Can patients with hypothyroidism (hypothyroidism) eat Chuyuan (nutritional)?

The best way to treat hypothyroidism, nearly two adults in China have hidden thyroid problems

:00 Reason: Strong Channel

China’s first nationwide thyroid disease outbreak Data released from the scientific survey project——

This survey covered more than 15,000 community residents in ten cities. The results of the survey indicate that one in every 15 people has hypothyroidism and one in every five people. Nearly one person suffers from thyroid nodules. Experts advise that thyroid disease is not a refractory disease, but is treatable and controllable. The key lies in early detection. Incorporating thyroid B-ultrasound examination into routine physical examination items can help detect thyroid cancer early

Recently, the Endocrinology Branch of the Chinese Medical Association announced the results of China’s first epidemiological survey on the prevalence of thyroid diseases. The results show that among the residents of the ten major cities who accepted this epidemiological survey, the prevalence of hypothyroidism (including clinical hypothyroidism and subclinical hypothyroidism, hereafter referred to as "hypothyroidism") has increased significantly and has reached 6.5 %, and the prevalence of thyroid nodules is also as high as 18.6%. The thyroid health status of the Chinese people is not optimistic. This flow investigation project was jointly carried out by the International Exchange and Solidarity Center of the Ministry of Health, the Endocrinology Branch of the Chinese Medical Association, and others.

Experts advise that thyroid disease is not a refractory disease, but treatable and controllable. The key is to present it early. Therefore, experts recommend adding thyroid B-ultrasound examination to daily physical examinations, and women who are planning to become pregnant or are already pregnant should undergo TSH (thyroid stimulating hormone) screening.

Data

1 in 15 people suffer from hypothyroidism

The thyroid is a butterfly-shaped organ located in front of the trachea. It secretes excessive thyroid hormone. Affects human metabolism, growth and development. At present, thyroid disease is far less well-known than cardiovascular disease, diabetes, etc., and many people often only know it as "big neck disease". In fact, thyroid disease is far more rare than most people think. In the field of endocrinology, it is the second most common disease after diabetes. More than 300 million people worldwide suffer from thyroid disease, and it has become a serious threat. Humans are strong. However, public awareness of thyroid disease is quite low, and there is a lack of relevant authoritative survey data internationally. This epidemiological survey project on thyroid disease fills a gap in the history of international disease prevention and treatment.

According to reports, this popularization project was launched in March 2009 and has lasted for 1 year and 5 months. It has selected various varieties from ten cities including Beijing, Guangzhou and Shanghai. Residents of the community are inspected, including questionnaires, on-site physical examinations, thyroid B-ultrasound examinations, fasting venous non-anticoagulated blood, fasting urine sample management and many other items.

Compared with the 2006 small-limit abortion survey data, the results of this thyroid survey of community residents in ten cities have significant changes in the following two aspects:

1. Hypothyroidism The incidence rate has increased from 3.8% to 6.5%, which means that one out of every 15 people is living with hypothyroidism. The growth rate of up to 70% shows that hypothyroidism is increasingly becoming the biggest killer of thyroid dysfunction in Chinese residents.

2. The prevalence of thyroid nodules (including single and multiple nodules) has also increased from 10.2% to 18.6%, that is, nearly 1 in 5 people has thyroid nodules. .

Incidence

Women are at higher risk of hypothyroidism

Hyperthyroidism and hypothyroidism are two common thyroid diseases. Hyperthyroidism means excessive secretion of thyroid hormone, resulting in rapid metabolism and obvious symptoms such as protruding eyes, rapid heartbeat, and abnormal weight loss. On the contrary, patients with hypothyroidism suffer from common sub-fever symptoms such as low vitality, mental weakness, and memory loss due to low secretion of thyroid hormone and slow metabolism.

Due to the mild initial symptoms, hypothyroidism is often looked down upon by the public and is a potential threat to human health. And women are more likely to suffer from hypothyroidism. According to statistics, one in every six women suffers from hypothyroidism. What is even more frightening is that if the patient is in pregnancy, the probability of miscarriage and the rate of fetal death in early pregnancy increase significantly, which can easily lead to impaired intellectual development and growth and development disorders in the newborn, causing irreparable damage to the mother and child.

