Role of a dietary goitrogen in the etiology of endemic goiter on Idjwi Island

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Abstract
The purpose of the present study was to detect the antithyroidal activity in man of the foods eaten in the endemic goitrous area on Idjwi Island. The presence of a dietary goitrogen in this region was suspected when earlier works showed that goiter prevalence is 10 times higher in the north of the Island than in the southwest, although the whole of Idjwi is subjected to a severe and uniform iodine deficiency. The ingestion of cassava grown in the goitrous area of the Island induces a considerable drop in thyroid uptake of radioiodine. This effect was observed by comparing several groups of patients who had eaten different types of foods, and also by giving the same subjects successive meals of a control food and then cassava. The drop in uptake was accompanied by a rise in urinary excretion of 131I and 127I. In contrast, the ingestion of cassava grown in the nongoitrous area of the Island did not modify thyroid uptake to any appreciable extent. These results suggest that the absorption of cassava grown in the goitrous area of the Island inhibits the penetration of iodide into the human thyroid, whereas the same plant (Manihot utilissima) grown in the nongoitrous area of the Island is free of this effect. The substance responsible for this action is probably of a thiocyanate-like character, resulting from the catabolism of a cyanogenic glucoside contained in large quantities in the cassava.

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