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J Clin Endocrinol Metab. 2014 Jul;99(7):2365-71. doi: 10.1210/jc.2013-3986. Epub 2014 Apr 4.

The association between perchlorate and thiocyanate exposure and thyroid function in first-trimester pregnant Thai women.

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  • 1Departments of Medicine (N.C.) and Obstetrics and Gynecology (C.S., A.C.), Faculty of Medicine, Thammasat University, Pathumthani 10200, Thailand; Department of Medicine (B.O., L.C.), Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; and Department of Medicine (E.N.P., X.H., L.E.B.), Boston University School of Medicine, Boston, Massachusetts 02118-2308.



Thyroid hormone is critical for fetal neurodevelopment. Perchlorate and thiocyanate decrease thyroidal iodine uptake by competitively inhibiting the sodium/iodide symporter. It is clear that perchlorate and thiocyanate anions can influence thyroid function. However, as pollutants in the environment, their impact is conflicting.


The objective was to determine the effects of environmental perchlorate and/or thiocyanate exposure on thyroid function in first-trimester pregnant women.


A cross-sectional study was conducted in 200 pregnant Thai women with a gestational age of 14 weeks or less.


Urinary iodide, perchlorate, thiocyanate, and serum thyroid function tests were measured.


The women were aged 28.6 ± 6.1 years and the mean gestational age was 9.6 ± 2.7 weeks. Median urinary iodide, perchlorate, and thiocyanate concentrations were 153.5 μg/L, 1.9 μg/L, and 510.5 μg/L, respectively. Using Spearman's rank correlation analyses, there were positive correlations between serum TSH and urine perchlorate to creatinine (r = 0.20, P = .005) and TSH and thiocyanate to creatinine ratios (r = 0.22, P = .001). There were negative correlations between free T4 and the perchlorate to creatinine ratio (r = -0.18, P = .01) and free T4 and the thiocyanate to creatinine ratio (r = -0.19, P = .008). In multivariate analyses adjusting for log thiocyanate to creatinine ratio, log iodide to creatinine ratio, and gestational age, log perchlorate to creatinine ratio was positively associated with log TSH (P = .002) and inversely associated with log free T4 (P = .002). Log thiocyanate to creatinine ratio was a significant positive predictor of log TSH (P = .02) in women with a urine iodide level of less than 100 μg/L.


Low-level environmental exposure to perchlorate and thiocyanate is common in Thailand. Low-level exposure to perchlorate is positively associated with TSH and negatively associated with free T4 in first-trimester pregnant women using multivariate analyses. In multivariate analyses, thiocyanate exposure is also positively associated with TSH in a subgroup of pregnant women with low iodine excretion.

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