"The Memoirs of Aga Khan", 1954 Simon & Schuster, NY. pp 367 with index.
Thyroid disease: p174-5.
The Aga Khan in 1916 at 39y showed signs & symptoms of weight loss, irregular pulse and "ocular distress"(exophthalmos). Diagnosed by a "physician in Paris" as Graves' Disease. Travelled to Berne to see Thyroid surgeon Emil Theodor KOCHER (1841-1917) who declared the "goiter" inoperable. Returned to Paris where he consulted Neuro-Endocrinologist Dr.Pierre MARIE (1853-1940) who treated condition medically.. Exophthalmus remained. Details of medication not given. Probably LUGOL'S IODINE ( Jean Guillaume Auguste LUGOL (1786-1851). BNF(Brit.National Formulary) Iodine-5% + Potassium iodide -10% in water, Content Iodine =130mg/ml. Dose 0.1- 0.3 ml tid.
Lugol's Iodine used by one of the Mayo Clinic Founders Dr.Henry Stanley PLUMMER (1874-1936).
Iodine acts through the WOLFF-CHAIKOFF effect. (1948)
WIKIPEDIA: The Wolff–Chaikoff effect (pronounced "woolf' cha'kof"),[1] discovered by Drs. Jan Wolff and Israel Lyon Chaikoff at the University of California, is a reduction in thyroid hormone levels caused by ingestion of a large amount of iodine.[2] In 1948, Wolff and Chaikoff reported that injection of iodine in rats almost completely inhibited organification (oxidation of iodide) in the thyroid gland.[3][4] Patients with Graves' disease are more sensitive than euthyroid patients,[5] and iodine has been used to manage Graves' disease.
The Wolff–Chaikoff effect is an autoregulatory phenomenon that inhibits organification in the thyroid gland, the formation of thyroid hormones inside the thyroid follicle, and the release of thyroid hormones into the bloodstream.[6] This becomes evident secondary to elevated levels of circulating iodide.
The Wolff - Chaikoff effect is an effective means of rejecting a large
quantity of imbibed iodide, and therefore preventing the thyroid from
synthesizing large quantities of thyroid hormone.[7] The Wolff–Chaikoff effect lasts several days (around 10 days), after which it is followed by an "escape phenomenon",[8]
which is described by resumption of normal organification of iodine and
normal thyroid peroxidase function. "Escape phenomenon" is believed to
occur because of decreased inorganic iodine concentration secondary to
down-regulation of sodium-iodide symporter (NIS) on the basolateral membrane of the thyroid follicular cell.
The Wolff–Chaikoff effect can be used as a treatment principle against hyperthyroidism (especially thyroid storm) by infusion of a large amount of iodine to suppress the thyroid gland. Iodide was used to treat hyperthyroidism before antithyroid drugs such as propylthiouracil and methimazole were developed. Hyperthyroid subjects given iodide may experience a decrease in basal metabolic rate that is comparable to that seen after thyroidectomy.[6] The Wolff–Chaikoff effect also explains the hypothyroidism produced in some patients by several iodine-containing drugs, including amiodarone. The Wolff–Chaikoff effect is also part of the mechanism for the use of potassium iodide in nuclear emergencies.[9][10][11]
