*7.2.1 Clinical presentation*

*Biochemical Testing - Clinical correlation and Diagnosis*

Individuals with underlying thyroid disease:

c.Euthyroid with a history of subacute thyroiditis

f. Euthyroid posthemithyroidectomy

g.Euthyroid after interferon-alpha therapy

manifestations of hypothyroidism and goitres [29].

Deaf mutism Stillbirths

Congenital anomalies Increased perinatal mortality Endemic cretinism

Neonatal hypothyroidism Endemic mental retardation

Subclinical hypothyroidism Impaired mental retardation Retarded physical development

Hypothyroidism Impaired mental function

Increased susceptibility of the thyroid gland to nuclear radiation

Increased susceptibility of the thyroid gland to nuclear radiation

Hyperthyroidism in the elderly (after iodized salt)

**Life stage Spectrum of IDD** Foetus Abortions

Neonate Neonatal goitre

Adult Goitre with its complications

Child and adolescent Goitre

*The spectrum of IDD across the life span.*

d.Euthyroid with a history of post-partum thyroiditis

or anti-thyroid drugs

b.Hashimoto's thyroiditis

individuals with underlying thyroid disease or other risk factors may be susceptible to

a.Euthyroid Graves' disease previously treated by radioactive iodine, thyroidectomy

e.Euthyroid with a history of type 2 amiodarone-induced thyrotoxicosis

The spectrum of iodine deficiency disorders (IDD) is seen across the life span in various age groups, i.e. foetus, neonate, infants, child, adolescent and adult. They include endemic goitre and cretinism, endemic mental retardation, decreased fertility rate, increased perinatal death and infant mortality and varying degrees of other growth and developmental abnormalities (**Table 3**) [27, 28]. Hypothyroidism due to very low iodine intake is now extremely rare. Adults usually have the typical clinical

iodine-induced thyroid dysfunction following acute or chronic exposure.

*7.1.2.1. Predisposing risk factors in iodine-induced hypothyroidism*

**22**

**Table 3.**

*Source: Refs. [27, 28].*

The severity and spectrum of symptoms and signs of hyperthyroidism may be related to the duration of the illness, the effects of excess thyroid hormone and the age of the patient [24].

The symptoms and signs include the following:

