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Iodine is an essential component of hormones produced by the thyroid gland. Thyroid hormones, and therefore iodine, are essential for mammalian life. Optimal dietary iodine intakes for healthy adults are 150–250 µg day −1 . Iodine deficiency has multiple adverse effects in humans due to inadequate thyroid hormone production that are termed as iodine deficiency disorders. Assessment methods of iodine status include urinary iodine concentration, goiter, and blood thyroglobulin. Globally, it is estimated that 2 billion individuals have an insufficient iodine intake, in both industrialized and developing countries. In most countries, the best strategy to control iodine deficiency in populations is carefully monitored iodization of salt.

Background Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients. Methods Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed. Results The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine. Conclusion Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.

Objective Mild to moderate iodine deficiency during pregnancy has been associated with adverse neurodevelopmental outcomes in offspring. Few research studies to date combine assessment of urinary iodine (UIC and/or ICr), biomarkers that best reflect dietary intake, with reported dietary intake of iodine rich foods in their assessment of iodine deficiency. Thus, a systematic review was conducted to incorporate both these important measures. Design Using PRISMA guidelines, a comprehensive search was conducted in three electronic databases (EMBASE®, MedLine® and Web of Science®) from January 1970–March 2021. Quality assessment was undertaken using the Newcastle Ottawa Scale. Eligible studies included reported assessment of iodine status through urinary iodine (UIC and/or ICr) and/or dietary intake measures in pregnancy alongside neurodevelopmental outcomes measured in the children. Data extracted included study author, design, sample size, country, gestational age, child age at testing, cognitive tests, urinary iodine assessment (UIC in μg/L and/or ICr in μg/g), dietary iodine intake assessment and results of associations for the assessed cognitive outcomes. Results Twelve studies were included with nine reporting women as mild-moderately iodine deficient based on World Health Organization (WHO) cut-offs for urinary iodine measurements Conclusion The majority of studies classified pregnant women to be mild-moderately iodine deficient based on urinary iodine assessment (UIC and/or ICr) and/or dietary intakes, with subsequent offspring neurodevelopment implications identified. Although a considerable number of studies did not report an adverse association with neurodevelopmental outcomes, these findings are still supportive of ensuring adequate dietary iodine intakes and urinary iodine monitoring throughout pregnancy due to the important role iodine plays within foetal neurodevelopment. This review suggests that dietary intake data may indicate a stronger association with cognitive outcomes than urinary iodine measurements alone. The strength of this review distinguishes results based on cognitive outcome per urinary iodine assessment strategy (UIC and/or ICr) with dietary data. Future work is needed respecting the usefulness of urinary iodine assessment (UIC and/or ICr) as an indicator of deficiency whilst also taking account of dietary intakes.

Dietary recalls have been used previously to identify food sources of iodine in Australian schoolchildren. Dietary assessment can provide information on the relative contributions of individual food groups which can be related to a robust objective measure of daily intake (24-h urinary iodine excretion (UIE)). In Australia, the government has mandated the use of iodised salt in breadmaking to address iodine deficiency. The aim of this study was to determine the dietary intake and food sources of iodine to assess their contribution to iodine excretion (UIE) in a sample of Australian schoolchildren. In 2011–2013, UIE was assessed using a single 24-h urine sample and dietary intake was assessed using one 24-h dietary recall in a convenience sample of primary schoolchildren from schools in Victoria, Australia. Of the 454 children with a valid recall and urine sample, 55 % were male (average age 10·1 (1·3 (sd) years). Mean UIE and dietary iodine intake were 108 (sd 54) and 172 (sd 74) μg/d, respectively. Dietary assessment indicated that bread and milk were the main food sources of iodine, contributing 27 and 25 %, respectively, to dietary iodine. Milk but not bread intake was positively associated with UIE. Multiple regression (adjusted for school cluster, age and sex) indicated that for every 100 g increase in milk consumption, there was a 3 μg/d increase in UIE (β = 4·0 (se 0·9), P < 0·001). In conclusion, both bread and milk were important contributors to dietary iodine intake; however, consumption of bread was not associated with daily iodine excretion in this group of Australian schoolchildren.

Lack of iodine knowledge might be a risk factor for inadequate iodine intake in populations. Therefore, we aimed to determine the relationship between iodine knowledge and intake in young Chinese adults. A cross-sectional study was conducted in Suzhou, China. Iodine intake was assessed using a validated 33-item iodine-specific Chinese food frequency questionnaire (FFQ) and iodine knowledge was determined using a Chinese iodine knowledge questionnaire. A total of 150 participants (mean age 20.3 years) completed the study. The median iodine intake plus iodized salt was 260 &mu, g/d, indicating iodine sufficiency (&gt, 150 &micro, g/d). The median iodine knowledge score was 16/24, suggesting a medium level of knowledge. The majority of participants correctly recognized fish and seafood (95%) and iodized salt (83%) as the most important dietary iodine sources. After adjusting for age and sex, studying in the science cluster and having received iodine education were the predictors of having a higher iodine knowledge score, with adjusted odd ratios (OR) of 4.33 (1.49, 12.61) and 2.73 (1.21, 6.14), respectively. In conclusion, young Chinese adults had an adequate iodine intake despite a medium iodine knowledge score. This study provides support that iodine fortification in China has been successful, but further research is required to more fully substantiate this finding.

