{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:47:42Z","timestamp":1782535662661,"version":"3.54.5"},"reference-count":303,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The thyroid gland is particularly vulnerable to the effects of environmental pollutants, due to its high vascularization, dependence on iodine uptake, and intrinsic oxidative environment required for hormone biosynthesis. Therefore, environmental exposure to heavy metals (HMs) and endocrine-disrupting chemicals (EDCs) has emerged as a potential contributor to thyroid dysfunction and carcinogenesis. Despite increasing interest, the clinical relevance of these exposures remains incompletely defined. Available epidemiological data suggest heterogeneous associations across EDCs and HMs classes. While evidence is more consistent for some pollutants, for other compounds it remains limited. Furthermore, while experimental studies provide strong mechanistic support for the key pathways linking environmental exposure to thyroid dysfunction and carcinogenesis, the clinical interpretation of epidemiological data is constrained by important methodological limitations. This narrative review aims to integrate current epidemiological and experimental evidence on the role of HMs and EDCs in thyroid diseases, including both non-neoplastic disorders and thyroid cancer, examining their environmental distribution, exposure pathways, and biological effects.<\/jats:p>","DOI":"10.3390\/ijms27125583","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:09:17Z","timestamp":1782270557000},"page":"5583","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Thyroid Under Pressure: Heavy Metals, Endocrine Disruptors and Translational Insights into Carcinogenesis and Thyroid Dysfunctions"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8624-5831","authenticated-orcid":false,"given":"Marco","family":"Capezzone","sequence":"first","affiliation":[{"name":"UOSD of Endocrinology, Misericordia Hospital, I-58100 Grosseto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-379X","authenticated-orcid":false,"given":"Gabriella","family":"Pellegriti","sequence":"additional","affiliation":[{"name":"Medical Oncology, Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ronchi","sequence":"additional","affiliation":[{"name":"Pavia Poison Control Centre\u2014National Toxicology Information Centre\u2014Clinical and Experimental Lab, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, I-2700 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorenza","family":"Gian\u00ec","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, \u201cKore\u201d University, I-94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8167-4338","authenticated-orcid":false,"given":"Andrea","family":"Corsello","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Surgery, Ospedale Isola Tiberina-Gemelli Isola, I-00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Maria","family":"Paragliola","sequence":"additional","affiliation":[{"name":"Departmental Faculty of Medicine, UniCamillus-Saint Camillus International University of Health Sciences, I-00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Forma, A., Klodnicka, K., Pajak, W., Flieger, J., Teresinska, B., Januszewski, J., and Baj, J. 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