Recommendations

Increase thyroid B-ultrasound in daily physical examinations

Another change worthy of concern during the investigation is that the prevalence of thyroid nodules has also increased significantly. Nearly 1 in 5 people have thyroid nodules. “Because a single nodule causes a higher incidence of thyroid cancer, we recommend adding thyroid B-ultrasound examinations to daily physical examinations. Nearly 20% of adults in China have thyroid nodules. Hidden dangers." said Professor Teng Weiping, chairman-elect of the Endocrinology Branch of the Chinese Medical Association and leader of the thyroidology group.

According to reports, thyroid cancer is the most common malignant tumor of the endocrine system and one of the top ten malignant tumors that women in my country are susceptible to. Its incidence has increased significantly in the past 30 years, and it is the only cancer with two cases in recent years. Malignant tumors with increasing digit speed. Because it has no symptoms in the early stages of its onset, it is often looked down upon. When a physical examination reveals thyroid nodules, special attention should be paid to thyroid cancer. Teng Weiping said that the cure rate of thyroid cancer is higher than that of other rare malignant tumors. As long as it is detected early and treated in time, patients can quickly live a healthy life like ordinary people.

Prevention

Regularly perform self-examination of the front of the neck

"Thyroid disease is not a refractory disease, but treatable and controllable. As long as you persist "The treatment is very effective." Teng Weiping said that hypothyroidism is currently the most effective endocrine disease. If you suffer from hypothyroidism, nearly two adults in China will have hidden thyroid problems. It can be treated simply by taking synthetic thyroxine. "But the important thing is early detection and early treatment, and don't ignore some symptoms in daily life."

Because hypothyroidism in pregnant women can cause intellectual development disorders in the fetus, experts recommend targeting children of childbearing age. Women carry out TSH (thyroid stimulating hormone) screening mission. Among them, women of childbearing age who plan to become pregnant should have their thyroid function tested 3 months before conception or pregnancy; for pregnant women who have been confirmed to have thyroid disease, their thyroid function should be tested every 6 to 8 weeks during pregnancy.

When thyroid disease occurs early, it is very important to conduct preliminary thyroid health diagnosis independently. "After taking a bath every day, you can touch the front of your neck by yourself. Once suspicious induration appears, you should see a doctor as soon as possible. Generally, a TSH test can confirm the diagnosis." Teng Weiping said.

In May 2009, an investigation on "Iodine Nutritional Status of Mainland Residents" was led by the Ministry of Health and launched in four provinces and cities: Zhejiang, Liaoning, Fujian, and Shanghai.

China was once one of the most serious countries with iodine deficiency in the world. More than 700 million people were iodine deficient, accounting for 40% of the world's iodine deficiency patients. In 1994, universal consumption of iodized salt was implemented as a national policy in China, similar to the family planning policy.

Under the slogan “Eat iodized salt, keep the whole family healthy!”, the complex situation of iodine nutrition in various places has been seriously underestimated. The "National Iodized Salt Monitoring Mission Briefing" released in February 2009 can give a glimpse of the complexity of China's "iodine situation": "In and outside key defense (iodine deficiency disease) provinces and regions, in recent years, water iodine and urinary iodine levels among key populations have The investigation showed that the water in some villages has high iodine, and there is a mix of high iodine and iodine-deficient and iodine-appropriate villages.”

However, the monopoly and monopoly system of the salt industry makes it extremely difficult for citizens to buy non-iodine products in the market. Iodized salt. For areas with high iodine levels in the mainland, such as Liaoning, Zhejiang, Tianjin, Shanghai, and Fujian, iodized salt, which was originally used to prevent large neck disease, has caused citizens to overdose on iodine and suffer from health risks.

Today, 15 years after the implementation of the national iodine supplementation policy, more and more epidemiological surveys in places have shown that some areas are ushering in the peak period of thyroid disease. The time period during which the disease broke out coincided with the forced consumption of iodized salt.