This study was conducted to determine the effects of dietary inclusion levels of iodine supplementation and duration of feeding on performance, carcass characteristics, meat iodine, thyroid hormones and some indices including red blood cell, haematocrit, haemoglobin, aspartate transaminase, alanine transaminase and alkaline phosphatase in broilers. A total of 450 one-day-old male broiler chicks were used during a 42 days experiment in 9 treatments with five replicates pen for each treatment. The experimental design was a 3 × 3 factorial arrangement of treatments including three levels of iodine (0, 2.5 and 5 mg/kg as a source of potassium iodide) during the T (total, 1-42 days), GF (grower and finisher, 11-42 days) and F (finisher, 25-42 days) periods (p .05). The results demonstrated that none of the performance data (feed intake, body weight gain and feed conversion ratio) were influenced by level and duration of iodine consumption (p .05). The diet supplemented with 5 mg/kg iodine had no effects on relative weights during total (T) and grower and finisher (GF) periods, but there was an effect on the finisher (F) period. Moreover, increasing the iodine level from 0 to 5 mg/kg linearly decreased the relative weights of the both small intestine and jejunum (p .05). Increasing the iodine level from 0 to 5 mg/kg linearly increased the breast iodine content. Also, the highest breast meat enrichment was observed during the T period (p .05). Blood triiodothyronine concentration was not changed by any of the iodine level and duration of consumption, but tetraiodothyronine concentration was higher for T period than GF and F ones (p .05) and even linearly increased by increasing the level of dietary iodine for 0 to 5 mg/kg (p .05). It was concluded that 5 mg/kg iodine from day 1 to day 42 of age is needed in the diet to enrich the broiler meat.

Enrichment of food crops with iodine is an option to alleviate dietary deficiencies. Therefore, foliar iodine fertilizer was applied on wheat and rice, in the presence and absence of the other micronutrients zinc and selenium. This treatment increased the concentration of iodine, as well as zinc and selenium, in the staple grains. Subsequently, potential iodine losses during preparation of foodstuffs with the enriched grains were studied. Oven-heating did not affect the iodine content in bread. Extraction of bran from flour lowered the iodine in white bread compared to wholegrain bread, but it was still markedly higher compared to the control. During subsequent in vitro gastrointestinal digestion, a higher percentage of iodine was released from foods based on extracted flour (82-92%) compared to wholegrain foods (50-76%). The foliar fertilization of wheat was found to be adequate to alleviate iodine deficiency in a population with a moderate to high intake of bread.

The daily consumption of iodine in Japan is higher than in most countries, and there are few reports on iodine metabolism and variance of habitual iodine ingestion in an iodine-sufficient area. To elucidate the patterns of short-term urinary iodine excretion (UIE) and long-term variability of habitual iodine intake, the urinary iodine excretion process after a high dietary iodine load of 3 mg was observed in eight Japanese adults under strict supervision with complete urine collections for three days. In addition, estimated UIE and dietary iodine intake (DII) were assessed in 24 university students using repeated spot urine samples of ten consecutive days and a food frequency questionnaire in each of the four seasons. Approximately 50, 75 and 90% of orally ingested iodine was excreted into the urine at 8, 13 and 22 hours after ingestion, respectively. Almost an equal amount of ingested iodine in meals was cleared within 33.5 h after eating with a maximum excretion rate at 3-4 h. There was a high fluctuation in the UIE and DII in the university students. The intra- and inter-individual crude coefficients of variation were 123 or 294.7% for UIE, and 58.3 or 88.7% for DII, respectively, indicating a higher variance of habitual iodine intake than in other countries. The frequency of occurrence for UIE above 3 mg was every 43 days. Rapid renal clearance of iodine and high variability as well as low frequency of dietary iodine intake might prevent people from being exposed to an excess iodine intake over the long term in Japan.

Iodine and selenium deficiencies are common worldwide. We assessed the iodine and selenium status of Gilgit-Baltistan, Pakistan. We determined the elemental composition (ICP-MS) of locally grown crops (n = 281), drinking water (n = 82), urine (n = 451) and salt (n = 76), correcting urinary analytes for hydration (creatinine, specific gravity). We estimated dietary iodine, selenium and salt intake. Median iodine and selenium concentrations were 11.5 (IQR 6.01, 23.2) and 8.81 (IQR 4.03, 27.6) µg/kg in crops and 0.24 (IQR 0.12, 0.72) and 0.27 (IQR 0.11, 0.46) µg/L in water, respectively. Median iodised salt iodine was 4.16 (IQR 2.99, 10.8) mg/kg. Population mean salt intake was 13.0 g/day. Population median urinary iodine (uncorrected 78 µg/L, specific gravity-corrected 83 µg/L) was below WHO guidelines; creatinine-corrected median was 114 µg/L but was unreliable. Daily selenium intake (from urinary selenium concentration) was below the EAR in the majority (46–90%) of individuals. Iodine and selenium concentrations in all crops were low, but no health-related environmental standards exist. Iodine concentration in iodised salt was below WHO-recommended minimum. Estimated population average salt intake was above WHO-recommended daily intake. Locally available food and drinking water together provide an estimated 49% and 72% of EAR for iodine (95 µg/day) and selenium (45 µg/day), respectively. Low environmental and dietary iodine and selenium place Gilgit-Baltistan residents at risk of iodine deficiency disorders despite using iodised salt. Specific gravity correction of urine analysis for hydration is more consistent than using creatinine. Health-relevant environmental standards for iodine and selenium are needed.

