Abstract
Thyroid diseases, including congenital hypothyroidism, thyroiditis, and childhood
thyrotoxicosis, are progressively increasing. The incidence of thyroid cancer in children and
adolescents has also increased in recent decades, mirroring the trends observed in adults. These
epidemiologic trends develop in parallel with the rising costs associated with diagnosis and
treatment of thyroid diseases. Both genetic and environmental factors are involved in these
diseases, and a number of widely diffused toxic chemicals of anthropogenic origin can impair
thyroid function and make thyroid cancer worse. Synthetic substances persistently contaminate
environmental matrices (i.e., air, soil, water) and the food chain and bio-accumulate in humans,
starting from in utero life. Environmental toxins such as air pollutants, endocrine disruptors, and
high-frequency electromagnetic fields can act on common targets through common pathways,
combined mechanisms, and with trans-generational effects, all of which contribute to thyroid
damage. Both experimental and epidemiologic observations show that mechanisms of damage
include: modulation of synthesis; transportation and metabolism of thyroid hormones; direct
interference with hormone receptors: modulation of gene expression; and autoimmunity. We
should not underestimate the available evidence linking environmental pollutants with thyroid
disease, cancer included, since toxic substances increasingly diffuse and thyroid hormones play
a key role in maintaining systemic metabolic homeostasis during body development. Thus,
primary prevention measures are urgently needed in particular to protect children, the most
exposed and vulnerable subjects.
Keywords:
Hypothyroidism, thyroid, endocrine disruptors, pesticides, pollution, electromagnetic fields.
Graphical Abstract
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