Iodine Deficiency Research Articles

Assessment of energy dispersive X-ray fluorescence (ED-XRF) for quantification of iodine in non-lyophilized milk.

Iodine represents a fundamental element for human health, with particular regard to thyroid function. Dietary intake of milk naturally rich in iodine becomes of primary importance in the prevention of syndromes related to iodine deficiency. The concentration of iodine in milk is characterized by wide variability, mainly related to animal feed and level of mineral supplementation. Therefore, there is interest in the development of fast analytical techniques which are able to predict milk iodine concentration. The aim of the present study was to investigate the effectiveness of energy-dispersive X-ray fluorescence (ED-XRF) for the prediction of iodine in cow milk. Results showed moderate accuracy of the ED-XRF technique, with a coefficient of determination in cross validation of 0.60. This study represents a first contribution towards the possibility to discriminate milk with high or low iodine concentration, as an essential preliminary step for the introduction into the market of naturally fortified milk.

Knowledge and Utilisation of Iodised Salt by School Children and Food Vendors in Dar es Salaam, Tanzania.

Universal Salt Iodisation (USI) is globally accepted as a cost-effective strategy for controlling Iodine Deficiency Disorders (IDD). However, there is a paucity of data on the proper use of iodised salt among food vendors. Thus, the present study assessed the School food environments and iodised salt practices among school food vendors in Tanzania. A cross-sectional study was conducted involving 322 school children and 30 school food vendors. A stratified multistage followed by a systematic random sampling technique was used to recruit schools and children. Salt samples were collected from food vendors and analyzed using the iodine rapid field test kit and then analyzed quantitatively using an iodometric titration method. The data on knowledge, attitude, and practices was collected using customized Iodine deficiency-related questionnaires recommended by FAO to assess iodine deficiency-related factors. For school food environments, 3 tools were designed and used to get information; the teachers, students, and school food vendors' tools. A chi-square test was used to establish an association between variables. About 76.7% of the salt samples from school food vendors were adequately iodised (≥15 ppm) with the mean iodine content of 39.26 ± 11.06. More than half (70%) of the food sold around school compound were junk food. Half (63.3%) of the food vendors had poor practices of iodised salt utilisation. A substantial achievement has been made in awareness creation of the importance of using iodised salt. Nonetheless, there is a limited knowledge on salt handling practices including discretionary salt use exacerbated by poor school food environment. To optimally eliminate IDDs, the government should now place more emphasis on proper salt handling practices from the production site, food handlers, and much more to consumers. School children should be encouraged on healthy eating habits, by improving school feeding programs and change the current food environments in schools.

Evaluation of the chemical composition and nutritional value of lettuce (Lactuca sativa L.) biofortified in hydroponics with iodine in the form of iodoquinolines

Iodine deficiency in the diet creates the need to search for innovative, more sustainable and more effective strategies for enriching food with this microelement. The adopted research hypothesis assumed that the use of organic forms of iodine for supplementation of lettuce (Lactuca sativa L.), compared to mineral iodine, has a more favorable effect not only on the concentration of iodine, but also on the yield and the content of other chemical components determining its nutritional and health-promoting value. Lettuce was planted in a nutrient film technique (NFT) hydroponic study in a greenhouse. The following application of iodine compounds (all in 5 µM molar mass equivalents) were tested in the studies: control (without of iodine application); potassium iodate (positive iodine control), 8-hydroxy-7-iodo-5-quinolinesulfonic acid, 5-chloro-7-iodo-8-quinolinol, 5,7-diiodo-8-quinolinol and 4-hydroxy-8-iodo-3-quinolinecarboxylic acid. In this work, it was shown for the first time that iodoquinolines can be 1) a source of iodine for plants; 2) they have a biostimulating effect on their yielding and 3) they increase the resistance of crops to stress (due to a significant increase in the level of polyphenolic compounds). Lettuce with the addition of 8-hydroxy-7-iodo-5-quinolinesulfonic acid was characterized by the highest content of iodine, which was 221.7 times higher than in control plants. The weight gain of the whole plant was particularly visible in the case of lettuce enriched with 5-chloro-7-iodo-8-quinolinol and amounted to 26.48% compared to the control. Lettuce biofortified with iodine in the form of iodoquinolines can successfully become part of a sustainable diet based on plant products, which has a low impact on the environment and contributes to the long-term good health of an individual or community. Reducing iodine deficiency through the use of organoiodine compounds can help achieve the sustainability goal of eliminating hidden hunger, improving nutritional status and promoting sustainable agriculture.

