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2.
Rev. chil. endocrinol. diabetes ; 4(4): 283-289, oct. 2011. tab
Artigo em Espanhol | LILACS | ID: lil-640611

RESUMO

The endemic goiter, nutritional collective problem due to iodine deficience, constitutes a chronic disease with easy prevention and control, nevertheless still it constitutes a serious problem of public world health, being thought that about 650 million persons have goiter, 43 millions suffer from endemic cretinism and 1570 millions are in risk of suffering this disease for living in areas that present a deficit of iodine. Both patterns, deficit and the excess of iodine can conducted to a thyroid disease. The relation between the ingestion of iodine and the risk of disease corresponds to a U curve, where both, the low one and high ingestion of iodine it is associate to high risk of thyroid disease. To have a program of iodine supplementation, it should imply a constant vigilance of iodine nutrition to see its effect on the goiter prevalence in the population, to control his degree of fulfillment, to avoid a possible excess of ingestion of iodine it might help to correct any precocious alteration. Endemic goiter is not longer a problem in Chile. Salt iodination is in agreement with present legislation, but it is very important to have a continuous surveillance of iodine nutrition in Chile to control if salt fortification is appropiate.


Assuntos
Humanos , Criança , Bócio Endêmico/epidemiologia , Bócio Endêmico/prevenção & controle , Serviços de Saúde Escolar , Iodo/administração & dosagem , Bócio Endêmico/tratamento farmacológico , Chile , Deficiência de Iodo , América Latina , Distribuição por Sexo , Tireoidite Autoimune/epidemiologia , Tireoidite Autoimune/induzido quimicamente , Iodo/urina
3.
Public Health Nutr ; 13(3): 424-9, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19519973

RESUMO

OBJECTIVE: The aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India. DESIGN: In a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content. RESULTS: A reduction in goitre prevalence was observed from 69 % reported in 1982 to 27.7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5-15 ppm) of iodine from salt. CONCLUSIONS: Although there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.


Assuntos
Bócio Endêmico/epidemiologia , Iodo/deficiência , Iodo/urina , Cloreto de Sódio na Dieta/uso terapêutico , Adolescente , Adulto , Criança , Pré-Escolar , Culinária/métodos , Estudos Transversais , Feminino , Bócio Endêmico/tratamento farmacológico , Humanos , Índia , Lactente , Iodo/administração & dosagem , Iodo/uso terapêutico , Masculino , Educação de Pacientes como Assunto , Prevalência , Vigilância de Evento Sentinela , Tireotropina/sangue , Tiroxina/sangue , Falha de Tratamento , Adulto Jovem
4.
Zhonghua Yi Xue Za Zhi ; 86(18): 1274-8, 2006 May 16.
Artigo em Chinês | MEDLINE | ID: mdl-16796889

