Öz
Publications concerning the effects in society of recommendations regarding iodine supplementation over the last approximately 30 years are inconsistent. The aim of this study is to evaluate the effects of iodine supplemented nutrition, recommended for endemic goiter both in the world and in Turkey. The iodine-reinforced nutrition was started due to the fact that urine iodine levels were found low in adolescents. The endemic goiter regions were determined by ignoring the limitations of these studies. Findings in recent studies indicate that iodine replacement therapy increases autoimmunity and the incidence of hyperthyroidism. It is claimed that even iodine supplement increases hypothyroid rates instead of decreasing them. Therefore, iodine supplemented nutrition approaches should be closely followed. As a result, we suggest that iodine supplemented nutrition programs should be re-evaluated.
Anahtar Kelimeler
Endemic goiter Hyperthyroidism Hypothyroidism Thyroid function tests Iodine
Kaynakça
- 1. World Health Organization. Nutrition unit & micronutrient deficiency information system project. Global prevalence of iodine deficiency disorders. Geneva 1993. http://www.who.int/iris/handle/10665/37149
- 2. F Delange, H Bürgi. Iodine deficiency disorders in Europe. Bull World Health Organ 1989; 67(3): 317-325.
- 3. Andersson M, Karumbunathan V, Zimmermann MB. Global iodine status in 2011 and trends over the past decade. J Nutr 2012; 142: 744-750.
- 4. Delange F, de Benoist B, Alnwick D. Risks of iodine-induced hyperthyroidism after correction of iodine deficiency by iodized salt. Thyroid 1999; 9(6):545-556.
- 5. Kim YA, Park YJ. Prevalence and risk factors of subclinical thyroid disease. Endocrinol Metab (Seoul) 2014; 29(1): 20-29.
- 6. Bjoro T, Holmen J, Krüger O, Midthjell K, Hunstad K, Schreiner T, et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT). Eur J Endocrinol 2000; 143(5): 639-647.
- 7. Teng X, Hu F, Teng W, Wang H, Shong S, Shan Z, et al. The study of thyroid diseases in a community not using iodized salt. Zhonghua Yu Fang Yi Xue Za Zhi 2002; 36(3): 176-179.
- 8. Lind P, Kumnig G, Heinisch M, Igerc I, Mikosch P, Gallowitsch HJ, et al. Iodine supplementation in Austria: methods and results Thyroid 2002; 12(10): 903-907.
- 9. Yamada T, Sato A. Iodine responsive autoimmune thyroid diseases. Nihon Rinsho 1999; 57(8): 1788-1793.
- 10. Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Carlé A, Pedersen IB, Rasmussen LB, et al. Lower prevalence of mild hyperthyroidism related to a higher iodine intake in the population: prospective study of a mandatory iodization programme. Clin Endocrinol (Oxf) 2009; 71(3): 440-445.
- 11. Pedersen IB, Laurberg P, Knudsen N, Jørgensen T, Perrild H, Ovesen L, et al. An Increased Incidence of Overt Hypothyroidism after Iodine Fortification of Salt in Denmark: A Prospective Population Study. The Journal of Clinical Endocrinology & Metabolism 2006; 92(8): 3122-3127.
- 12. Delange F, Bürgi H, Chen ZP, Dunn JT. World status of monitoring iodine deficiency disorders control programs. Thyroid 2002; 12(10): 915-24.
- 13. Pearce EN, Andersson M, Zimmermann MB. Global iodine nutrition: Where do we stand in 2013? Thyroid. 2013;23(5):523-528.
- 14. Özbakır Ö, Doğukan A, Keleştimur F. The Prevalence of Elderly Subjects in Central Anatolia. Thyroid Dysfunction Among an Endemic Goiter Area of Central Anotolia. Endocrine Journal. 1995; 42(5), 713-716
- 15. Erdoğan G, Erdoğan MF, Delange F, Sav H, Güllü S, Kamel N. Moderate to severe iodine deficiency in three endemic goitre areas from the Black Sea region and the capital of Turkey. Eur J Epidemiol. 2000; 16: 1131-1134.
- 16. Erdoğan MF, Ağbaht K, Altunsu T, Ozbaş S, Yücesan F, Tezel B, et al. Current iodine status in Turkey. J Endocrinol Invest 2009; 32(7): 617-22.
- 17. Yakar RM, Yıldırım Z, Özay Y, Çaycı MK, Dayıoğlu H. Kütahya bölgesinde tiroid metabolizmasına bağlı hastalıkların araştırılması. J Clin Anal Med 2012; 3(3): 311-315.
- 18. Emral R, Bastemir M, Erdogan G, Gullu S. High prevalence of thyroid dysfunction and autoimmune thyroiditis in adolescents after elimination of iodine deficiency in Eastern Black Sea Region of Turkey. Turk Jem 2006; 1: 13-20.
