Sources of dietary iodines bread, cows' milk, and infant formula in the Boston area

Dietary iodine is essential for thyroid hormone production. Although U.S. dietary iodine is generally adequate, some groups, especially women of childbearing age, are at risk for mild iodine deficiency. Children's average urinary iodine is higher than that of adults. U.S. dietary iodine sources have not been assessed recently. A survey of iodine content in 20 brands of bread, 18 brands of cows' milk, and eight infant formulae was performed between 2001 and 2002. Three bread varieties contained more than 300 μg iodine per slice. Iodine content in other brands was far lower (mean ± SD, 10.1 ± 13.2 μg iodine/ slice). All cows' milk samples had at least 88 μg iodine/250 ml, ranging from 88-168 μg (116.0 ± 22.1 μg/250 ml). Infant formulae values ranged from 16.2 to 56.8 μg iodine/5 oz (23.5 ± 13.78 μg/5 oz). The public should be aware of the need for adequate dietary iodine intake and should be aware that ingredient lists do not reflect the iodine content of foods

Breast milk iodine and perchlorate concentrations in lactating Boston-area women

Context: Breastfed infants rely on adequate maternal dietary iodine intake. Objective: Our objective was to measure breast milk iodine and perchlorate, an inhibitor of iodide transport into the thyroid and potentially into breast milk, in Boston-area women. Participants: The study included 57 lactating healthy volunteers in the Boston area. Measurements: Breast milk iodine and perchlorate concentrations and urine iodine, perchlorate, and cotinine concentrations were measured. For comparison, iodine and perchlorate levels in infant formulae were also measured. Results: Median breast milk iodine content in 57 samples was 155 μg/liter (range, 2.7-1968 μg/liter). Median urine iodine was 114 μg/liter (range, 25-920 μg/liter). Perchlorate was detectable in all 49 breast milk samples (range, 1.3-411 μg/liter), all 56 urine samples (range, 0.37-127 μg/liter), and all 17 infant formula samples (range, 0.22-4.1 μg/liter) measured. Breast milk iodine content was significantly correlated with urinary iodine per gram creatinine and urinary cotinine but was not significantly correlated with breast milk or urinary perchlorate. Conclusions: Perchlorate exposure was not significantly correlated with breast milk iodine concentrations. Perchlorate was detectable in infant formula but at lower levels than in breast milk. Forty-seven percent of women sampled may have been providing breast milk with insufficient iodine to meet infants' requirements. Copyright © 2007 by The Endocrine Society

Prevalence of goiter among schoolchildren from Gorgan, Iran, a decade after national iodine supplementation: Association with age, gender, and thyroperoxidase antibodies

Background: One decade after universal salt iodization in Iran, goiter prevalence, urinary iodine concentration (UIC) and thyroperoxidase antibody (TPOAb) values were assessed among schoolchildren in Gorgan, Iran. Methods: From 2003-2004, 500 girls and 900 boys aged 7-11 yr were evaluated for goiter by palpation. UIC was measured in 183 randomly-selected goitrous children. Serum TSH, T 4, and TPOAb were measured in 53 goitrous and 30 non-goitrous children with adequate UIC. Results: Goiter was detected in 370 (26.4%) children. Goiter was present in 31 % of girls and 17% of boys age 9 (p<0.012); 37% of girls and 20% of boys age 10 (p<0.003); and 52% of girls and 19% of boys age 11 (p<0.0001). Median (range) UIC for all goitrous children sampled was 190 (20-600) μg/l; 220 (30-590) in boys and 170 (20-600) in girls (p=0.001). Eight point seven percent of goitrous children and 22% of goitrous girls aged 10-11 had UIC<100 μg/l, while 47% of the goitrous children had UIC≥200 μg/l. TPOAb was present in 52.8% of goitrous children and 10% of non-goitrous children (p=0.0001 ). TPOAb was present in 53.9% of 10-11 and 22.7% of 7-9 yr old goitrous and non-goitrous children (p=0.003) with adequate UIC. Median (range) TSH was 2.9 (0.3-10.9) mlU/l in TPO-positive and 1.8 (0.5-4.1) in TPO-negative children (p=0.001 ). Conclusions: Gorgan, Iran, is an iodine-sufficient area and almost half of schoolchildren have more than adequate UIC. TPOAb is associated with endemic goiter. Despite sufficient UIC overall, some school-aged girls remain at risk of iodine deficiency. ©2005, Editrice Kurtis

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

The authors review anatomical, clinical characteristics and prevalence of thyroid microcarcinoma. Diagnostic procedures and risk factors of aggressiveness at diagnosis and during follow-up are also covered. The possible clinical, pathologic and therapeutic risk factors are analyzed by meta-analysis study. Treatment procedures by different authors and guidelines suggested by societies are reporte

A clinical and therapeutic approach to thyrotoxicosis with thyroid-stimulating hormone suppression only

Subclinical hyperthyroidism is defined as normal serum free thyroxine (T4) and triiodothyronine (T3) concentrations and persistently suppressed thyroid stimulating hormone (TSH) concentrations. The most common cause of subclinical hyperthyroidism is the use of suppressive doses of L-thyroxine for treatment of hypothyroidism or, less commonly, diffuse nontoxic goiter or thyroid carcinoma (exogenous subclinical hyperthyroidism). Endogenous subclinical hyperthyroidism may be caused by a variety of thyroid disorders that result in overproduction and release of thyroid hormones from the gland with normal/high 24-hour thyroid radioiodine uptake or by inflammation in the thyroid resulting in release of excess thyroid hormones and low 24-hour thyroid radioiodine uptake. Several groups have investigated whether persistent endogenous or exogenous subclinical yperthyroidism, like overt hyperthyroidism, causes symptoms, adverse effects on the cardiovascular and the skeletal systems, and increased mortality, whether endogenous subclinical hyperthyroidism evolves to overt thyrotoxicosis, and whether or not it should be treated. The present report reviews the most important and recent studies of subclinical hyperthyroidism and attempts to draw conclusions based upon the literature and the authors' experience. (c) 2005 Elsevier Inc. All rights reserved