RESUMO

OBJECTIVE: To investigate the effects of chronic mild and moderate iodine excess on thyroid oxidative injury and anti-oxidative ability of iodine deficiency and non-iodine deficiency Wistar rats. METHODS: Four-week-old Wistar rats were fed with iodine deficient diet for three months to make iodine deficient goiter models, then divided randomly into three groups: iodine deficient control group (Group IDC) fed with double distilled water, iodine-supplement group I (Group IS I) fed with potassium iodate solutions with the iodine concentrations of 100 microg/L, and iodine-supplement group II (Group IS II), fed with potassium iodate solution with the iodine concentrations of 330 microg/L. Another four-week-old Wistar rats were fed with normal diet for three months, and then divided randomly into three groups: normal control group (NC) fed with double distilled water, iodine-excess group I (IEI) fed with potassium iodate solution with the iodine concentration of 300 microg/L, and iodine-excess group II (Group IEII), fed with potassium iodate solution with the iodine concentration of 660 microg/L. 1, 2, 4, 8, and 24 weeks after treatment samples of urine were collected to detect the median urine iodine (MUI), samples of plasma were collected from the hearts of 8-14 rats from each group and then rats were killed. Their thyroid glands were taken out to measure the wet weight and made into homogenate. Biochemical method was used to measure the activities of glutathione-peroxidase (GSH-P(X)) and superoxide dismutase (SOD) as well as the contents of malonyldialdehyde (MDA) and H2O2 in the homogenates of thyroid glands. RESULTS: The GSH-P(X) activity 2 weeks after treatment of Group IS II was significantly lower than that of Group IDC (P < 0.05), and the GSH-P(X) activity 4 weeks after treatment of Group IS I was significantly lower than that of Group IDC (P < 0.001). The activities of GSH-P(X) 4, 8, and 24 weeks after treatment of Groups IS I and IS II were all lower than those of Group C at the same time points significantly (P < 0.001, < 0.01, and < 0.05 respectively). The activities of SOD were decreased gradually in Groups IS I and IS II and were significantly lower than those of Group IDC since 8 weeks after treatment (P < 0.001 or < 0.05). The SOD activities in thyroid glands of Groups IEI and IEII since 8 weeks after treatment decreased significantly in comparison with Group NC (all P < 0.01 or < 0.001). The contents of H2O2 in thyroid glands of Groups IS I and IS II were significantly lower than those of Group IDC at different time points (P < 0.001, < 0.01, or < 0.05), and were significantly lower than those of Group NC 8 and 24 weeks after treatment (P < 0.001 or < 0.01). The contents of MDA in thyroid glands since 2 weeks after treatment of Group IEI were all significantly lower than those of Group IDC at the same time points (all P < 0.05), and the content of MDA in thyroid glands since 1 week after treatment of Groups IS II were all significantly lower than those of Group IDC at the same time points (all P < 0.05). CONCLUSION: Supplementation of 100 microg/L and 330 microg/L iodine on iodine deficiency Wistar rats may alleviate the oxidative injury but weaken the anti-oxidative protection of thyroid. The anti-oxidative protection of thyroid glands of non-iodine deficiency Wistar rats may also be weakened by supplementation of 300 microg/L and 660 microg/L iodine.


Assuntos
Bócio Endêmico/tratamento farmacológico , Iodo/administração & dosagem , Iodo/deficiência , Estresse Oxidativo/efeitos dos fármacos , Animais , Doença Crônica , Deficiências Nutricionais/tratamento farmacológico , Deficiências Nutricionais/metabolismo , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Feminino , Glutationa Peroxidase/metabolismo , Bócio Endêmico/metabolismo , Peróxido de Hidrogênio/metabolismo , Iodo/urina , Masculino , Malondialdeído/metabolismo , Distribuição Aleatória , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismo , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia
5.
An Med Interna ; 21(4): 171-4, 2004 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-15109284

RESUMO

OBJECTIVE: Correction of iodine deficiency diminishes the incidence of toxic nodular goitre. The aim of this study was to assess the etiology of thyrotoxicosis in two areas with different goitre prevalence in Galicia, fifteen years after the institutional campaign of salt iodination. Results of the present survey are compared with those from a study performed ten years ago. METHODS: Two hundred and two thyrotoxic patients attended in La Coruña (coastal zone) and Lugo (inland zone) from January 2000 to May 2002 were included. Clinical and exploratory data were recorded. Thyroid hormones, thyroid-directed antibodies and thyroid stimulating immunoglobulin (TSI) were measured. A thyroid 99m technetium or 123 iodine scintigram was performed. RESULTS: In the whole group 58.6% of the cases were diagnosed of nodular goitre, 30.3% of Graves disease, 7.1% of iodine induced thyrotoxicosis and 3.5% of subacute thyroiditis. In coastal zone these percentages were 52.2, 37.0, 5.4 and 4.3%, respectively. In the inland area, 64.2% nodular goitre, 24.5% Graves disease, 8.5% iodine induced thyrotoxicosis and 2.8% subacute thyroiditis. The most frequent diagnosis in both the whole group and in each area was toxic multinodular goitre. CONCLUSIONS: In some areas of Spain, toxic nodular goitre continues to be the most frequent cause of thyrotoxicosis. It is necessary to insist on implementation and monitoring of iodine supplementation programs.


