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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2006; 16(6): 342-348
DOI: 10.1055/s-2006-940101
Aus der Praxis
© Georg Thieme Verlag KG Stuttgart · New York

Trinkkuren mit Jodquellen

Jodbelastung der Schilddrüse durch Trinkkuren - ein Vergleich zu anderen JodapplikationenDrinking Cures with Iodine Mineral WaterIodide Load of the Thyroid Gland by Drinking Cures in Comparison with Other Iodine ApplicationsM.  Klieber1 , R.  Winkler1
  • 1Paracelsus Gesellschaft für Balneologie und Jodforschung, Bad Hall, Österreich
Further Information

Publication History

Eingegangen: 7. Dezember 2005

Angenommen: 9. August 2006

Publication Date:
01 December 2006 (online)

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Zusammenfassung

Trinkkuren mit natürlich vorkommenden Heilwässern werden nach wie vor in vielen Kurorten verabreicht. Jodtrinkkuren bedürfen aber mehr als andere Trinkkuren einer strengen Indikationsstellung und genauen Dosierung. Obwohl der Jodmangel in den industrialisierten Ländern weitgehend beseitigt ist, kann vorübergehende Erhöhung der Jodzufuhr durchaus sinnvoll sein. Auch sind Kurärzte mit dem Verlangen der Kurpatienten nach dem Trinken des örtlichen Heilwassers konfrontiert, das zu seinem Nutzen angewandt werden soll. Der derzeitige Wissensstand über die Auswirkungen unterschiedlicher Joddosen auf die Schilddrüse wird dargelegt und soll die Entscheidungsfindung im Einzelfall ermöglichen. Auch bei Beachtung der klaren Kontraindikationen ist der individuelle Nutzen und das Risiko immer abzuschätzen. Jod ist nicht nur ein lebenswichtiges Spurenelement zur Produktion der Schilddrüsenhormone, es wird auch gezielt in bestimmten Geweben angereichert, wobei die Bedeutung der nachgewiesenen antioxidativen und antiproliferativen Wirkung erst langsam erkannt wird.

Abstract

Drinking cures with naturally occurring mineral waters were applied now as before in many spas. Iodine drinking cures more than other drinking cures require a strict indication and an exact dosage. Though iodine deficiency is largely abolished, a transient increase of the iodine supply can quite make sense. Also spa doctors are confronted with the desire of the patients for drinking the local mineral water, which should be applied for their benefit. The state of art about the effect of different iodine doses on the thyroid is presented and should make it possible to find the decision in the individual case. Also, in consideration of the clear contra-indications, the individual benefit and risk have always to be estimated. Iodine not only is an essential trace element for the production of the thyroid hormones, it also is enriched in a controlled manner in certain tissues. The importance of the proven antioxidant and antiproliferative effect is being gradually recognized.

Schlüsselwörter

Trinkkur - Jod - Schilddrüse - Hyperthyreose - Hypothyreose - Antioxidans

Key words

Drinking cure - iodine - thyroid - hyperthyroidism - hypothyroidism - antioxidant