Iodine Status of School Children Aged 6 to 12 Years in Rural and Urban Communities in Imo State, Southeast Nigeria

Background: Iodine is a trace element essential for the synthesis of thyroid hormones, thyroxine and triiodothyronine, which in turn play a crucial role in the growth and development of most organs, especially the brain. Iodine deficiency is therefore a serious medical condition fraught with dire consequences. Median urinary iodine concentrations of 100–199 mcg/L in children and adults, 150–249 mcg/L in pregnant women and >100 mcg/L in lactating women indicate iodine intakes are adequate. Objective: This study set to determine the Iodine status of children aged 6-12 years using MUIC in selected urban and rural communities of Imo state, South East Nigeria. Methods: It was cross sectional in nature and was carried out between July 2018 and January 2019. It involved 386 children aged 6-12 years who were selected from primary schools in both urban and rural local areas within the three educational zones of Imo State. Their urinary Iodine concentration was assayed using Ammonium persulphate technique of the Sandell- Koltkoff reaction method. Results: The median urine iodine concentration (MUIC) in the study participants ranged from 65 – 490 mcg/l with a median of 160mcg/l. While median urine iodine concentrations (MUIC) of 160 mcg/L and 156mcg/L, respectively, were observed in urban-dwelling and rural-dwelling school children respectively. Of the 386 participants, 30 had a MUIC of < 100\(\mu\)g/L therefore giving an iodine deficiency prevalence of 7.8%. They consisted of 14 participants from the urban areas and 16 from the rural areas. The difference between MUIC of children in rural and urban areas of Imo state was not statistically significant . (χ2 = 0.10: p = 0.75). Conclusion: While there was Iodine deficiency prevalence of 7.8%, there was no statistically significant difference between the Iodine status of pupils in urban and rural areas of Imo state.

Nutritive and Anti-Nutritive Compounds of Oil Seeds Renewables and By-Products in the Livestock Industry

Nigeria is one of the major oilseeds producers in Africa due to favorable climatic and edaphic factors. They strive well under rain-fed conditions; under low rainfall the crops experience moisture stress causing low yield. Oil seeds have recently attracted more interest due to their nutritional composition and the demand keeps rising due to the increase in population growth. Oil seed products such as soybeans, cottonseed, rapeseed, sunflower, and camelina meal or cake are sources of amino acids, and digestible rumen protein and minerals that influence animal growth and development. Due to the considerable amount of polyunsaturated fatty acids, it causes toxins accumulation and inflammation. The presence of antinutrients such as glucosinolates, trypsin inhibitors, gossypol, and lectins in these oilseeds inhibits their protein degradability, mineral bioavailability, flavor, and taste. Animals are affected by the toxicity of antinutrients leading to diseases and death. Glucosinolates, trypsin inhibitors, are known to reduce feed intake and cause iodine deficiency causing goiter and enlargement of the liver, kidney, and thyroid of animals which consequently affects the body. This paper summarizes the nutritive and anti-nutritive values of different oil seeds, the effect of different livestock animals, and the methods of reducing or eliminating the attributive compounds.

Serum iodine concentration and its associations with thyroid function and dietary iodine in pregnant women in the southeast coast of China: a cross-sectional study.

Iodine deficiency is a major public health problem in pregnant women. Serum iodine (SI) may represent a useful biomarker for iodine nutrition evaluation. We aimed to assess the relationship between serum iodine concentration (SIC) and urinary iodine concentration (UIC), dietary iodine, thyroid function, and thyroid diseases in pregnant women in the southeast coast of China, and to provide a normal reference range of SIC for pregnant women. A multistage random sampling method was used to select the study population. We collected urine and blood samples from pregnant women and determined UIC and SIC as well as thyroid function using Arsenic-Cerium Catalytic Spectrophotometry, inductively coupled plasma mass spectrometry, and Beckman Coulter Access2 chemiluminescent immunoanalyzer and kit, respectively, and administered a questionnaire on dietary iodine intake in pregnant women. There was a significant negative correlation between SI and thyroid-stimulating hormone (TSH) (r = -0.141) and a significant positive correlation between SI and free triiodothyronine (FT3) (r = 0.106), free thyroxine (FT4) (r = 0.236), triiodothyronine (TT3) (r = 0.229), total thyroxine (TT4) (r = 0.433), and dietary iodine intake (r = 0.068). There was a significant difference in SI levels of pregnancy between the second (78.13 μg/L) and third trimester (75.37 μg/L) (p = 0.018). SI levels between inadequate intake (74.58 μg/L) and appropriate intake (77.92 μg/L) groups were statistically different (p = 0.036). Low SIC was a risk factor for the development of hypothyroxinemia (adjusted OR = 3.14, 95% confidence interval: 1.75-5.66). The reference range for SIC in normal pregnant women is 45.03-112.44 μg/L. SI may be a composite indicator of iodine nutritional status and thyroid function.

