主题：【原创】闲话食盐加碘 -- 青方

等有空了俺写一下。

KI这东西比较容易被氧化，当时做试验，装KI的瓶子好象颜色都有些深。

因为碘酸钾是氧化剂，而很多食物中都含有还原性的物质

好象没有特别的界限，只是说明碘的长期过量摄取与甲亢的发病关系密切。

Thyroid. 1998 Dec;8(12):1179-83.

Epidemiology of thyroid diseases in iodine sufficiency.

Lind P, Langsteger W, Molnar M, Gallowitsch HJ, Mikosch P, Gomez I.

Department of Nuclear Medicine & Endocrinology LKH Klagenfurt, Austria.

Epidemiology of thyroid diseases in iodine-sufficient areas (ISA) deals with sporadic goiter, thyroid autoimmune diseases, and thyroid cancer. A comparison between the different studies performed is difficult because methods have changed over time and selection criteria and definitions such as prevalence or incidence were not used consistently by some authors. Sporadic goiter: in ISA, autoimmune processes play a major role in the development of sporadic goiter. In adults, sporadic diffuse goiter is most frequent in young women (16%), perhaps due to additional relative iodine deficiency especially in pregnancy, and declines with age (<10%). Sporadic nodular goiter increases from 5% in young women to 9% in older women. Autoimmune thyroid disease (AITD): thyroid autoantibodies (TAb) and histopathological lymphocytic infiltration of the thyroid is much more common in ISA (4.6% in women; 1.1% in men) than in iodine-deficient areas (IDA). The prevalence and incidence of hypothyroidism and hyperthyroidism varies, depending on whether overt and subclinical forms are included and whether newly or previously diagnosed dysfunction is considered. In an overview of the literature, the prevalence is 2 in 1000 for overt and 6 in 1000 for subclinical hyperthyroidism in ISA. The values for hypothyroidism are 5 in 1000 and 15 in 1000, respectively. Change from IDA to ISA: in former IDA, the percentage of hyperthyroidism increases up to 4 years after salt iodination. Whereas this effect is transient for Plummer's disease, a change from IDA to ISA seems to lead to a permanent increase in overt and subclinical Graves' disease. Thyroid cancer: most studies demonstrate that the histopathological types of thyroid cancer are different in IDA and ISA. There is a tendency toward an increase in differentiated and decrease of anaplastic cancer. The ratio of papillary to follicular thyroid cancer ranges from 6.5:1 to 3.4:1 in areas with high iodine intake, decreases 3.7:1 to 1.6:1 in areas with moderate iodine intake, and ranges from 1.7:1 to 0.19:1 in IDA.

其实中国这么大，不同的地方面对的问题可能想反。联邦制挺好的，3级政府各有职责，这种加碘的政策应该权利下放，地方根据不同情况不同政策。美国、加拿大、俄罗斯地方都大着呢，没有这么多一刀切的政策，也没有出现有的地方甲衰，有的地方甲亢.

四川就发生过专卖局自己把过期变质的盐混进好盐里卖,结果被自己的监察大队给抓了这种乌龙事件.

而且现在甲亢的其实比缺碘的多得是.(只不过症状大部分不明显,或者虽然过量而还没有发病)

私盐的主要买主就是他们.

至于双轨制,其实很容易,专供不就得了,放开买卖,收税,然后补贴给缺碘的地方碘药片就可以了.还有针对性

青方兄的多个帖子都显示兄台是正经医生出身。 小弟也是。 但是没记得吃多了碘会得甲亢啊？ 兄台能给个专业文章看看吗？ 小弟补补课。

起码在我们老家是这样，当地不产盐，自从解放后就是食盐专卖，解决了数百年来的食盐价高、吃盐难的问题……

食盐强制加碘是在如今一片反垄断和政企分开的呼声中，坚持政府垄断的借口啊。

有违国策，这类文章不容易发表。

英文文献不少，我的回帖中有一篇，记得1990年（也可能是92年）在一次国际会议，专门讨论这个话题，会议结论就是我此文要表达的。

我的医学背景，也算名校出来的，但现在已经多年不当医生了，但还是在美国一家很好的医院工作，做科研，搞的就是糖尿病。

由于长期摄取过多碘，甲状腺组织中无机碘离子过多，会阻碍碘的有机化过程，致甲状腺素合成减少，加之高碘还可能抑制甲状腺素的释放，使血中甲状腺素更加缺乏，因而促甲状腺激素分泌增加，引起甲状腺肿大

至少我见过的国外食盐，还没有不加碘的。

在美东所有超市里都同时有加碘与不加碘的卖