Summary
High prevalence of goiter, other IDD such as impaired physical and intellectual growth
and hearing deficit have been reported previously in Kiga. In order to evaluate the
effect of iodized oil injection, this study was conducted in schoolchildren of Kiga
village from 1989 to 1992. One ml of iodized oil solution containing 480 mg of iodine
was injected into 198 schoolgirls and boys aged 8-14 years. Serum thyroid hormones,
RT3U, TSH and thyroglobulin, before and 12, 24 and 36 months after the intra-muscular
injection of iodized oil were measured. Assessment of urinary iodine was performed
at the same periods by Foss method. Prior to the injection, all schoolchildren had
goiters larger than grade 1 A (48% were grade 3); 3 years after intervention 20% had
grades zero and 1 A and 8% grade 3 (P < 0.001). Urinary iodine was 11.4 ± 19.8 before
and increased to 113 ± 63 and 83 ± 66 μg/g creatinine 2 and 3 years after intervention.
Mean serum T4 was 5.0 ± 2.1, 10.8 ± 2.8, 9.8 ± 2.5 and 9.5 ± 2.1 μg/dl before and 12, 24 and 36
months after the injection, respectively (P < 0.001). Mean serum TSH was 20.3 ± 22.8,
1.2 ± 1.6, 0.8 ± 1.2 and 2.2 ± 0.9 mU/L in the same intervals, respectively (P < 0.001).
Mean serum thyroglobulin was 132 ± 107, 10 ± 12 and 23 ± 20 ng/ml before and at 2
and 3 years after injection, respectively (P < 0.001). Slight but significant increases
in serum TSH and thyroglobulin occurred at 3 years after the injection. Findings show
benefits of iodized oil administration in decreasing goiter size and in resuming normal
thyroid function up to 3 years after the intervention. An increase in TSH and or thyroglobulin
could be considered as the first sign of a fall in effectiveness of iodized oil injection.
Key words:
Iodized oil - Iodine deficiency disorders - Goiter
References
- 1
Azizi F.
Success in prevention of Iodine Deficiency Disorders (IDD).
J Iran Nucl Med.
3
((Farsi))
1995;
1-3
- 2
Azizi F, Bentley D, Vagenakis A, Braverman L.
Abnormal thyroid function and the response to iodide in cystic fibrosis.
Trans Assoc Am Phys.
1979;
87
111-119
- 3
Azizi F, Daftarian N.
Side effects of iodized oil administration in patients with simple goiter.
J Endocrinol Invest.
2001;
24
72-77
- 4
Azizi F, Kalani H, Kimiagar M, Ghazi A, Sarshar A, Nafarabadi M, Rahbar N, Noohi S,
Mohajer M, Yassai M.
Physical, neuromotor and intellectual impairement in non-cretinous schoolchildren
with iodine deficiency.
Int J Vitam Nutr Res.
1995;
65
199-205
- 5
Azizi F, Kimiagar M, Ghazi A, Nafarabadi M.
The effects of iodized oil injection in eu-and hypothyroid iodine deficiency girls.
J Endocrinol Invest.
1997;
20
18-23
- 6
Azizi F, Kimiagar M, Ghazi A, Nafarabadi M, Behjati J, Esfahanian F.
Treatment of goitrous hypothyroidism with iodized oil supplementation in an area of
iodine deficiency.
Exp Clin Endocrinol.
1996;
104
387-391
- 7
Azizi F, Kimiagar M, Nafarabadi M, Yassai M.
Current status of iodine deficiency disorders in the Islamic Republic of Iran.
East Meditter Health Serv J.
1990;
8
23-27
- 8
Boyages S C, Halpern J P, Maberly G F, Collins J, Jupp J, Eastman C J, Jin C E, Gu Y H,
Zhou L.
Supplementary iodine fails to reverse hypothyroidism in adolescents and adults with
endemic cretinism.
J Clin Endocrinol Metab.
1990;
70
336-341
- 9
Braverman L E, Woeber K A, Inbar S H.
The induction of myxedema by iodide in euthyroid patients following radioiodine or
surgical treatment of diffuse toxic goiter.
N Engl J Med.
1969;
281
816-821
- 10
Delange F, Camus M, Ermans A M.
Circulating thyroid hormones in endemic goiter.
J Clin Endocrinol Metab.
1972;
34
891-898
- 11 Dunn J T, Thilly C, Pretell E A. Iodized oil and other alternatives to iodized
salt for the prophylaxis of endemic goiter and cretinism. In: Dunn JT, Pretell EA,
Daza CH, Viteri FF (eds) Towards the Eradication of Endemic Goiter, Cretinism, and
Iodine Deficiency PAHO, Washington DC 1986: 170-181
- 12
Eltom M, Karlsson F A.
The effectiveness of oral iodized oil in the treatment and prophylaxis of endemic
goiter.
J Clin Endocrinol Metab.