- 19. Aydin Y, Besir FH, Erkan ME, Yazgan O, Gungor A, Onder E, et al. Spectrum and prevalence of nodular thyroid diseases detected by ultrasonography in the Western Black Sea region of Turkey. Med Ultrason 2014; 16(2): 100-106.
- 20. Gokcel A, Serteser M, Coskun A, Unsal İ. Iodine deficiency has recurred in Istanbul, Turkey. Endocrinol Metab Int J 2017; 5(1): 172-175.
- 21. Sezgin Y, Akgun AE. The evaluation of thyroid function tests in patients presenting to the family medicine clinics. J Clin Anal Med 2018; 9(5): 439-441.
- 22. Makay Ö, Yoldaş T, İçöz G, Akyıldız M, Yetkin E. Tiroid kanserinde değişim süreci: 1995’den 2006’ya. Turkish Journal of Surgery 2007; 23(2): 58-61.
- 23. Sürmelioğlu A, Tilki M, Birsen O, Bağcı P. İyot eksikliğine bağlı endemik bir bölgede yapılan guatr ameliyatlarında tiroid karsinomu sıklığı ve hücre tipleri. Haydarpasa Numune Med J 2017; 57(3): 161-166.
- 24. Bournaud C, Orgiazzi JJ. Iodine excess and thyroid autoimmunity. J Endocrinol Invest 2003;26(2):49-56.
- 25. Papanastasiou L, Vatalas IA, Koutras DA, Mastorakos G. Thyroid autoimmunity in the current iodine environment. Thyroid 2007; 17(8): 729-739.
- 26. Pedersen IB, Laurberg P, Knudsen N, Jørgensen T, Perrild H, Ovesen L, et al. Increase in incidence of hyperthyroidism predominantly occurs in young people after iodine fortification of salt in Denmark. The Journal of Clinical Endocrinology & Metabolism 2006; 91(10): 3830-3834.
- 27. Delange F, Lecomte P. Iodine supplementation: benefits outweigh risks. Drug Saf 2000; 22(2): 89-95.
- 28. Laurberg P, Cerqueira C, Ovesen L, Rasmussen LB, Perrild H, Andersen S, et al. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab 2010; 24(1): 13-27.
Öz
Otuz yılı aşkın bir süredir devam eden iyot takviyeli beslenme önerilerinin ilgili toplumlarda oluşturduğu etkiler üzerine birbiri ile çelişkili yayınlar mevcuttur. Bu çalışmanın amacı hem dünyada hem de Türkiye’deki endemik guatr sebebiyle önerilen iyot takviyeli beslenme etkilerini değerlendirmektir. İyot takviyeli beslenme, adelosanlarda idrar iyot seviyelerinin düşük bulunması nedeniyle başlatılmıştır. Sözkonusu bu çalışmaların kısıtlılığı göz ardı edilerek endemik guatr bölgeleri belirlenmiştir. Son çalışmalardaki bulgular, iyot replasman tedavisinin otoimmuniteyi arttırdığına ve hipertroidi insidansını yükselttiğine işaret etmektedir. İyot takviyesinin bile hipotroidi oranlarını azaltmak yerine arttırdığı iddia edilmektedir. Bu yüzden iyot takviyeli beslenme yaklaşımlarının yakından takip edilmesi gerekmektedir. Sonuç olarak iyot takviyeli beslenme proğramlarının yeniden değerlendirilmesi gerektiğini öneriyoruz.
Anahtar Kelimeler
Endemik guatr Hipertroidi Hipotroidi Tiroit fonksiyon testleri İyot
Kaynakça
- 1. World Health Organization. Nutrition unit & micronutrient deficiency information system project. Global prevalence of iodine deficiency disorders. Geneva 1993. http://www.who.int/iris/handle/10665/37149
- 2. F Delange, H Bürgi. Iodine deficiency disorders in Europe. Bull World Health Organ 1989; 67(3): 317-325.
- 3. Andersson M, Karumbunathan V, Zimmermann MB. Global iodine status in 2011 and trends over the past decade. J Nutr 2012; 142: 744-750.
- 4. Delange F, de Benoist B, Alnwick D. Risks of iodine-induced hyperthyroidism after correction of iodine deficiency by iodized salt. Thyroid 1999; 9(6):545-556.
- 5. Kim YA, Park YJ. Prevalence and risk factors of subclinical thyroid disease. Endocrinol Metab (Seoul) 2014; 29(1): 20-29.
- 6. Bjoro T, Holmen J, Krüger O, Midthjell K, Hunstad K, Schreiner T, et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT). Eur J Endocrinol 2000; 143(5): 639-647.
- 7. Teng X, Hu F, Teng W, Wang H, Shong S, Shan Z, et al. The study of thyroid diseases in a community not using iodized salt. Zhonghua Yu Fang Yi Xue Za Zhi 2002; 36(3): 176-179.
- 8. Lind P, Kumnig G, Heinisch M, Igerc I, Mikosch P, Gallowitsch HJ, et al. Iodine supplementation in Austria: methods and results Thyroid 2002; 12(10): 903-907.
