Iodine is an element that is needed for the production of thyroid hormone. The body does not make iodine, so it is an essential part of your diet. Iodine is found in various foods If you do not have enough iodine in your body, you cannot make enough thyroid hormone. Thus, iodine deficiency can lead to enlargement of the thyroid (goiter ), hypothyroidism ( low thyroid levels) and to intellectual disabilities in infants and children whose mothers were iodine deficient during pregnancy
Before the 1920s, iodine deficiency was common in the Great Lakes, Appalachian, and Northwestern U.S. regions and in most of Canada. Prevention of iodine deficiency by the introduction of iodized salt has virtually disappeared
HOW DO YOU DIAGNOSE IODINE DEFICIENCY?
Iodine deficiency is diagnosed across populations and not specifically in individuals.
Since iodine is released from the body through the urine, the best way to determine iodine deficiency across a large population is to measure the amounts of iodine in urine samples.
Iodine deficiency is defined as a median urinary iodine concentration less than 100μg/L in a nonpregnant population, or <150 μg/L in a population of pregnant women.
In the United States, iodine status has remained generally adequate in since the 1940s although recent studies show women 20-39 years of age had the lowest urine iodine levels compared to all other age groups. Iodine intake in young women merits special attention to ensure the best possible brain development of the fetus during pregnancy. have shown that urinary iodine studis most recently mild iodine deficiency has re-emerged in pregnant women.
WHAT ARE THE SOURCES OF IODINE?
Iodine is present naturally in soil and seawater. The availability of iodine in foods differs in various regions of the world.
Individuals in the United States can maintain adequate iodine in their diet by using iodized table salt, by eating foods high in iodine, particularly dairy products, seafood, meat, some breads, and eggs, and by taking a multivitamin containing iodine (see below).
However, the amount of iodine in foods is not listed on food packaging in the U.S., and it can be difficult to identify sources of iodine in foods.
WHAT ARE THE SYMPTOMS OF IODINE DEFICIENCY?
All of the symptoms of iodine deficiency are related to its effect on the thyroid:
GOITER – Without adequate iodine, the thyroid progressively enlarges (develops a goiter) as it tries to keep up with demand for thyroid hormone production. Within a goiter, nodules can develop. Patients with a large goiter may experience symptoms of choking, especially when lying down, and difficulty swallowing and breathing and even develop thyroid cancer
HYPOTHYROIDISM – As the body’s iodine levels fall, hypothyroidism may develop, since iodine is essential for making thyroid hormone. This is rare in the United State
PREGNANCY-RELATED PROBLEMS – Iodine deficiency is especially important in women who are pregnant or nursing their infants. Severe iodine deficiency in the mother has been associated with miscarriages, stillbirth, preterm delivery, and congenital abnormalities in their babies.
Children of mothers with severe iodine deficiency during pregnancy can have intellectual disabilities and problems with growth, hearing, and speech. In the most severe form, an underactive thyroid can result in cretinism (a syndrome characterized by permanent brain damage, deaf mutism, spasticity, and short stature), although this has become rare worldwide. Iodine deficiency is the most common preventable cause of intellectual disabilities in the world. Even mild iodine deficiency during pregnancy, which may be present in some women in the United States, may be associated with low intelligence in children..
HOW IS IODINE DEFICIENCY TREATED?
Iodine levels can be measured in the blood or the urine. However, these tests are not good at accurately determining how much iodine is in your body and so cannot be used to diagnose iodine deficiency. When iodine deficiency is seen in an entire population, it is best managed by ensuring that common foods that people eat contain sufficient levels of iodine. Since even mild deficiency during pregnancy can have effects on a pregnancy and the developing baby, all U.S. women who are planning pregnancy, pregnant, or breastfeeding should take a multivitamin containing 150 μg iodine per day.
HOW IS IODINE DEFICIENCY PREVENTED?
. Iodized salt has been the mainstay of the prevention of iodine deficiency worldwide. In regions where iodized salt is not widely available, or where pregnant women are known to have inadequate iodine intakes, use of a daily iodine-containing supplement may be recommended for pregnant and breastfeeding women. Injections of iodized oil are occasionally used in severely iodine deficient regions of the world where widespread iodized salt use is not possible.
