Endemic Goiter in Greece: Clinical and Metabolic Effects of Iodized Salt1

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Abstract
A study of iodine metabolism, including a field balance, was performed in 15 goitrous and 15 nongoitrous adult women following 6 months of iodized salt administration, in the same endemic village of Livadi where a similar control study was previously performed. Clinically, the incidence of goiter decreased and the size of the remaining enlargements was reduced. Biochemically, an increase in the dietary iodine intake by several times the control value resulted in normalization of most parameters studied, while differences observed previously between goitrous and nongoitrous were now obviated after iodine supplementation. The fecal and urinary iodine excretion were greatly increased and resulted in a negative iodine balance in both groups studied. A prompt fall in the thyroidal uptake and clearance to normal levels for both groups did not fully compensate the increased plasma inorganic iodine levels, thus resulting in high values for the absolute iodine uptake by the thyroid. This increase in the AIU was out of proportion to the observed increase in the PBI and BEI levels and may be taken as indirect evidence that an increase in the dietary intake of iodine beyond a certain value is accompanied by a decrease in the thyroidal utilization of this element. Furthermore, while before iodized salt administration the thyroidal iodine utilization in the goitrous was less efficient than in the nongoitrous, this difference disappeared after iodine repletion. In conclusion, failure to increase the efficiency of the intrathyroidal iodine utilization in the deficiency state may play a role in the development of endemic goiter.

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