In 1970, before iodized salt was introduced as prophylaxis against goitre in Kenya, we performed quantitative studies of iodine metabolism in 81 African subjects living in the highland provinces. Iodine deficiency was detected in those with and without goitre, a result expected in view of the known prevalences of endemic goitre in these regions. Iodine deficiency was more severe and prevalent in those with goitre. Unexpectedly, we found those with goitre had a significant defect in the utilization of iodine by the thyroid gland. We argue that this defect is probably caused by an environmental factor. If adequate iodine prophylaxis is followed by a significant decline in the goitre rate, our finding is of theoretical interest only. It would assume practical importance if a significant goitre problem remained following improvement in iodine nutrition. We have decided to publish these findings now because of the disappointing results of iodine prophylaxis to date.