UNITED STATES RECOMMENDATIONS – The Institute of Medicine has set the Recommended Dietary Allowance (RDA) for iodine in adult men and women at 150 μg per day. Individuals who add salt to their food regularly during cooking or at the table should use iodized salt. In the US and Canada, one teaspoon of iodized salt contains approximately 250 μg iodine. Most U.S. iodine-containing multivitamins marketed for non-pregnant adults have at least 150 μg iodine, but only about 60% of the types of prenatal multivitamins in the U.S. contain iodine.
RECOMMENDATIONS FOR IODINE INTAKE DURING PREGNANCY AND BREAST FEEDING – Recommended iodine intakes are higher for women who are pregnant or breastfeeding than for other adults. The RDA is 220 μg iodine per day for pregnant women and 290 μg iodine per day for breastfeeding women. Because the effects of iodine deficiency are most severe in pregnant women and their babies, the American Thyroid Association® has recommended that all U.S. women who are planning pregnancy, pregnant, or breastfeeding take a prenatal multivitamin containing 150 μg iodine per day.
ARE THERE PROBLEMS WITH TAKING TOO MUCH IODINE?
Taking too much iodine can also cause problems. This is especially true in individuals that already have thyroid problems, such as nodules, hyperthyroidism and autoimmune thyroid disease. Administration of large amounts of iodine through medications (i.e.: Amiodarone), radiology procedures (iodinated intravenous dye) and dietary excess (Dulce, kelp) can cause or worsen hyperthyroidism and hypothyroidism.
In addition, individuals who move from an iodinedeficient region (for example, parts of Europe) to a region with adequate iodine intake (for example, the United States) may also develop thyroid problems since their thyroids have become very good at taking up and using small amounts may develop an overactive thyroid when given a higher dose
FROM THE CDC
What foods provide iodine?
Iodine is found naturally in some foods and is also added to salt that is labeled as “iodized”. You can get recommended amounts of iodine by eating a variety of foods, including the following:
- Fish (such as cod and tuna), seaweed, shrimp, and other seafood, which are generally rich in iodine
- Dairy products (such as milk, yogurt, and cheese), which are major sources of iodine in American diets
- Iodized salt, which is readily available in the United States and many other countries*
*Processed foods, such as canned soups, almost never contain iodized salt. In addition, specialty salts, such as sea salt, kosher salt, Himalayan salt, and fleur de sel, are not usually iodized. Product labels will indicate if the salt is “iodized” or provides iodide.
What kinds of iodine dietary supplements are available?
Iodine is available in dietary supplements, usually in the form of potassium iodide or sodium iodide. Many multivitamin-mineral supplements contain iodine. Dietary supplements of iodine-containing kelp (a seaweed) are also available.
Am I getting enough iodine?
Most people in the United States get enough iodine from foods and beverages. However, certain groups of people are more likely than others to have trouble getting enough iodine:
- People who do not use iodized salt. Adding iodine to salt is the most widely used strategy to control iodine deficiency. Currently, about 88% of households worldwide use iodized salt.
- Pregnant women. Women who are pregnant need about 50% more iodine than other women to provide enough iodine for their baby. Surveys show that many pregnant women in the United States may not get quite enough iodine, although experts do not know whether this affects their babies.
- People who follow a vegan diet or who eat few or no dairy products, seafood, and eggs. Seafood, eggs, milk, and milk products are among the best sources of iodine. People who don’t eat much of these foods or don’t eat them at all might not get enough iodine.
- People living in regions with iodine-deficient soils who eat mostly local foods. These soils produce crops that have low iodine levels. Among the regions with the most iodine-poor soil are mountainous areas, such as the Himalayas, the Alps, and the Andes regions, as well as river valleys in South and Southeast Asia.
- People who get marginal amounts of iodine and who also eat foods containing goitrogens. Goitrogens are substances that interfere with the way the body uses iodine. They are present in some plant foods including soy, and cruciferous vegetables such as cabbage, broccoli, cauliflower and brussels sprouts. For most people in the United States who get adequate amounts of iodine, eating reasonable amounts of foods containing goitrogens is not a concern.
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