Volume 180 - Issue 10
Diagnosis and management of hyperthyroidism and hypothyroidism
Author: Ngaire T Jones
Med J Aust 2004; 180 (10): 541-542. || doi: 10.5694/j.1326-5377.2004.tb06067.x
Published online: 17 May 2004
Published online: 17 May 2004
To the Editor: The recent article on thyroid disorders by Topliss and Eastman notes that “around the world, iodine deficiency still remains the predominant cause of hypothyroidism” and furthermore that “mild iodine deficiency is re-emerging in Australia”.1 Indeed, the Journal has recently published at least two articles suggesting that the iodine status of the Australian population needs to be further explored.2,3
My question therefore is: when treating a patient who has results indicating clinical or subclinical hypothyroidism, would it be relevant and important to test for iodine deficiency (by 24-hour urine collection)? This seems analogous to undertaking iron studies in a patient with a falling haemoglobin level. In the same way that iron deficiency can exist and produce symptoms, even in the absence of anaemia, may not iodine deficiency affect health and well-being? Without the elemental “building blocks” of iron and iodine, the relevant systems are put into overdrive to no avail.
It seems simple to test routinely for this possibility, correct any deficiency and then recheck thyroid function. There may be more “clinically significant iodine deficiency” than we realise.
As it will no doubt be some time until further studies in the Australian population shed more light on this, is it not relevant meanwhile to at least check for this possibility in individual patients?
References
- Topliss DJ, Eastman CJ. Diagnosis and management of hyperthyroidism and hypothyroidism. Med J Aust 2004; 180: 186-193. CHDBICCB
- McElduff A, McElduff P, Gunton JE, et al. Neonatal thyroid-stimulating hormone concentrations in northern Sydney: further indications of mild iodine deficiency? Med J Aust 2002; 176: 317-320. i1083046
- McDonnell CM, Harris M, Zacharin MR. Iodine deficiency and goitre in schoolchildren in Melbourne, 2001. Med J Aust 2003; 178: 159-162. i1083048