Iodine prophylaxis adults

Walinder, G. 1990. A review of risks of internal irradiation of the thyroid gland — in utero, neonatally, adults. Pages 105-110 in Iodine Prophylaxis Following Nuclear Accidents. Proceedings of the Joint WHO/CEC Workshop. July 1988. Pergamon Press, New York. 

The daily requirement for iodine in adults is 1-2 /ag/kg body weight. In the U.S., recommended daily allowances for iodine range from 40 to 120 /xg for children, 150 fxg for adults, 220 fxg for pregnancy, and 270 p,g for lactation. Dairy products and fish have relatively high iodine contents. Because of concerns of iodine insufficiency, iodine supplementation has been widely used for prophylaxis and therapy. The most practical form of this supplementation has been addition of iodide or iodate (now preferred) to table salt. In the U.S., such supplementation is optional and iodized salt provides 100 fxg of iodine/g. 

Studies on the effectiveness of iodine prophylaxis in children and adults should be continued. 

It can be summarized that the dual iodine prophylaxis system (iodization of householdsalt, and mineral mixtures for animal food) used in the new federal states of Germany was clearly effective in terms of reduction of goiter prevalence in newborns, children and adults and normalization of thyroid function in newborns. 

J.F. Malone and P. Gilligan, Problems in dosimetry including considerations of special groups in utero, the neonate, children and adults, in "Iodine Prophylaxis following Nuclear Accidents, E. Rubery and E. Smales, eds., Pergamon Press for WHO, Oxford (1990). 

Kinalska at al. The results of study of influence of radiological contamination and iodine prophylaxis after Chernobyl accident on the thyroid morphology and fiinction of the inhibitants of north -east region of Poland. Polish J. Endocrinol. 42 215 ( 1991 ). Szybifiski at al, Hie results of the epidemiological survey undertaken after Chernobyl accident in adult population of Craco-vian region. Polish J. Endocrinol. 42 263 ( 1991 ). 

Neonatal thyroid screening is an important additional tool for evaluating the potential consequences of iodine deficiency on brain development and for monitoring iodine prophylaxis at the population level. Indeed, neonates, whose very low thyroidal iodine stores make them hypersensitive to iodine deficiaicy, frequently have altered thyroid function tests (elevated serum TSH, possibly low T4) even at moderate degrees of iodine deficiency that do not appear to affect thyroid function in the adults. Therefore, a shift towards higher neonatal TSH values has been proposed as a useful tool to detect and monitor iodine deficient newborn populations. However, such a shift can be interpreted validly if representative sampling of newborns is carried out (at least one hundred determinations in randomly selected populations), with the use of sensitive assays for TSH measurements. 

Changes in Ioduria As can be seen in Figures 86.1 and 86.2, after the introduction of the improved program of iodine deficiency prophylaxis that took place in 1995—1996, there was a statistically significant increase in ioduria values, in both adults (Figure 86.1) and children (Figure 86.2). 

A lot of epidemiological data also fit well into the assumption that there is some age dependency of the iodine utilization by the thyroid. 13 years after the onset of iodized salt prophylaxy in Austria, the incidence of "school goiter diminished from 31% to 4%. In contrast, 31,8% of the adult women and 13% of men still had goiters at this time (62). A similar "dying out" of non-toxic goiter occurred in Switzerland (22). One has to admit, however, that only the preventive effect on goiter development has been ascertained by these studies. 

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