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Background:Nontoxic nodular goiter (NTNG) is common in endemic goiter regions. Thyroxine (T4) is often used to treat NTNG. There is little information regarding T4 treatment in regions that have recently become iodine sufficient. We studied the effect of T4 treatment on thyroid function tests in southwestern Greece (SWG), a recently iodine-sufficient area.Methods:We studied 827 residents of SWG (group A) to determine goiter prevalence, thyroid function, and urinary iodine concentration (UIC). Group B: 385 consecutive patients with thyroid dysfunction. Of these, 89 had NTNG and followed for 10 years on T4 treatment, and 296 had hyperthyroidism. Group C: 29 patients with NTNG, treated with triiodothyronine (T3) 50 μg/day and followed for 6 months. Measurements included serum T4 and 24-hour radioactive iodine uptake (RAIU) before and at the end of T3 administration.Results:The median UIC in group A was 114 μg/L. In group B (89 patients), the incidence of newly diagnosed hyperthyroidism was 5–7 per year with a cumulative percentage of 33 at the 10th year. The initial thyrotropin (TSH) was lower (0.78 ± 0.51 mIU/L) in those who developed thyrotoxicosis compared to those who remained euthyroid (1.17 ± 0.74 mIU/L) (p< 0.05). In 296 thyrotoxic patients, the incidence of autoimmune hyperthyroidism and toxic multi-nodular goiter (TMNG) was similar. In group C, 10/29 patients remained euthyroid and the 24-hour RAIU decreased by 49 during T3 treatment. Similarly, serum T4 decreased by 49. In the remaining patients who developed hyperthyroidism, 24-hour RAIU and T4 were decreased by 19 and 22, respectively.Conclusions:In SWG, a recently iodine-sufficient region, the risk of developing hyperthyroidism in patients with NTNG after administration of 100–150 μg T4 is relatively high in those whose serum TSH before T4 treatment is in the lower normal range. Therefore, T4 treatment should be avoided in these patients. [ABSTRACT FROM AUTHOR]

Background:Iodine deficiency (ID) is still a major universal health problem. Iodine deficiency disorders (IDDs) affect people of all ages, among whom the most vulnerable are children and adolescents. The aim of the present study was to assess the long-term effects on growth and pubertal development of correcting severe ID in areas of Azerbaijan between 1999 and 2000.Methods:Iodized oil was administered orally to 293,000 children, aged 6–16 years. Among those, 364 children were randomly selected and were examined 1 year before the administration of iodized oil (Group I-neg, iodine negative) and 295 children (Group I-Rx, iodine treated) were examined 4 years (Group I-Rx4, iodine treated 4 years later; n 173) or 5 years (Group I-Rx5, iodine treated 5 years later; n 122) after the last dose of iodide.Results:In Group I-neg the median urine iodine concentration (UIC) (mcg/L) was 36 (mean: 36.272 ± 11.036) and increased significantly (p< 0.001) in Group I-Rx4: 188 (mean: 230.969 ± 155.818) and in Group I-Rx5: 175 (mean: 201.176 ± 130.369). The prevalence of goiter was 99 in Group I-neg and 2 in Group I-Rx4. Children in Group I-Rx had a greater standard deviation score (SDS) for height (−0.1364 ± 1.279, n 294) than children in Group I-neg (−0.5019 ± 1.17, n 363) (p< 0.001, t −3.817), which was more significant for boys. SDS for weight was similar in both groups (Group I-neg: −0.17 ± 0.78, n 363; Group I-Rx: −0.115 ± 0.917, n 294). The rate of puberty development as judged by the development of breast and pubic hair was normalized in both sexes after the correction of ID.Conclusions:Our results demonstrate that long-term correction of severe ID leads to sustained improvement of linear growth accompanied by a normalization of the time of onset of pubertal development for both sexes. [ABSTRACT FROM AUTHOR]