Analysis of the scientific publications confirmed a significant influence of medico-social, hygienic, and environmental factors on the epidemiology of iodine deficiency diseases and as well as an absence of the direct dependence of thyroid pathology on the degree of iodine deficiency. Ecological factors (pollution of air, water, and soil with heavy metals, pesticides, fertilizers, radioactive isotopes) significantly affect the occurence and prevalence of thyroid gland diseases. The long-term effect of the factors, exhibiting the goitrogenic effect, increases the iodine deficiency, significantly affects the iodine-thyroid state and functioning of thyroid gland, and leads to an increase in the incidence of thyroid pathology, especially in goiter endemic areas.

However, the growth of morbidity in the iodine deficiency non-endemic regions of Ukraine shows that iodine deficiency is not a prior factor in the genesis of diffuse nontoxic goiter, and the cause of the disorders is in a numerical imbalance of microelements.

Both natural and anthropogenic environmental factors were established to affect the occurence and course of thyroid disease, but none of these factors is isolated, they operate in a complex, accumulating on the social and hereditary factors. The occurrence and prevalence of goiter is a result of the complex interaction of endogenous and numerous exogenous factors, including those related to human activity. Goiter is a multifactorial disease and can be an indicator of the environmental disadvantage of the settlements.

To understand the problem of iodine deficiency and to develop more effective approaches to the treatment of the patients with iodine deficiency, the doctors and the scientists should conduct a systematic analysis of the relationships between iodine metabolism, thyroid function and some microelements on the basis of the data of physiology, biochemistry, molecular biology, pharmacology, food hygiene, and evidence-based medicine.

Thyroid gland, iodine deficiency diseases, goitrogenic factors, deficiency of microelements

1. Abramova N.А., Fadeev V.V., Gerasimov G.А. and Melnichenko G.А. Klinicheskaya I eksperimentalnaya tireoidologiya. 2006 ; 1 : 21-32 (in Russian). DOI : https://doi.org/10.14341/ket20062121-32

2. Agadzhanian N.А. and Skalnyi А.V. Khimicheskie elementy v srede obitaniya I ekologicheskiy portret cheloveka [Chemical Elements in the Habitat and Ecological Portrait of the Human]. Мoscow ; 2001 : 83 p. (in Russian).

3. Antonenko А.М. and Korshun М.М. Dovkillia ta zdorovia. 2016 ; 3 : 74–79 (in Ukrainian). DOI : https://doi.org/10.32402/dovkil2016.03.074

4. Afanasiev D.Ye., Samoilov О.О. and Belingio Т.О. Klinichna endokrynolohiia ta endokrynna khirurhiia. 2004 ; 2 (7) : 59–62 (in Ukrainian).

5. Bakanov B.К., Makarova I.I., Zhmakin I.А., Galkin V.Т. and Zaikina Е.О. Yodnyi defitsit I okruzhayushchaya sreda [Iodine Deficiency and Environment]. In : Sotsialno-meditsinskie aspekty ekologicheskogo sostoyaniya Tsentralnogo ekonomicheskogo rayona Rossii [Socio-Medical Aspects of the Ecological State of the Central Economic Region of Russia: Mater. All-Russian Scientific Conf.]. Tver (Russia) ; 2007 : 255–258 (in Russian).

6. Bardov V.H., Omelchuk S.Т., Pelo H.М. Problemy medytsyny. 1998 ; 2 : 34–37 (in Ukrainian).

7. Bezrukov О.P. Hihienichni aspecty formuvannia zakhvoriuvan shchytopodibnoi zalozy v Krymskomu rehioni : avtoref. dys. … doktora med. nauk [Hygienic Aspects of the Formation of Thyroid Gland Diseases in the Crimean Region: Author's Abs. Dis. Dr. Med. Sciences ]. Kyiv ; 2010 : 26 p. (in Ukrainian)

8. Boev V.М. Gigiena I sanitaria. 2002 ; 5 : 3–8 (in Russian).

9. Boev V.М. and Utenina V.V. Gigiena I sanitaria. 2001 ; 5 : 68 (in Russian).

10. Vashkulat N.P., Palgov V.I., Spektor D.R. et al. Dovkillia ta zdorovia. 2002 ; 2 (21) : 44–46 (in Russian).

11. Veldanova М.V. Mikroelementy v meditsine. 2000 ; 1 : 17–25 (in Russian). URL : http://journal.microelements.ru/trace_elements_in_medicine/15_pdfsam_2000_1.pdf