- 9. Yamada T, Sato A. Iodine responsive autoimmune thyroid diseases. Nihon Rinsho 1999; 57(8): 1788-1793.
- 10. Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Carlé A, Pedersen IB, Rasmussen LB, et al. Lower prevalence of mild hyperthyroidism related to a higher iodine intake in the population: prospective study of a mandatory iodization programme. Clin Endocrinol (Oxf) 2009; 71(3): 440-445.
- 11. Pedersen IB, Laurberg P, Knudsen N, Jørgensen T, Perrild H, Ovesen L, et al. An Increased Incidence of Overt Hypothyroidism after Iodine Fortification of Salt in Denmark: A Prospective Population Study. The Journal of Clinical Endocrinology & Metabolism 2006; 92(8): 3122-3127.
- 12. Delange F, Bürgi H, Chen ZP, Dunn JT. World status of monitoring iodine deficiency disorders control programs. Thyroid 2002; 12(10): 915-24.
- 13. Pearce EN, Andersson M, Zimmermann MB. Global iodine nutrition: Where do we stand in 2013? Thyroid. 2013;23(5):523-528.
- 14. Özbakır Ö, Doğukan A, Keleştimur F. The Prevalence of Elderly Subjects in Central Anatolia. Thyroid Dysfunction Among an Endemic Goiter Area of Central Anotolia. Endocrine Journal. 1995; 42(5), 713-716
- 15. Erdoğan G, Erdoğan MF, Delange F, Sav H, Güllü S, Kamel N. Moderate to severe iodine deficiency in three endemic goitre areas from the Black Sea region and the capital of Turkey. Eur J Epidemiol. 2000; 16: 1131-1134.
- 16. Erdoğan MF, Ağbaht K, Altunsu T, Ozbaş S, Yücesan F, Tezel B, et al. Current iodine status in Turkey. J Endocrinol Invest 2009; 32(7): 617-22.
- 17. Yakar RM, Yıldırım Z, Özay Y, Çaycı MK, Dayıoğlu H. Kütahya bölgesinde tiroid metabolizmasına bağlı hastalıkların araştırılması. J Clin Anal Med 2012; 3(3): 311-315.
- 18. Emral R, Bastemir M, Erdogan G, Gullu S. High prevalence of thyroid dysfunction and autoimmune thyroiditis in adolescents after elimination of iodine deficiency in Eastern Black Sea Region of Turkey. Turk Jem 2006; 1: 13-20.
- 19. Aydin Y, Besir FH, Erkan ME, Yazgan O, Gungor A, Onder E, et al. Spectrum and prevalence of nodular thyroid diseases detected by ultrasonography in the Western Black Sea region of Turkey. Med Ultrason 2014; 16(2): 100-106.
- 20. Gokcel A, Serteser M, Coskun A, Unsal İ. Iodine deficiency has recurred in Istanbul, Turkey. Endocrinol Metab Int J 2017; 5(1): 172-175.
- 21. Sezgin Y, Akgun AE. The evaluation of thyroid function tests in patients presenting to the family medicine clinics. J Clin Anal Med 2018; 9(5): 439-441.
- 22. Makay Ö, Yoldaş T, İçöz G, Akyıldız M, Yetkin E. Tiroid kanserinde değişim süreci: 1995’den 2006’ya. Turkish Journal of Surgery 2007; 23(2): 58-61.
- 23. Sürmelioğlu A, Tilki M, Birsen O, Bağcı P. İyot eksikliğine bağlı endemik bir bölgede yapılan guatr ameliyatlarında tiroid karsinomu sıklığı ve hücre tipleri. Haydarpasa Numune Med J 2017; 57(3): 161-166.
- 24. Bournaud C, Orgiazzi JJ. Iodine excess and thyroid autoimmunity. J Endocrinol Invest 2003;26(2):49-56.
- 25. Papanastasiou L, Vatalas IA, Koutras DA, Mastorakos G. Thyroid autoimmunity in the current iodine environment. Thyroid 2007; 17(8): 729-739.
- 26. Pedersen IB, Laurberg P, Knudsen N, Jørgensen T, Perrild H, Ovesen L, et al. Increase in incidence of hyperthyroidism predominantly occurs in young people after iodine fortification of salt in Denmark. The Journal of Clinical Endocrinology & Metabolism 2006; 91(10): 3830-3834.
- 27. Delange F, Lecomte P. Iodine supplementation: benefits outweigh risks. Drug Saf 2000; 22(2): 89-95.
- 28. Laurberg P, Cerqueira C, Ovesen L, Rasmussen LB, Perrild H, Andersen S, et al. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab 2010; 24(1): 13-27.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Editöre Mektup |
| Yazarlar | |
| Yayımlanma Tarihi | 9 Mart 2021 |
| Gönderilme Tarihi | 23 Mayıs 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 15 Sayı: 1 |
Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.