Assuntos
Bócio Endêmico/tratamento farmacológico , Bócio Nodular/tratamento farmacológico , Iodo/administração & dosagem , Iodo/deficiência , Cloreto de Sódio na Dieta/administração & dosagem , Tireotoxicose/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos Locais/administração & dosagem , Estudos Epidemiológicos , Feminino , Bócio Endêmico/complicações , Bócio Nodular/complicações , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Espanha/epidemiologia , Testes de Função Tireóidea , Tireotoxicose/epidemiologia
6.
Am J Clin Nutr ; 77(6): 1453-8, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12791623

RESUMO

BACKGROUND: Serum thyroglobulin appears to be a sensitive marker of thyroid dysfunction in endemic goiter. However, its value as an indicator of thyroid status in children after the introduction of iodized salt has not been tested. OBJECTIVE: The objective was to optimize and validate a thyroglobulin assay on dried whole blood spots and to evaluate thyroglobulin as an indicator of thyroid response to iodized salt. DESIGN: A standardized, commercially available, sandwich fluoroimmunometric serum thyroglobulin assay was adapted for use on blood spots and validated in Swiss children. In a 1-y prospective study in 377 goitrous Moroccan children aged 6-15 y, the assay was used to measure thyroglobulin before and after the introduction of iodized salt. Urinary iodine, thyroid volume, thyrotropin, and thyroxine were measured, and regression was done with thyroglobulin as the dependent variable. RESULTS: Correlation between the blood spot and serum assays was excellent (r = 0.98). The SD of the difference between the blood spot and serum assays was 3.8 micro g/L; the median CVs for the blood spot assay in controls and samples were 6.3% and 14.4%, respectively. Median thyroglobulin was 24.5 (range: 0-328.8) micro g/L at baseline and fell significantly after the introduction of iodized salt to 6.2 (0-83.1) and 4.4 (0-47.1) micro g/L at 5 and 12 mo, respectively (P < 0.0001). Regression of urinary iodine and thyroid volume on thyroglobulin was highly significant at baseline and at 5 mo (P < 0.001). CONCLUSION: Thyroglobulin, measured in dried whole blood spots, may be a valuable indicator of improving thyroid function in children after supplementation with iodized salt.


Assuntos
Bócio Endêmico/tratamento farmacológico , Bócio Endêmico/fisiopatologia , Iodo/administração & dosagem , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/uso terapêutico , Tireoglobulina/análise , Testes de Função Tireóidea , Glândula Tireoide/fisiopatologia , Adolescente , Criança , Feminino , Bócio Endêmico/sangue , Testes Hematológicos/métodos , Humanos , Masculino , Marrocos , Instituições Acadêmicas
7.
Am J Clin Nutr ; 75(4): 743-8, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11916762

RESUMO

BACKGROUND: In many developing countries, children are at high risk of both goiter and iron deficiency anemia. Iron deficiency adversely affects thyroid metabolism and may reduce the efficacy of iodine prophylaxis in areas of endemic goiter. OBJECTIVE: The aim of this study was to determine whether iron supplementation in goitrous, iron-deficient children would improve their response to iodized salt. DESIGN: We conducted a randomized, double-blind, placebo-controlled trial in 5-14-y-old children in Côte d'Ivoire. Goitrous, iron-deficient children (n = 166) consuming iodized salt (10-30 mg I/kg salt at the household level) were supplemented with either iron (60 mg Fe/d, 4 d/wk for 16 wk) or placebo. At 0, 1, 6, 12, and 20 wk, we measured hemoglobin, serum ferritin, serum transferrin receptor, whole-blood zinc protoporphyrin, thyrotropin, thyroxine, urinary iodine, and thyroid gland volume (by ultrasonography). RESULTS: Hemoglobin and iron status at 20 wk were significantly better after iron treatment than after placebo (P < 0.05). At 20 wk, the mean reduction in thyroid size in the iron-treated group was nearly twice that in the placebo group (x +/- SD percentage change in thyroid volume from baseline: -22.8 +/- 10.7% compared with -12.7 +/- 10.1%; P < 0.01). At 20 wk, goiter prevalence was 43% in the iron-treated group compared with 62% in the placebo group (P < 0.02). There were no significant differences between groups in whole-blood thyrotropin or serum thyroxine at baseline or during the intervention. CONCLUSIONS: Iron supplementation improves the efficacy of iodized salt in goitrous children with iron deficiency. A high prevalence of iron deficiency among children in areas of endemic goiter may reduce the effectiveness of iodine prophylaxis.


