Does Iodine Excess Lead to Hypothyroidism? Evidence from a Case-Control Study in India

Background Iodine deficiency disorders have been known to mankind since antiquity and various researchers elucidated the role of iodine in its causation. However, recent evidence shows that the entire control program ignored multi-causality and association of increased iodine intake with hypothyroidism. This study was conducted to assess differences of iodine intake as measured by urinary iodine excretion (UIE) between cases of hypothyroidism and healthy controls. Methods A case-control study was conducted with three groups (cases, hospital controls and community controls) in two cities of India. Patients with overt hypothyroidism were cases ( n  = 150) and were compared with age, sex and socioeconomic status-matched hospital ( n  = 154) and community ( n  = 488) controls. Thyroid function tests (T3, T4, TSH) were used as diagnostic and inclusion criteria. TPOAb and UIE estimation were carried out for all study participants. Results Mean values of TPOAb and UIE were higher in cases as compared to hospital controls as well as community controls ( p 34 as compared to hospital controls ( p p p  = 0.090) and community controls ( p  = 0.001) had higher levels; OR, 0.671, (0.422, 1.066) and 0.509, (0.348, 0.744), respectively. Conclusion The study has clearly shown that cases of hypothyroidism are associated with excess iodine intake. Cohort studies to generate further evidence and an eco-social epidemiological approach have been suggested as the way forward.