Iodine deficiency can lead to a variety of health conditions; if encountered during pregnancy, it can even result in stillbirths and abortions. It is an easily preventable issue, and used to be a global health problem in the early 2000’s. With the introduction of iodized salts, there was a significant decline in the number of iodine deficiency disorders (IDD)– a term coined to refer to all the health consequences of iodine deficiency.
Since 1980’s, the public health departments have taken considerable measures to tackle iodine deficiency. The number of countries having adequate iodine intake has increased from 67 to 116 as of 2014. However, the steady progress seen in Europe and Western Pacific is less progressive in Africa and some parts of Asia. Additionally, sustainable iodine sufficiency is seen in only a few countries: Canada, Norway, Sweden, Switzerland, Peru, Panama, Japan, the United States, Finland, Austria, and a few more.
The iodine intake of people that had stated to improve in the late 20thcentury is now on the low side. The increasing use of non-iodized salt in commercially available food products is a major reason of this decline in iodine intake.
The aim of this article is to take you through the details of health consequences of iodine deficiency and provide science-baked information on how to take enough of this mineral.
Signs and Symptoms of Iodine Deficiency
Iodine deficiency can present as prominent features like goiter and ignorable factors like fatigue. A clinical manifestation of iodine deficiency is usually diagnosed as one of these: hypothyroidism, nodular goiter, hyperthyroidism, or cretinism. Children born to women who had mild to moderate deficiency during pregnancy may have minor neurophysiologic defects like low verbal IQ. Mentioned below are some of the common manifestations of iodine deficiency.
1. Swelling in the neck (Goiter)
Goiter is a swelling in front of the neck that results from excessive growth of thyroid gland.
Here’s a little physiology class: Thyroid gland – a butterfly shaped gland in front of the neck – is responsible for delivering thyroid hormones to the body. The gland requires signals from Thyroid Stimulating Hormone (TSH) to start creating thyroid hormones.
As soon as the blood levels of TSH rise, thyroid gland starts manufacturing hormones with the help of iodine and a few other components. Now, you can well imagine how this gland would fail to provide sufficient thyroid hormones in the case of iodine deficiency.
What would organizations do if when demand is high and supply is low? They increase their employs. Thyroid gland does something similar. When iodine is deficient, the thyroid cells multiply and grow in an attempt to fulfill body’s requirement for the thyroid hormones. This leads to increased mass of thyroid gland and therefore, a swelling in the neck.
2. Hair Loss
Hair loss is a common feature of hypothyroidism (a health condition resulting from a lack of thyroid hormone production). While hypothyroidism can be due to many causes, a highly prevalent cause – especially in the developing world – is iodine deficiency.
The growth of hair follicles is linked to adequate thyroid hormone levels. A 2014 study found that out of 700 individuals with hypothyroidism, 30 percent experienced hair loss.
3. Dry Skin
Just like hair loss, dry skin is also a result of hypothyroidism, which may result from iodine deficiency.
A normal level of thyroid hormones helps with the skin cell regeneration. With low levels of thyroid, this process doesn’t occur as often as required, and may lead to dry, flaky skin.
4. Unexpected weight gain
Iodine deficiency can lead to unexpected weight gain. Thyroid hormones are in control of the metabolism. A deficiency of thyroid hormones lowers the metabolic rate of the body. With this knowledge, you can form the link between weight gain and low iodine.
Iodine deficiency leads to low production of thyroid hormones, which in turn leads to low metabolic rate, which encourages food to be stores as fat rather than being burned to generate calories. So, even when your dietary intake has NOT increased, there is weight gain.
5. Slowed mental functioning
Iodine deficiency disorders can jeopardize a child’s mental health. In fact, severe iodine deficiency during pregnancy can result in
- spontaneous abortion
- congenital abnormalities
Of the congenital abnormalities, Cretinism is the most severe. It is an irreversible form of mental retardation, and affects a significant proportion of people living in iodine-deficient areas. An even important aspect of iodine deficiency is the less visible damage that reduces the mental functioning and performance in school and at work.
