We investigated thyroid function and urinary iodine concentration (UIC) in seven patients with severe motor intellectual disabilities. All seven received total enteral nutrition (TEN) for more than three years with a daily iodine intake of less than 20 µg. They were diagnosed as hypothyroidism due to iodine deficiency (HID) because of high TSH levels (7.6-82.3 µIU/ml), lower free T4 (FT4 0.4-1.5 ng/dl), negative anti-thyroid antibodies (anti-thyroglobulin antibody, anti-thyroidal peroxidase antibody) and extremely low UIC (<25-58 µg/l) levels. We gave them 1-2 g powdered kelp (200-400 µg as iodine) once a day, which restored their thyroid function and normalized their UICs. We proposed that daily powdered kelp would be effective and safe to treat HID in patient receiving long term TEN.
Keywords: enteral nutrition; hypothyroidism due to iodine deficiency; severe motor intellectual disabilities; urinary iodine concentration.