Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Front Endocrinol (Lausanne). 2023 Apr 3;14:1150036. doi: 10.3389/fendo.2023.1150036. eCollection 2023.
Iodine is a crucial trace element for the human body and the basic raw material for the synthesis of thyroid hormones. Oral inorganic iodine includes dietary iodine and therapeutic iodine, both of which are closely associated with thyroid immunity and metabolism. Graves' disease (GD), also known as diffuse toxic goiter, is characterized by hyperthyroidism and high iodine metabolism. Clinically, patients diagnosed with GD are often asked to limit iodine intake or even avoid iodine in their diet. The latest research has demonstrated that the interference of dietary iodine with antithyroid drugs (ATDs) treatment may be overestimated. In addition, as a medication for GD treatment, the administration of inorganic iodine has shown positive results in patients with mild hyperthyroidism, a low thyroid autoantibody concentration, a small thyroid volume, a high iodine diet and so on. Inorganic iodine may also be used as an alternative when patients experience side effects with traditional ATDs and for those who still prefer conservative treatment. Due to its low teratogenicity, blood toxicity and bone marrow toxicity, inorganic iodine plays a unique role in special populations, such as pregnant or lactating patients and patients receiving tumor radiotherapy or chemotherapy. In this review, the research progress, biological function, doses and effects, applicable populations and specific applications of dietary iodine and therapeutic iodine are summarized to provide references for the diagnosis and treatment of GD, thus improving the quality of life of GD patients.
碘是人体必需的微量元素，也是合成甲状腺激素的基本原料。口服无机碘包括食物碘和治疗碘，两者均与甲状腺免疫和代谢密切相关。Graves 病（GD）又称弥漫性毒性甲状腺肿，以甲亢和高碘代谢为特征。临床上，GD 患者常被要求限制碘摄入，甚至避免饮食中的碘。最新研究表明，膳食碘对抗甲状腺药物（ATD）治疗的干扰可能被高估。此外，作为 GD 治疗的药物，无机碘在轻度甲亢、甲状腺自身抗体浓度低、甲状腺体积小、高碘饮食等患者中的治疗效果已得到证实。对于使用传统 ATD 药物出现副作用的患者，以及那些仍倾向于保守治疗的患者，无机碘也可作为替代药物。由于无机碘的致畸性、血液毒性和骨髓毒性较低，因此在特殊人群中具有独特的作用，如妊娠或哺乳期患者、接受肿瘤放化疗的患者。本文综述了食物碘和治疗碘的研究进展、生物学功能、剂量和作用、适用人群及具体应用，为 GD 的诊断和治疗提供参考，从而提高 GD 患者的生活质量。
