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Iodine and the Body

 

Pregnancy

 

Dunn

 

Iodine supplementation for pregnancy and lactation-United States and Canada: recommendations of the american thyroid association.

Becker DV, Braverman LE, Delange F, Dunn JT, Franklyn JA, Hollowell JG, Lamm SH, Mitchell ML, Pearce E, Robbins J, Rovet JF.

Thyroid. 2006 Oct;16(10):949-51.

[abstract only]

 

"The fetus is totally dependent in early pregnancy on maternal thyroxine for normal brain development. Adequate maternal dietary intake of iodine during pregnancy is essential for maternal thyroxine production and later for thyroid function in the fetus. If iodine insufficiency leads to inadequate production of thyroid hormones and hypothyroidism during pregnancy, then irreversible fetal brain damage can result. In the United States, the median urinary iodine (UI) was 168 microg/L in 2001-2002, well within the range of normal established by the World Health Organization (WHO), but whereas the UI of pregnant women (173 microg/L; 95% CI 75-229 microg/L) was within the range recommended by WHO (150-249 microg/L), the lower 95% CI was less than 150 microg/L. Therefore, until additional physiologic data are available to make a better judgment, the American Thyroid Association recommends that women receive 150 microg iodine supplements daily during pregnancy and lactation and that all prenatal vitamin/mineral preparations contain 150 microg of iodine."
 

 

Iodine should be routinely added to complementary foods.

Dunn JT.

J Nutr. 2003 Sep;133(9):3008S-10S. Review.

[abstract only]

 

"Iodine deficiency has major health consequences for the fetus and infant. Most individuals can tolerate fairly high intakes of iodine without problems. The Western Hemisphere has made great progress towards correcting its iodine deficiency, but pockets of deficiency remain and fragile monitoring systems endanger sustainability. Because the consequences of iodine deficiency are severe and the risks of excess treatment with modest supplements are minimal, we recommend the regular addition of 90 microg of iodine daily to complementary foods for children and 150 micro g for pregnant or lactating women, accompanied by effective monitoring of urinary iodine concentration in the population."
 

 

Damaged reproduction: the most important consequence of iodine deficiency.

Dunn JT, Delange F.

J Clin Endocrinol Metab. 2001 Jun;86(6):2360-3. Review.

 

"Need for iodine during pregnancy.  International organizations, including the United States Institute of Medicine (IOM) of the National Academy of Sciences, the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), and the International Council for Control of Iodine Deficiency Disorders (ICCIDD), recommend a daily intake of 150 µg iodine for nonpregnant adults. This number is based on studies of iodine accumulation and turnover, the T4 dose required to maintain euthyroidism in athyreotics, T4 disposal rates, and the amounts of iodine necessary to prevent goiter in populations. Pregnant women need more than this baseline requirement, to cover the iodine needs of the developing fetus and to compensate for increased renal iodine losses. Renal clearance of iodine increases during pregnancy; in one study, the concentration of iodine in urine was 60% higher during pregnancy in women from a mildly iodine-deficient area . An older balance study estimated an average iodine requirement of 160 µg/day during pregnancy. Several reports from iodine-deficient areas in Europe indicated that a total daily iodine intake of about 200 µg prevents pregnancy-associated goiter. The most recent IOM methodology defines an estimated average requirement (EAR) for a nutrient as the amount that will be sufficient for 50% of the population, and from this calculates a recommended daily allowance (RDA); the EAR for iodine in pregnancy is 160 µg/day, and the RDA is 220 µg/day.

 

"During lactation, the mother must obtain enough iodine for her own thyroid plus that of her growing infant. Calculations from the EAR for nonpregnant adult women (95 µg/day) and from an average loss in human breast milk (about 114 µg/day) lead to an EAR during lactation of 209 µg iodine/day and a RDA of 290 µg/day. The IOM report also includes "adequate intake" (AI) estimates (used when an EAR cannot be calculated) and RDAs for other population groups. The AI is less exact and, therefore, reaches higher levels than those derived by the EAR/RDA methodology, which is based largely on balance studies. The IOM sets the AI at 110 µg iodine/day for infants 0–6 months old and at 130 µg/day for those 7–12 months old; the RDA is 90 µg/day for children 1–8 yr old, 120 µg/day for those 9–13 yr, and 150 µg/day for older ages. These values correspond fairly closely to those recommended by WHO, ICCIDD, and other groups and provide a reasonable target in considering iodine nutrition for mother and child. Positive iodine balance for the neonate and young infant, which is required to accommodate the increasing stores of the thyroid, is achieved only when the iodine intake is at least 15 µg/kg·day in full term and 30 µg/kg·day in preterm infants. This corresponds to an iodine intake of approximately 90 µg/day and is the present recommendation by WHO/UNICEF/ICCIDD for infants and children aged 0–59 months."

 
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