|
|
The Iodine Group | |
|
Home | Orthoiodosupplementation | Body | Disease | Special | Overviews |
||
|
|
Kahaly
Iodide induces thyroid autoimmunity in patients with endemic goitre: a randomised, double-blind, placebo-controlled trial.Kahaly GJ, Dienes HP, Beyer J, Hommel G. Eur J Endocrinol. 1998 Sep;139(3):290-7.
"OBJECTIVE: Iodine is essential for normal thyroid function and the majority of individuals tolerate a wide range of dietary levels. However, a subset of individuals, on exposure to iodine, develop thyroid dysfunction. In this double-blind trial, we evaluated the efficacy and tolerability of low-dose iodine compared with those of levo-thyroxine (T4) in patients with endemic goitre.
METHODS: Sixty-two patients were assigned randomly to groups to receive iodine (0.5 mg/day) or T4 (0.125 mg/day) for 6 months. Subsequently, both groups were subject to placebo for another 6 months. Thyroid sonography, determination of thyroid-related hormones and antibodies, and urinary excretion of iodine were carried out at baseline and at 1, 6 and 12 months.
RESULTS: At 6 months, markedly increased urinary values of iodine were found in patients receiving iodine (36 microg/24 h at baseline, 415 microg/24 h at 6 months) compared with those receiving T4 (47 microg/ 24 h at baseline, 165 microg/24 h at 6 months; P < 0.0001 compared with iodine group). T4 administration engendered a greater (P < 0.01) decrease in thyroid volume (from 32 ml to 17 ml, P < 0.0001) than did intake of iodine (3 3 ml to 21 ml. P < 0.005). High microsomal and thyroglobulin autoantibody titres were present in six of 31 patients (19%) receiving iodine, and iodine-induced hypo- and hyperthyroidism developed in four and two of them, respectively. Fine-needle biopsy revealed marked lymphocyte infiltration in all six. After withdrawal of iodine thyroid dysfunction remitted spontaneously and antibody titres and lymphocyte infiltration decreased markedly. Follow-up of these six patients for an additional 3 years showed normalisation of antibody titres in four of them.
CONCLUSION: Although nearly comparable results were obtained with both treatment regimens regarding thyroid size, partly reversible iodine-induced thyroid dysfunction and autoimmunity were observed among patients with endemic goitre."
Randomized, double blind, placebo-controlled trial of low dose iodide in endemic goiter.Kahaly G, Dienes HP, Beyer J, Hommel G. J Clin Endocrinol Metab. 1997 Dec;82(12):4049-53.
"Iodine (I) is
essential for normal thyroid function, and the majority of
subjects tolerate a wide range of dietary levels. However, a
subset of individuals upon exposure to normal or elevated levels
of I develop thyroid dysfunction and autoimmunity. In this double
blind trial, we evaluated efficacy and tolerability of low dose I
in adults with euthyroid, diffuse, endemic goiter. Sixty-two
subjects were randomly assigned I (0.2 mg/day) or placebo for 12
months. After termination of therapy, both groups were followed
for a further 6 months. Thyroid sonography and determinations of
thyroid-related hormones, urinary I excretion per 24 h, and
thyroid antibodies were carried out at baseline and at 3, 6, 9,
12, 15, and 18 months. Markedly elevated urinary I values were
found during therapy in subjects receiving I (32 at baseline vs.
213 micrograms/24 h at 12 months; P = 0.0001) compared to placebo
(34 and 33 micrograms/24 h, respectively; P < 0.0001 vs. I). I
substantially reduced thyroid volume (29 vs. 18 mL at 12 months;
-38%; P = 0.0001), and at 18 months, the therapeutic effect was
sustained. In the placebo group, no significant changes were
observed. High microsomal and thyroglobulin autoantibody titers
were present in 3 of 31 (9.7%) subjects receiving I, and
I-induced hypo- and hyperthyroidism developed in 2 and 1,
respectively. Fine needle biopsy revealed marked lymphocytic
infiltration in all 3 cases. After withdrawal of I, thyroid
dysfunctions spontaneously remitted, and antibody titers as well
as lymphocytic infiltration decreased markedly. Follow-up of
these 3 subjects for an additional 2 yr showed normalization of
antibody titers in 2. Thus, among subjects with endemic goiter,
low dose I successfully normalized thyroid volume and body I
supplementation; nevertheless, reversible I-induced thyroid
dysfunctions and autoimmunity were observed in nearly 10% of the
subjects." |
|
Home | Orthoiodosupplementation | Body | Disease | Special Topics | OverviewsThe Iodine Group | Books | Disclaimers | Contact Us | Search
|
||