Assuntos
Anemia Ferropriva/tratamento farmacológico , Bócio Endêmico/tratamento farmacológico , Iodo/uso terapêutico , Ferro/uso terapêutico , Cloreto de Sódio na Dieta/uso terapêutico , Adolescente , Anemia Ferropriva/complicações , Anemia Ferropriva/epidemiologia , Criança , Pré-Escolar , Côte d'Ivoire/epidemiologia , Método Duplo-Cego , Feminino , Bócio Endêmico/complicações , Bócio Endêmico/epidemiologia , Hemoglobinas/efeitos dos fármacos , Humanos , Masculino , Prevalência , Tireotropina/sangue , Tiroxina/sangue , Resultado do Tratamento
8.
Int J Vitam Nutr Res ; 72(1): 19-25, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11887748

RESUMO

In the developing countries of Africa, many children are at high risk for both goiter and iron-deficiency anemia (IDA). Because iron (Fe) deficiency can have adverse effects on thyroid metabolism, Fe deficiency may influence response to supplemental iodine in areas of endemic goiter. Therefore, our aims were to determine: 1) if goitrous children also suffering from IDA could respond to oral iodine supplementation; and 2) if Fe supplementation in goitrous children with IDA would improve their response to oral iodized oil and iodized salt. First, we compared the efficacy of oral iodized oil in two groups of goitrous children: a nonanaemic group vs. an IDA group. The therapeutic response to iodized oil was impaired in the goitrous children with IDA. Second, an open trial of Fe treatment in goitrous children with IDA improved their response to oral iodized oil. Finally, in a randomized double-blind trial, goitrous, Fe-deficient children consuming iodized salt were given Fe supplementation or placebo. Fe supplementation improved the efficacy of the iodized salt. In these studies, both anatomic (thyroid size) and biochemical (TSH, T4) measures indicated that iodine significantly improved thyroid function in the nonanaemic children compared to the Fe deficient children. Iodine was less efficacious in children with lower Hb at baseline and in those with a poorer response to Fe. The data suggest that a high prevalence of IDA among children in areas of endemic goiter may reduce the effectiveness of iodine prophylaxis.


Assuntos
Anemia Ferropriva/fisiopatologia , Bócio Endêmico/tratamento farmacológico , Iodo/farmacocinética , Óleo Iodado/farmacocinética , Ferro da Dieta/farmacocinética , Cloreto de Sódio na Dieta/farmacocinética , Adolescente , Anemia Ferropriva/dietoterapia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/metabolismo , Disponibilidade Biológica , Criança , Côte d'Ivoire/epidemiologia , Suplementos Nutricionais , Feminino , Alimentos Fortificados , Bócio Endêmico/epidemiologia , Bócio Endêmico/metabolismo , Humanos , Absorção Intestinal , Iodo/administração & dosagem , Iodo/metabolismo , Óleo Iodado/administração & dosagem , Ferro/metabolismo , Ferro da Dieta/administração & dosagem , Masculino , Cloreto de Sódio na Dieta/administração & dosagem , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/metabolismo , Resultado do Tratamento , Ultrassonografia
10.
Br J Nutr ; 84(2): 139-41, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11029963

