Iodine restrictive diet adversely affects Graves’ disease management

  • Clin Endocrinol (Oxf)

  • from Antara Ghosh
  • Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Recurrence after anti-thyroid drug therapy (ATDT) withdrawal is lower for iodine supplemented vs restrictive diet post-ATDT for Graves’ disease (GD).

Why this matters

  • Relation between iodine intake and ATDT effectiveness had been suggested previously, and few studies have tried iodine restrictive diet for GD management.
  • Relatively less is known about benefits of iodine optimal diet for reduced GD recurrence post-ATDT.

Study design

  • Study evaluated 405 patients with newly diagnosed GD who remained on strict dietary iodine restriction ATDT.
  • 1 month later, patients were randomly allocated to either iodine supplemented (n=203) or restricted (n=202) groups.
  • Funding: Natural Science Foundation of China.

Key results

  • GD recurrence was significantly lower in the iodine supplemented vs restricted group (HR, 1.381; P=.04) in 12 months of follow-up after ATDT withdrawal.
  • Thyrotropin receptor antibody levels were significantly lower in the iodine supplemented vs restricted group from 9 to 24 months (P<.001).
  • Urine iodine concentration was significantly higher for the supplemented vs restrictive (161 vs 38 μg/L; P<.001) group, but within recommended standards for both.

Limitations

  • Recurrence after 12 months of ATDT withdrawal not covered.