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April 5, 1985

For many, endemic goiter remains a baffling problem

JAMA. 1985;253(13):1846-1847. doi:10.1001/jama.1985.03350370020003

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Before iodine prophylaxis began in 1924, endemic goiter was a major problem in areas of the United States. Today, iodized salt and other measures have largely alleviated this problem, supplementing the iodine washed away by glaciation in areas such as the Great Lakes.

But in many areas of the world—even a few in the United States—endemic goiter remains a major public health problem. And, as recent research in one state indicates, iodine deficiency may not always be a prerequisite for goiter.

This intriguing research is being conducted in some coal-rich areas of Kentucky that still are reporting a high prevalence of goiter in spite of sufficient iodine intake. In these areas, iodine supplementation appears to be of little help.

At the American Thyroid Association meeting in New York City, Eduardo Gaitan, MD, presented initial results of this study, which reassessed the situation by contrasting goiter occurrence in two Kentucky counties.