Thyroid diseases

It is difficult to define the normal range of iodine intake in humans, and despite efforts to provide iodine supplementation in many geographic areas of the world, endemic iodine deficiency and attendant goiter remain a world health problem (147). Exposure to excess iodine may sometimes lead to the development of thyroid disease. This unusual type of iodide-induced goiter has been found, for example, in 10% of the population of a Japanese island where fishermen and their families consume large quantities of an iodine-rich seaweed and have an iodine intake as high as 200 mg/d (148). 

Paschke R, Ludgate M (1997) The thyrotropin receptor in thyroid diseases. N Engl J Med 337 1675-1681... 

Iodoquinol is contraindicated in patients with known hypersensitivity. Iodoquinol is used with caution in patients with thyroid disease and during pregnancy and lactation. Iodoquinol may interfere with the results of thyroid function tests. This interference not only occurs during therapy, but may last as long as 6 months after iodoquinol therapy is discontinued. 

D. Coomans, M. Jonckheer, D.L. Massait, I. Broeckaert and P. Blockx, The application of linear discriminant analysis in the diagnosis of thyroid diseases. Anal. Chim. Acta, 103 (1978) 409-415. 

Discuss the relationship between serum thyroid-stimulating hormone (TSH) levels and primary thyroid disease and the advantages for the use of TSH levels over other tests such as serum T4 (thyroxine) and T3 (triiodothyroinine) levels. 

The assessment of patients for thyroid disorders entails a history and physical examination. In many patients with subclinical or mild thyroid disease, there may be an absence of specific signs and symptoms, and the physical examination may be normal. Various diagnostic tests can be used, including serum thyroid hormone(s), TSH, and thyroid antibody levels and imaging techniques to evaluate patients for thyroid disorders. Normal values for selected laboratory tests are given in Table 41-1. 

Thyroid Disease. Hypothyroidism (myxedema) [169] and hyperthyroidism [170] alter small bowel motility. Although today these diseases are usually recognized before such symptoms develop, thyroid function must be examined in unexplained intestinal pseudoobstruction. 

Christensen J, Schedl HP, Clifton JA The basic electrical rhythm of the duodenum in normal human subjects and in patients with thyroid disease. J Clin Invest 1964 43 1659-1667. 

Cho, B. 2002. Clinical applications of TSH receptor antibodies in thyroid diseases. Journal of Korean Medical Science 17(3), 293-301. 

Uncomplicated valvular heart disease Thyroid disease... 

Endocrine Thyroid gland atrophies with age Increased incidence of diabetes mellitus, thyroid disease Menopause... 

Many environmental factors have been implicated in the induction of autoimmunity. One dietary component, iodine, has been well studied as a factor that increases autoimmune thyroid disease.67 68 Based on studies in the OS chicken, the increasing prevalence of autoimmune thyroid disease observed in U.S. and Western European populations has been ascribed to increased use of iodized salt.69 Experimentally, it can be shown that iodinated thyroglobulin is a more potent autoantigen than the equivalent noniodinated molecule. Food additives or pesticides may also be important in contributing to the development of autoimmune disease in susceptible individuals.70... 

Adapted from Jacobson3, Cooper and Stroehla4 thyroid disease prevalence data from HollowellS and includes clinical and subclinical disease limited to clinical disease estimates are 500 per... 

A recent report by the National Institutes of Health estimated that at 14 to 22 million people in the United States are affected by an autoimmune disease.1 As a group, these diseases represent a leading cause of death among women under age 65, with systemic lupus erythematosus, multiple sclerosis, and type 1 diabetes being the major sources of this impact on mortality.2 The autoimmune thyroid diseases, type 1 diabetes and rheumatoid arthritis are the most common of the autoimmune diseases (Table 25.1).3-5 Most autoimmune diseases disproportionately affect women. In the thyroid diseases, primary biliary cirrhosis, scleroderma, systemic lupus erythematosus, and Sjogren s syndrome, more than 85% of patients are female, but it is not known why the female predominance is so high in these specific diseases. 

There are now thought to be several thousand different genetic diseases, about 10% of which have known biochemical lesions. As has already been seen with the thyroid diseases and diabetes, the phenotypic manifestation, hemophilia, for example, may have genetically, biochemically or clinically different causes. Some of the biochemically identified disturbances, such as those affecting glycogen or galactose, have been important in establishing metabolic pathways (see Chapter 4). 

There have been occasional case-reports of infants with goiter and hypothyroidism associated with soy-based infant formula consumption (Tuohy, 2003). There has been one case control study, by Fort et al. (1990), which suggested a higher prevalence of soy-based formula feeding in infants with subsequent autoimmune thyroid disease. However, an alternative explanation may be a greater tendency for atopic infants (who may be more likely to be fed soy-based infant formulas) to have such antibodies. 

Fort, P., Moses, N., Fasano, M., Goldberg, T. and Lifshitz, F. (1990). Breast and soy-formula feedings in early infancy and the prevalence of autoimmune thyroid disease in children, J. Am. Coll. Nutr., 9, 164-167. 

Thyroid Disease and Thyroid-Stimulating Hormone Receptor Mutations... 

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