Iodine and Hashimoto’s Autoimmune Thyroid Disease

Iodine and Hashimoto’s Autoimmune Thyroid Disease

Iodine and Hashimoto’s Autoimmune Thyroid Disease
by Jeffrey Dach MD

Hashimotos Thyroiditis is an autoimmune disease.   Microscopic examination of the thyroid gland shows infiltration with lymphocytes and deposition of antibodies on the basement membranes of the thyrocytes (see above image).   Clinical examination may show painless enlargement of the gland.  Diagnosis is made by laboratory testing showing elevated serum TPO (Thyroid Peroxidase) and Thyroglobulin antibodies.  Other antibodies to the NIS, pendrin and TSH receptor may also co-exist.

Thyroid function may be variable.  Early stage disease may have normal function.  Late stage disease is usually associated with a low thyroid condition (hypothyroidism), as damage to the thyrocytes reduces the ability of the gland to produce thyroid hormone.

In approximately 20% of cases there is spontaneous recovery.(2)  How can we predict which patients will recover?

Iodine Restriction for Hashimotos Patients

Dr Yoon from Korea noted that Hashimotos thyroiditis is reversible for some patients.(2)  He points out that Hashimoto’s was more prevalent in Iodine replete areas that have introduced salt iodination programs (18), and less prevalent in iodine deficient regions, so he speculated that perhaps Iodine levels had something to do with spontaneous recovery from Hashimotos.(7)  Dr. Yoon thought Iodine restriction would be beneficial, and he did a study on Iodine Restriction in Korea in 2003 to try to prove his point.  (1)

 

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