Production cooked sausages with the addition of iodized salt

Iodine deficiency in the biosphere, mainly in the soil, leads to endemic goiter and other iodine deficiency disorders. As shown by numerous studies, this disease affects over 1 billion people in the world. Endemic goiter and much of the territory of Ukraine, including the Vinnytsia region. Presented current research study of recipes and technologies on system-cooked sausages. Currently, boiled sausage enjoys relatively high demand among the population because it is significant for most people, giving it an advantage. Innovation activity represents one of the most effective directions. It should facilitate the development of innovative activity that promotes penetration into new markets and production growth. Today, the most essential and effective innovative organizational and technical measures introduced in sausage production can be considered are the use of new recipes for manufacturing products and the installation of new equipment, which can significantly reduce the cost of manual labor and power inputs and improve product quality and reduce the share of marriage. Sausage production is seen as a thermochemical method of preserving meat products. For each type of sausage, set production process-approved technological instructions and recipes. Strict adherence to recipes, specialized instructions, and sanitary regimes is a prerequisite for obtaining high-quality links. Crucial in the production of sausages is raw. The primary raw materials are beef and pork. Occasionally, use lamb and horsemeat. Equally important is the creation of a new generation of products that have general strengthening and preventive action. The components of these products can protect the body from the harmful effects of the environment and the emergence of human diseased cells. The constant lack of iodine leads to a reduction in the synthesis and secretion of the primary thyroid hormone - thyroxine. The role of thyroid hormones in the body is extremely high, and most of the vital functions are performed by their participation. The main physiological effects of thyroid hormone are stimulating synthesis, growth, development, and differentiation of tissues. Developed products to include microorganisms that can synthesize biologically active structures (antibodies, receptors, hormones) that contribute to the removal or destruction of harmful decay and systems, thereby preventing human disease.

Why More Prevalence of Thyroid Disorders in Women in Present Scenario

It is no surprise that women nowadays face a slew of health challenges. Thyroid dysfunctions, which are primarily caused by an imbalance of thyroid hormones are growing more frequent, with the American Thyroid Association estimating that one out of every eight women may experience thyroid challenges over her lifetime. Furthermore, it is expected that women are 5 to 8 times more prone than males to acquire thyroid issues. Because of modernity and increased stress in everyday life, Vega dharana, hormonal changes, iodine insufficiency, auto-immune disorders resulting in numerous endocrinal disorders in females. Hypothyroidism and hyperthyroidism is a prevalent endocrine illness that affects people all over the world. These figures point to an increase in the number of women experiencing health issues such as menstrual cycle imbalance, polycystic ovarian syndrome, sudden weight gain or loss, hypertension, lethargy, dry skin and hair, constipation and so on, all of which have their own effects on the body and are directly or indirectly related. The review will be useful in understanding the pathophysiology of Thyroid disorders and changing the disease's treatment regimen.

TSH Pulses Finely Tune Thyroid Hormone Release and TSH Receptor Transduction.

