Fairly elevated incidence of goiter with marginally low urinary iodine in adolescents living in the north-western part of Tunisia

In order to study the etiology of endemic goiter in the north-western part of Tunisia, we examined 93 adolescents of this region. We measured urinary iodine concentrations, serum total thyroxine, total triiodothyronine, thyrotropin, thyroglobulin and antithyrogobulin antibody concentrations. The adolescents were questioned about their alimentary habits, the origin of their drinking water and the presence of known goiter(s) in their family. Among these adolescents, 49.5% of them had a goiter. Urinary iodine concentrations showed mild iodine deficiency. The serum determinations gave results within the reference ranges, without any significative differences between adolescents, with or without goiter. We found two risk factors: the age of adolescents, and the presence of a known goiter in the family. These results suggest that the actual prevention may not be adequate, or most likely that goitrogenic factors are to be looked for, especially in drinking water, since the majority of these adolescents drink no controlled water