The calls from the official and medical circles for independent iodine supplementation are getting louder and louder. Should mainland residents take iodine supplements? Can frequent thyroid disease be related to excessive iodine nutrition? A comprehensive and in-depth census cannot wait.

China’s “one-size-fits-all” salt iodization policy may face in-depth adjustments.

The deadly catalyst?

In order to find a trustworthy doctor to perform surgery on his wife, Cui Gonghao searched in major hospitals and finally found Wang Ping.

Wang is the chief physician of the Department of Internal Medicine at the Second Affiliated Hospital of Zhejiang University School of Medicine. He has been engaged in the removal of thyroid hyperplasia tissue for many years.

The "iodine sentiment" in Zhejiang Province has also attracted his attention. In recent years, the number of thyroid patients admitted to his department has increased significantly.

From 2005 to 2008, he personally performed more than 550 surgeries every year, and this year it exceeded 600. Among them, the proportion of thyroid cancer gradually increased from 10% in 2005 to 23.15% in 2008.

The thyroid gland is the largest endocrine gland in the human body. It is located under the thyroid cartilage and closely behind the third and fourth cartilage rings of the trachea. Inorganic iodine compounds in food are absorbed through the gastrointestinal tract and circulated in the blood, and are quickly diluted for uptake by the thyroid gland. After iodide enters the cells, it produces active iodine through the action of oxidase, which is combined with other substances to become thyroxine, which is then secreted into the blood circulation.

It would actually be best if there was no involvement of iodine. If thyroid hormone cannot be secreted normally, the operation of the endocrine system, reproductive system and digestive system in the body will be affected.

"Just like a factory, iodine is a catalyst in the production process. Without it, production cannot proceed." Cui Gonghao said, "But if there are too many catalysts, it will also disturb the original physiological reactions. The consequences are equally disastrous."

In 2007, with the support of the Zhejiang Provincial Department of Science and Technology Fund, Zhang Yongkui led a research team to conduct a large-scale epidemiological survey on the iodine nutrition level of the Zhoushan population, which was reported in April this year. Officially released. Zhang Yongkui said in an interview with a reporter from Nandu Weekly: Can Hashimoto's hypothyroidism be cured? "Our investigation can effectively answer whether iodized salt leads to the occurrence of thyroid disease, but the iodine nutrition of Zhoushan people does exceed the standard, and thyroid diseases are indeed increasing every year."

In the several-month investigation , they conducted B-ultrasound and urine iodine testing on 1,389 urban residents. The results showed that the median urinary iodine value of urban residents in the Zhoushan island area was 320 micrograms/liter, and that of children aged 8-10 years old was 259 micrograms/liter. The proportion of people with urinary iodine values ??greater than the 200 micrograms/liter peace line defined by the WHO was 77% of the survey subjects.

Sometimes the hospital diagnoses a dozen or even dozens of patients with goiter and thyroid tumors in a day, and then measures the urinary iodine content of the patients. What shocked the doctors at Zhoushan People's Hospital was that the patients were almost full of iodine. Too much, and a few days after the patients switched to non-iodized salt, the urinary iodine content of most patients dropped significantly.

Zhang Yongkui often comes into contact with some thrilling cases. "There was also an old female teacher. Her mother had just undergone surgery last year to remove a thyroid tumor. Not long after, she herself was diagnosed with thyroid enlargement. As a result, after further questioning, she found that there were already five people in her family suffering from the disease. This kind of disease has occurred.” “Among the patients with thyroid cancer that I treat, the youngest is only 9 years old.” Wang Ping told reporters.

The side effects of universal iodine supplementation

With nationwide restrictions, especially in the mainland, do you know that Hashimoto’s hypothyroidism can be cured? The salt iodization policy has been increasingly questioned. In cities such as Tianjin, Shenyang, Shanghai, Guangzhou, and Fuzhou, a large number of medical surveys every year indicate that thyroid diseases are increasing dramatically, and iodine excess is regarded as an important factor. Many of the research results were published in the "Chinese Journal of Endocrinology and Metabolism" and "Chinese Journal of Endocrinology and Metabolism". Published in authoritative medical journals such as "Journal of Epidemiology".

