Table 2.

Effect of pollutants on thyroid-stimulating hormone, thyroid hormone and thyroglobulin levels in healthy individuals.

Factor	Compounds Used in the Study			Effect on Hormone Levels	Number of Participants	Reference
Chemicals	Polychlorinated biphenyls and polybrominated biphenyls	PBB		TSH, ↓fT4, ↑fT3, ↑tT3, ↑fT3/fT4	715	[349]
		PCB		TSH, ↑fT4, fT3, ↑fT3/fT4
		PCBs and hydroxylated PCBs		TSH, fT4, tT4, fT3, tT3	79	[348]
		PCB		TSH, ↑fT4, ↑tT4, ↑fT3, ↑tT3	551	[347]
		PCB		TSH, ↓fT4, ↓fT3	122	[346]
		PCB		TSH, ↓fT4, ↑tT4, tT3	87	[345]
		PCB		↓TSH, ↑fT4, ↑tT4, ↑fT3, ↑tT3	67	[353]
		PCB		↓tT3	114	[435]
		PCB x BDE		↑tT3
		PCB		TSH, fT4, ↓tT3	623	[344]
		PCB		↑TSH, ↓T4, ↓T3	211	[351]
		PCB		↑TSH, ↓fT4, tT4, tT3	232	[423]
		PCB		TSH, ↑fT4, ↑tT3	2042	[484]
		PCB		TSH, fT4, ↓tT3	341	[343]
		PCB		TSH, ↑fT4	2045	[422]
		PCB		↓tT4	2445	[356]
		Dioxin-like toxic equivalents		↑TSH, ↓tT4
		PCB		↓TSH	454	[418]
		PCB		TSH, fT4	196	[341]
		PCB		↓TSH, ↓tT4, ↓tT3	66	[352]
		Dioxin-like toxic equivalents		↓TSH
		PCB		TSH, fT4, tT4, fT3, tT3	110	[354]
		PCB		TSH, fT4, tT4, fT3, ↓tT3	182	[339]
		PCB		↓T4	229	[355]
		PCB		TSH, fT4, tT4	192	[421]
		PCB		TSH, fT4, tT4, fT3	173	[340]
		PCB		tT4	111	[350]
	Polybrominated diphenyl ethers	PBDE		↑TSH, fT4, tT4, ↑fT3, ↓tT3	85	[362]
		PBDE		TSH, fT4, ↑tT4, fT3, ↑tT3	79	[348]
		PBDE		TSH, fT4, ↓tT4, tT3	52	[361]
		PBDE		TSH, fT4, ↑tT3	623	[344]
		PBDE		↑TSH	49	[363]
		PBDE		TSH, fT4, tT4, tT3	36	[360]
		PBDE		↓TSH, ↑tT4, ↓tT3, ↑rT3	308	[364]
		PBDE (BDE-47)		↓TSH, tT4, fT4, tT3, fT3	110	[354]
	Bisphenol A	BPA		TSH, tT4, ↑tT3	90	[368]
		BPA		↓TSH, tT4, tT3	6003	[372]
		BPA		↑TSH, fT4	194	[370]
		BPA		TSH, ↓fT4	2340	[367]
		BPA		↓TSH, fT4, ↑fT3	3394	[371]
		BPA		TSH, fT4, tT4, tT3, Tg	1346	[369]
		BPA		↓TSH, fT4, tT3	167	[373]
	Phthalates	DEHP metabolites and MEHHP		↓tT4	Meta-analysis (included studies on pregnant women and children)	[382]
		MEOHP		↓fT4
		MEHHP, DEHP metabolite		TSH, fT4, ↓T4, T3	279	[379]
		MEHP, MEOHP		TSH, ↓fT4, T4, T3
		Monoethyl phthalate		TSH, ↑fT4, T4, T3
		MEOHP		↑TSH, tT4, tT3	6003	[372]
		DEHP metabolites		TSH, ↓tT4, tT3
		MnBP		TSH, tT4, ↓tT3
		MnBP		↑TSH, fT4	43 (all subjects)	[380]
		MnBP, 5Cx-MEP, 5Oxo-MEHP, MBzP		↑TSH, fT4	30 (women)
		MEHHP		↓tT4	1877 (all subjects)	[381]
		MEOHP		↑tT4	907 (women)
		DEHP		↑TSH, ↓fT4, ↓tT4, ↓tT3, ↓Tg	1346	[369]
		MEHP		TSH, ↓fT4, ↓tT3	408	[378]
	Perchlorate	Perchlorate		TSH, ↓fT4	2702	[388]
				↓fT4	564	[387]
				TSH, ↓fT4, ↓tT4	4023	[386]