Detection of circulating TSH is a first-line test of thyroid dysfunction, a major health problem (affecting about 5% of the population) that, if untreated, can lead to a significant deterioration of quality of life and adverse effects on multiple organ systems. Human TSH levels display both pulsatile and (nonpulsatile) basal TSH secretion patterns; however, the importance of these in regulating thyroid function and their decoding by the thyroid is unknown. Here, we developed a novel ultra-sensitive ELISA that allows precise detection of TSH secretion patterns with minute resolution in mouse models of health and disease. We characterized the patterns of ultradian TSH pulses in healthy, freely behaving mice over the day-night cycle. Challenge of the thyroid axis with primary hypothyroidism because of iodine deficiency, a major cause of thyroid dysfunction worldwide, results in alterations of TSH pulsatility. Induction in mouse models of sequential TSH pulses that mimic ultradian TSH profiles in periods of minutes were more efficient than sustained rises in basal TSH levels at increasing both thyroid follicle cAMP levels, as monitored with a genetically encoded cAMP sensor, and circulating thyroid hormone. Hence, this mouse TSH assay provides a powerful tool to decipher how ultradian TSH pulses encode thyroid outcomes and to uncover hidden parameters in the TSH-thyroid hormone set-point in health and disease.

THYROID STATUS IN WOMEN OF REPRODUCTIVE AGE LIVING UNDER MILD IODINE DEFICIENCY CONDITIONS

Purpose. This study aimed to examine thyroid picture in twenty-five women of reproductive age (18-35 years old, mean age 27.28 ±0.23 yrs) living in conditions of moderate iodine deficiency but being not diagnosed with obvious thyroid.
 Materials and Methods. A Beckman Coulter Dx1800 analyzer was applied to perform a serum marker test for thyroid gland performance level with the immunochemiluminescent method using paramagnetic particles. A Toshiba Aplio 500 unit was used for thyroid gland ultrasound examination with a linear sensor.
 Results. The pituitary-thyroid analysis showed no severe impairment in the examined women. Of all the 25 subjects, 8 women (32%) reported a normally high level of TSH (2.0–4.2 mME/L), which may indicate minimal thyroid insufficiency seen in its early, mild stage. We analyzed the content of hormones depending on the TSH variables, and found a statistically significant decrease in the integral thyroid index ITI (p=0.0001) in examinees with normally high TSH levels, which also indicated the initial stage of hypothyroidism, in spite of the individual blood serum iodothyronines lying within the reference ranges. The tendency to the raised free T3 concentration with a fall in free T4 showed a strong link to an increase in the processes of peripheral conversion of iodothyronines in subjects with higher TSH levels.
 By the thyroid gland ultrasound examination we revealed no structural disorders or pathologies in 18 of 25 women (72%); 5 women (20%) exhibited single or multiple cysts in different localities of the organ; 2 women (8%) demonstrated signs of autoimmune thyroiditis with grade 1 hyperplasia; and 1 woman (4%) had a node of the thyroid gland.
 Conclusion. The research showed the necessity to conduct assessment studies on thyroid performance in groups at special risk for developing iodine deficit diseases, especially in women of reproductive age who are planning pregnancy and living in conditions of moderate iodine deficiency.

Adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia, 2022.

The inadequacy of iodine in salt is the a contributing factor behind lack of awareness and poor economic performance in developing countries. To address the issue of iodine deficiency, universal salt iodization has been implemented globally. Nevertheless, it is imperative to closely monitor the sufficiency of iodine in salts to achieve its intended objective at the household level in the Bahir Dar Zuria district. To assess the adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia. A community-based cross-sectional study was conducted from May to June 2022 among households in Bahir Dar Zuria district. The data were gathered from 825 households that were chosen using a multistage sampling process. Iodometric titration was used to assess the amount of iodine in salt. The data were gathered using a structured questionnaire that was administered by an interviewer. For data entry and analysis, EpiData version 3.01 and SPSS version 25.0 were used, respectively. To evaluate the association between explanatory factors and the outcome variable, binary logistic regression was conducted, and significance was determined at alpha 0.05. This study analyzed a total of 825 households. Of these, only 384 [46.5, 95% CI, 43.5-50.5%] households had adequately iodized salt at home. Age increase of 1 year [AOR = 1.04, 95% CI = 1.02-1.06], being an urban resident [AOR = 3.18, 95% CI = 1.84-5.48], diploma and above educational attainment [AOR = 3.74, 95% CI = 1.99-7.02], checking salt by asking the seller [AOR = 2.21, 95% CI = 1.26-3.88], storing salts in closed containers [AOR = 1.57, 95% CI = 1.13-2.19], and storing salts in a dry and cool area [AOR = 2.72, 95% CI =1.37-5.42] were associated with the adequacy of iodized salt at the household level. The percentage of households in the district (46.5%) that had enough iodized salt in their homes is still extremely low and falls short of the targeted level for the country. At the household level, adequate iodized salt was found to be associated with age, place of residence, level of education, checking salt iodization while purchasing, place of salt storage, and cover use for salt containers. Therefore, increasing the accessibility of iodized salt at the household level is essential.

