Persistence of goiter despite oval iodine supplementation in goitrous children with iron deficiency anemia in Cote d'Ivoire

Background: In developing countries, many children are at high risk of goit er and iron deficiency anemia. Because iron deficiency can have adverse eff ects on thyroid metabolism, iron deficiency may influence the response to s upplemental iodine in areas of endemic goiter. Objective: The aim of this study was to determine whether goitrous children with iron deficiency anemia would respond to oral iodine supplementation. Design: A trial of oral iodine supplementation was carried out in an area o f endemic goiter in western Cote d'Ivoire in goitrous children (n = 109) ag ed 6-12 y. Group 1 (n = 53) consisted of goitrous children who were not ane mic. Group 2 (n = 56) consisted of goitrous children who had iron deficienc y anemia. At baseline, thyroid gland volume and urinary iodine, thyrotropin , and thyroxine were measured by using ultrasound. Each child received 200 mg I orally and was observed for 30 wk, during which urinary iodine, thyrot ropin, thyroxine, hemoglobin, and thyroid gland volume were measured. Results: The prevalence of goiter at 30 wk was 12% in group 1 and 64% in gr oup 2. The mean percentage change from baseline in thyroid volume 30 wk aft er administration of oral iodine was -45.1% in group 1 and -21.8% in group 2 (P < 0.001). Among the anemic children, there was a strong correlation be tween the percentage decrease in thyroid volume and hemoglobin concentratio n (r(2) = 0.65). Conclusion: The therapeutic response to oral iodine was impaired in goitrou s children with iron deficiency anemia, suggesting that the presence of iro n deficiency anemia in children limits the effectiveness of iodine interven tion programs.