Literatur

  • 1 Becherer A, Buchberger W, Klieber M. Jodresorption durch die in Bad Hall üblichen Kuranwendungen mit dem örtlichen Kurmittel - Quantifizierung durch die Harnjodausscheidung.  Balneol-Bioklimatol Mitteilungen. 1990;  43 1-9
    PubMedGoogle Scholar
  • 2 Bosch E H, Doorne H Van, Fries S De. The lactoperoxidase system: the influence of iodide and the chemical and antimicrobial stability over a period of about 18 months.  J Appl Microbiol. 2000;  89 (2) 215-224
    CrossrefPubMedGoogle Scholar
  • 3 Braverman L E, Ingbar S H. Changes in thyroid function during adaptation to large dosis of iodide.  J Clin Invest. 1964;  42 1216
    PubMedGoogle Scholar
  • 4 Brown-Grant K. Extrathyroidal iodide concentrating mechanisms.  Physiol erv. 1961;  41 189-213
    PubMedGoogle Scholar
  • 5 Buchberger W, Holler W, Winsauer K. Effects of Sodium Bromide on the Biosynthesis of Thyroid Hormones and Brominated/Iodinated Thyronines.  J Trace Elem Electrolytes Health Dis. 1990;  4 25-30
    PubMedGoogle Scholar
  • 6 Capuano V, Coppola M. The Role of OH Radicals and of Absorbed Energy in the Mechanism of the Radiosensitizing Action of Iodine Containing Compounds. Oxygen Radicals in Chemistry and Biology. Berlin; W de Gruyter & Co 1984: 638-641
    Google Scholar
  • 7 Carrasco N. Iodide transport in the thyroid gland.  Biochim Biophys Acta. 1993;  1154 65-82
    PubMedGoogle Scholar
  • 8 Chow C C, Phillips I D, Lazarus J H, Parkes A B. Effect of low dose iodine supplementation on thyroid function in potentially susceptible subjects: are dietary iodine levels in Britain acceptable?.  Clin Endocrinol. 1991;  34 413-416
    PubMedGoogle Scholar
  • 9 Corvilain B. The natural history of thyroid autonomy and hot nodules.  Ann Endocrinol. 2003;  64 (1) 17-23
    PubMedGoogle Scholar
  • 10 Delange F, Benoist B de, Alnwick D. Risks of iodine-induced hyper-thyroidsm after correction of iodine deficiency by iodide salt.  Thyroid. 1999;  9 545-556
    PubMedGoogle Scholar
  • 11 Dorbach M, Schicha H. Frequency and temporal occurence of a functional autonomy in recurring goiter.  Nuclearmedizin. 1993;  32 (6) 316-320
    PubMedGoogle Scholar
  • 12 Dugrillon A, Uedelhoven W M, Pisaerv M A, Bechtner G, Gartner R. Identification of delta-iodolactone in iodide human goiter and its inhibitory effect on proliferation of human thyroid follicles.  Horm Metab Res. 1994;  26 465-469
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Dugrillon A. Iodolactones and iodoaldehydes-mediators of iodine in thyroid autoregulation.  Exp Clin Endocrinol Diabetes. 1996;  104 41-45
    PubMedGoogle Scholar
  • 14 Eber O. Zur Entwicklung der Jodsalzprophylaxe in Österreich.  Wien Klin Wschr. 1998;  110 (21) 733-737
    PubMedGoogle Scholar
  • 15 Eng P HK, Cardona G R, Fang S L, Previti M, Alex S, Carrasco N, Chin W W, Braverman L E. Escape from the Acute Wolff-Chaikoff Effect Is Associated with a Decrease in Thyroid Sodium/Iodide Symporter Messenger Ribonucleic Acid and Protein.  Endocrinology. 1999;  140 (8) 3404-3410
    CrossrefPubMedGoogle Scholar
  • 16 Aghini-Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F, Rago T, Grasso L, Valeriano R, Balestrieri A, Pinchera A. The Spectrum of Thyroid Discorders in a Iodine-Deficient Community. The Pescopagano Survey.  J of Clin Endocrin and Metab. 1999;  84 (2) 561-566
    CrossrefPubMedGoogle Scholar
  • 17 Fritzsche H, Benzer W, Furlan W, Hammerle D, Langsteger W, Weiß P. Zur Vorbeugung jodinduzierter Hyperthyreosen nach Koronarangiographie.  AMA. 1993;  20 (1/2) 13-17
    PubMedGoogle Scholar
  • 18 Garcia-Solis P, Alfaro Y, Anguiano B, Delgado G, Guzman R C, Nandi S, Diaz-Munoz M, Vazquez-Martinez O, Acaves C. Inhibition of N-methyl-N-nitrourea-induced mammary carcinogenesis by molecular iodine (I2) but not by iodide (I-)treatment Evidence that I2 prevents cancer promotion.  Molecular and Cellular Endocrinology. 2005;  236 49-57
    CrossrefPubMedGoogle Scholar
  • 19 Hintze G, Blombach O, Fink H, Burkhardt U, Köbberling J. Risk of iodine-induced thyrotoxicosis after coronary angiography: an investigation in 788 unselected subjects.  Europ J of Endocrinol. 1999;  140 264-267
    CrossrefPubMedGoogle Scholar
  • 20 Henderson W R, Hubbard W C, Klebanoff S J. Iodination of Arachidonic Acid by the Iron/H2O2/Iodide System.  Lipids. 1983;  18 (5) 390-392
    PubMedGoogle Scholar
  • 21 Hollowell J G, Staehling N W, Hannon W H, Flanders D W, Gunter E W, Maberly G F, Braverman L E, Pino S, Miller D T, Garbe P l, DeLozier D M, Jackson R J. Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from National Health and Nutrition Examination Surveys I and III.  J Clin Endocrino Metab. 1998;  83 3401-3408
    PubMedGoogle Scholar
  • 22 Huwiler M, Jenzer H, Kohler H. The role of compound III in reversible and irreversible inactivation of lactoperoxidase.  Eur J Biochem. 1986;  158 (3) 609-614
    CrossrefPubMedGoogle Scholar
  • 23 Huwiler M, Bürgi U, Kohler H. Mechanism of enzymatic and non-enzymatic tyrosine iodination - Inhibition by excess hydrogen peroxide and/or iodide.  Eur J Biochem. 1985;  147 469-476
    PubMedGoogle Scholar
  • 24 Kahaly G J, Dienes H P, Beyre J, Hommel G. Iodide induces thyroid autoimmunity in patients with endemic goitre: a randomised, double-blind, placebo controlled trial.  European J Endocrinoly. 1998;  139 (3) 290-297
    PubMedGoogle Scholar
  • 25 Kelly M, Golman K. Metabolism of Urographic Contrast Media.  Invest Radiol. 1981;  16 (2) 159 -164
    CrossrefPubMedGoogle Scholar
  • 26 Kohler H, Taurog A, Dunford H B. Spectral studies with lactoperoxidase and thyroid peroxidase interconversions between native enzyme, compound II, and compound III.  Arch Biochem Biophys. 1988;  264 438-449
    CrossrefPubMedGoogle Scholar
  • 27 Kussmaul H. Iodid in Mineral und Heilwässern. Referat 92. Deutscher Bädertag, Bad Reichenhall. 1996
    Google Scholar
  • 28 Laurberg P, Pedersen K M, Vestergaard H, Sigurdsson G. High incidence of multinodular toxic goiter in the elderly population in a low intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland.  J Intern Med. 1991;  229 414-420
    PubMedGoogle Scholar
  • 29 Majerus P M, Courtois P A. Susceptibility of Candida albicans to peroxidase-catalyzed oxidation products of thiocyanate, iodide and bromide.  J Biol Buccale. 1992;  20 241-245
    PubMedGoogle Scholar
  • 30 Mann K, Rendl J, Busley R, Saller B, Seybold S, Hoermann R, Sauerbruch T, Borner W. Systemic iodine absorption during endoscopic application.  Europ J of Endocrinol. 1994;  130 498-501
    PubMedGoogle Scholar
  • 31 Many M C, Mestdagh C, Hove M F Van den, Denef J F. In Vitro Study of Acute Toxic Effects of High Iodide Dosis in Human Thyroid Follicles.  Endocrinology. 1992;  131 (2) 621-629
    CrossrefPubMedGoogle Scholar
  • 32 Mason R P, Walter M F, Mason P E. Effect of oxidative stress on membrane structure: small-angle x-ray diffraction analysis.  Free Radical Biology & Medicine. 1997;  23 (3) 419-425
    CrossrefPubMedGoogle Scholar
  • 33 Meng W, Schindler A, Spieker K, Krabbe S, Behnke N, Schulze W, Blumel C. Iodine therapy for iodine deficency goiter and autoimmune thyreoiditis. A prospective study.  Med Klin. 1999;  94 (11) 597-602