Factors responsible for the persistence of Hypothyroidism among Pakistani Women.

Substantial change in climate over the years in South Asia is directly affecting the diet and health of the population. It is important to analyze the aftermath of this change and its impact on the thyroid status. In recent years, a complex interplay of the changing climate with the environmental, geographical and dietary factors has contributed to the continued prevalence of hypothyroidism in Pakistani women. To study the influence of various factors which might be aggravating hypothyroidism in the female population of Pakistan, a thorough search of literature was conducted of various databases including Google Scholar and PubMed. Google as a search engine was also explored. This included both interventional and observational studies, published in English, from the year 1950 onwards uptil June 2023. It also included WHO website and local news clips about the awareness campaigns on iodine deficiency over the past years. All studies conducted on females to diagnose hypothyroidism, with both positive and negative outcomes were included in this study. The factors contributing to hypothyroidism among the female population in Pakistan encompass the effects of climate change, both direct and indirect, topographical factor, indiscriminate use of hazardous pesticides, presence of chemical contaminants in food and water, and a lack of awareness among the public and healthcare professionals about the condition's symptoms and management.

Iodine status of school-aged children in the changing context of universal salt iodization program during 1997–2018 in Chongqing, China

ObjectiveTo illustrate the changes of iodized salt usage, goiter rate of school-aged children and median urinary iodine concentration (MUIC) of school-aged children in Chongqing for the last 21 years. This study aims to estimate the variational provincial status of iodine nutrition and provide scientific evidence for fine-tuning and adaptation of the current program. MethodsDifferent number of families and school children aged 8–10 years from Chongqing during 1997–2018 participated in the study. UIC and iodine content in table salt were measured. Thyroid volumes of students were examined and goiter prevalence was calculated across years. ResultsThe median iodine content of table salt was negatively associated with years(r = −0.727, P < 0.01). The MUIC were decreased annually (ranged between 200 and 300 μg/L) and was negatively associated with year(r = −0.831, P < 0.01). Goiter of school-aged children in Chongqing was decreased from the highest rate of 23.58% in 1999 to 1.62% in 2018(Cochran-Armitage Trend Test: χ2=-30.695, P < 0.01). Thyroid volume were negatively associated with years(r = −0.962, P < 0.01) and had a positive relationship with MUIC 1997–2018 (r = 0.862, P < 0.01). ConclusionsThe consumption of adequately iodized salt can eliminate Iodine deficiency disorders (IDD) in children, but possible excessive iodine intake from salt could result in high urinary iodine excretion and even goiter. A systematic, well-designed and continual program monitoring is essential to ensure the adequacy of iodine fortification levels and to regularly change the iodine concentration in household table salt.

Maternal Urinary Iodine Concentration during Pregnancy and Its Impact on Child Growth and Neurodevelopment: An 11-Year Follow-Up Study.

Mild-to-moderate iodine deficiency during pregnancy is prevalent worldwide, but its consequences for maternal and child health are not clear. We aimed to investigate the impact of maternal iodine intake during pregnancy on the child's growth and neurodevelopment. This study involved a cohort of 11-year-old children (n = 70) whose mothers had participated in an iodine intake survey during pregnancy. Gestational, neonatal, anthropometric, intelligence quotient (IQ), and socioeconomic parameters were analyzed according to maternal urinary iodine concentration (UIC). There was a positive linear trend of current height Z-score, full-scale IQ, verbal IQ, family income, maternal education, and a negative trend of neonatal TSH levels with increasing maternal UIC levels. However, regression analysis indicated that maternal UIC was not an independent predictor of any gestational, neonatal, or childhood development parameter. Only maternal school education was positively associated with child height and IQ. In conclusion, we did not find any evidence of a direct effect of maternal iodine intake during pregnancy on the long-term growth and neurodevelopment of children. The results suggest that socioeconomic factors are important confounding factors that affect both maternal iodine intake and child development and must be considered when investigating the association between maternal iodine intake and child outcomes.

Iodine status, including breastmilk iodine content, of lactating mothers and their infants aged 0 to 6 months in Vhembe and Mopani districts of the Limpopo province, South Africa.