Maternal hormones constitute a key signalling pathway for mothers to shape offspring phenotype and fitness. Thyroid hormones (THs; triiodothyronine, T3; and thyroxine, T4) are metabolic hormones known to play crucial roles in embryonic development and survival in all vertebrates. During early developmental stages, embryos exclusively rely on exposure to maternal THs, and maternal hypothyroidism can cause severe embryonic maldevelopment. The TH molecule includes iodine, an element that cannot be synthesised by the organism. Therefore, TH production may become costly when environmental iodine availability is low. This may yield a trade-off for breeding females between allocating the hormones to self or to their eggs, potentially to the extent that it even influences the number of laid eggs. In this study, we investigated whether low dietary iodine may limit TH production and transfer to the eggs in a captive population of rock pigeons (Columba livia). We provided breeding females with an iodine-restricted (I−) diet or iodine-supplemented (I+) diet and measured the resulting circulating and yolk iodine and TH concentrations and the number of eggs laid. Our iodine-restricted diet successfully decreased both circulating and yolk iodine concentrations compared with the supplemented diet, but not circulating or yolk THs. This indicates that mothers may not be able to independently regulate hormone exposure for self and their embryos. However, egg production was clearly reduced in the I− group, with fewer females laying eggs. This result shows that restricted availability of iodine does induce a cost in terms of egg production. Whether females reduced egg production to preserve THs for themselves or to prevent embryos from exposure to low iodine and/or THs is as yet unclear., Summary: Restricted dietary iodine in captive rock pigeons reduces egg production in some females, thus inducing a trade-off between offspring quality and offspring quantity.

Background: The iodine status of the US population is considered adequate, but subpopulations remain at risk for iodine deficiency and a biomarker of individual iodine status has yet to be determined. The purpose of this study was to determine whether a 3 day titration diet, providing known quantities of iodized salt, is reflected in 24 h urinary iodine concentration (UIC), serum iodine, and thyroglobulin (Tg). Methods: A total of 10 participants (31.3 ± 4.0 years, 76.1 ± 6.3 kg) completed three, 3 day iodine titration diets (minimal iodine, US RDA, (United States Recommended Daily Allowance), and 3× RDA). The 24 h UIC, serum iodine, and Tg were measured following each diet. The 24 h UIC and an iodine-specific food frequency questionnaire (FFQ) were completed at baseline. Results: UIC increased an average of 19.3 μg/L for every gram of iodized salt consumed and was different from minimal to RDA (p = 0.001) and RDA to 3× RDA diets (p = 0.04). Serum iodine was different from RDA to 3× RDA (p = 0.006) whereas Tg was not responsive to diet. Baseline UIC was associated with iodine intake from milk (r = 0.688, p = 0.028) and fish/seafood (r = 0.646, p = 0.043). Conclusion: These results suggest that 24 h UIC and serum iodine may be reflective of individual iodine status and may serve as biomarkers of iodine status.

Objectives: Iodine is a trace element that is essential for the synthesis of thyroid hormone. Both chronic iodine deficiency or iodine excess have been associated with hypertrophy and hyperplasia of follicular cells in thyroid gland and the influence of thyroid hormone (T3, T4) and thyrotropin (TSH) secretion. Increase rates of the thyroid cancer are increasing after radiation exposure to 131I in children or aldolescents. Methodology: In respective published reports in literature and in combination of our previous study, dietary iodine excess goiter, iodine induced hyperthyroidism (IIH) and IIT, Iodine intake and the prevalence of papillary carcinoma (PTC), as well as the case-control and cohort studies of thyroid cancer and intake of seafood and milk products, were systematically reviewed. Relative factors that should be considered when studying the effect of dietary iodine in the development of thyroid cancer include screening programs, pathological criteria, diagnostic techniques, radioactive iodine, and standard of medical care in the studied population. Results and conclusion: In current surveys, papillary thyroid carcinoma forms the largest group of thyroid malignancies, after iodine intake excess or iodine prophylaxis where an increase in the papillary: follicular carcinoma ratio was uncovered. Also, there is clear temporal relationship in many countries between introduction of iodine intake excess especially as to radioactive iodine and an increase in incidence of PTC. Iodine goiter, IIH and IIT were also noted. Autoimmune hashimoto's thyroiditis are linked to dietary iodine. Dietary iodine intake is another care of environmental relevance factor in thyroid diseases and papillary carcinoma. Available evidence of oncogenic thyroid hormone receptor mutants from animal experiments and clinical investigation have been a shift toward the oncogenic function of human thyroid carcinoma, and also its target therapy. Peer Review History: Received: May 2021; Revised: June; Accepted: June, Available online: 15 July 2021 Academic Editor: Ahmad Najib, Universitas Muslim Indonesia, Makassar, Indonesia, ahmad.najib@umi.ac.id UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewer(s) detail: Prof. Dr. A. Hakan AKTAŞ, Süleyman Demirel University, Faculty of Science and Art, Department of Chemistry, Isparta-Turkey, hakanaktas@sdu.edu.tr Dr. Vladimir Zaichick, Radionuclide Diagnostics Department, Medical Radiological Research Centre, Obninsk, 249036, Russia. vzaichick@gmail.com Dr. U. S. Mahadeva Rao, Universiti Sultan Zainal Abidin, Terengganu Malaysia, raousm@gmail.com Similar Articles: TREATMENT OF PATIENTS WITH ADVANCED CANCER FOLLOWING CHEMOTHERAPY AND TRADITIONAL MEDICINE - LONG TERM FOLLOW UP OF 75 CASES EpCAM- AN OLD CANCER ANTIGEN, TURNED ONCOGENIC RECEPTOR AND ITS TARGETING IMMUNOTHERAPY

Objectives Deficiency as well as excess dietary iodine is associated with several thyroid disorders including Grave’s disease and goitre. Previously, cross sectional studies conducted among school children in Nepal showed high prevalence of iodine deficiency. In contrast, recently, few studies have revealed emerging trends of excess urinary iodine concentration in children. This paper, reports excess urinary iodine excretion and thyroid dysfunction among school age children from eastern Nepal. Results It was a community based cross sectional study in which we measured urinary iodine excretion levels among school age children at baseline and after educational program. The educational program consisted of audio-visual and pamphlets on thyroid health. We also screened them for thyroid function status by physical examination and measuring serum thyroid hormones. Our results show that 34.4% of the children had excess urinary iodine concentration above the WHO recommended levels. Overall, 3.2% of the children were identified to have thyroid dysfunction. Urinary iodine concentration was significantly different between types of salt used and between salt iodine content categories.

