{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:27:47Z","timestamp":1792124867841,"version":"4.4.0"},"reference-count":112,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2018,9,13]],"date-time":"2018-09-13T00:00:00Z","timestamp":1536796800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Proc. Nutr. Soc."],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>\n                    Hashimoto's thyroiditis (HT) and Graves\u2019 disease (GD) are examples of autoimmune thyroid disease (AITD), the commonest autoimmune condition. Antibodies to thyroid peroxidase (TPO), the enzyme that catalyses thyroid-hormone production and antibodies to the receptor for the thyroid-stimulating hormone, are characteristic of HT and GD, respectively. It is presently accepted that genetic susceptibility, environmental factors, including nutritional factors and immune disorders contribute to the development of AITD. Aiming to investigate the effect of iodine, iron and selenium in the risk, pathogenesis and treatment of thyroid disease, PubMed and the Cochrane Library were searched for relevant publications to provide a narrative review.\n                    <jats:italic>Iodine<\/jats:italic>\n                    : chronic exposure to excess iodine intake induces autoimmune thyroiditis, partly because highly-iodinated thyroglobulin (Tg) is more immunogenic. The recent introduction of universal salt iodisation can have a similar, although transient, effect.\n                    <jats:italic>Iron<\/jats:italic>\n                    : iron deficiency impairs thyroid metabolism. TPO is a haem enzyme that becomes active only after binding haem. AITD patients are frequently iron-deficient since autoimmune gastritis, which reduces iron absorption and coeliac disease which causes iron loss, are frequent co-morbidities. In two-thirds of women with persistent symptoms of hypothyroidism despite appropriate levothyroxine therapy, restoration of serum ferritin above 100 \u00b5g\/l ameliorated symptoms.\n                    <jats:italic>Selenium<\/jats:italic>\n                    : selenoproteins are essential to thyroid action. In particular, the glutathione peroxidases remove excessive hydrogen peroxide produced there for the iodination of Tg to form thyroid hormones. There is evidence from observational studies and randomised controlled trials that selenium, probably as selenoproteins, can reduce TPO-antibody concentration, hypothyroidism and postpartum thyroiditis. Appropriate status of iodine, iron and selenium is crucial to thyroid health.\n                  <\/jats:p>","DOI":"10.1017\/s0029665118001192","type":"journal-article","created":{"date-parts":[[2018,9,13]],"date-time":"2018-09-13T04:19:04Z","timestamp":1536812344000},"page":"34-44","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":223,"title":["Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease"],"prefix":"10.1017","volume":"78","author":[{"given":"Margaret P.","family":"Rayman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,9,13]]},"reference":[{"key":"S0029665118001192_ref45","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0041"},{"key":"S0029665118001192_ref17","first-page":"970","article-title":"Changes of the spectrum on thyroid disease after the 10-year implementation of universal salt iodization in Guangxi Zhuang Autonomous Region","volume":"34","author":"Zhang","year":"2013","journal-title":"Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi"},{"key":"S0029665118001192_ref57","doi-asserted-by":"publisher","DOI":"10.1159\/000339444"},{"key":"S0029665118001192_ref111","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2018.02.015"},{"key":"S0029665118001192_ref110","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djt456"},{"key":"S0029665118001192_ref100","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61452-9"},{"key":"S0029665118001192_ref99","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665109991807"},{"key":"S0029665118001192_ref109","first-page":"630","article-title":"Baseline characteristics and the effect of selenium supplementation on cancer incidence in a randomized clinical trial: a summary report of the Nutritional Prevention of Cancer Trial","volume":"11","author":"Duffield-Lillico","year":"2002","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"S0029665118001192_ref97","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1821"},{"key":"S0029665118001192_ref94","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-15-115"},{"key":"S0029665118001192_ref93","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-015-0285-8"},{"key":"S0029665118001192_ref92","doi-asserted-by":"publisher","DOI":"10.5603\/EP.2016.0064"},{"key":"S0029665118001192_ref87","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-14-119"},{"key":"S0029665118001192_ref83","first-page":"3029379","article-title":"Serum trace elements profile in graves\u2019 disease patients with or without orbitopathy in Northeast China","volume":"2018","author":"Liu","year":"2018","journal-title":"BioMed Res Int"},{"key":"S0029665118001192_ref88","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0256"},{"key":"S0029665118001192_ref44","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.15.1726"},{"key":"S0029665118001192_ref77","volume-title":"The Thyroid and Its Diseases","author":"Rayman","year":"2018"},{"key":"S0029665118001192_ref75","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-2222"},{"key":"S0029665118001192_ref74","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1480309"},{"key":"S0029665118001192_ref70","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2011.174"},{"key":"S0029665118001192_ref78","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/18.1.45"},{"key":"S0029665118001192_ref64","doi-asserted-by":"publisher","DOI":"10.2903\/j.efsa.2015.4254"},{"key":"S0029665118001192_ref91","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-014-0477-6"},{"key":"S0029665118001192_ref63","first-page":"R380","article-title":"Effect of exposure to low temperature on normal and iron-deficient subjects","volume":"246","author":"Martinez-Torres","year":"1984","journal-title":"Am J Physiol"},{"key":"S0029665118001192_ref59","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-144-37531"},{"key":"S0029665118001192_ref54","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/52.5.813"},{"key":"S0029665118001192_ref52","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/128.8.1401"},{"key":"S0029665118001192_ref39","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/132.7.1951"},{"key":"S0029665118001192_ref48","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-008-8117-8"},{"key":"S0029665118001192_ref98","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-014-0822-9"},{"key":"S0029665118001192_ref46","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.09.025"},{"key":"S0029665118001192_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70225-6"},{"key":"S0029665118001192_ref79","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2008.12.008"},{"key":"S0029665118001192_ref40","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.274.15.10533"},{"key":"#cr-split#-S0029665118001192_ref35.1","unstructured":"1. 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