Zhong Wen, who has been conducting epidemiological investigations of thyroid diseases at the Guangdong Provincial Center for Disease Control and Prevention for many years, has conducted relevant investigations many times in the past ten years. As early as 2001, he believed that urinary iodine levels in some areas of Guangdong Province tended to be high, and the amount of iodized salt in Guangdong must be lowered to 20-30 micrograms/g. In the years since then, he has published multiple conclusions, pointing out that high levels of breast milk iodine in some areas are related to excessive salt iodization, and that the side effects of widespread salt iodization policies should be emphasized.

In 2003, the Guangdong Provincial Center for Disease Control and Prevention and the Gansu Provincial Center for Disease Control and Prevention conducted a joint study and selected Huangpo Town, Wuchuan County, Zhanjiang, which began to consume iodized salt in 1996, and Xuwen, Zhanjiang, which has not yet implemented iodized salt. An inspection point was set up in Maichen Town of the county, with 70,000 and 50,000 people inspecting respectively.

The results showed that after 8 years of iodine supplementation, the average annual incidence of hyperthyroidism in Huangpo Town more than doubled, while there were no changes in Maichen Town without iodine supplementation. Zhong Wen explained that this increase in incidence was transient - it increased and then fell back.

A survey conducted in Shanghai with mild iodine deficiency also showed that the incidence of hyperthyroidism has approximately doubled after two years of iodine addition. In old wards that have implemented iodized salt prevention and treatment for many years, iodine-induced hyperthyroidism has not increased after universal salt iodization, indicating that the population has adapted to the gradual increase in iodine intake. However, in new wards that have just implemented iodized salt prevention and treatment, iodine-induced hyperthyroidism has not increased. A major outbreak of iodine hyperthyroidism.

"

"In the case of iodine deficiency, people make automatic arrangements, such as increasing the size of the thyroid gland, to produce sufficient thyroid hormone. However, when the iodine intake is suddenly sufficient, the human body still needs to It takes a while to transform into the normal form. "Zhong Wen said.

What surprised Zhong Wen was that in Xuwen, Guangdong, due to the conservative salt production industry, people had heard about the treatment of Hashimoto's hypothyroidism. Most of the people ate illicit salt. According to Guangdong The local urine iodine test organized by the Provincial Center for Disease Control and Prevention shows that the area is a mild iodine deficiency area and requires appropriate iodine supplementation, with a concentration of (25±5) micrograms/g.

"At least in Guangdong. , universal iodine supplementation should be implemented. "People usually think that mainland residents eat more seafood and the iodine they get from food is enough, but this is not the case," Zhong Wen said. Every 1,000 grams of marine fish contains about 200 micrograms of iodine. You need to eat at least 750 grams a day to ensure the normal amount of iodine needed by the human body. This amount of food is impossible for most people. So it is wrong to think that eating seafood does not lead to iodine deficiency. ”

Iodine supplementation for fifteen years

Cui Gonghao was also a strong supporter of the salt iodization policy.

In the 1980s, he worked with the Several doctors formed a team and went to the Lin'an mountainous area to conduct a census of iodine deficiency diseases. They spent ten or twenty days checking almost all the middle-aged and elderly people. The prevalence of thyroid disease may be around 50%, most of which is caused by iodine deficiency. Caused by shortage.

China was once one of the most serious countries with iodine deficiency, with more than 700 million people suffering from iodine deficiency, accounting for 40% of the world's iodine deficiency patients.

In 1993, the State Council hosted and co-organized the "Initiative Conference on Eliminating Iodine Deficiency Diseases", which adopted the National Outline for the Prevention and Control of Iodine Deficiency Diseases and decided on a prevention and control strategy to promote universal salt iodization to eliminate iodine deficiency.

In 1994, the country officially promulgated the "Regulations on the Management of Salt Iodization to Eliminate the Risk of Iodine Shortage", and salt iodization became a national policy. By 1995, edible iodized salt was implemented throughout the country except Tibet.