Iodine, an essential micronutrient, is required to produce thyroid hormones. Iodine deficiency disorders (IDD) comprise a range of adverse maternal and fetal outcomes, with the most significant irreversible effect resulting from neurodevelopmental deficits in fetal brain caused by deficient iodine status during early pregnancy. The objective of this scoping review was to summarize the studies that assessed iodine status of women of reproductive age in the USA. A systematic review of literature using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) statement was conducted. PubMed, Medline, CINAHL, EMBASE, EBSCOHost, Cochrane, ERIC, Google Scholar, and Web of Science databases were searched, 1652 records were identified. One thousand six hundred forty-one records that did not satisfy the inclusion/exclusion criteria and quality review were excluded, and 11 peer-reviewed articles were determined to be eligible for this scoping review. Despite the USA being considered iodine sufficient for the general population, the US dietary iodine intakes have decreased drastically since the 1970s, with iodine deficiency reemerging in vulnerable groups such as women of reproductive age. Although data to conduct a scoping review of iodine status among women of reproductive age in the USA was scarce, majority of the articles reviewed demonstrate emergent iodine deficiency in this population of women of reproductive age, indicating alarm for a public health concern needing immediate attention.

Women consuming a strictly vegan/plant-based diet may be at increased risk of low iodine intake due to avoidance of animal products containing iodine. The aim of this pilot study was to determine the iodine excretion and intake in women consuming vegan/plant based diets compared with women consuming omnivore diets. Fifty-seven women (n = 31 plant-based, n = 26 omnivores), provided two spot urine samples to assess urinary iodine concentration (UIC). Two days of dietary intake were also recorded by participants. As the data were not normally distributed results are reported as median (IQR). UIC was significantly different between groups, 44 (26–66) ug/L in the vegan/plant-based group versus 64 (40–88) ug/L in omnivores (p &lt, 0.05). UIC did not meet the &gt, 100 µg/L level recommended by the World Health Organization. Iodine intake was also significantly different, 78 (62–91) µg/day in the vegan/plant-based group and 125 (86–175) µg/day in the omnivores (p = 0.000). Iodine intake and bread intake were correlated with iodine excretion (CC 0.410–4.11, p = 0.003). These data indicate iodine insufficiency in both groups of women as the median values were below the minimum WHO recommendation. A larger study assessing iodine excretion in the Australian women of reproductive age who are not pregnant or breastfeeding is needed to confirm these findings.

Maternal hormones constitute a key signalling pathway for mothers to shape offspring phenotype and fitness. Thyroid hormones (THs; triiodothyronine, T3 and thyroxine, T4) are metabolic hormones known to play crucial roles in embryonic development and survival in all vertebrates. During early developmental stages, embryos exclusively rely on the exposure to maternal THs, and maternal hypothyroidism can cause severe embryonic maldevelopment. The TH molecule includes iodine, an element that cannot be synthesised by the organism. Therefore, TH production may become costly when environmental iodine availability is low. This may yield a trade-off for breeding females between allocating the hormones to self or to their eggs, potentially to the extent that it even influences the number of laid eggs. In this study, we investigated whether low dietary iodine may limit TH production and transfer to the eggs in a captive population of Rock pigeons (Columba livia). We provided breeding females with an iodine-restricted (I- diet) or iodine-supplemented diet (I+ diet) and measured the resulting circulating and yolk iodine and TH concentrations and the number of eggs laid. Our iodine-restricted diet successfully decreased both circulating and yolk iodine concentrations compared to the supplemented diet, but not circulating or yolk THs. This indicates that mothers may not be able to independently regulate hormone exposure for self and their embryos. However, egg production was clearly reduced in the I- group, with fewer females laying eggs. This result shows that restricted availability of iodine does induce a cost in terms of egg production. Whether females reduced egg production to preserve THs for themselves or to prevent embryos from exposure to low iodine and/or THs is as yet unclear.

Background: Seaweeds and kelps, also known as macroalgae, have long been common in the East-Asian diet. During recent years, macroalgae have entered the global food market, and a variety of macroalgae products are now available for consumers. Some macroalgae species are known to be particularly rich in iodine, but little data regarding the iodine content of macroalgae-containing foods exists. Objective: The aim of this research study was to analyse the iodine content in a large variety of commercially available macroalgae-containing foods and supplements and to evaluate whether such products are sources of adequate dietary iodine. Design: Ninety-six different products were collected after surveying the Norwegian market for commercially available macroalgae products, collected from three categories: 1) wholefood macroalgae products (n = 43), 2) macroalgae-containing foods (n = 39), and 3) dietary supplements containing macroalgae (n = 14). All products were analysed for iodine content by inductively coupled plasma-mass spectrometry (ICP-MS). Results: The iodine content in one portion of wholefood macroalgae products ranged from 128 to 62,400 µg. In macroalgae-containing foods, the iodine content ranged from 30 to 25,300 µg per portion, and in supplements it ranged from 5 to 5,600 µg per daily dose. The species with the highest analysed iodine content were oarweed, sugarkelp and kombu, with mean iodine levels of 7,800, 4,469 and 2,276 µg/g, respectively. For 54 products, the intake of one portion or dose would exceed the tolerable upper intake level (UL) for iodine. Discussion and conclusion: The iodine content in the included products was variable and for most products high, exceeding the tolerable upper intake level (UL) if consumed as a serving or portion size. The labelling of macroalgae species included, and declaration of iodine content, were inadequate or inaccurate for several products. As macroalgae-containing products are unreliable iodine sources, inclusion of such products in the diet may pose a risk of consuming excessive amounts of iodine. This research study is financially supported by the Insti- tute of Marine Research.