RESUMO

In areas where iodized salt is not available, oral iodized oil is often used to correct I deficiency despite a lack of consensus on the optimal dose or duration of effect, particularly in children, a main target group. Annual doses ranging from 400 to 1000 mg have been advocated for school-age children. Because lower doses of iodized oil have been shown to be effective in treating I deficiency in adults, the aim of this study was to evaluate the efficacy and safety of a low dose of oral iodized oil in goitrous I-deficient children. Goitrous children (n 104, mean age 8.4 years, range 6-12 years, 47% female) received 0.4 ml oral iodized poppyseed-oil containing 200 mg I. Baseline measurements included I in spot urines (UI), serum thyroxine (T4), whole blood thyroid-stimulating hormone (TSH), and thyroid-gland volume using ultrasound. At 1, 5, 10, 15, 30 and 50 weeks post-intervention, UI, TSH and T4 were measured. At 10, 15, 30 and 50 weeks, thyroid-gland volume was remeasured. At 30 and 50 weeks the mean percentage change in thyroid volume from baseline was -35% and -41% respectively. The goitre rate fell to 38% at 30 weeks and 17% at 50 weeks. No child showed signs of I-induced hypo- or hyperthyroidism. UI remained significantly increased above baseline for the entire year (P < 0.001); the median UI at 50 weeks was 97 micrograms/l, at the World Health Organization cut-off value (100 micrograms/l) for I-deficiency disorders risk. In this group of goitrous children, an oral dose of 200 mg I as Lipiodol (Guerbert, Roissy CdG Cedex, France) was safe and effective for treating goitre and maintaining normal I status for at least 1 year.


Assuntos
Bócio Endêmico/tratamento farmacológico , Iodo/deficiência , Óleo Iodado/administração & dosagem , Criança , Feminino , Humanos , Iodo/sangue , Iodo/urina , Masculino , Glândula Tireoide/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia
12.
Eur J Endocrinol ; 142(3): 217-23, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10700714

RESUMO

OBJECTIVE: In developing countries, many children are at high risk for both goiter and iron-deficiency anemia. Because iron deficiency may impair thyroid metabolism, the aim of this study was to determine if iron supplementation improves the response to oral iodine in goitrous, iron-deficient anemic children. DESIGN: A trial of oral iodized oil followed by oral iron supplementation in an area of endemic goiter in the western Ivory Coast. METHODS: Goitrous, iodine-deficient children (aged 6-12 years; n=109) were divided into two groups: Group 1 consisted of goitrous children who were not anemic; Group 2 consisted of goitrous children who were iron-deficient anemic. Both groups were given 200mg oral iodine as iodized oil. Thyroid gland volume using ultrasound, urinary iodine concentration (UI), serum thyroxine (T(4)) and whole blood TSH were measured at baseline, and at 1, 5, 10, 15 and 30 weeks post intervention. Beginning at 30 weeks, the anemic group was given 60mg oral iron as ferrous sulfate four times/week for 12 weeks. At 50 and 65 weeks after oral iodine (8 and 23 weeks after completing iron supplementation), UI, TSH, T(4) and thyroid volume were remeasured. RESULTS: The prevalence of goiter at 30 weeks after oral iodine in Groups 1 and 2 was 12% and 64% respectively. Mean percent change in thyroid volume compared with baseline at 30 weeks in Groups 1 and 2 was -45.1% and -21.8% respectively (P<0.001 between groups). After iron supplementation in Group 2, there was a further decrease in mean thyroid volume from baseline in the anemic children (-34.8% and -38.4% at 50 and 65 weeks) and goiter prevalence fell to 31% and 20% at 50 and 65 weeks. CONCLUSION: Iron supplementation may improve the efficacy of oral iodized oil in goitrous children with iron-deficiency anemia.