However, while controlling iodine shortages, the possible harm caused by iodized salt has not been emphasized. For a long time, eight cities in Beijing, Hebei, Shanxi, Jiangsu, Anhui, Fujian, Shandong and Henan have high levels of iodine. Provinces and regions are also forced to promote iodized salt.

An expert from the Zhejiang Provincial Center for Disease Control and Prevention said that the "Regulations" have already clearly stated that iodized salt is not required to be consumed in high-iodine areas. This policy has not been implemented well. In order to pursue higher costs, salt companies in many places sell iodized salt uniformly. The "2008 National Iodized Salt Monitoring Report" shows that iodized salt is still consumed in many high-iodine areas, including Beijing and Fujian. The iodized salt rates were only 25% and 22.67% respectively.

In 2005, a report in China Business Daily revealed that the Henan Provincial Health Department listed Shangqiu City as a high-iodine area and requested the salt industry. The salt industry company has never responded to the department's "stop supply of iodized salt". In various provinces in China, the salt franchise is linked to the assessment of iodized salt extension purposes, and the salt industry company is both an enterprise and an administrative department of salt management.

On the other hand, relevant departments are not in place to monitor the iodine nutrition level of residents. Lou Xiaoming, the person in charge of the Zhejiang Provincial Iodine Nutrition Status Survey Project, said that the current Zhejiang Provincial Center for Disease Control and Prevention is in short supply before 2000. Information. As far as the country is concerned, the national iodine deficiency disease surveillance plan was just implemented in 2008. It was not until 2008 that Cui Gonghao's wife was diagnosed with thyroid cancer. The national common salt iodization policy has been implemented for 14 years. During this time, the international concept of salt iodization has undergone significant changes.

Previous. In the 1990s, the World Health Organization vigorously promoted the elimination of iodine deficiency disorders. For a long time, the organization believed that "a daily intake of 1,000 micrograms of iodine was safe for healthy adults." The organization defined iodine overdose for the first time and pointed out that daily iodine intake should not exceed 300 micrograms/liter (urinary iodine test).

Obviously, Cui Gonghao’s powerful personal efforts to reverse the salt iodization policy were achieved. After more than a year of in-depth research, Cui Gonghao had to admit that he had no basis for thyroid pathology caused by excessive intake of iodized salt. “This is not a task that can be accomplished by one person or a few experts, it requires a nationwide census.

"

"In the context of the national iodine supplementation campaign, the strength of the 500 million iodine-sufficient population has been completely despised. Cui said.

In 2000, Teng Weiping, the former president of China Medical University and an expert on endocrinology, had already put forward his own conclusion in a paper published in the "Chinese Journal of Endocrinology and Metabolism": At present, China is at the peak of the incidence of thyroid disease.

Confirming his conclusion, in Shanghai, in 2001, Huang Qin and others from the Department of Secretion of Changhai Hospital affiliated to the Second Military Medical University conducted an experiment on Baosteel Group. A four-month investigation found that 183 of the 310 diagnosed patients with thyroid disease developed within 3 and a half years after salt was iodized; Qian Biyun, affiliated with Tianjin Medical University, can Hashimoto's hypothyroidism be cured? An investigation by others found that the average annual incidence rate of thyroid cancer in Tianjin from 1981 to 2001 was 1.77/100,000, and it was increasing year by year.

The country has made great efforts to eliminate iodine shortages and implement salt reduction. After 15 years of iodine, what causes the frequent occurrence of thyroid disease? What is the relationship between iodized salt and thyroid disease? The Chinese Ministry of Health and Disease Control and Prevention have not yet reached a conclusion on this issue.

"This is not true. It may be sporadic things that happen sometimes." Cui Gonghao, a 72-year-old retired professor at Zhejiang University School of Medicine, began a personal in-depth investigation.

The National Government monitored the salt consumed in the homes of households, including iodized salt. , the national iodized salt coverage rate is 97.48%, and has remained above 95% for five consecutive years since 2004. At the provincial level, 24 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps have an iodized salt coverage rate of greater than or equal to 95%. 95%; the coverage rate of iodized salt in 5 provinces (autonomous regions and municipalities) is greater than or equal to 90%, but less than 95%; iodized salt in Tibet and Hainan?