    PubMedGoogle Scholar
  • 34 Moser M, Buchberger W, Mayer H, Winkler R. Einfluss einer Jodtrinkkur auf den antioxidativen Status von Diabetikern.  Wien Klin Wochenschr. 1991;  103 (6) 183-186
    PubMedGoogle Scholar
  • 35 Mostbeck A, Galvan G, Bauer P, Eber O, Atefie K, Dam K, Feichtinger H, Fritzsche H, Haydl H, Kohn H, Konig B, Koriska K, Kroiss A, Lind P, Markt B, Maschek W, Pesl H, Ramschak-Schwarzer S, Riccabona G, Stockhammer M, Zechmann W. The incidence of hyperthyroidism in Austria from 1987 to 1995 before and after iodization an increase in salt iodination in 1990.  European Journal of Nuclear Medicine and Molecular Imaging. 1998;  25 (4) 367-374
    CrossrefPubMedGoogle Scholar
  • 36 Nakamura M, Yamazaki I, Nakagawa H, Ohtaki S, Ui N. Iodination and Oxidation of Thyroglobulin Catalyzed by Thyroid Peroxidase.  The Journal of Biological Chemistry. 1984;  259 (1) 359-364
    PubMedGoogle Scholar
  • 37 Ohtaki S, Nakagawa H, Kimura S, Yamazaki I. Analyses of Catalytic Intermediates of Hod Thyroid Peroxidase during Its Iodinating Reaction.  The Journal of Biological Chemistry. 1981;  256 (2) 805-810
    PubMedGoogle Scholar
  • 38 Pavelka S. Metabolism of Bromide and its Interference with the Metabolism of Iodine.  Physiol Res. 2004;  53 (1) 81-90
    PubMedGoogle Scholar
  • 39 Pfeil G. Entwicklung des Heilbades Bad Hall. Beitrag für medizinhistorisches Museum in Oberösterreich. Bad Hall; Paracelsus Institut 1998
    Google Scholar
  • 40 Pommier J, Dème D, Nunez J. Effect of iodide concentration on thyroxine synthesis catalyzed by thyroid peroxidase.  Eur J Biochem. 1973;  37 406
    CrossrefPubMedGoogle Scholar
  • 41 Reinhardt W, Luster M, Rudorff K H, Heckmann C, Petrasch S, Lederbogen S, Haase R, Saller B, Reiners C, Reinwein D, Mann K. Effect of small dosis of iodine on thyroid function in patients with Hashimoto's thyroiditis residing in an area of mild iodine deficiency.  Europ J of Endocrinol. 1998;  139 23-28
    PubMedGoogle Scholar
  • 42 Rieger G, Griebenow S, Winkler R, Stoiser E. Der antioxidative Status (TAS) der Tränenflüssigkeit vor und nach kombinierten Kurbehandlungen in Bad Hall.  Spektrum Augenheilkunde. 2000;  14 (6) 319-324
    PubMedGoogle Scholar
  • 43 Saji M, Isozaki O, Tsushima T, Arai M, Miyakawa M, Ohba Y, Tsuchiya Y, Sano T, Shiume K. The inhibitory effect of iodide on growth of rat thyroid (FRTL-5) cells.  Acta Endocrinol. 1988;  119 145-151
    PubMedGoogle Scholar
  • 44 Saller B, Fink H, Mann K. Kinetics of acute and chronic iodine excess.  Exp Clin Endocrinol Diabetes. 1998;  106 (3) 34-38
    PubMedGoogle Scholar
  • 45 Schumm-Draeger P M, Müller O A. Diagnostik der Hyperthyreose.  Dtsch Med Wochenschr. 2003;  128 496-499
    PubMedGoogle Scholar
  • 46 Sherwin J R, Tong W. The actions of iodide and TSH on thyroid cells showing a dual control system for the iodide pump.  Endocrinology. 1974;  94 1465
    PubMedGoogle Scholar
  • 47 Singh B, Dhawan D, Chand B, Mangal P C. Biokinetics of iodine 131 in rat thyroid following lead and lithium supplementation.  Biol Trac Elem Res. 1994;  40 287-293
    PubMedGoogle Scholar
  • 48 Smyrk T C, Goellner J R, Brennan M D, Carney J A. Pathology of the thyroid in amiodarone-associated thyrotoxicosis.  Am J Surg Pathol. 1987;  11 197-204
    PubMedGoogle Scholar
  • 49 Szabolcs I, Ploenes C, Bernard W, Herrmann J. Screening of geriatric patients for thyroid dysfunction with thyrotropin-releasing-hormone test, sensitive thyrotropin and free thyroxine estimation.  Horm Metab Res. 1990;  22 (5) 298-303