12. Horlenko О.М. and Aleksandrov О.Yu. Sovremennaiya pediatriya. 2009 ; 5 (27) : 129–133 (in Ukrainian).

13. Hulchii М.V., Tsymbaliuk S.N., Chernychenko І.О., Korzun V.N. and Bahlii Ye.А. Do pytannia stosovno vplyvu kantserohenonebezpechnykh faktoriv dovkillia na rozvytok raku shchytopodibnoi zalozy [On the Issue of the Influence of Carcinogenic Factors on the Development of Thyroid Cancer]. In : Aktualni pytannia hihiieny ta ekolohichnoi bezpeky Ukrainy (vosmi marzieievski chytannia) [Actual Issues of Hygiene and Ecological Safety of Ukraine (the Eighth Marzieiev’s Readings)]. Kyiv ; 2012 ; 12 : 217–218 (in Ukrainian).

14. Zub S.Т. Toksykoloho-hihiienichna otsinka vplyvu svyntsiu na foni yoddefitsytu I efektyvnist yodoprofilaktyky : avtoref. dys. … kand. med. nauk [Toxicologic-and-Hygienic Assessment of the Influence of Lead on the Background of Iodine Deficiency and the Effectiveness of Iodine Prophylaxis: Author's Abs. Dis. Candidate Med. Sciences]. Kyiv ; 2009 : 20 p. (in Ukrainian).

15. Kovalskiy V.V. Geokhimicheskaya sreda I zhizn [Geochemical environment and life]. Мoscow : Nauka ; 2009 : 357 p. (in Russian).

16. Korzun V.N., Bolokhnova T.V., Nester Т.I. and Parats А.N. Problema mikroelementozov u naseleniya, podvergshegosya sochetannomu deystviyu radiatsionnogo I endemicheskogo faktorov [The Problem of Microelementoses in the Population Exposed to the Joined Effect of Radiation and Endemic Factors]. In : Zdorovie I okruzhayushchaya sreda: sb. nauch. trudov [Health and Environment: Coll. Sci. Papers]. Minsk ; 2008 ; 12 :149–156 (in Russian).

17. Korzun V.N., Parats А.M., Kolesnikov М.К. and Hlynka Z.І. Yoddefitsytni zakhvoriuvannia: novi pohliady na etiolohiiu, patolohiiu ta profilaktyku [Iodine Deficiency Diseases: New Standpoint Towards Etiology, Pathology, and Prophylaxis ]. In : Dovkillia i zdorovia : mater. konf. [Environment and Health : Mater. Conf.]. Uzhhorod : Hoverla ; 2008 : 115–120 (in Ukrainian).

18. Pozdniak А.О. Gigiena I sanitariia. 2002 ; 4 : 13–15 (in Russian).

19. Rustambekova S.А. and Barabashkina Т.А. Rol mikroelementov v disfunktsii shchitovidnoy zhelezy [The Role of Microelements in Thyroid Dysfunction]. In : Aktualnye problemy ekologii I prirodopolzovaniya : mater. konf. [Actual Problems of Ecology and Environmental Management: Mater. All-Russian Sci. Conf.]. Moscow ; 2004 : 11–14 (in Russian).

20. Suslikov V.L. Geokhimicheskaya ekologiya bolezney [Geochemical Ecology of Diseases]. Т.1. Dialektika biosfery I noosfery [Vol. 1. Dialectics of Biosphere and Noosphere]. Мoscow : Gelios АRV; 1999 : 410 p. (in Russian).

21. Suslikov V.L. Geokhimicheskaya ekologiya bolezney. Мoscow : Gelios АRV; 2000 ; Vol. 2 : 672 p. (in Russian).

22. Tliashinova А.М. and Rustambekova S.А. Mizhnarodnyi endokrynolohichnyi zhurnal. 2006 ; 2 (4) : 71–74 (in Russian).

23. Utenina V.V., Pligina Е.V., Utenin V.V., Barysheva Е.S., Gorlov А.V. and Karpov А.I. Gigiena I sanitariia. 2002 ; 5 : 57–59 (in Russian).

24. Fabri А.Z. and Fera О.V. Bukovinian Medical Herald. 2004 ; 3-4 : 248–253 (in Ukrainian).

25. Tsymbaliuk S.М., Chernychenko І.О., Lytvychenko О.М., Hulchii М.V., Balenko N.V., Fedorenko Z.P. and Voloshchuk О.V. Dovkillia ta zdorovia. 2017 ; 1 : 11–14. (in Ukrainian). DOI : https://doi.org/10.32402/dovkil2017.01.011

26. Köhrle J. Flavonoids as a Risk Factor for Goiter and Hypothyroidism. The Thyroid and Environment : Proceedings of the Merck European Thyroid Symposium. Stuttgart - New York : Schattauer; 2000 : 41–63.