Background. Both iodine deficiency and excess may affect lactating women and their infants. In Limpopo Province, South Africa (SA), there are no data on the iodine status of individuals in these vulnerable groups.Objective. To determine the iodine status, including breastmilk iodine content, of lactating mothers and their infants aged 0 - 6 months in Vhembe and Mopani districts, Limpopo, SA.Methods. A cross-sectional descriptive study in the quantitative domain was undertaken in Vhembe and Mopani districts. Mother-infant pairs were randomly selected. Breastmilk iodine content (BMIC), urinary iodine content (UIC) of infants, UIC of mothers, household (HH) salt iodine content (SIC) and water iodine content (WIC). The iodine nutrition knowledge of mothers was determined.Results. The median (interquartile range (IQR)) of BMIC among lactating mothers in Vhembe and Mopani was 102 (62 - 179.7) μg/Land 150.4 (89.4 - 201.7) μg/L, respectively. The median (IQR) UIC of mothers in Vhembe and Mopani was 96.3 (54.8 - 154.8) μg/L and137.9 (72 - 212.4) μg/L, respectively. The median UIC of infants was 217.7 (107.1 - 409.9) and 339.8 (162.9 - 490.3) μg/L in Vhembe andMopani, respectively. There was a significant difference between SIC of coarse and fine salt in both districts. Lactating mothers in both areas had limited iodine nutrition knowledge.Conclusion. The results suggest that iodised salt is a major contributor to iodine status in lactating mothers and their infants. Our results also show that the salt iodisation programme in SA supplies sufficient iodine for children, women of reproductive age, lactating mothers and breastfed infants.

Autoimmune thyroid status in subclinical thyroid disorders in patients attending a tertiary care center in Nepal: a hospital-based cross-sectional study

BackgroundThyroid dysfunction is the leading endocrine disorder worldwide. Iodine deficiency disorders, which were once the major etiology of thyroid dysfunctions, now have been succeeded by autoimmune thyroid diseases with the rise in aberrant salt ionization protocols. This study endeavors to access the level of thyroid autoantibodies viz. anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (TGA), and anti-thyroid stimulating hormone receptor (TRAb) in individuals with subnormal thyroid profiles.MethodsThis hospital-based cross-sectional study was conducted at the Department of Clinical Biochemistry, Tribhuvan University for a period of six months. Using non-probability (purposive) sampling method, a total of 60 patients were enrolled with subnormal thyroid profiles to include the population who have not yet started medication. Thyroid hormones (free T3, free T4, TSH) and thyroid antibodies (anti-TPO, TGA, and TRAb) were measured. For non-parametric data, Chi-square test and Kruskal-Wallis test were used. Spearman’s correlation was done to determine the association between variables.ResultsOut of 60 participants, the majority of the population between 25 and 44 years were diagnosed with thyroid dysfunction with female preponderance. Among all, 40% (n = 24) had subclinical hyperthyroid states while, 60% (n = 36) had subclinical hypothyroid states, and 75% (n = 45) of the total exhibited positive thyroid antibodies. In subclinical hypothyroid patients with TSH above 10 µIU/ml, anti TPO (58.5%) and TGA (66.7%) positivity were highly prevalent. On the other hand, TRAb was exclusively positive in hyperthyroid condition (50% among the group) which is by far the first of its kind reported in Nepal.ConclusionThe rise in autoimmune thyroid disease among the Nepalese population infers that addressing iodine deficiency simply through salt iodinization may not be adequate to deal with the rising burden of thyroid disorders, especially in iodine-depleted areas. Also, the increasing prevalence of thyroid autoantibodies positivity in subclinical hypothyroidism in the Nepalese population accounts for the arduous screening and monitoring of autoimmune thyroid disorders in Nepal.

Modern forms of iodine-containing food components

The article presents the statistics of iodine deficiency disorders and the possible causes of their occurrence. The methods of iodine deficiency correction on the basis of state programs are reviewed. The recommendations from the World Health Organization on the amount of iodine added to iodized salt are given. A review of scientific databases on the topic of iodine-containing food components of various nature and their classification are given based on the form of the components (organic or inorganic). The analysis of iodine preservation in foods incorporating iodine-containing components under various conditions of technological processing and storage has been carried out.