Background. As the dietary iodine content depends on the iodine contents of the soil where the crop is harvested, in highland areas where the iodine content of topsoil was washed away due to erosion, iodized salt is the main source of iodine. This study assessed the magnitude of iodine deficiency disorder and knowledge about the benefit and food sources of iodine among adolescent girls in the highland areas of the North Shewa Zone, Amhara Region, central Ethiopia. Methods. An institutional cross-sectional study was conducted from October 5, 2018, to December 30, 2019. Through a multistage sampling technique, 625 adolescent school girls were selected from 9 schools. A pretested semistructured self-administered questionnaire was used for data collection. Anthropometric measures and thyroid gland physical examinations were performed by trained nurses. The collected data were entered into the computer through Epi Data 3.1 software, and analysis was performed using Anthro plus and SPSS software. Results. The total goiter rate was 317 (50.7%) with 95%CI of 46.9% to 54.6%. Grade-one and grade-two goiter accounts 226 (36.2%) and 91 (14.6%), respectively. About one-third, 428 (68.5%), had knowledge about locally available iodine source foods and 309 (72.2%) of them mentioned salt as a source of iodine. Over half, 216 (55.1%), of 392 (62.7%) participants who had knowledge about the benefit of iodine knew it prevents goiter. Diet diversity score of

SUMMARY – Lactating women (LW) and infants have high dietary iodine requirements and are at risk of iodine deficiency.The aim of the study was to assess iodine status and thyroid function in LW and their breastfed infants in Zagreb, Croatia. The study included 133 LW and breastfed infant pairs. Urinary iodine concentration (UIC) and thyroid function parameters were measured in all subjects. In LW, breast milk iodine concentration (BMIC) was measured and iodine and salt rich food frequency questionnaire data were collected. Results of analysis indicated that 99.2% of the LW used iodized salt in household and 20.4% used iodine-containing vitamin and mineral supplements. Median (IQR) UIC was 75 μg/L (19.0-180.5 μg/L) in LW and 234 μg/L (151.0-367.5 μg/L) in infants, whereas BMIC was 121 μg/kg (87.8-170.8 μg/kg). Multivariate regression analysis revealed BMIC to be a significant predictor of infant UIC (p, Acta Clinica Croatica, 60 (2), ISSN:0353-9466, ISSN:1333-9451

Bolesti štitnjače druge su najzastupljenije bolesti endokrinološkog sustava. Žene obolijevaju čak osam puta češće u odnosu na muškarce. Hipotireoza i hipertireoza su dva najčešća poremećaja štitnjače. Češće je zastupljena hipotireoza, a jedan od glavnih uzroka ove bolesti je nedostatak joda u organizmu. Cilj ovog rada bio je analizirati prehrambene i životne navike oboljelih s naglaskom na poznavanje prehrambenih izvora joda te goitrogena u prehrani. Provedeno je opažajno istraživanje primjenom anonimnog online upitnika. Analizirani su odgovori 107 ispitanika (93,5 % žena i 6,5 % muškaraca) u dobi od 42,2 ± 14,9 godina. Dijagnozu hipotireoze ima 74,2 % ispitanika, a hipertireoze 8,6 %. Ispitanici svoje trenutno stanje ocjenjuju bolje ako im je ocjena kvalitete života bolja, odnosno ako su im zbog bolesti štitnjače manje narušeni društveni aspekti života te bolja samoprocjena vlastitog psihofizičkog stanja. Prehrambene navike relativno su loše budući da samo 35,5 % ispitanika ima redovite obroke, 61,7 % nije promijenilo prehranu nakon dijagnoze bolesti, dok ih je 37,4 % totalno neaktivno. Unos joda kroz sol i hranu su dostatni no zastupljena je značajna količina hrane koja je izvor goitrogena koji remeti iskorištenje joda u organizmu. Rezultati upućuju na potrebu edukacije o prehrani prilagođenoj bolestima štitnjače. Thyroid diseases are the most common endocrine conditions. Women have eight times higher incidence rate in comparison to men. Hypothyroidism and hyperthyroidism are the most prevalent conditions, with hypothyroidism being oppressively abundant. The lack of iodine is the main cause of hypothyroidism. The aim of this research was to analyse diet and lifestyle of people with various thyroid conditions, while focusing on their knowledge of dietary sources of iodine and goitrogens. An observational study was conducted on 107 participants (93,5% women, 6,5% man), aged 42,2 ± 14,9 years. Hypothyroidism have 74,2% of participants and hyperthyroidism 8,6%. Participants subjectively rate their current condition as better if their quality of life is better, i.e. if the condition did not deteriorate social aspects of their life and their psychological condition. Dietary habits are poor given that only 35,5% of participants have regular meals, and 61,7% did not change their diet after being diagnosed with thyroid disease. In addition, 37,4% have sedentary lifestyle. Dietary iodine consumption from foods and salt is sufficient but also significant amount of foods rich in goitrogens which alter iodine body utilization. The results indicate the need for nutritional education of people with thyroid diseases.

