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Iodine nutrition optimization: are there risks for thyroid autoimmunity?

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Abstract

Iodine deficiency is still the main cause of preventable thyroid disorders, worldwide. To optimize iodine intake, programs of voluntary or mandatory iodization of salt have been implemented in several iodine-deficient countries and iodine sufficiency has been achieved in many. Despite the clear beneficial effects on thyroid health, some concerns have been raised on the presumed detriment of iodine prophylaxis on thyroid autoimmunity. Very recent studies aimed at evaluating the long-term consequences of iodine supplementation on thyroid autoimmunity and related dysfunction, have clearly demonstrated that the early post-iodization increase in thyroid antibody positivity is largely transient and not clinically relevant, since the prevalence of overt thyroid dysfunction has remained reassuring low over two decades. The recommended iodine intake is therefore safe with regard to thyroid autoimmunity, the benefits largely outweighing the risks in a population with a stable median iodine concentration not exceeding 300 μg/L. Thus, a possible increase in thyroid autoimmunity should not represent a limitation to promoting iodine supplementation in the general population, also taking into account the steady rise in prevalence of autoimmune disorders which has occurred in the last few decades because of environmental factors other than iodine.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Messina, via Consolare Valeria, 1, 98125, Messina, Italy

    R. M. Ruggeri & F. Trimarchi

  2. Endocrine Unit At University Hospital “AOU Policlinico G.Martino”, Messina, Italy

    R. M. Ruggeri

  3. Accademia Peloritana Dei Pericolanti at the University of Messina, Messina, Italy

    F. Trimarchi

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Both authors contributed to the review article. Francesco Trimarchi had the idea for the article. Rosaria M. Ruggeri performed the literature search and data analysis and drafted the work. Francesco Trimarchi critically revised the work. Both authors read and approved the final manuscript.

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Ruggeri, R.M., Trimarchi, F. Iodine nutrition optimization: are there risks for thyroid autoimmunity?. J Endocrinol Invest 44, 1827–1835 (2021). https://doi.org/10.1007/s40618-021-01548-x

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