Supplementary iodine fails to reverse hypothyroidism in adolescents and adults with endemic cretinism

Steven C. Boyages*, Jean Pierre Halpern, Glen F. Maberly, John Collins, James Jupp, Creswell J. Eastman, Jin Chen-En, Gu Yu-Hai, Zhou Lin

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)

    Abstract

    The efficacy of supplemental iodine in correcting hypothyroidism in adults and older children with endemic myxedematous cretinism is not known. To investigate this issue we administered im iodized oil (1.5 mL) to 28 hypothyroid endemic cretins (TSH, >5 mlU/L) from western China, aged 14–52 yr (mean = 29 SD = 11 yr). Clinical examination, intelligence testing (Hiskey Nebraska Test of Learning Aptitude and the Griffiths Mental Development Scales), and thyroid function tests were performed before and 6 months after iodine supplementation. We found that signs of thyroid hormone deficiency, dwarfism, and delayed sexual maturity persisted after iodine supplementation. Further, mental disability and other clinical features of neurological damage were not altered by treatment. The mean serum concentration of total T4 before treatment was 75 nmol/L (SD = 40) and fell after iodized oil administration to 56 nmol/L (SD = 29; P < 0.001). Mean serum levels of TSH before and after iodine showed a paradoxical fall [85 mlU/L (SD = 102) and 46 mlU/L (SD = 46), respectively]. Serum TSH levels decreased into the normal range (<5 mlU/L) in only 1 of 28 patients (4%). We conclude that iodine supplementation does not reverse thyroid hormone deficiency or its sequelae in adolescents and adults with endemic myxedematous cretinism. Iodized oil in this age group of patients with endemic cretinism does not appear to be beneficial and should be used with caution.

    Original languageEnglish
    Pages (from-to)336-341
    Number of pages6
    JournalJournal of Clinical Endocrinology and Metabolism
    Volume70
    Issue number2
    DOIs
    Publication statusPublished - 1990

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