SAT472 A Case of Contrast Induced Thyrotoxicosis in a Patient Newly Diagnosed with Hyperthyroidism

Abstract Disclosure: E. Askar: None. B. Reddy: None. Background: It is quite uncommon for thyrotoxicosis to manifest itself after the administration of iodinated contrast. Although the actual prevalence has not yet been identified, estimates showed that the prevalence in areas with iodine deficiency is 0.25 to 0.5% and 0.025% in non-iodine-deficient areas with higher risk in elderly patients. Clinical Case: A 68-year-old female presented to the emergency department for 2 weeks of intermittent substernal chest pain associated with diaphoresis. She was diagnosed with hyperthyroidism by an outside clinic approximately one week prior to her presentation and was prescribed methimazole but did not start it. Her physical examination was significant for mild exophthalmos. EKG showed ST depression in anterolateral leads. Laboratory data showed a troponin of 0.328 ng/ml (0.0.015-0.45) which trended up to 4.830 after 3 hours and TSH of &amp;lt;0.005 mIU/L (0.358-3.74), otherwise BMP and CBC were within normal limits. Patient was started on aspirin, statin and heparin infusion along with methimazole. Patient was transferred to tertiary hospital for urgent cardiac catheterization that showed 90 % stenosis of left anterior descending artery (LAD) and 95 % stenosis in distal right coronary artery (RCA). A successful drug eluting stent was deployed in LAD with a plan of staged PCI in RCA. An hour after the procedure, Patient complained of palpitations and diaphoresis. Laboratory findings at that time revealed Free T4 of 17.5 ng/dl (0.9-1.8), Free T3 of 12.3 pg/ml (1.8-4.6) with positive Thyroperoxidase antibody, TSI and TSH Receptor Antibody. Thyroid ultrasound revealed diffusely heterogeneous thyroid gland with increased vascularity, consistent with Graves’ disease. The patient was diagnosed with thyrotoxicosis secondary to contrast administration. She was treated with methimazole 20 mg TID, metoprolol tartrate 25mg BID and hydrocortisone 25 mg BID. Decision was made to postpone the second procedure until trending down of thyroid hormones and improvement of symptoms. A successful staged RCA PCI was performed eight days later and patient did not experience any complications despite exposure to the same dose of iodinated contrast. Conclusion: Rarely, hyperthyroid patients may experience chest discomfort and EKG abnormalities that are consistent with cardiac ischemia. This usually happens in older patients with known underlying coronary artery disease in response to the rise in cardiac contractility and strain caused by thyrotoxicosis. Our case did not have any history or risk factors of coronary artery disease other than hyperthyroidism. This case highlights how recognition of hyperthyroidism may alter management, because the use of some procedures or treatments may acutely exacerbate the condition of the patient. Presentation Date: Saturday, June 17, 2023

