Adaptation of thyroid function to excess iodine

NORMALLY: The production of thyroid hormones is normally stable, despite iodine supplies that may vary widely and even on sudden excess iodine. The metabolism of iodine is characterised by adapted thyroid uptake, the requirements varying on the age and physiological status of the individual (pregnancy, breastfeeding) and by insufficient supplies in several areas in France. IN THE CASE OF EXCESS: The mechanisms that permit the thyroid to adapt to a sudden or chronic excess of iodine are immature in the newborn and sometimes deficient in adults, and may lead to iodine-induced dysthyroidism. Thanks to the recent progress made in thyroid physiology, these mechanisms are now better known. PATHOLOGICAL IMPACT: Iodine-induced hyperthyroidisms in a healthy or pathological thyroid are frequent. They are predominantly related to amiodarone. Iodine-related hypothyroidism frequently appears in cases of pre-existing thyroid diseases (asymptomatic autoimmune thyroiditis, for example). They are frequent in the newborn, notably in the premature. The iodine prophylaxis organised in Poland following the Tchernobyl accident led to very few pathological consequences in adults or children.