Prevention of iodine deficiency disorders

      More than half of all citizens in Russia live in iodine-deficient regions — areas where the water and soil contain little iodine, which means that an insufficient amount of this micronutrient enters the human body with food. This situation provokes iodine-deficient conditions in children and adults, which in turn leads to an increase in the incidence of endemic goiter.

      Why do we need iodine?

      Iodine is an indispensable substance necessary for the biosynthesis of thyroid hormones. To produce a sufficient amount of hormones, an adequate intake of iodine into the body is required. Under the action of these hormones (thyroxine and triiodothyronine), energetic processes occur in the human body, body temperature is maintained, damaged and diseased tissues are repaired, sugar is released from cells into the bloodstream, heart rhythm is regulated, and brain activity increases. Thyroxine is also very important for the regeneration of liver cells; without it the liver cannot function. And the main work of the thyroid gland is connected with the physical and mental development of a person.

      Why do iodine-deficiency diseases occur?

      There are many reasons, but the most important is insufficient consumption of iodine-containing foods (sea fish, kelp (seaweed), shrimp, squid, walnuts, persimmon, black chokeberry, carrots, buckwheat and oat groats, eggs, etc.). Another reason is a deficiency in the body of trace elements involved in the synthesis of thyroid hormones (copper, molybdenum, cobalt, bromine).

      Poor absorption of iodine in the intestine can be hindered by legumes if they make up a significant part of the diet, as well as by products such as cabbage, radishes, and black radish. Another cause of poor iodine absorption is the use of medications: antibiotics, sulfonamides, nonsteroidal anti-inflammatory drugs.

      The need for iodine increases with viral and bacterial diseases, and with diseases of the gastrointestinal tract accompanied by malabsorption.

      What consequences can iodine deficiency lead to?

      Iodine deficiency leads to the development of various diseases that significantly, and sometimes irreversibly, worsen a person’s quality of life and condition.

      Low iodine levels in a pregnant woman lead to iodine deficiency in the fetus, arresting its development, including brain formation; in severe cases this causes congenital retardation of physical and mental development, and can cause miscarriage or premature birth.

      In the first year of life, iodine deficiency contributes to increased susceptibility to infectious diseases. At the age of 3–4 months, alarming signs that may indicate decreased thyroid function in the infant include poor appetite, slight weight gain, increased flatulence, constipation, dryness and flaking of the skin, pallor, cold hands and feet, brittle, dry, dull hair, and reduced muscle tone. At later stages, a progressively increasing delay in physical and mental development becomes prominent.

      Iodine deficiency in schoolchildren can result in decreased concentration in class and poor memory of learned material. Rapid fatigue and reduced performance are noted.

      Consequences of iodine deficiency in adults include goiter — enlargement of the thyroid gland, possibly with nodules — and hypothyroidism — reduced thyroid function manifested by decreased mental activity, anemia, hypercholesterolemia, and infertility.

      Prevention is better than cure!

      Prevention are measures to prevent disease. Carrying out measures to prevent iodine deficiency and endemic goiter can, without large material, technical, or financial costs, significantly improve the health of the populations of large regions of Russia in a short time and practically eliminate iodine-deficiency diseases. However, unlike infectious diseases, iodine-deficiency diseases cannot be eradicated once and for all, since their cause lies in an irremediable ecological insufficiency of iodine.

      The most effective and inexpensive method is mass iodine prophylaxis, which consists in iodizing table salt and other products. Salt is consumed by almost everyone in roughly the same amount (about 5–10 g per day) throughout the year. In addition to direct consumption of salt in food, it is also used in the food industry and animal husbandry to enrich food products. Such salt retains iodine after enrichment for a maximum of 12 months. Already 3–4 months after production, salt loses up to 40% of its iodine — it simply volatilizes. Therefore, pay attention to the production date of the salt. It is important to store iodized salt properly — only in conditions of moderate humidity and in a closed container. Prolonged heating and boiling completely remove iodine from salt, so add salt to food after cooking. Such salt should not be added to marinades and brines during canning. Iodized dairy products and baked goods can also be found on store shelves.

      In addition, there are group and individual iodine prophylaxis programs. They are carried out primarily in groups at particular risk for developing iodine-deficiency diseases. These include young children, adolescents, pregnant and breastfeeding women. For group iodine prophylaxis, both iodized foods and iodine preparations can be used.

      Unfortunately, it is quite difficult to meet daily iodine requirements solely by including certain food products in the diet. It should also be taken into account that part of the iodine volatilizes during cooking. It should be noted that iodine must enter the body in specific physiological doses. Achieving this by dietary measures alone is difficult. Therefore, potassium iodide preparations with strictly dosed iodine content are also used for the prevention of iodine deficiency.

      In early childhood, for breastfed infants, adequate iodine intake can be achieved by adjusting the mother’s diet and organizing regular intake of pharmacological iodine preparations by the mother. Formula-fed infants receive iodine as part of adapted milk formulas. In the second half of the first year of life, iodine can also be introduced with some iodine-fortified complementary foods (porridges, biscuits, meat and fish purees). Depending on the method of feeding the child, the introduction of iodine-fortified complementary foods and their iodine content, an individual iodine prophylaxis plan is required for the first year of life. If necessary, pharmacological preparations of iodine salts can be added.

      In essence, treatment and prevention of iodine-deficiency diseases do not differ from each other and are carried out using preparations that contain iodine salts. Dosages of the preparation are selected individually by the physician for each patient.

      It should be borne in mind that regardless of the methods of iodine replenishment, it is most optimally absorbed when the diet contains sufficient protein, iron, zinc, copper, and vitamins A and E.

      Eat well and stay healthy!