Assuntos
Anemia Ferropriva/complicações , Anemia Ferropriva/tratamento farmacológico , Suplementos Nutricionais , Bócio Endêmico/complicações , Bócio Endêmico/tratamento farmacológico , Óleo Iodado/uso terapêutico , Ferro/administração & dosagem , Hormônios Tireóideos/metabolismo , Administração Oral , Anemia Ferropriva/metabolismo , Criança , Côte d'Ivoire , Feminino , Bócio Endêmico/metabolismo , Humanos , Masculino , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/efeitos dos fármacos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia
13.
Am J Clin Nutr ; 71(1): 88-93, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10617951

RESUMO

BACKGROUND: In developing countries, many children are at high risk of goiter and iron deficiency anemia. Because iron deficiency can have adverse effects on thyroid metabolism, iron deficiency may influence the response to supplemental iodine in areas of endemic goiter. OBJECTIVE: The aim of this study was to determine whether goitrous children with iron deficiency anemia would respond to oral iodine supplementation. DESIGN: A trial of oral iodine supplementation was carried out in an area of endemic goiter in western Côte d'Ivoire in goitrous children (n = 109) aged 6-12 y. Group 1 (n = 53) consisted of goitrous children who were not anemic. Group 2 (n = 56) consisted of goitrous children who had iron deficiency anemia. At baseline, thyroid gland volume and urinary iodine, thyrotropin, and thyroxine were measured by using ultrasound. Each child received 200 mg I orally and was observed for 30 wk, during which urinary iodine, thyrotropin, thyroxine, hemoglobin, and thyroid gland volume were measured. RESULTS: The prevalence of goiter at 30 wk was 12% in group 1 and 64% in group 2. The mean percentage change from baseline in thyroid volume 30 wk after administration of oral iodine was -45.1% in group 1 and -21.8% in group 2 (P < 0.001). Among the anemic children, there was a strong correlation between the percentage decrease in thyroid volume and hemoglobin concentration (r(2) = 0.65). CONCLUSION: The therapeutic response to oral iodine was impaired in goitrous children with iron deficiency anemia, suggesting that the presence of iron deficiency anemia in children limits the effectiveness of iodine intervention programs.


Assuntos
Anemia Ferropriva/complicações , Bócio Endêmico/tratamento farmacológico , Óleo Iodado/uso terapêutico , Administração Oral , Criança , Côte d'Ivoire/epidemiologia , Feminino , Bócio Endêmico/complicações , Bócio Endêmico/epidemiologia , Humanos , Iodo/urina , Óleo Iodado/administração & dosagem , Masculino , Prevalência , Tireotropina/sangue , Tiroxina/sangue
14.
Med Klin (Munich) ; 93(7): 401-6, 1998 Jul 15.
Artigo em Alemão | MEDLINE | ID: mdl-9711053

RESUMO

BACKGROUND: Iodine deficiency is the main cause of endemic goitre. Iodine supplementation and decrease of pituitary TSH are the therapeutical aims. In this study, bioavailability of levothyroxine combined with iodide and the same dose of levothyroxine alone were compared. PATIENTS AND METHODS: Fourty-eight subjects aged 18 to 40 years were randomly assigned for 6 days either 150 micrograms levothyroxine and 150 micrograms iodide (group A, n = 25) or 150 micrograms levothyroxine (group B, n = 23). Baseline TSH and thyroid hormones were measured 2 days before starting therapy as well as daily till day 6. TRH-test (delta TSH) and thyroid sonography were performed at day -2 and 6. RESULTS: During therapy baseline TSH decreased markedly from 1.26 to 0.35 mU/ml (median) in group A and from 1.37 to 0.39 to 0.39 mU/ml in group B (both p < 0.001), as well as delta TSH (A from 5.66 to 2.61 mU/ml; B from 6.3 to 2.95 mU/ml; p < 0.001). Difference of delta TSH (day -2 versus day 6) was negatively correlated to body surface (r = -0.307; p < 0.05). TT4 levels increased in both groups (A from 7.1 to 9.1 microU/dl; B from 7.2 to 9.4 microU/dl; p < 0.005). No significant differences were noted between both groups for thyroid-related parameters. In both groups, confidence intervals for baseline TSH and TT4 were in the expected range. CONCLUSION: In this study, similar bioavailability and bioequivalence for levothyroxine and the combination of levothyroxine with iodide were demonstrated.


