Arsenic Toxicity and Thyroid Disorders – From Bangladesh’s Perspective

Thyroid disorders have become a major public health concern in the areas of Bangladesh where arsenic contamination is very high. The issue has gained significant attention due to a high prevalence of both arsenic contamination and thyroid disorders in this region. Approximately 21% of Bangladeshis have thyroid disorders, with women being more susceptible.[1] In the arsenic-contaminated areas of Bangladesh, the prevalence of thyroid disorders is even higher.[2] One of the most common causes of thyroid disorders found in Bangladesh is autoimmunity. But, in Bangladesh, whenever there is an issue about thyroid disorder, iodine deficiency has always been considered as the main reason. However, due to the geographical position of Bangladesh, only a few areas are high enough above the sea level to be considered as iodine-deficient areas. Thanks to the government's plan to fortify sea salt with iodine, over a few decades, the prevalence of thyroid disorder due to iodine deficiency has greatly reduced. However, we are still unaware of the reason behind the increased prevalence of autoimmune thyroid disorders in Bangladesh. Scientists have stated that selenium is an important trace element for thyroid hormone production, and its deficiency can lead to the development of autoimmune thyroid disease. On the other hand, arsenic has a counter-active action on selenium.[3] Unfortunately, Bangladesh is the worst affected country in the world due to arsenic toxicity, and the land is also selenium deficient.[2,4,5] Arsenic contamination of groundwater in Bangladesh is a well-documented issue. It is estimated that approximately 29.1% of the population is exposed to arsenic-contaminated water, with the affected area covering 62 of the country's 64 districts.[6] Chronic exposure to arsenic has been linked to various health issues, including skin lesions, cardiovascular diseases, endocrine disorders, respiratory disorders, and cancers.[6-8] The thyroid gland is crucial for hormone regulation and has a significant impact on the metabolism, growth, and development of the human body. Arsenic exposure has been shown to alter thyroid hormone production in various ways – interfering with the iodine transport system, resulting in hypothyroidism, or increasing the production of thyroid hormones, leading to hyperthyroidism.[4,6,8-10] Both of these conditions can result in significant health issues if left untreated. The issue of thyroid disorders in the arsenic-contaminated area of Bangladesh is complex and requires a multidisciplinary approach. While it is essential to address the arsenic contamination of groundwater, there is also a need for increased public awareness and medical support for those impacted by thyroid disorders. More research is needed to fully understand the impact of arsenic exposure on thyroid disorders and to develop effective interventions and treatments. In conclusion, thyroid disorders in the arsenic-contaminated areas of Bangladesh are a significant public health concern that requires attention from both the scientific and medical communities. The link between arsenic exposure and thyroid dysfunction has been established in various studies, but there is a need for more research to fully understand the issue. The Government of Bangladesh and international organizations should increase their efforts to address the issue of arsenic contamination while also providing medical support and education to those impacted by thyroid disorders. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.