				↓fT4, ↓tT4, ↓fT3, tT3	1877	[381]
				↑TSH, ↓tT4	1111	[385]
	Perfluoroalkyl substances	PFAS		TSH, fT4, fT3	3297	[399]
		PFOS, PFNA, PFAS, PFHxS		TSH, ↑fT4, tT4, fT3, tT3	1325	[400]
		PFOA		TSH, ↓tT4, ↓fT4, tT3	3070	[398]
PFOS		TSH, ↓tT4, fT4, tT3
PFNA, PFDeA		↓TSH, tT4, fT4, tT3
PFOA, PFNA		↑TSH, tT4, fT4, tT3, fT3	85	[406]
PFNA		↑tT3, ↑fT3	47 (women)
PFNA		↓tT3, ↓fT3	38 (men)
PFOS		↑fT3	47 (women)
PFOS		↓fT3	38 (men)
PFOS		↑TSH, ↓tT4, ↑fT4, ↓tT3	Meta-analysis (including pregnant women)	[401]
PFOA		TSH, ↓tT4, tT3
PFNA		TSH, T4, ↑fT4, ↑T3	99	[397]
PFOA		TSH, T4, fT4, ↑T3
PFOA		TSH, fT4, tT4, tT3, ↑fT3	1012	[396]
PFOS		TSH, ↑fT4, ↑tT4, tT3	87	[345]
PFOS, PFNA		↓TSH, tT4, fT4, tT3, fT3	158 (male adolescents)	[402]
PFOA		↓TSH, tT4, fT4, tT3, fT3	145 (female adolescents)
PFOA, PFOS, PFNA		TSH, tT4, ↑fT4, tT3, fT3	257 (women 20-40 years old)
PFOA		TSH, tT4, fT4, ↑tT3, ↑fT3	199 (women 60-80 years old)
PFNA		TSH, ↑fT4	567	[403]
PFOA		↑TSH, tT4, fT4, ↑tT3, fT3, Tg	1540	[254]
PFHxS		TSH, ↑tT4, fT4, tT3, fT3, Tg
PFOA		TSH, tT4, fT4, ↑tT3, fT3	509 (women)	[395]
PFHxS		TSH, ↑tT4, fT4, ↑tT3, fT3	509 (women)
		TSH, tT4, ↓fT4, tT3, fT3	672 (men)
PFTrDA		↑TSH, ↓tT4	633	[405]
PFOS, PFOA		TSH, ↑tT4	50,113	[394]
PFC		TSH, fT4	31	[393]
PFOS		↓TSH, ↑fT4, ↓tT3	623	[344]
PFOA		TSH, ↓fT4, T4, ↑T3	506	[392]
PFOA		TSH	371	[391]
PFOS		TSH, fT4, T4, ↑T3	255	[404]
Pesticides	Conventional farmers that use insecticides, herbicides and fungicides in comparison to organic farmers		↑TSH, ↓fT4, ↑T4, ↑fT3, ↑T3	438	[410]
	Organophosphate insecticides		TSH, fT4, tT4, fT3, tT3	41	[432]
	Rural workers exposed to pesticides in comparison to controls		↓TSH, ↑fT4, ↑tT3	73	[420]
	3-PBA (metabolite of pyrethroid insecticide)		TSH, ↓tT4, ↓tT3	6208	[429]
	Insecticides and pyrethroids for >20 years		↓fT4, ↓tT3	106	[436]
	TCPY (a metabolite of chlorpyrifos)		TSH, ↓tT4, fT4, tT3, fT3, ↓Tg	2015	[427]
	Mancozeb (fungicide)		TSH, fT4, ↓T4, ↑fT3, T3, ↓Tg	63	[428]
	3-PBA		TSH, fT4, tT4, fT3, tT3, Tg	2015	[430]
	p,p′-DDE (a stable metabolite of DDT)		TSH, ↑tT4, ↑tT3	136	[434]
	Pesticide sprayers exposed to organophosphate and organochlorine pesticides		↑TSH, T4, ↓T3	60	[417]
	DDT+DDE		↑tT4, ↑tT3	48 (women)	[435]
	DDT+DDE + PCB		↑tT4
	DDT+DDE + PCB		↓tT3	66 (men)
	Exposure to organophosphate and carbamate pesticides		TSH, fT4	99	[425]
	High exposure pesticide season		TSH, ↓fT4, tT3	91	[426]
	HCH		↑TSH, ↓fT4	303 (men)	[416]
	HCB, heptachlor, o,p′-DDT and p,p′-DDT		↑fT4	305 (women)