6. Problems with the menstrual cycle
Heavy bleeding or irregular periods may be due to hypothyroidism, which may be secondary to iodine deficiency.
Studies show that hypothyroidism causes frequent, heavy bleeding and irregular menstrual cycles.
A deviation from normal thyroid levels interrupt with the signals of menstrual-cycle-hormones.
7. Slow heart beat
Heart rate is the number of times your heart beats in one minute. A deficiency of iodine leading to hypothyroidism can affect the beating of your heart. It can cause the heart to beat slower than usual, whereas excess of thyroid hormones (hyperthyroidism) can cause the heart to beat rapidly.
Individuals with hypothyroidism are more likely to feel tired and weak. Studies have shown that up to 80 percent of hypothyroid cases complaint of fatigue; it is also one of the most common symptom of hypothyroidism.
Risk Factors of Iodine Deficiency
Various factors can predispose a person to iodine deficiency disorders.
- Low intake of dietary iodine
- Iodine deficiency coupled with high intake of goiter foods, such as cassava, cauliflower, broccoli, and kale.
- Paleo eating
- Dairy-free diets
- Chlorinated and fluoridated water
- Coexistent deficiencies of iron,selenium, and vitamin A
- Pregnancy and lactation
- Infants and children
- Tobacco smoking
Iodine Sufficiency & Deficiency
The iodine status of the population is taken as median urinary iodine concentration.
- Children and non-pregnant adults: 100 to 299mcg/L
- Pregnant women: 150 to 249mcg/L
- Mild iodine deficiency: 50 to 99mcg/L
- Moderate deficiency: 20 to 49mcg/L
- Severe deficiency: Less than 20mcg/L
Daily Iodine Requirements
Severe iodine deficiency develops when a person is chronically exposed to low intake of iodine, i.e., less than 20 mcg/day. The World Health Organization (WHO)recommends the daily intake of iodine for various age groupsas follows:
|Infants and children up to 5 years||90 mcg/day|
|Children 6 to 12 years||120 mcg/day|
|Children ≥12 years and adults||150 mcg/day|
|During pregnancy and lactation||250 mcg/day|
Dietary Sources of Iodine
Regular diet is not the best source of iodine, which is why iodine deficiency remained a worldwide problem before the introduction of iodized salts. However, there are certain foods that are a good source of iodine. These foods coupled with iodized salt intake (3 grams daily) can prevent iodine deficiency.
- Navy beans
- Baked potato
- Raw milk
- Dried prunes
Seaweed is the best source of iodine and can even provide more than 100 percent of the recommended daily intake. However, the iodine content in a seaweed depends on the region where it came from. The ones from Japan are especially high in iodine. Examples of seaweed include kombu, wakame, hijiki, arame, and kelp – kelp being the riches source of iodine in foods.
Other than these foods, chicken, lima, beef, shellfish, dairy products, and chicken also contain small amounts of iodine.
Benefits of Iodine
1. It Controls Metabolic Rate
Iodine influences greatly the functioning of the thyroid glands by helping with the production of hormones directly responsible for controlling the body’s base metabolic rate. Metabolic rate ensures the efficiency of the body’s organ systems and basal biochemical processes, including sleep cycle, absorption of food and transformation of food into energy we can use.
Hormones, like thyroxin and triiodothyronine, influence blood pressure, heart rate, body temperature and weight. Themetabolic rate is maintained by the body with the help of these hormones, which also plays a role in protein synthesis.
2.It Maintains Optimal Energy Levels
Iodine plays an important role in the utilization of calories and maintains energy levels. The thyroid hormones that utilize iodine in their formation are also involved in keeping us active.
3. Helps Prevent Certain Kinds of Cancer
Iodine plays a role in boosting immunity and inducing apoptosis, the self-destruction of dangerous, cancerous cells. While iodine assists in destroying mutated cells, it doesn’t destroy healthy cells in the process. Evidence shows the ability of iodine-rich seaweed to inhibit growth of breast tumor development. This is supported by the low rate of breast cancer in parts of world, especially in Japan, where women consume a diet rich in iodine. If you notice breast changes in your breast tissue, it could be a sign of iodine deficiency.
