Urinary Iodine Excretion and Serum Thyroid Function in Adults After Iodinated Contrast Administration
Open accessAbstract
Background: Iodinated contrast media (ICM) is a source of excess iodine that may induce thyroid dysfunction. A prospective cohort study was conducted to assess the effects of ICM on urinary iodine clearance and serum thyroid function tests (TFTs) in adults. Methods: In this prospective cohort study of 54 adults undergoing elective computed tomography (CT) scans at an academic medical center, serial urinary iodine concentrations (UIC) and serum TFTs were obtained until UIC normalized following ICM administration. Thyroid volume/nodularity were assessed by ultrasound. Associations between covariates and peak UIC, duration for UIC to peak and normalize, and thyroid dysfunction risk were assessed. Results: The mean±standard deviation ( SD ) iodine administered was 34.6±6.0 g. Baseline median (range) UIC was 105.1 (17.0–866.1) μg/L, and serum thyrotropin (TSH) concentration was 1.26 (0.5–11.2) mIU/L. The mean± SD times to achieve peak UIC (median [range]: 3519 [233–157,500] μg/L] and normalized UIC were 1.1±0.5 and 5.2±4.0 weeks, respectively. Four subjects had elevated baseline TSH, and one had missing baseline TSH values. Of the remaining 49 subjects, 11 (22%) developed an abnormal TSH within one to four weeks (six elevated and five decreased). Administered iodine amount correlated with peak UIC following ICM administration ( p <0.001). Increasing age and administered iodine amount predicted peak UIC ( p =0.024 and p <0.001, respectively). Age, sex, race/ethnicity, smoking status, family history of thyroid disease, personal or family history of thyroid autoimmunity, thyroid volume, presence of thyroid nodules ≥1 cm, iodine dose, baseline UIC, and baseline TFTs were not predictive of durations to achieve peak or normalized UIC. Conclusion: Peak UIC occurred at 1.1 weeks and normalized by 5.2 weeks following ICM administration for outpatient CT scans. Because thyroid dysfunction developed in 22% of individuals following a single ICM dose, monitoring of thyroid function should be considered in at-risk patients.
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In a Boston study, 5 of 49 (10.2%) patients developed a suppressed TSH value 1-4 weeks following exposure to a single CT study with contrast, with only one patient developing overt hyperthyroidism.
“A study of patients living in Boston showed that 5 of 49 (10.2%)developed a suppressed TSH value 1-4 weeks following exposure to a single computed tomography (CT) study with contrast, with only one patient developing overt hyperthyroidism (565).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [565]
Recent data suggest that urinary iodine normalizes more rapidly than previously believed, with a return to baseline urinary iodine excretion within 1-2 months in most patients.
“Recent data suggest that urinary iodine normalizes more rapidly than previously believed, with a return to baseline urinary iodine excretion within 1-2 months in most patients (565,572).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [565]
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- Authors
- Lee, S. Y., Chang, D. L. F., He, X., Pearce, E. N., Braverman, L. E., & Leung, A. M.
- Affiliations
- Boston University (US)
- Reliant Medical Group (US)
- University of California, Los Angeles (US)
- Corresponding author
- Lee, Sun Y.
- Venue
- Thyroid®
- Publisher
- SAGE Publications
- Published
- 2015-05
- Volume
- 25
- Issue
- 5
- Pages
- 471-477
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- PMC
- PMC4426305
- OpenAlex
- W1535396839
- Cited by
- 57
- References
- 25
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 8 · 2023: 1 · 2022: 6 · 2021: 5 · 2020: 9 · 2019: 7 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 2
- FWCI
- 4.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Thyroid (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (U54TR001012)
- Clinical and Translational Science Institute, Boston University (U54TR001012)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007201)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD068552)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Chemical Analysis and Environmental Impact
- Keywords
- iodinated contrast media, urinary iodine excretion, thyroid-stimulating hormone, thyroid dysfunction, iodine excess, computed tomography, iodine dose, thyroid nodules, thyroid volume, thyroid autoimmunity
- MeSH terms
- Adult, Contrast Media, Female, Humans, Iodine, Male, Middle Aged, Prospective Studies, Radiography, Thyroid Gland, Thyrotropin, Thyroxine, Triiodothyronine
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