	Endosulphan 2		↓tT3	303 (men)
	Alpha-chlordane, p,p′- DDT, endosulphan 2 and methoxychlor		↑tT3	305 (women)
	TCPY (a metabolite of chlorpyrifos)		↓TSH, ↑tT4	1589 (men)	[415]
			↑TSH	218 (women)
	Insecticide fipronil sulfone metabolite		↓TSH, fT4, tT4	155	[419]
	DAP		↑TSH, ↑tT4	215	[414]
	DMP		↑TSH, ↑tT4, ↓tT3
	Organochlorine pesticides		↓tT3	623	[344]
	Hexachlorobenzene		↓fT4
	cis-DCCA (pyrethroid metabolite)		TSH, fT4, tT3	161	[424]
	3-PBA and trans-DCCA (pyrethroid metabolites)		TSH, fT4, tT3
	HCB		TSH, fT4, ↓tT4, tT3	232	[423]
	DDE		TSH, ↓fT4, ↑tT3	2045	[422]
	HCB		↑TSH, ↓fT4, tT3
	p,p′-DDE		↓TSH, ↑fT4, ↑tT3	341	[343]
	HCB		↓tT3
	p,p′-DDE		TSH, tT4	2445	[356]
	PCB + DDE + HCB		↓TSH	454	[418]
	DDE		TSH, tT4, tT3	66	[352]
	p,p′-DDE		↑TSH, fT4	196	[341]
	High exposure pesticide season		TSH, ↓fT4, fT3, tT3	122	[433]
	In the fall in comparison to the spring season (people are exposed to higher levels of pesticides in fall)		↓TSH, ↑fT4, ↑fT3, ↑tT3
	TCPY (a metabolite of chlorpyrifos)		↑TSH, fT4, tT3	322	[413]
	1N (a metabolite of carbaryl and naphthalene)		TSH, fT4, tT3
	EBDC fungicides		TSH	131	[431]
	HCB		T4	66	[485]
	High exposure pesticide season		↑TSH, ↑fT4, ↑tT4	193	[412]
	DDT, HCB		↓T3	16	[438]
	DDE		TSH, T4, T3	51	[355]
	HCB		TSH, fT4, ↓tT4	192	[421]
	Exposure to organophosphates and organochlorine pesticides		TSH, T4, ↓T3	50	[437]
	EBDC fungicides		↑TSH, T4	94	[411]
Nitrate	Nitrate		T4, T3	30	[445]
			↑TSH, fT4	41	[443]
			↓fT4	307	[387]
			TSH, ↓tT4	1111	[385]
			TSH, T4, T3	20	[444]
			↓TSH, ↑T4	60	[442]
Heavy metals	Studies determining multiple metals	Pb, Cd, As		TSH	102	[454]
		Pb		↑TSH, fT4, fT3	100	[460]
		Cd		TSH, fT4, fT3
		Pb		↑TSH, tT4, tT3	5628	[461]
		Cd		TSH, tT4, tT3
		Cd		TSH, fT4, tT4, fT3, tT3, Tg	1391	[459]
		Pb		TSH, fT4, tT4, fT3, tT3, Tg
		Cd		TSH, ↑fT4, tT4, fT3, tT3, ↑Tg	6231 (all subjects)	[458]
				TSH, fT4, tT4, fT3, ↑tT3, ↑Tg	3231 (men)
		Pb		TSH, fT4, tT4, ↑fT3, tT3, Tg	6231 (all subjects)
				TSH, fT4, ↓tT4, fT3, tT3, Tg	3231 (men)
				TSH, ↑fT4, tT4, fT3, tT3, Tg	3000 (women)
		Hg		TSH, fT4, ↓tT4, ↓fT3, ↓tT3, Tg	4409	[457]
		Cd		TSH, fT4, ↑tT4, ↑fT3, ↑tT3, ↑Tg
		Pb		TSH, fT4, tT4, fT3, tT3, Tg
		Hg		TSH, fT4, ↓T4, ↓fT3, ↓T3	1587	[456]
		Cd		↓TSH, ↑fT4, ↑T4, ↑fT3, ↑T3
		Pb		↓TSH	219	[318]
		As		↑TSH
		Hg, Cd		TSH
		Pb		↓TSH, T4, ↑T3	211	[351]
		Hg		↑TSH, T4, T3
		Pb		TSH, fT4, tT4, ↑T3	232	[423]
		Hg		TSH, fT4, tT4, T3