How much iodized salt should be eaten? < /p>

Iodine that has to be supplemented

Cui Gonghao collected almost all the reports he could find.

He noticed: Since 2008, “should Hangzhou people eat it?” The discussion of "iodized salt" has frequently appeared in major newspapers. Before that, "advocating the consumption of iodized salt to prevent thyroid tumors" was the mainstream voice.

The country has widely implemented salt iodization since 1994. policy, and the rapid increase in thyroid disease in recent years, is it related to the population's consumption of iodized salt?

Cui Gonghao believes that the most suspected "culprit" is the iodized salt consumed every day. p>

A report from the China Nutrition Society shows that the average daily salt intake of Chinese urban residents is 11 grams, and that of rural residents reaches 17 grams.

“This means that according to most of the salt intake currently on the market. Each gram of iodized salt contains 20-50 micrograms of iodine, and the Chinese people's daily iodine intake reaches an astonishing 220-850 micrograms, far exceeding the safety line of 200 micrograms per day set by the World Health Organization. Cui Gonghao came up with this astonishing figure after statistics.

In China, the iodized range of iodized salt is 20-50 micrograms/g. There are differences between regions, but the amount of iodine added In the relatively small Pearl River Delta region, it is said that the amount of iodine added for treatment has reached 30 micrograms.

Wang Xingguo, a nutritionist and associate professor at the Second Affiliated Hospital of Dalian Medical University, believes that the problem of excessive iodine should be alerted: " Excessive iodine can actually cause thyroid diseases, such as hyperthyroidism, thyroid nodules, thyroiditis, thyroid tumors, etc. "Just in April this year, some media in Dalian raised the issue of whether the local supply of iodized salt was excessive and caused an increase in thyroid diseases, but the response from the local Centers for Disease Control and Prevention was "not found."

What Cui Gonghao finds hard to accept is that he, who lives in Hangzhou, can hardly buy iodized salt in ordinary supermarkets and small stores.

In China, salt is basically sold exclusively by salt companies. Uniform purchase and sales. In provinces that are iodized, uniodized salt cannot be circulated through legal channels, otherwise it will be treated as "illegal salt"

International Cooperation to Eliminate Iodine Deficiency Disease in China. On the website of the Project Technical Steering Center (NTTST), the only sales points for iodized salt that can be found are Beijing, Shanghai, Tianjin, and Guangzhou.

Cui Gonghao repeatedly called the Zhejiang Salt Industry. The staff of the company told him: iodine supplementation is a basic national policy. If you must buy non-iodized salt, you can go to a salt product store operated by the salt company, but you must present a relevant disease certificate issued by the hospital.

"This makes it difficult for me to accept. The premise is that unless you get sick first, how do patients with Hashimoto's hypothyroidism and hyperthyroidism supplement. And prove it to them, then you can stop eating it. Iodized salt," Cui said.

In many years of iodine supplementation education in Zhejiang and even across the country, preventing large neck disease and improving children’s IQ have always been the two major arguments for the general understanding of iodine supplementation. In 2006, the Ministry of Health included IQ as a mandatory target for monitoring to eliminate iodine shortage diseases, and pointed out that the average iodized salt coverage rate in Zhejiang and other provinces was above 94%, and the "average IQ of children aged 8-10 in Zhejiang Province was above 110." The IQ of children aged 8-10 in Guangdong was only 101. In the same year, the consumption rate of qualified iodized salt in Guangdong was only 84.39%.

Now, Zhejiang people are facing a new problem: excessive iodine intake may be dangerous.

Li Guixiang, a retired teacher at Zhejiang Sci-Tech University, was also diagnosed with thyroid nodules last year. She found that the number of people suffering from thyroid disease is increasing every year in the school's physical examination.

From then on, she began to pay attention to controlling the amount of salt her family eats every day to avoid hidden dangers. And it is intended to delay the addition of salt when cooking. However, Li Guixiang, who studies chemistry, soon discovered that it would be in vain to speculate for any length of time. Currently, the main iodide added to table salt is potassium iodate, and potassium iodate is very stable. The original "defect" of increased iodine volatilization was overcome as early as 1989. In that year, seven departments including the Ministry of Health issued a notice requesting that the country gradually switch to using potassium iodate to process iodized salt.