1985;
61
1112-1117
- 13 Ermans A M. Etipathogenesis of endemic goiter. In: Stanbury JB, Hetzel BS (eds)
Endemic goiter and endemic cretinism John Wiley, New York 1980: 287-301
- 14
Fierro-Benitez R, Cazar R, Stanbury J B, Rodriguez P, Garces F, Fierro-Renoyt F, Estrella E.
Effects on schoolchildren of prophylaxis of mothers with iodized oil in an area of
iodine deficiency.
J Endocrinol Invest.
1988;
11
327-335
- 15
Fierro-Benitez R, Penafiel W, De Groot L J, Ramirez I.
Endemic goiter and endemic cretinism in the Andean region.
N Engl J Med.
1969;
280
296-300
- 16
Foss O P, Hankes L, Van Skyke D D.
A study of alkaline ashing method for determination of protein-bound iodine in serum.
Clin Chem Acta.
1960;
5
301-326
- 17
Lazarus J H, Parkes A B, John R, N'Diaye M, Prysor-Jones S G.
Endemic goiter in Senegal-thyroid function, etiological factors and treatment with
oral iodized oil.
Acta Endocrinol.
1992;
126
149-154
- 18
Lima N, Knobel M, Medeiros-Neto G A.
Long term effect of iodized oil on serum thyroglobulin levels in endemic goiter patients.
Clin Endocrinol (Oxf).
1986;
24
635-641
- 19
Maberly G F, Corcoran H M, Eastman C J.
The effect of iodized oil on goiter size, thyroid function and the development of
the Jod Basdow phenomen.
Clin Endocrinol (Oxf).
1982;
17
235-256
- 20 Medeiros-Neto G. Endemic goiter and endemic cretinism. In: DeGroot (ed) Endocrinology
WB Saunders, Philadelphia 1989: 749-757
- 21
Pharoah P OD, Burrfield I H, Hetzel B S.
Neurological damage to the fetus resulting from severe iodine deficiency during pregnancy.
Lancet.
1971;
1
308-310
- 22
Pharoah P OD, Connolly K.
A controlled trial of iodinated oil for the prevention of endemic cretinism: A long-term
follow-up.
Int J Epidemiol.
1987;
16
68-73
- 23
Phillips D IW, Osmond C.
Iodine supplementation with oral or intramuscular iodized oil; a two-year follow up
of a comparative trial.
Int J Epidemiol.
1989;
18
907-910
- 24
Pretell E A, Moncloa F, Salinas R, Kawano A, Guerra-Garcia R, Gutierrez L, Beteta L,
Pretell J, Wan M.
Prophylaxis and treatment of endemic goiter in peru with iodized oil.
J Clin Endocrinol Metab.
1969;
29
1586-1590
- 25
Shenkman L, Medeiros-Neto G A, Mitsuma T, Monteiro K, Penna M, Pupo A A, Hollander C S.
Evidence for hypothyroidism in endemic cretinism in Brazil.
Lancet.
1973;
2
67-70
- 26
Thilly C H, Delange F, Goldstein-Golaire J, Ermans A M.
Endemic goiter prevention by iodized oil: a reassessment.
J Clin Endocrinol Metab.
1973;
36
1196-1204
- 27
Tonglet R, Bourdoux P, Minga T, Ermans A M.
Efficacy of low oral doses of iodized oil in the control of iodine deficiency in Zaire.
N Engl J Med.
1992;
326
236-241
- 28
Vanderpas J, Bourdoux P, Lagasse R, Rivera M, Dramaix M, Lody D, Nelson G, Delange F,
Ermans A M, Thilly C H.
Endemic infantile hypothyroidism in severe endemic goiter area of central Africal.
Clin Endocrinol.
1984;
20
327-340
- 29
Vanderpas J B, Rivera-Vanderpas M T, Bourdoux P, Luvivila K, Lafasse R, Perlmutter-Cremer N,
Delange F, Lanoie L, Ermans A M, Thilly C H.
Reversibility of severe hypothyroidism with supplementary iodine in patients with
endemic cretinism.
N Engl J Med.
1986;
315
791-795
- 30
Van Herle A J, Hershman J M, Hornabrook R W, Chopra I J.
Serum thyroglobulin in inhibitants of and endemic goiter region of New Guinea.
J Clin Endocrinol Metab.
1976;
43
512-516
- 31 Watanabe T, Moran D, El Tamer E, Staneloni L, Salvaneschi J, Altschuler N, Degrossi O J,
Niepominiszcze H. Iodized oil in the prophylaxis of endemic goiter in Argentina. In:
Dunn JT, Medeiros-Neto G (eds) Endemic goiter and Cretinism: Continuing Threats to
World Heralth. Pan American Health Organization, Washington DC 1974: 231-241
- 32 World Health Organization .Report of Joint WHO/UNICEF/ICCIDD Consultation on Indicators
for Assessing Iodine Deficiency Disorders and their Control Programmes. World Health
Organization, Geneva 1992: 22-29
Professor Fereidoun Azizi
Endocrine Research Center
P.O.Box: 19395-4763
Tehran, I.R.
Iran
Phone: + (98)21-2409309
Fax: + (98)21-2402463
Email: azizi@erc-iran.com