IntroductionAn Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (MethodsA cross-sectional study including 100 healthy women without prior thyroid disease, in their first trimester of a singleton pregnancy were recruited from an HMO clinic in central Israel. The women were followed from their first trimester. All women completed a 24-h dietary recall and life habits questionnaires. We tested for UIC, maternal and neonatal thyroid function, maternal autoantibodies, and neonatal outcomes.ResultsMedian UIC in our cohort was 49 µg/L [25%–75% interquartile range (IQR) 16-91.5 µg/L], with 84% below adequacy range. No correlation was found between iodine deficiency and maternal or neonatal thyroid function which remained within normal ranges. Antibody status did not differ, but thyroglobulin levels were significantly higher in iodine insufficient subjects. UIC was higher in women consuming an iodine containing supplement. There was no association between UIC and dietary iodine content or water source.ConclusionsModerate iodine deficiency is common in our healthy pregnant women population. Our data imply that moderate iodine deficiency in pregnancy seem sufficient to maintain normal maternal and neonatal thyroid function.

Background: Several studies have investigated the factors affecting the effects of radioactive iodine (131I) treatment (RAIT) in patients with Graves' disease. However, the influence of dietary or therapeutic iodine on the effect of RAIT has not been fully elucidated yet. The aim of this study was to investigate whether dietary or therapeutic iodine before RAIT influences the therapeutic effects of RAIT with a fixed-dose regimen and a short-term restriction of iodine intake in an iodine-sufficient area. Materials and Methods: We retrospectively analyzed 81 Japanese patients with Graves' disease treated with the following RAIT regimen: dietary iodine restriction for 7 days as well as discontinuation of antithyroid drugs (ATDs), potassium iodine (KI), or both for 5 days before RAIT. On the day of RAIT, we measured urinary iodine content to estimate daily iodine intake. After RAIT, we adjusted the dose of ATDs, KI, or both according to serum thyroid hormone levels every 1-2 months. Using the data from these patients, we investigated the effect of dietary and therapeutic iodine on the therapeutic effects of RAIT. The therapeutic effects at 1 year after RAIT were evaluated based on the necessity of ATDs, KI, or both. Results: Dietary iodine intake was weakly correlated with 131I uptake (RAIU), but the dose of therapeutic iodine was not correlated with RAIU. The therapeutic effects of RAIT were strongly negatively associated with estimated thyroid volume before RAIT. Neither dietary iodine intake nor therapeutic iodine before RAIT affected this association. Conclusion: This study did not find an association between short-term dietary or therapeutic iodine restriction before RAIT and the therapeutic effects of RAIT in an iodine-sufficient area.

Backgound: Even a minor iodine deficiency can result in adverse thyroidal health consequences while excess iodine intake can also result in thyroid function disorders. One source of iodine is seaweed which as a foodstuff is enjoying an increasing profile in Western countries. Apart from its potential involvement in thyroidal health, gaseous iodine released from seaweeds plays a significant role in influencing coastal climate through cloud formation. Summary: Sources of dietary iodine, its assessment, recommended dietary intake, and consequences of iodine excess are outlined. The benefits and possible dangers of dietary intake of iodine-rich seaweed are described. Studies linking seaweed intake to breast cancer prevalence are discussed as is the role of gaseous iodine released from seaweeds influencing weather patterns and contributing to iodine intake in coastal populations. Key Messages: Universal salt iodization remains the optimum method of achieving optimum iodine status. Promoting increased dietary iodine intake is recommended in young women, in early pregnancy, and in vegan and vegetarian diets. Even where iodine intake is enhanced, regular assessment of iodine status is necessary. Caution against consumption of brown seaweeds (kelps) is required as even small amounts can have antithyroid actions while product labelling may be insufficient. Gaseous iodine produced from seaweeds can have a significant effect on cloud formation and associated global warming/cooling. Increased overall iodine deposition through rainfall and apparent uptake in populations dwelling in seaweed-rich coastal regions may provide a partial natural remedy to global iodine deficits.

OBJECTIVE: Iodine deficiency is a worldwide public health problem and a preventable cause of neuro-developmental delay in children. There are no data regarding iodine sufficiency and knowledge on iodine nutrition among pregnant women in Puerto Rico. The objective of this study was to assess iodine status, potential factors influencing iodine status, and knowledge regarding iodine nutrition among Puerto Rican pregnant women. METHODS: This was a cross-sectional study of 125 pregnant women recruited from an ambulatory high-risk obstetric clinic in San Juan, Puerto Rico. The participants completed a survey and provided spot urine samples. We excluded women on thyroid medications or those who had undergone iodinated contrast studies in the last 6 months. Spot urine iodine concentrations (UICs) were measured spectrophotometrically. RESULTS: The median UIC was 182 μg/L. Only 3 (2%) of the participants were aware that pregnant women need increased iodine intake, and 78% reported taking prenatal vitamins, 77% of which were prescription products. The participants who reported taking prescription prenatal vitamins had a median (range) UIC of 148.6 (15.3–1188.6) μg/L compared to those who were not taking prescription prenatal vitamins, who had a median UIC of 249.7 (47.8–2179.0) μg/L (P = .05). The iodine content of the prenatal vitamins was unknown. CONCLUSIONS: The World Health Organization has defined iodine deficiency as a median UIC of

