FOODS AND THE GENESIS OF GOITER*†

Abstract

THE nutritional complex eventually resulting in the development of goiter is composed of one or more of three differing elements, deficiency, excess, or toxicity; moreover, more recent studies have even suggested two other factors, antagonism as well as synergism. Among these the role of deficiency is best known. Nearly world-wide experience indicates that iodine lack is concerned in the production of at least one form of thji-oid disease, endemic goiter, although other circumstances may contribute to a varying degree. The iodine-deficiency hypothesis alone, however, fails to explain satisfactorily several situations which are still enigmatic. Thus, there is the puzzle of certain isolated seacoast regions where the iodine intake is presumably high and yet simple goiter is prevalent; or the more baffling observations concerning cretinism, which over-runs certain areas endemically while shunning others. It is particularly owing to such exceptions, and also perhaps to certain chance associations, that efforts are constantly being made, despite the well grounded hypothesis of iodine lack, to isolate as yet unknown or unconfirmed etiologic factors in simple goiter and to disclose the causes of other thyroid disease as well. In the complicated domain of medicine, there are usually to be found new shock absorbers, occasional synergists and many antagonists.