.1136/archdischild-2013-303799.CrossRefGoogle Scholar
  131. 131.
    Pinsker JE, McBayne K, Edwards M, Jensen K, Crudo DF, Bauer AJ. Transient hypothyroidism in premature infants after short-term topical iodine exposure: an avoidable risk? Pediatr Neonatol. 2013;54:128–31.  https://doi.org/10.1016/j.pedneo.2012.10.005.CrossRefGoogle Scholar
  132. 132.
    Darouiche RO, Wall MJJ, Itani KM, Otterson MF, Webb AL, Carrick MM, et al. Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis. N Engl J Med. 2010;362:18–26.  https://doi.org/10.1056/NEJMoa0810988.CrossRefGoogle Scholar
  133. 133.
    Ader AW, Paul TL, Reinhardt W, Safran M, Pino S, McArthur W, et al. Effect of mouth rinsing with two polyvinylpyrrolidone-iodine mixtures on iodine absorption and thyroid function. J Clin Endocrinol Metab. 1988;66:632–5.CrossRefGoogle Scholar
  134. 134.
    Pearce EN, Gerber AR, Gootnick DB, Khan LK, Li R, Pino S, et al. Effects of chronic iodine excess in a cohort of long-term American workers in West Africa. J Clin Endocrinol Metab. 2002;87:5499–502.CrossRefGoogle Scholar
  135. 135.
    Luo Y, Kawashima A, Ishido Y, Yoshihara A, Oda K, Hiroi N, et al. Iodine excess as an environmental risk factor for autoimmune thyroid disease. Int J Mol Sci. 2014;15:12895–912.  https://doi.org/10.3390/ijms150712895.CrossRefPubMedCentralPubMedGoogle Scholar
  136. 136.
    Prete A, Paragliola RM, Corsello SM. Iodine supplementation: usage “with a grain of salt”. Int J Endocrinol. 2015;2015:312305.  https://doi.org/10.1155/2015/312305.CrossRefPubMedCentralPubMedGoogle Scholar
  137. 137.
    Hudzik B, Zubelewicz-Szkodzińska B. Radiocontrast-induced thyroid dysfunction: is it common and what should we do about it? Clin Endocrinol (Oxf). 2014;80:322–7.  https://doi.org/10.1111/cen.12376.CrossRefGoogle Scholar
  138. 138.
    Roti E, Vagenakis AG. Effect of excess iodide: clinical aspects. In: Braverman LE, Cooper DS, editors. Werner & Ingbar’s the thyroid: a fundamental and clinical text. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 242–56.Google Scholar
  139. 139.
    Wolff J. Iodide goiter and the pharmacologic effects of excess iodide. Am J Med. 1969;47:101–24.CrossRefGoogle Scholar
  140. 140.
    Wiersinga WM, Touber JL, Trip MD, van Royen EA. Uninhibited thyroidal uptake of radioiodine despite iodine excess in amiodarone-induced hypothyroidism. J Clin Endocrinol Metab. 1986;63:485–91.CrossRefGoogle Scholar
  141. 141.
    Stanbury JB, Ermans AE, Bourdoux P, Todd C, Oken E, Tonglet R, et al. Iodine-induced hyperthyroidism: occurrence and epidemiology. Thyroid. 1998;8:83–100.CrossRefGoogle Scholar
  142. 142.
    Roti E, Uberti ED. Iodine excess and hyperthyroidism. Thyroid. 2001;11:493–500.CrossRefPubMedGoogle Scholar
  143. 143.
    Ross DS. Syndromes of thyrotoxicosis with low radioactive iodine uptake. Endocrinol Metab Clin North Am. 1998;27:169–85.CrossRefGoogle Scholar
  144. 144.
    Burman KD, Wartofsky L. Iodine effects on the thyroid gland: biochemical and clinical aspects. Rev Endocr Metab Disord. 2000;1:19–25.CrossRefGoogle Scholar
  145. 145.
    Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21:593–646.  https://doi.org/10.1089/thy.2010.0417.CrossRefPubMedGoogle Scholar
  146. 146.
    De Leo S, Lee SY, Braverman LE. Hyperthyroidism. Lancet. 2016;388(10047):906–18.  https://doi.org/10.1016/S0140-6736(16)00278-6.CrossRefPubMedCentralPubMedGoogle Scholar
  147. 147.
    Fricke E, Fricke H, Esdorn E, Kammeier A, Lindner O, Kleesiek K, et al. Scintigraphy for risk stratification of iodine-induced thyrotoxicosis in patients receiving contrast agent for coronary angiography: a prospective study of patients with low thyrotropin. J Clin Endocrinol Metab. 2004;89:6092–6.CrossRefGoogle Scholar
  148. 148.
    Nolte MR, Siggelkow H, Emrich D, Hufner M. Prophylactic application of thyrostatic drugs during excessive iodine exposure in euthyroid patients with thyroid autonomy: a randomized study. Eur J Endocrinol. 1996;134:337–41.CrossRefGoogle Scholar

Copyright information

© 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

Personalised recommendations