By: B Elnagar
59 pages, Figs, tabs.
The studies in this thesis were carried out in Sudan and Sweden. In the first study goitrous subjects in Sudan were given three different oral doses of iodised oil (200, 400 and 800 mg) and then monitored for one year. The 200 mg dose proved more effective than the higher doses in reducing goitre size and normalising urinary iodine and thyroid-related hormones. It also had fewer side effects.
The effects of iodinated sugar were studied in two populations for one and six months. In both groups iodine status improved and no side effects were reported.
Iodinated water was introduced in four villages with different types of wells, and the effects were assessed during a two-year period. Beneficial effects on iodine status were noted in all the villages. Efficacy was shorter in villages with the traditional types of wells.
Thyroid function during pregnancy was studied in relation to the iodine status of the mother. In both the Sudanese and Swedish groups urinary iodine loss remained stable with progression of pregnancy, but with lower levels in the Sudanese than in the Swedish women. Among the Swedish women, serum free thyroxine decreased and TSH increased to levels outside the reference range. The levels in the Sudanese women with moderate iodine deficiency remained stable.
TSH was measured in filter paper blood samples to evaluate the iodine status in newborns and adults living in three Sudanese areas with different iodine statuses and the results were compared with those in Swedish neonates. Mean TSH in all the Sudanese newborns was significantly higher than the Swedish mean, but the method failed to discriminate between the Sudanese groups. Comparison between TSH in blood spots and in serum showed a significant correlation only for levels above 5 mμ/L.Use of three instead of two monoclonal antibodies in the test procedures only gave minor improvement in the correlation for levels around the reference range.
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