Iron supplementation in goitrous, iron-deficient children improves their response to oral iodized oil

Objective: In developing countries, many children are at high risk for both goiter and iron-deficiency anemia. Because iron deficiency may impair thyr oid metabolism the aim of this study was to determine if iron supplementati on improves the response to oral iodine in goitrous, iron-deficient anemic children. Design: A trial of oral iodized oil followed by oral iron supplementation i n an area of endemic goiter in the western Ivory Coast. Methods: Goitrous, iodine-deficient children (aged 6-12 years; n = 109) wer e divided into two groups: Group 1 consisted of goitrous children who were not anemic; Group 2 consisted of goitrous children who were iron-deficient anemic. Both groups were given 200 mg oral iodine as iodized oil. Thyroid g land volume using ultrasound, urinary iodine concentration (UI), serum thyr oxine (T-4) and whole blood TSH were measured at baseline, and at 1, 5, 10, 15 and 30 weeks post intervention, Beginning at 30 weeks, the anemic group was given 60 mg oral iron as ferrous sulfate four times/week for 12 weeks, At 50 and 65 weeks after oral iodine (8 and 23 weeks after completing iron supplementation), UI, TSH, T-4 and thyroid volume were remeasured. Results: The prevalence of goiter at 30 weeks after oral iodine in Groups 1 and 2 was 12% and 64% respectively Mean percent change in thyroid volume c ompared with baseline at 30 weeks in Groups 1 and 2 was -45.1% and -21.8% r espectively (P < 0.001 between groups). After iron supplementation in Group 2, there was a further decrease in mean thyroid volume from baseline in th e anemic children (-34.8% and -38.4% at 50 and 65 weeks) and goiter prevale nce fell to 31% and 20% at 50 and 65 weeks. Conclusion: Iron supplementation may improve the efficacy of oral iodized o il in goitrous children with iron-deficiency anemia.