	Studies determining single metal	Arsenic	UDMA	↑TSH, ↓fT4, ↓tT4, fT3, tT3, Tg	4126	[453]
			UAAS	TSH, fT4, ↓tT4, fT3, tT3, Tg
			UAS, UAB	↓TSH, fT4, tT4, fT3, tT3, ↓Tg
				↑TSH, fT4, fT3	38	[452]
				↑TSH, ↓fT4, ↓fT3, ↑Tg	185	[451]
		Cadmium		TSH, ↓fT4	1972	[463]
				TSH, ↑fT4, ↑fT3	1724	[462]
				↑TSH, ↓fT4, ↓fT3	277	[455]
				↓fT4, ↑tT3	105	[464]
		Mercury		↑TSH, ↑fT4, ↓T4, fT3, T3	Meta-analysis	[480]
				↑TSH, fT4, fT3, tT3	110	[479]
				TSH, ↓T4, ↓T3	137	[482]
				TSH, ↑fT4, ↓fT3, ↑fT4/fT3	82	[481]
				↑rT3, ↑fT4/fT3	94	[483]
		Lead		↓TSH, ↑fT4, ↑fT3	87	[468]
				TSH, fT4, T4, fT3, T3	Meta-analysis	[475]
				TSH, T4, T3	195	[474]
				T4, ↓fT4	220	[478]
				↑T3, ↑T4	76	[477]
				↑TSH	125	[467]
				TSH, ↓fT4, fT3	97	[473]
				TSH, fT4, T4, ↓fT3, ↓T3	157	[472]
				TSH, fT4, fT3	103	[471]
				↑TSH, fT4, ↓T4, ↓T3	75	[465]
				↑TSH, fT4, fT3	93	[466]
				TSH, ↑fT4, ↑tT4, ↑fT3, tT3	57	[476]
				TSH, T4	151	[469]
				TSH, ↓fT4, ↓tT4, tT3	176	[470]

Studies in pregnant women, infants, kids and individuals with a history of thyroid diseases were not included in this table. 1N, 1-naphthol; 3-PBA, phenoxybenzoic acid; 5Cx-MEP, mono-ethyl phthalate; 5Oxo-MEHP, mono-(2-ethylhexyl) phthalate; As, arsenic; BPA, bisphenol-A; Cd, cadmium; DAP, dialkylphosphate; cis and trans-DCCA, cis and trans-3-2,2-dichlorovinyl-2,2-dimethylcyclopropane carboxylic acid; DDE, p,p′-diphenyldichloroethene; DDT, p,p′-dichlorodiphenyltrichloroethane; DEHP, di-(2-ethylhexyl) phthalate; DMP, dimethyl metabolites; EBDC, ethylene bisdithiocarbamates; fT3, free triiodothyronine; fT4, free thyroxine; HCB, hexachlorobenzene; HCH, beta-hexachlorocyclohexane; Hg, mercury; MBzP, mono-benzyl phthalate; MEHP, mono(2-ethylhexyl) phthalate; MEHHP, mono (2-ethyl-5-hydroxyhexyl) phthalate; MEOHP, mono-(2-ethyl-5-oxohexyl) phthalate; MnBP, mono-n-butyl phthalate; PBB, polybrominated biphenyls; PBDE, polybrominated diphenyl ethers; PCB, polychlorinated biphenyls; PFAS, perfluoroalkyl substances; PFC, perfluorinated compounds; PFDeA, perfluorodecanoate; PFHxS, perfluorohexane sulfonate; PFNA, perfluorononanoic acid; PFOA, perfluorooctanoic acid; PFOS, perfluorooctane sulfonic acid; PFTrDA; perfluorotridecanoic acid; rT3, reverse triiodothyronine; T3, triiodothyronine; T4, thyroxine; tT3, total T3; tT4, total T4; TCPY, trichloro-2-pyridinol; Tg, thyroglobulin; TSH, thyroid-stimulating hormone; UAAS, arsenic adjusted for arsenobetaine; UAB, arsenobetaine; UAS, total arsenic; UDMA, dimethylarsinic acid.