{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:31Z","timestamp":1784557051623,"version":"3.55.0"},"reference-count":9,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,5,30]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Lugol\u2019s solution is usually employed for a limited period for thyroidectomy preparation in patients with Graves\u2019 disease and for the control of severe thyrotoxicosis and thyroid storm. We describe a rare case of Lugol\u2019s solution-induced painless thyroiditis. In November 2014, a 59-year-old woman was prescribed Lugol\u2019s solution four drops per day for the alleviation of menopausal symptoms. She was referred to our clinic in June 2015 for fatigue, hair loss, and a 20-lb weight loss without thyroid pain or discomfort. Physical examination revealed a normal thyroid gland. On 7 May 2015, laboratory tests revealed a suppressed thyroid-stimulating hormone (TSH) 0.01\u2009U\/L with elevated free T4 3.31\u2009ng\/dL (42.54\u2009pmol\/L). Repeat testing on 25 May 2015 showed spontaneous normalization of the free thyroid hormone levels with persistently low TSH 0.10\u2009U\/L. Following these results, a family physician prescribed methimazole 10\u2009mg PO TID and very soon after, the TSH concentration rose to &gt;100\u2009U\/L along with subnormal free T4 and T3 levels. Methimazole was promptly discontinued, namely within 18 days of its initiation. Over the course of the next few months, the patient spontaneously achieved clinical and biochemical euthyroidism. To our knowledge, this is a unique case of painless thyroiditis induced by Lugol\u2019s solution, which has not been reported before. Lugol\u2019s solution is a short-term medication given for the preparation of thyroidectomy in patients with Graves\u2019 disease and for the control of severe thyrotoxicosis. Iodine excess can cause both hyperthyroidism and hypothyroidism. Rarely, Lugol\u2019s solution can cause acute painless thyroiditis.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Lugol\u2019s solution is used for thyroidectomy preparation in patients with Graves\u2019 disease and for the control of severe thyrotoxicosis and thyroid storm.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Iodine excess can cause both hypothyroidism and thyrotoxicosis. Thyroid glands with an underlying pathology are particularly susceptible to the adverse effect of iodine.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>The prolonged off-label use of Lugol\u2019s solution can be harmful. Rarely, Lugol\u2019s solution can cause acute painful thyroiditis.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-17-0034","type":"journal-article","created":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T02:43:14Z","timestamp":1496112194000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":2,"title":["Lugol's solution-induced painless thyroiditis"],"prefix":"10.1530","volume":"2017","author":[{"given":"Ji Wei","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, McGill University Health Centre, Montreal, Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"How","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, McGill University Health Centre, Montreal, Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"key20170602173545454_bib1","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/S0021-9258(18)57335-X","article-title":"Plasma inorganic iodide as a homeostatic regulator of thyroid function","volume":"174","author":"Wolff","year":"1948","journal-title":"Journal of Biological Chemistry"},{"key":"key20170602173545454_bib2","doi-asserted-by":"crossref","first-page":"3404","DOI":"10.1210\/endo.140.8.6893","article-title":"Escape from the acute Wolff-Chaikoff effect is associated with a decrease in thyroid sodium\/iodide symporter messenger ribonucleic acid and protein","volume":"140","author":"Eng","year":"1999","journal-title":"Endocrinology"},{"key":"key20170602173545454_bib3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/MED.0b013e3283565bb2","article-title":"Iodine-induced thyroid dysfunction","volume":"19","author":"Leung","year":"2012","journal-title":"Current Opinion in Endocrinology: Diabetes and Obesity"},{"key":"key20170602173545454_bib4","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7326\/0003-4819-101-1-28","article-title":"Environmental iodine intake and thyroid dysfunction during chronic amiodarone therapy","volume":"10","author":"Martino","year":"1984","journal-title":"Annals of Internal Medicine"},{"key":"key20170602173545454_bib5","doi-asserted-by":"crossref","first-page":"2529","DOI":"10.1210\/jc.2010-0180","article-title":"Approach to the patient with amiodarone-induced thyrotoxicosis","volume":"95","author":"Bogazzi","year":"2010","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"key20170602173545454_bib6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1177\/003591576105401001","article-title":"Iodine in medicine and pharmacy since its discovery-1911-1961","volume":"54","author":"Kelly","year":"1961","journal-title":"Proceedings of the Royal Society of Medicine"},{"key":"key20170602173545454_bib7","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1136\/bmj.1.4909.354-a","article-title":"Acute thyroiditis from potassium iodide","volume":"1","author":"Edmunds","year":"1955","journal-title":"BMJ"},{"key":"key20170602173545454_bib8","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1089\/thy.2010.0300","article-title":"Acute thyrotoxicosis secondary to destructive thyroiditis associated with cardiac catheterization contrast dye","volume":"21","author":"Calvi","year":"2011","journal-title":"Thyroid"},{"key":"key20170602173545454_bib9","first-page":"1013","article-title":"Jod-Basedow effect due to prolonged use of lugol solution\u2013case report","volume":"118","author":"Leustean","year":"2014","journal-title":"Revista Medico-Chirurgicala a Societatii De Medici Si Naturalisti Din Iasi"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2017\/1\/EDM17-0034.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2017\/1\/EDM17-0034.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:46:33Z","timestamp":1784555193000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,30]]},"references-count":9,"URL":"https:\/\/doi.org\/10.1530\/edm-17-0034","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,30]]}}}