[Iodine deficiency due to an abnormal diet]

In the past, iodine deficiency was an important cause of goitre and mental retardation. Since the introduction of iodised salt the incidence of iodine deficiency has declined enormously.

An 8-year old girl had goitre for several months. Her diet was modified to take into account supposed food allergies. She never ate bread products and no salt was added to the food on the assumption that salt is harmful. The thyroid stimulating hormone (TSH) level was not abnormal, the free T4 value was reduced and the T3 value high to normal. Urine investigation indicated reduced iodine excretion. Echography demonstrated a diffusely enlarged thyroid. The iodine deficiency was successfully treated with oral iodine supplementation.

This case report shows that iodine deficiency based on an inadequate iodine intake still occurs in the Netherlands. An increase in supposed allergies and subsequent decrease of iodine supplementation in the diet may lead to a higher frequency of this "forgotten" disease.