Question

" graves' disease is the most common cause of hyperthyroidism in the developed world. "

What would be the most common cause of hyperthyroidism in other global areas?

Answer 1

• Thyroid disease is a global health problem that can substantially impact well-being, particularly in pregnancy and childhood.

• Iodine nutrition remains a key determinant of thyroid function worldwide, and continued vigilance against the popularity of iodine deficiency in previously sufficient regions remains essential.
• Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. Iodine nutrition is a key determinant of thyroid disease risk; however, other factors, such as ageing, smoking status, genetic susceptibility, ethnicity, endocrine disruptors and the advent of novel therapeutics, including immune checkpoint inhibitors, also influence thyroid disease epidemiology.
• Graves disease is the most common cause of hyperthyroidism in developed countries where iodine is rich. Other common causes include toxic multinodular goitre and autonomously functioning Thyroid adenoma. Less common causes of hyperthyroidism are thyroiditis, pituitary TSH secreting adenoma and drug-induced hyperthyroidism.

• Extrathyroidal source of hormone
  Excess intake of thyroid hormone	Excess exogenous thyroid hormone (iatrogenic or factitious)
  Ectopic hyperthyroidism (thyroid hormone  produced outside the thyroid gland)	Struma ovarii; functional thyroid cancer metastases

• Exposure to excessive iodine
  Jod-Basedow effect	Iodine-induced hyperthyroidism (iodine, iodine-containing drugs, radiographic contrast agents)