    PubMedGoogle Scholar
  • 50 Taurog A, Dorris M L. Peroxidase-catalyzed bromination of tyrosine, thyroglobulin and bovine serum albumin: comparison of thyroid peroxidase and lactoperoxidase.  Arch Biochem Biophys. 1991;  287 (2) 288-296
    CrossrefPubMedGoogle Scholar
  • 51 Torremante P. Mastopathie, Mammacarcinom und Jodlactone.  Dtsch Med Wochenschr. 2004;  129 641-646
    Article in Thieme ConnectPubMedGoogle Scholar
  • 52 Turk J, Henderson W R, Klebanoff S J, Hubbard W C. Iodination of arachidonic acid mediated by eosinophil peroxidase, myeloperoxidase and lactoperoxidase.  Biochim Biophys Acta. 1983;  751 189-200
    PubMedGoogle Scholar
  • 53 Turk J, Klebanoff S J, Hubbard W C. Iodination of arachidonic acid mediated by eosinophil peroxidase, myeloperoxidase and lactoperoxidase.  Biochim Biophys Acta. 1983;  751 189-200
    PubMedGoogle Scholar
  • 54 Sande J Van, Massart C, Beauwens R, Schoutens A, Costaglila S, Dumont J E, Wolff J. Anion Selectivity by the Sodium Iodide Symporter.  Endocrinology. 2003;  144 (1) 247-252
    CrossrefPubMedGoogle Scholar
  • 55 Leeuwen F XR Van, Hanemaaijer R, Loeber J G. The effect of sodium bromide on thyroid function.  Arch Toxicol. 1988;  12 93-97
    PubMedGoogle Scholar
  • 56 Vitale M, Matola T Di, D'Ascoli F, Salzano S, Bogazzi F, Fenzi G, Martino E, Rossi G. Iodide Excess Induces Apoptosis in Thyroid Cells through a p53-Independent Mechanism Involving Oxidative Stress.  Endocrinology. 2000;  141 (2) 598-605
    CrossrefPubMedGoogle Scholar
  • 57 Wartofsky L, Ingbar S H. Estimation of the rate of release of non thyroxine iodine from the thyroid glands of normal subjects and patients with thyrotoxicosis.  Clin Endocrinol Metab. 1971;  33 488
    PubMedGoogle Scholar
  • 58 Weller P E, Markey C M, Marnett L J. Enzymatic Reduction of 5-Phenyl-4-pentenyl-hydroperoxide: Detection of Peroxidases and Identification of Peroxidase Reducing Substrates.  Archives of Biochemistry and Biophysics. 1985;  243 (2) 633-643
    CrossrefPubMedGoogle Scholar
  • 59 Wiener J D. Long-term follow-up in untreated Plummer's disease (autonomous goiter).  Clin Nucl Med. 1987;  12 (3) 198-203
    CrossrefPubMedGoogle Scholar
  • 60 Winkler R, Griebenow S, Wonisch W. Effect of Iodide on Total Antioxidant Status of Human Serum.  Cell Biochemstry and Function. 2000;  18 143-146
    CrossrefPubMedGoogle Scholar
  • 61 Winkler R, Moser M. Jodid Ein potenzielles Antioxidans und Sauerstoffradikalfänger und seine Rolle bei Peroxidase-Reaktionen.  VitaMinSpur. 1992;  7 124 -134
    PubMedGoogle Scholar
  • 62 Winkler R, Moser M, Buchberger W. Die Wirksamkeit von Jodid als Sauerstoff-Radikalfänger.  Wiss Zeitschr d. Humboldt-Universität. 1989;  38 (1) 76-79
    PubMedGoogle Scholar
  • 63 Wolff J, Chaikoff I L. Plasma inorganic iodide as a homeostatic regulator of thyroid function.  J Biol Chem. 1948;  174 555
    PubMedGoogle Scholar
  • 64 Yoon S J, Choi S R, Kim D M, Kim J U, Kim K W, Ahn C W, Cha B S, Lim S K, Kim K R, Lee H C, Huh K B. The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto's thyroiditis.  Yonsei Med J. 2003;  44 (2) 227-235
    PubMedGoogle Scholar
  • 65 Zimmermann M B, Ito Y, Hess S Y, Fujieda K, Molinari L. High volume in children with excess dietary iodine intakes.  American Journal of Clinical Nutrition. 2005;  81 (4) 840-844
    PubMedGoogle Scholar

Prim. Dr. M. Klieber
Univ.-Prof. Dr. R. Winkler

Paracelsus Gesellschaft

Dr.-K.-Renner-Straße 6

4540 Bad Hall · Österreich

Email: paracelsus.badhall@utanet.at

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