SAT490 Graves’ Disease In Remission Aggravated By Himalayan Salt Consumption

Abstract Disclosure: M.K. Shakir: None. K.F. Brown: None. J.S. Hatfield: None. N.O. Vietor: None. T.D. Hoang: None. Introduction: In iodine-replete countries, iodine-induced thyrotoxicosis may occasionally develop after ingestion or therapy with high doses of iodine. Recently, Himalayan salt has become very popular to bridge iodine deficiency, control hypothyroidism, and improve thyroid function. We report a patient with a history of treated Graves’ disease (GD) who developed acute thyrotoxicosis following the use of Himalayan salt. Case report: A 58-year-old woman presented with symptoms of heat intolerance, and unexpected 18-lbs weight loss over 3 months. Physical examination: HR 108 bpm, BP 110/70 mm Hg, normal eye examination, thyroid 45 gms, diffusely enlarged. Examinations of the heart, lungs and abdomen were normal. Lab tests: TSH 0.01 IU/mL, free T4 3.8 ng/dL, T3 308 pg/dL, thyrotropin receptor Ab 4.2 IU/L (&amp;lt;1.0), and thyroid stimulating immunoglobulin 1.89 1U/L (0.06-0.55). The I131 uptake was 60% at 4 hours and the thyroid scan revealed diffuse homogenous uptake confirming GD. She was treated with methimazole (MMI) for 2 years and remission was achieved. MMI was stopped and she remained euthyroid. Twelve months later, she developed hyperthyroid symptoms with a 15-lb weight loss, palpitations, and anxiety. Examination confirmed a 50-gram diffuse goiter and other physical findings consistent with hyperthyroidism. She admitted that she had been taking Himalayan salt (approximately 10 grams daily) in place of regular salt for the past 6 months. Lab tests confirmed recurrent GD: TSH &amp;lt;0.01 IU/mL, FT4 4.1 ng/dL, total T3 278 pg/dL, and I131 uptake was 55% at 24 hours. A 24-hours urine iodine was 898 mcg (normal 100-199) and plasma iodine level was 484 mcg/L (normal 52-109). A diagnosis of iodine-induced recurrence of GD was made, and she was treated with MMI and low iodine diet. After 3 months, she improved significantly and was able to discontinue the MMI by 6 months. A follow- up urine iodine was 189 mcg/L with a plasma iodine level of 78 mcg/L. Subsequently she remained euthyroid for an additional 18 months of follow-up without any treatment. Conclusion: The recommended daily dietary allowance for iodine in adults is 150mcg. Himalayan rock salt may provide a rich source of iodine and consumption of large amounts can lead to iodine excess. However, the available studies do not provide the iodine content in commercially available Himalayan salt preparations. Although the Himalayan salt is advertised to have beneficial effects in patients with thyroid disorders, this food supplement may have deleterious effects in susceptible patients who do not have iodine deficiency, have GD, or are at risk for thyrotoxicosis. Indeed, Himalayan salt use exacerbated GD in our patient, as evidenced by iodine overdose during acute exacerbation and resolution of GD with iodine normalization and low dose MMI. We recommend that patients with thyroid disorders be educated regarding Himalayan salt use. Presentation Date: Saturday, June 17, 2023

FRI491 The Impact Of Insulin Resistance On Thyroid Function In Pregnancy

Abstract Disclosure: M. Trofimiuk-Muldner: None. A.J. Nowak: None. J. Podlewski: None. A. Hubalewska-Dydejczyk: None. The influence of hyperinsulinemia on thyroid function is debatable. Insulin as an anabolic hormone may be responsible for thyroid hypertrophy and nodular development. The interplay between insulin and the function of the pituitary-thyroid axis may influence thyroid tests’ results and their interpretation. This study evaluated the association between thyroid hormones and insulin resistance in pregnant women. The study group was recruited from the Polish National Program for Elimination of Iodine Deficiency, conducted between 2007-2017. We assessed the fasting glucose, insulin levels, thyroid hormones (TSH, FT4, FT3), and ATPO antibodies in 1069 pregnant women (median age 29 years, IQR 6 years). Based on calculated HOMA-IR, participants were stratified into three subgroups HOMA1 (324 women with HOMA-IR &amp;lt; 1), HOMA 2 (570 women with HOMA-IR ≥1&amp; &amp;lt;2.5) and HOMA3 (175 women with HOMA-IR ≥ 2.5). Results: Median (IQR) TSH concentrations were 1.42 (1.33) mIU/L, 1.65 (1.31) mIU/L, and 1.77 (1.29) mIU/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. Median (IQR) FT4 concentrations were 12.9 (3.0) pmol/L, 12.48 (2.85) pmol/L, and 11.38 (2.8) pmol/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. Median (IQR) FT3 concentrations were 4.79 (1.75) pmol/L, 4.6 (1.02) pmol/L, and 4.47 (0.88) pmol/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. Median (IQR) aTPO concentrations were 10 (11.34) IU/L, 11.59 (8.54) IU/L, and 10.15 (7.5) mIU/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. HOMA1 and HOMA2 subgroups differed significantly in TSH (p=0.026) and FT3concentrations (p=0.001). HOMA2 and HOMA3 subgroups differed significantly in FT4 (p&amp;lt;0.001) and aTPO concentrations (p=0.045). HOMA1 and HOMA3 patients differed in TSH (p=0.001), FT4 (p&amp;lt;0.001), and FT3 (p=0.001) concentrations. aTPO-positivity was not related to HOMA-IR values (mean HOMA-IR in aTPO-positive andaTPO-negative women were 1.63 and 1.80 respectively, p=0.32). Conclusions: Insulin resistance may impact thyroid function in pregnancy independently of thyroid autoimmunity, with higher TSH and lower thyroid hormones concentrations in pregnant women with higher HOMA-IR indices. Presentation: Friday, June 16, 2023