甲状腺结节发病越来越多，原因众说纷纭，门诊上，很多患者都会问一个问题：我有甲状腺结节，加碘盐到底要不要吃？

今天周末空闲，我来给大家捋一捋这件事。

首先要明确的是：“甲状腺结节、甲状腺肿大、甲状腺的各种相关抗体阳性、各类甲状腺功能减退”这五类疾病的患病率，是随着年龄的增长而增加的。

那么大多数的甲状腺疾病都与碘缺乏有关，例如“甲亢、毒性甲状腺肿、甲减、各种甲状腺相关抗体阳性、甲状腺结节”等，只有部分临床甲状腺功能亢进和减退症和碘过量有关。

那么重点来了：对着碘摄入量的增加，尽管会让一个叫做“TSH”的指标增加，导致飞自身免疫性亚临床甲减的患病率升高，但是----------TPOAb、TgAB、甲状腺结节的患病率是下降的！！

结论：食盐加碘的益处要远大于它所带来的风险。

所以说：只要医生没有要求你戒碘，你就可以正常实用碘盐啦。

还有最最关键的一点：小朋友的发育对碘要求非常高，女性妊娠同样需求碘，如果家里有这两种人，千万不要用无碘盐啦。

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以上内容来自世界顶级甲状腺期刊“THYROID”，2020年的一个研究：Efficacy and Safety of Long-Term Universal Salt Iodization on Thyroid Disorders: Epidemiological Evidence from 31 Provinces of Mainland China.                 

摘要如下文：

Mandatory universal salt iodization (USI) has been implemented in China for 20 years. Although iodine deficiency disorders are effectively controlled, the risk of excess iodine have been debated. A nationally representative cross-sectional study with 78,470 enrolled participants, aged 18 years or older, from all 31 provincial regions of mainland China was performed. The participants were given a questionnaire and underwent B-mode ultrasonography of the thyroid. Serum concentrations of thyroid hormones, thyroid antibodies, and urine iodine concentration (UIC) were measured. The median UIC of the adult population was 177.89 μg/L. The weighted prevalence of thyroid disorders in adults were as follows: 0.78% of overt hyperthyroidism, 0.44% of subclinical hyperthyroidism, 0.53% of Graves disease, 1.02% of overt hypothyroidism, 12.93% of subclinical hypothyroidism, 14.19% of positive thyroid antibodies, 10.19% of positive thyroid peroxidase antibodies, 9.70% of positive thyroglobulin antibodies, 1.17% of goiter, and 20.43% of thyroid nodules. Iodine excess was only associated with higher odds of overt hyperthyroidism and subclinical hypothyroidism, while iodine deficiency was significantly associated with higher odds of most thyroid disorders. In addition, increased iodine intake was significantly associated with elevated serum thyrotropin levels but was inversely associated with thyroid antibodies and thyroid nodules. The long-term mandatory USI program with timely adjustments is successful in preventing iodine deficiency disorders, and it appears to be safe. The benefits outweigh the risks in a population with a stable median iodine intake level of up to 300 μg/L.        

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笔者所在的上海市中医医院是上海卫健委、上海申康医院管理中心直属的公立三级甲等中医医院，超声科与中西医结合外科的联合MDT项目：“超声引导下甲状腺结节微创消融术”是国内最早把中医药治疗与微创消融有机结合的综合性微创诊疗项目。

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专家介绍：

沈睿，上海市中医医院超声科副主任医师，擅长肝脏、甲状腺与乳腺良恶性肿瘤诊断、肿瘤微创消融与介入治疗。总院专家门诊：周一上午、周四上午，地址：上海市静安区芷江中路274号。

（为保证医疗质量，目前专家门诊限号，建议提前一到两周网上预约挂号）