Objective Type 2 diabetes mellitus (T2DM) is a worldwide health problem, and medical nutrition therapy is essential for improving the quality of life of patients with type 2 diabetes. Salt restriction may lead to iodine deficiency in these patients. Moreover, type 2 diabetes can be an indirect reason for thyroid disorders. This study was conducted to determine the relationship between dietary iodine intake, urinary iodine excretion and thyroid functions in people with T2DM. Materials and methods Iodine nutritional status was determined by a one day 24-h dietary recall and food-frequency questionnaire. Iodine status was detemined by urinary iodine excretion with morning urine sample. Results Iodine intake according to one day 24-h dietary recall was lower in T2DM patients [94.8 (76.0-112.0) μg] than people in control group [137.1 (123.1-165.4) μg] (p < 0.05). Iodine intake determined by food-frequency questionnaire rich in iodine was lower in T2DM patients [93.1 (84.4-113.9) μg] than people in control group [140.2 (125.1-166.1) μg] (p < 0.05). Mild iodine deficiency was found in %38.8 of diabetic and %55.1 of healthy individuals (p < 0.05). No significant relationship was found between urinary iodine excretion and thyroid function tests in groups (p > 0.05). However, the relationship between dietary iodine excretion and urinary iodine intake in the diabetic group was lower than in the control group (p < 0.05). Conclusion With this respect, the results showed that while planning medical nutrition therapy for diabetic individuals, the risk of iodine deficiency should be considered.

Background Consumption of plant-based milk in the UK is increasing at the expense of cow's milk. Cow's milk consumption has traditionally been advocated by the dental profession as 'good for teeth'.Aims To identify the range of plant-based milks available in the UK and compare their nutritional benefits with cow's milk. A secondary aim was to explore reasons behind the increase in popularity of plant-based milks and discuss dental relevance.Methods Branded plant-based milks available in UK supermarkets were identified and nutritional data collected. Data were obtained from product labelling and manufacturer websites. The sample was collected in December 2019.Results Eighty-two products were identified. Differences were observed between plant-based and cow's milk, in particular regarding calcium, iodine, vitamin B12 and sugar content. Sugar content varied from 0-7.6 g/100 ml.Conclusions Dairy is a key source of dietary iodine and many plant-based milks contain much lower levels. Many plant-based milks contain free sugars which are cariogenic. Dentists should be aware of this emerging market and be able to advise patients accordingly.

Summary Iodine is an essential component of hormones produced by the thyroid gland. Thyroid hormones, and therefore iodine, are essential for mammalian life. Optimal dietary iodine intakes for healthy adults are 150–250 μg/d. In regions where iodine in soils and drinking water is low, humans and animals may become iodine deficient. Iodine deficiency has multiple adverse effects in humans due to inadequate thyroid hormone production that are termed the iodine deficiency disorders. Iodine deficiency during pregnancy and infancy may impair growth and neurodevelopment of the offspring and increase infant mortality. Deficiency during childhood reduces somatic growth and cognitive and motor function. Assessment methods include urinary iodine concentration, presence of goiter, newborn serum thyroid-stimulating hormone concentration, and serum thyroglobulin concentration. In most countries, the best strategy to control iodine deficiency in populations is carefully monitored iodization of salt.

Milk and dairy products are a major source of iodine in many countries, particularly those, like the United Kingdom, do not have an iodised-salt programme. Iodine, a component of the thyroid hormones, is essential for brain development; therefore it is vital that intake is adequate during pregnancy and early life. More than half of the countries that have data on iodine status in pregnant women are classified as having inadequate iodine status. In the United Kingdom, milk and dairy products provide as much as 34% of iodine intake and studies of UK pregnant women have shown that milk intake is an important predictor of iodine status. The iodine content of milk is very variable depending on the country, on the season and on farming practice. Those who replace milk with nondairy alternative drinks may need to find alternative iodine sources.

Background Excessive iodine exposure is an often overlooked cause of neonatal hypothyroidism. Case presentation We present an infant with iodine-induced hypothyroidism, which was detected at age 15 days by newborn screening. The infant’s iodine excess resulted from maternal intake of seaweed soup both during and after pregnancy. Treatment included discontinuation of seaweed soup, temporary interruption of breastfeeding and short-term levothyroxine therapy. By age 4 months, the infant’s hypothyroidism had resolved, and her growth and development were normal. Conclusions This case illustrates the importance of considering excess dietary iodine as a possible cause of hypothyroidism in infants.

Purpose. Iodine is an essential trace element necessary for thyroid hormone synthesis. Iodine deficiency is a continuing public health problem despite international efforts to eliminate it. Studies on iodine status in preschoolers are scarce. Thus, the aims of the current study were to determine the iodine status and to investigate possible associations between urinary iodine concentration (UIC) and estimated 24 h iodine extraction (UIE) and iodine-rich foods. Methods. Data are cross-sectional baseline data, obtained from the two-armed randomized controlled dietary trial “Fish Intervention Studies-KIDS” (FINS-KIDS) conducted in Bergen, Norway. UIC was determined by inductively coupled plasma-mass spectrometry in spot urine samples. Inadequate UIC was defined as median