Assuntos
Bócio Endêmico/sangue , Iodo/farmacocinética , Tiroxina/farmacocinética , Adolescente , Adulto , Disponibilidade Biológica , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Bócio Endêmico/tratamento farmacológico , Humanos , Iodo/administração & dosagem , Iodo/deficiência , Masculino , Equivalência Terapêutica , Tiroxina/administração & dosagem
16.
Coll Antropol ; 22(1): 51-62, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10097420

RESUMO

A new iodised oil, called Brassiodol, is proposed to prevent or eradicate 127I-deficiency disorders. Its original synthesis utilises rapeseed oil as vehicle of iodination, allowing the covalent binding of 127I atoms to all olefin groups of fatty acids (FAs). The final product contains 376 mg 127I/mL, manifests high refractoriness to degradative processes and is well tolerated by goitrous patients. The proposed dosage is 1 mL/year in adults owing to the rapid deiodination and massive 127I leakage of larger amounts in the urinary output. About 300-350 mg 127I may undergo tissue sequestration, insuring appropriate iodine coverage during 9-12 months. Clinical follow-up, hormonal data, and 127I excretory kinetics point to the normalisation of thyroid function within 3 months is stages I and II of the goitrous disease. This iodised oil, characterised by low cost, easy handling and high nutritional efficiency, seems ideally suited to meet public health and economical problems in countries facing severe goitrous areas.


Assuntos
Brassica , Bócio Endêmico/tratamento farmacológico , Óleos de Plantas/uso terapêutico , Adolescente , Adulto , Feminino , Humanos , Masculino
17.
Med Klin (Munich) ; 91(8): 489-93, 1996 Aug 15.
Artigo em Alemão | MEDLINE | ID: mdl-8965746

RESUMO

BACKGROUND: In terms of the pathomechanism, TSH and intrathyroid iodine deficiency are the interconnecting elements between alimentary iodine deficiency and the growth and genesis of goiter. L-Thyroxine treatment for suppression of hypophyseal TSH production and supplementary iodide have a synergistic effect in reducing the size of goiter. An individual adaptation of the L-Thyroxine dose is necessary for optimal TSH suppression. Excessive suppression of the TSH level prevents uptake of iodine by the thyroid and thus compensation of the intrathyroid iodine deficiency. Combination therapy of an individually adjusted amount of L-Thyroxine with a small, mostly constant amount of iodine is a recognized concept of goiter therapy today. Administration of a combination preparation with an individually adjustable dose of L-Thyroxine and 150 micrograms iodine complies with these recommendations and improves compliance since only one tablet is required. PATIENTS AND METHODS: In the present study, the thyroid iodine supply, efficacy and tolerance of such a combination preparation was tested for the first time in 49 patients with euthyroid iodine deficiency goiter (group A). 45 patients receiving an individual L-Thyroxine therapy served as controls (group B). RESULTS: Supplementation of individually dosable L-Thyroxine with 150 micrograms iodide leads to a markedly raised iodine excretion in the urine (p < 0.005). This is an indirect indication of an improved thyroid iodine supply. Patients of group A showed a greater reduction of the thyroid volume (18.5% as compared to 16.8%, p = n. s.) and a more persistent TSH suppression (lowering by 39% [group A] as compared to a rise of 17% [group B]) in relation to the initial value (p < 0.004). This is attributable to the improved supply of iodine. CONCLUSION: The combination therapy tested was tolerated just as well as the mono-L-Thyroxine treatment with better efficacy.


