Patient: Description of condition (onset, main symptoms, hospital visited, etc.): In August 2009, ultrasound showed a 1.6-0.7 nodule in the left thyroid gland, with a discernible border and uneven internal echogenicity, and abundant blood flow in the nodule. The doctor recommended not to operate, but to review the nodule every six months, but not to eat iodized salt. After that, I went to see a Chinese medicine doctor, but he prescribed iodine-containing herbs such as kombucha, and said I had to eat iodized salt. I am very confused, I don’t know whether to listen to Chinese or Western doctors, please help me to analyze which doctor I should listen to, and whether salt with or without iodine has any effect on the growth and change of thyroid nodules. How can I treat my condition properly and is there any medicine available? Wang Jianzhong, Department of General Surgery, The First Affiliated Hospital of Gannan Medical College: Your question is a good one, and it is a hot topic of discussion in the medical community in recent years about whether iodized salt should be legally enforced, but unfortunately medical research is not yet clear. Iodine is one of the essential trace elements for the human body, especially important for maintaining normal thyroid function. Both iodine deficiency and high iodine can lead to corresponding thyroid disorders. Confusingly our statutory textbook “Surgery 7th edition” has no content related to high iodine disorders. It is only suggested that in order to avoid the risk of surgery in hyperthyroid patients with high basal metabolic rate, preoperative oral iodine is given; however, the effect of iodine is to inhibit the release of thyroxine, reduce the blood flow to the thyroid gland, make the gland less congested and more conducive to surgery, but not to inhibit the synthesis of thyroxine, so once the drug is stopped, the symptoms of hyperthyroidism will return or even be more severe than before. Therefore, patients who are not preparing for surgery should not take iodine. From your examination results, it is more likely to be a thyroid adenoma, which is a benign tumor, not yet large in size, and not absolutely indicated for surgery. I agree with the advice given to you by the western doctor, but I would still recommend you to have further thyroid nuclear scan, thyroid function (T3 T4 TSH, etc.) to understand your condition more deeply to determine the treatment plan. You are located in a coastal area with high iodine content (in food) and existing medical experts suggest that it is advisable to limit the intake of iodized salt in such areas. I personally agree with this view. Since there are no scientific studies on iodized salt, my opinion may not be correct, so I would appreciate limited reference!