Bromine plays a role here as well, as research shows bromine is a suspected carcinogen that “may exacerbate iodine insufficiency since bromine competes for iodine uptake by the thyroid gland and other tissues (i.e. breast).”
4. It Removes Toxic Chemicals
Iodine can remove heavy metal toxins like lead, mercury and other biological toxins. Accumulating evidence suggests there are many extrathyroidal benefits of iodine, including antioxidant functions, maintaining the integrity of the mammary gland as well as antibacterial properties, particularly against H. pylori, which is a bacterial infection in the stomach and associated with gastric cancer.
5. It Boosts Immunity
Iodine doesn’t just affect the thyroid; it does many other things, including playing an important role as an immune booster. Iodine is a scavenger of free hydroxyl radicals and stimulates and increases the activity of antioxidants throughout the body to provide a strong defensive measure against various diseases, including cancer and cardiovascular disease.
Recent studies have shown that iodine directly protects the brain cells of rats from the harmful effects of free radicals by bonding onto fatty acids in the cell membrane, leaving less room for free radicals to have a negative impact on the organism.
6. It Forms Healthy and Shiny Skin
Dry, irritated and rough skin that becomes flaky and inflamed is a common sign of iodine deficiency. Iodine helps with the formation of shiny and healthy skin, hair and teeth and is an important trace element, as a lack of iodine results in hair loss.
A clinical study performed in Mexico wanted to determine the trace elements of healthy hair in malnourished children. Iodine levels were 10-fold higher than what has been reported by other authors.
7. It Prevents Enlarged Thyroid Gland
Iodine deficiency is the most prevalent cause of goiter in the world. A meta-analysis in China showed that the communities with low iodine concentration in the urine had an increased risk of goiter.
One can add eggs, diary products, especially milk, sea salt in the food to prevent iodine deficiency. Including these foods in the diet are also recommended if one already has goiter.
8. It Helps Prevent Impaired Growth and Development in Children
Various research studies have shown that women who have iodine deficiency during pregnancy have children with impaired growth and development. These infants are more vulnerable to neurodegenerative problems, such as cretinism and learning disabilities. Moreover, they are more likely to have motor function problems, low growth rate and high mortality rates.
Professors at the university of Sydney and the Swiss Federal Institute of Technology in Sweden have conducted researches on the subject matter and concluded that irreversible mental retardation and brain damage are by far the most common and important disorders induced by severe iodine deficiency.
Potential Side Effects of Iodine Over Dosage
As per the European and United States expert committees, iodine overdose can be dangerous. The upper tolerable range for adults is from 600 to 1100 mcg/day, whereas for adolescents (15-17 years old), it is 500-900 mcg. The younger children can tolerate no more than 200 to 450 mcg per day.
These are just ranges based on data gathered by scientists. Based on various factors, each person has different response to the upper dose. For example, a dose greater than 2,000 mcg could specifically be dangerous in individuals who have tuberculosis or kidney diseases.
As mentioned earlier, pregnant and nursing mother need more iodine than others. However, extra caution is required of them; they should not consume more than the recommended amount.
Where lack of iodine results in hypothyroidism, it’s excess can lead to hyperthyroidism and thyroid papillary cancer. A healthy balance is essential to prevent overdose or deficiencies.
Iodine deficiency is a public health concern and rather than an individualized approach, community based efforts through iodized salts can produce greater benefits.
Iodine is essential for the synthesis of thyroid hormones. An iodine deficiency during pregnancy can result in serious consequences, such as improper mental growth, cretinism, neonatal and infant mortality. A deficiency later in life can result in hypothyroidism and its associated complications.
Adequate amounts of iodine can easily be obtained by consuming iodine-rich foods and iodized salt.