High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East‐Jutland Denmark and Iceland
Abstract
Abstract. Little is known about the optimum level of iodine intake for iodine supplementation programmes, or about the effects of the high levels of iodine intake that are found in some countries. We compared the incidence of different types of hyperthyroidism in East‐Jutland Denmark with a low average iodine intake but no endemic goitre, and the incidence in Iceland with a relatively high iodine intake. Hyperthyroidism was more common in East‐Jutland than in Iceland, due to a much higher incidence of multinodular toxic goitre and also of single toxic adenoma. Most of the patients with these diseases were over 50 years of age. By contrast, the incidence of Graves' disease was significantly higher in Iceland than in East‐Jutland. This difference was most marked in the younger age groups, in which hyperthyroidism was more than twice as common in Iceland as in East‐Jutland. These results demonstrate that even mild iodine deficiency has a significant effect on population health, since it leads to a high incidence of autonomous thyroid nodules with hyperthyroidism in the elderly population. However, population iodine intake probably should not exceed a level much higher than that necessary to avoid iodine deficiency, otherwise Graves' disease may be induced in the young population.
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Toxic nodular goiter is less common than Graves' disease, but its prevalence increases with age and in the presence of dietary iodine deficiency.
“Although toxic nodular goiter is less common than GD, its prevalence increases with age and in the presence of dietary iodine deficiency.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [13]
Toxic nodular goiter may actually be more common than Graves' disease in older patients, especially in regions of iodine deficiency.
“Therefore, toxic nodular goiter may actually be more common than GD in older patients, especially in regions of iodine deficiency (13,14).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [13]
Hyperthyroidism caused by thyroid autonomy is very common in people having current or previous mild to moderate iodine deficiency, but it mostly develops in patients after the age of 50 years.
“Hyperthyroidism caused by thyroid autonomy is very common in people having current (or previous) mild to moderate iodine deficiency (13), but it mostly develops in patients after the age of 50 years.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [13]
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Self-citation
- Authors
- LAURBERG, P., PEDERSEN, K. M., VESTERGAARD, H., & SIGURDSSON, G.
- Affiliations
- Aalborg University Hospital (DK)
- Regional Hospital Randers (DK)
- Corresponding author
- LAURBERG, P.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 1991-05
- Volume
- 229
- Issue
- 5
- Pages
- 415-420
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W2014820821
- Cited by
- 361
- References
- 20
- Citations by year
- 2025: 7 · 2024: 13 · 2023: 11 · 2022: 14 · 2021: 16 · 2020: 12 · 2019: 13 · 2018: 17 · 2017: 8 · 2016: 14 · 2015: 9 · 2014: 11 · 2013: 17 · 2012: 12
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- Graves' disease, hyperthyroidism, iodine intake, iodine deficiency, iodine excess, autonomously functioning thyroid nodules, toxic multinodular goiter, toxic adenoma, age differences in incidence, Iceland, iodine supplementation
- MeSH terms
- Adolescent, Adult, Aged, Child, Denmark, Graves Disease, Health Surveys, Humans, Hyperthyroidism, Iceland, Iodine, Middle Aged, Thyrotoxicosis, Incidence
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