Effect of iodination of a village water-supply on goitre size and thyroid function
Maberly, G.F.; Eastman, C.J.; Corcoran, J.M.
Lancet 2(8258): 1270-1272
1981
ISSN/ISBN: 0140-6736 PMID: 6118679 Document Number: 175932
An iodinator was fitted to the existing gravity-fed water-supply of a remote village in Sarawak, Malaysia, where goiter was endemic. Within 9 mo., the prevalence of goiter had been reduced from 61 to 30%, with 79% of goiters showing visible reduction in size. All subjects were clinically euthyroid before and 9 mo. after the start of iodination, although pretreatment serum TSH concentrations varied from normal to 24 mU/l. Before treatment basal serum triiodothyronine (T3) and thyroxine (T4) concentrations were typical of endemic goiter with a low mean serum T4 (80 .+-. 30 [SD] nmol/l) and a slightly raised mean serum T3 (2.3 .+-. 0.7 nmol/l). After iodination, circulating TSH concentration was generally undetectable (< 0.1 mU/l), mean T3 concentration was unchanged, but the mean T4 rose significantly to 109 .+-. 41 nmol/l (P < 0.01). Urinary I concentrations fluctuated; this largely reflected intermittent blockage of the iodinator, but concentrations became consistent with a return to the I-replete state. There was no evidence of the Jod Basedow effect in the group studied. Iodinated water was more convenient to distribute than iodized salt and less likely to cause Jod Basedow phenomenon than were injections of iodized oil. Iodination of water was effective in killing most microorganisms and this additional benefit could contribute significantly to village health.