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Effects of iodine contrast media on thyroid function - a prospective study.

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|October 14, 2024
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Iodine contrast medium (ICM) rarely causes thyroid dysfunction in adults aged 50-65. Most cases are mild and asymptomatic, with few developing subclinical issues, especially in iodine-sufficient regions.

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contrast mediadrug-related side effects and adverse reactionshyperthyroidismhypothyroidismprospective studies

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Area of Science:

  • Radiology
  • Endocrinology
  • Cardiology

Background:

  • Iodine contrast medium (ICM) can potentially induce thyroid dysfunction due to excess iodide.
  • Previous studies on contrast-induced thyroid dysfunction (CITD) are limited by observational and retrospective designs.
  • The Swedish CArdioPulmonary bioImage Study (SCAPIS) offers a prospective cohort for evaluating CITD.

Purpose of the Study:

  • To prospectively assess the incidence, magnitude, and clinical impact of contrast-induced thyroid dysfunction.
  • To evaluate thyroid hormone levels and thyroid-related symptoms after contrast-enhanced coronary CT angiography (CCTA).
  • To identify risk factors associated with ICM-induced thyroid dysfunction.

Main Methods:

  • Analysis of thyroid hormone levels before and after CCTA in 422 individuals.
  • Administration of thyroid-related patient-reported outcome questionnaires (ThyPRO) to 368 participants.
  • Measurement of thyroid peroxidase antibodies (TPOab) and thyroid ultrasound to detect nodules.

Main Results:

  • A small, statistically significant effect on thyroid hormone levels was observed, with no overt hypo- or hyperthyroidism.
  • Subclinical thyroid dysfunction or isolated free thyroxine (fT4) level changes occurred in 3.5% of individuals without increased symptoms.
  • Elevated TPOab and being foreign-born were risk factors for subclinical hypothyroidism; thyroid nodules were not associated with ICM-induced dysfunction.

Conclusions:

  • Contrast-induced thyroid dysfunction is rare, typically mild, self-limiting, and often asymptomatic in iodine-sufficient populations aged 50-65.
  • Prospective assessment using the SCAPIS cohort provides reliable data on ICM's impact on thyroid function.
  • The findings support that ICM use is generally safe concerning thyroid function in this demographic.