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[A particular case of iodine-induced hypothyroidism]
1Divisione di Medicina Interna, Ospedale Maria Vittoria, ASL 3, Torino.
A surplus of iodine taken through drugs or food can cause a functional thyroidal deficiency, especially if there are pre-existent alterations in the gland. The case described of a young woman with a iodine-induced hypothyroidism without goitre due to an excessive trans-cutaneous/trans-mucous absorption of iodine in sea-bath salts. The woman, aged 32, showed a symptomatology characterized by asthenia, ponderal increase, constipation and bradypsychia. The thyroid appears normal after echography and scintigraphy. Iodized sea-bath salts have been used for three months in a hot water bath for a slimming effect. A complete regression is noticed with their suspension after one year. An excessive supply of iodine can even if rarely cause a hypothyroidism with/without goitre, because of an intrinsic defect in the mechanism of the organic link which permits a persistent Wolff-Chaickoff effect. A genetic predisposition is supposed and also a higher frequency in patients with a preceding thyroiditis, Basedow disease or Hashimoto disease. Particular attention should be given to a differential diagnosis in case of hypothyroidism in young women with a normal thyroid and negative antibodies. It is clear that a careful pharmacological anamnesis is essential as well as a careful anamnesis on the way of life.
A surplus of iodine taken through drugs or food can cause a functional thyroidal deficiency, especially if there are pre-existent alterations in the gland. The case described of a young woman with a iodine-induced hypothyroidism without goitre due to an excessive trans-cutaneous/trans-mucous absorption of iodine in sea-bath salts. The woman, aged 32, showed a symptomatology characterized by asthenia, ponderal increase, constipation and bradypsychia. The thyroid appears normal after echography and scintigraphy. Iodized sea-bath salts have been used for three months in a hot water bath for a slimming effect. A complete regression is noticed with their suspension after one year. An excessive supply of iodine can even if rarely cause a hypothyroidism with/without goitre, because of an intrinsic defect in the mechanism of the organic link which permits a persistent Wolff-Chaickoff effect. A genetic predisposition is supposed and also a higher frequency in patients with a preceding thyroiditis, Basedow disease or Hashimoto disease. Particular attention should be given to a differential diagnosis in case of hypothyroidism in young women with a normal thyroid and negative antibodies. It is clear that a careful pharmacological anamnesis is essential as well as a careful anamnesis on the way of life.