"Even if it is boiled in a beaker in the laboratory, it will not volatilize." Unable to succeed, Li Guixiang had to go to the hospital to issue a disease certificate and go to the salt company store to buy iodized salt, otherwise The whole family will face the adversity of having to continue "iodine supplementation".

The difficult-to-describe U-shape

Although more and more doubts point to the excessive iodine intake of mainland residents, there is still a lot of controversy in medicine.

Wang Ping observed during clinical practice that most of the patients who come to the hospital for diagnosis of thyroid disease come from Taizhou, Ningbo, Wenzhou and other places, and these areas are mainly distributed in the mainland of Zhejiang Province. "Regionally speaking, there seems to be a certain correlation."

However, in an investigation report completed last year and provided to reporters by the Zhejiang Provincial Center for Disease Control and Prevention, the conclusion was exactly the same. This reporting form is the urinary iodine monitoring of students aged 8-10 and women aged 18-55 in key monitoring counties in the province, limited to 6 counties: Chun'an, Qingyuan, Anji, Tongxiang, Yuhuan and Daishan. The first two are mountainous counties, the central two are vegetable processing areas and use non-iodized salt in large quantities, and the last two are island counties. The results of the investigation showed that the median urinary iodine in mountainous counties was the highest, with Qingyuan reaching 268.5, while the lowest was in Daishan and Yuhuan, which are located in salt-producing areas, with 110 and 120 respectively.

Lou Xiaoming believes that due to the lack of comparison group and comprehensive investigation data, it is currently impossible to say that the incidence of thyroid disease has increased substantially. He explained that detection rate and incidence rate are two concepts. In the 1990s, the thyroid gland was mainly palpated, but current B-ultrasound equipment can detect nodules with a diameter exceeding 3 mm. He believes that the current increase in thyroid diseases is largely due to the increase in detection rates.

The medical community’s concern about the changes in the distribution of thyroid diseases before and after universal iodine supplementation actually began more than ten years ago.

Zhang Kaizhen and others from the Union Hospital affiliated to Fujian Medical University conducted a 10-year investigation. They found that widespread consumption of iodized salt significantly reduced the prevalence of hypothyroidism, but increased the prevalence of hyperthyroidism. In Liaoning, a scientific research team led by Teng Weiping, the former president of China Medical University, implemented a five-year project on "The Impact of Iodine Intake on Thyroid Disease" in 1999.

The research team selected three areas for monitoring. Do you know whether Hashimoto’s hypothyroidism can be cured? These include an iodine deficiency area, an iodine supersufficiency area and an iodine excess area. The final conclusion is: the nutrient form of iodine is an ecological environment for human survival. We should be very cautious in artificially changing the ecological environment. The more iodine intake is by no means the better.

Teng Weiping’s research has far-reaching influence.

At the fourth session of the Ninth National People's Congress in March 2001, Professor Teng Weiping, then a representative of the National People's Congress, took the lead in submitting a 9,000-word bill proposing to amend the national salt iodization regulations. The bill received great attention from the country, and relevant departments promptly revised the national standards for salt iodization and lowered the upper limit of iodine content in salt. The best way to treat hypothyroidism.

On the "Prevention and Treatment of Iodine Deficiency Diseases" day of the same year, the country proposed a new policy of "adapting measures to current conditions, providing classified guidance, and scientifically supplementing iodine".

Since 2005, the country has in principle stopped supplying iodized salt in high-iodine areas.

"After Teng Weiping's contribution came into play, it promoted a common understanding in the medical community. Too much or too little iodine intake will lead to thyroid disease, which is roughly a U-shaped relationship, that is to say, lack of iodine will lead to thyroid disease. Both iodine and iodine-rich causes thyroid disease, but the specific process is not yet clear. What is the appropriate amount of iodine intake? What are the individual differences in different regions and different groups? ?" Wang Ping said.