Assuntos
Síndromes do Eutireóideo Doente/tratamento farmacológico , Bócio Endêmico/tratamento farmacológico , Iodo/deficiência , Tiroxina/administração & dosagem , Adolescente , Adulto , Idoso , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Síndromes do Eutireóideo Doente/etiologia , Feminino , Bócio Endêmico/etiologia , Humanos , Iodo/administração & dosagem , Masculino , Pessoa de Meia-Idade , Testes de Função Tireóidea , Tireotropina/sangue , Resultado do Tratamento
18.
Orv Hetil ; 137(6): 287-90, 1996 Feb 11.
Artigo em Húngaro | MEDLINE | ID: mdl-8714404

RESUMO

Following a short historical review the authors summarize the latest results regarding domestic iodine supply. Iodine content in drinking waters, samples of mother's milk, urine and goiter screening data from all regions of Hungary unanimously verify that significant part of the population is deficient in iodine, yet supplementation of iodine is still even today an unsolved problem in our country. In the search for the reasons the authors review the theoretical possibilities of iodine supplementation by discussing advantages and disadvantages of the individual models. They establish that alimentary iodine supplementation in itself is not suitable due to both theoretical and practical reasons for the complete elimination of iodine deficiency, therefore they make recommendations to supplement iodine in other ways. They also discuss the effect of selenium deficiency on the metabolism of thyroid hormones. They call attention that domestic, endemic selenium deficiency may be related to the frequency of Hungarian occurrences of iodine deficiency disorders. The authors review the iodine deficiency disorders and their effects on the health of present and future generations. They compare the practical benefit and costs of iodine supplementation, and furthermore discuss in detail the possible side effects of iodine supplementation.


Assuntos
Bócio Endêmico/epidemiologia , Iodo/deficiência , Selênio/deficiência , Glândula Tireoide/metabolismo , Hormônios Tireóideos/metabolismo , Alimentos Fortificados , Bócio Endêmico/tratamento farmacológico , Bócio Endêmico/etiologia , Humanos , Hungria/epidemiologia , Iodo/administração & dosagem , Iodo/análise , Leite Humano/química , Selênio/administração & dosagem , Glândula Tireoide/efeitos dos fármacos , Água/química
19.
J Endocrinol Invest ; 19(1): 1-5, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8851684

RESUMO

In order to reduce the prevalence of goiter in a village of Mali liable to iodine deficiency, an iodized product (Lipiodol Ultra Fluide) was orally administered to their inhabitants. Taking into account a series of demographic variables and goiter types, a protocol was conducted using Lipiodol at three different dosage levels. Six months after the treatment, the hormone levels regained normal values, whereas only the smallest dose reduces the volume of goiters significantly.


Assuntos
Bócio Endêmico/tratamento farmacológico , Óleo Iodado/uso terapêutico , Feminino , Bócio Endêmico/sangue , Bócio Endêmico/epidemiologia , Humanos , Masculino , Mali/epidemiologia , Testes de Função Tireóidea , Hormônios Tireóideos/sangue
20.
Ann Endocrinol (Paris) ; 54(3): 191-6, 1993.
Artigo em Francês | MEDLINE | ID: mdl-8024245

RESUMO

The efficiency of iodized salt in Cameroon has been tested during 7 months in school children living in an endemic goitrous area. The salt contained 150 mg of iodine per kilogramme of salt when it left the production site. The regression rate of goiter was 84.0% and was not different from that obtained with a single oral administration of 240 mg of iodized oil to an age and sex matched population. Excretion of iodine in urine increased significantly (P < 0.05). Eight biochemical cases of thyroid dysfunction (7 cases of hypothyroidism and 1 case of hyperthyroidism) were observed. However these observations do not preclude the use of iodized salt in the prevention and the treatment of goiter in endemic areas.


Assuntos
Bócio Endêmico/tratamento farmacológico , Iodo/uso terapêutico , Cloreto de Sódio na Dieta/uso terapêutico , Adolescente , Adulto , Camarões/epidemiologia , Criança , Pré-Escolar , Bócio Endêmico/epidemiologia , Humanos , Iodo/urina , Óleo Iodado/uso terapêutico , População Rural , Instituições Acadêmicas , Tiocianatos/urina
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