The main objective of this study was to investigate the effect of increasing dietary levels of heat treated low glucosinolate rapeseed expeller press cake (RSC) on the transfer of iodine from feed to cow milk. Eight cows of the Norwegian red cattle breed were split in two 4 × 4 Latin squares, using 4 treatments and 4 periods of 14 days each. The 4 different treatments were 1) Control, 0.0 kg RSC/day, 2) RSC-Low, 0.6 kg RSC/day, 3) RSC-Medium, 1.4 kg RSC/day and 4) RSC-High, 2.0 kg RSC/day. Irrespective of a planned constant dietary iodine content, the analysed concentration of iodine ranged from 1.4 mg/kg DM in the RSC-High diet to 1.9 mg/kg DM in the Control diet. From day 11–14 in each period, samples were collected and the total iodine concentrations in feed, milk and plasma were determined by inductively coupled plasma mass spectrometry. The iodohormones, triiodothyronine (T3) and thyroxin (T4) in plasma were determined by fluoroimmunoassay. No differences (P > 0.05) in total iodine as well as the T3 and T4 plasma concentrations were observed between the four treatments, even though the plasma iodine reflected the somewhat varying dietary iodine. Feed intake, milk production and milk composition was not affected by the different treatments (P > 0.05). Although the levels of glucosinolates were low and no glucosinolate metabolites (e.g., goitrin and indole acetonitrile) were found in the RSC, an increasing offer decreased the milk iodine concentration from 0.35 mg/kg in the Control to 0.25 mg/kg with RSC-Low, to 0.15 mg/kg with RSC-Medium and to 0.10 mg/kg with RSC-High treatments. The iodine transfer, i.e. the output of iodine via milk related to the iodine intake, amounted to 25, 19, 13 and 10% in the Control and the 3 groups with increasing dietary RSC level. This study indicates that milk iodine transfer is severely inhibited at considerably lower levels of glucosinolates in RSC than previously anticipated.

Dietary iodine requirements are high during pregnancy, lactation, and infancy, making women and infants vulnerable to iodine deficiency. Universal salt iodization (USI) has been remarkably successful for preventing iodine deficiency in the general population, but it is uncertain if USI provides adequate iodine intakes during the first 1000 d.We set out to assess if USI provides sufficient dietary iodine to meet the iodine requirements and achieve adequate iodine nutrition in all vulnerable population groups.We conducted an international, cross-sectional, multicenter study in 3 study sites with mandatory USI legislation. We enrolled 5860 participants from 6 population groups (school-age children, nonpregnant nonlactating women of reproductive age, pregnant women, lactating women, 0-6-mo-old infants, and 7-24-mo-old infants) and assessed iodine status [urinary iodine concentration (UIC)] and thyroid function in Linfen, China (n = 2408), Tuguegarao, the Philippines (n = 2512), and Zagreb, Croatia (n = 940). We analyzed the iodine concentration in household salt, breast milk, drinking water, and cow's milk.The salt iodine concentration was low (15 mg/kg) in 2.7%, 33.6%, and 3.1%, adequate (15-40 mg/kg) in 96.3%, 48.4%, and 96.4%, and high (40 mg/kg) in 1.0%, 18.0%, and 0.5% of household salt samples in Linfen (n = 402), Tuguegarao (n = 1003), and Zagreb (n = 195), respectively. The median UIC showed adequate iodine nutrition in all population groups, except for excessive iodine intake in school-age children in the Philippines and borderline low intake in pregnant women in Croatia.Salt iodization at ∼25 mg/kg that covers a high proportion of the total amount of salt consumed supplies sufficient dietary iodine to ensure adequate iodine nutrition in all population groups, although intakes may be borderline low during pregnancy. Large variations in salt iodine concentrations increase the risk for both low and high iodine intakes. Strict monitoring of the national salt iodization program is therefore essential for optimal iodine nutrition. This trial was registered at clinicaltrials.gov as NCT02196337.

Milk and dairy products are important iodine sources and contribute about 30–40 % of total iodine in the Swiss diet. Information about variation in milk iodine concentration (MIC) in Switzerland is limited. We examined MIC and its potential determinants in milk from organic and conventional farms. We collected bulk milk samples at 3-month intervals over 1 year from thirty-two farms throughout Switzerland and Aosta valley, North-West Italy. We sampled all feed components including tap water, collected information on farm characteristics, feeding and teat disinfection practices by questionnaire and estimated the cows’ winter and summer iodine intake. Iodine in milk and feed components was measured using inductively coupled plasma MS. The overall median MIC was 87 (range 5–371) µg/l. In multivariate analysis, predictors of MIC were as follows: (1) farm type: median MIC from organic and conventional farms was 55 and 93 µg/l (P=0·022); (2) season: 53, 97 and 101 µg/l in September, December and March (Pv. 56 µg/l without (P=0·028). In conclusion, MIC varied widely between farms because of diverse farming practices that result in large differences in dairy cow exposure to iodine via ingestion or skin application. Standardisation of MIC is potentially achievable by controlling these iodine exposures. In order for milk to be a stable iodine source all year round, dietary iodine could be added at a set level to one feed component whose intake is regular and controllable, such as the mineral supplement, and by limiting the use of iodine-containing teat disinfectants.

Iodine is indispensable for the functioning of the organism and the daily recommended amounts of this mineral are crucial for the prevention of a large number of diseases. The available sources of iodine are food, water, as well as dietary iodine supplements. Well-balanced diet, safe and strictly controlled drinking water and consultation with experts about which quantities at certain times reduce the possibility of deficiency, but also the iodine surplus. The legal regulations enabled the successful implementation of iodine prophylaxis in the middle of the XX century, and consequently the reduction of diseases caused by insufficient iodine intake. Today, the problem of raising awareness about the importance of iodine in food is still being addressed to the professional public, especially due to the trend of reducing salt intake in the body for the prevention of cardiovascular diseases.

BackgroundThe effect of mild-to-moderate maternal iodine deficiency on the neuropsychological development of their offspring is uncertain. We aimed to assess the association between iodine status during pregnancy and the cognitive and motor development of children at 4–5 years.MethodsWe conducted a prospective cohort study in four Spanish regions with recruitment of pregnant women between 2003 and 2008 and follow-up of their children up to 4–5 years (mean (SD)=4.8 (0.6)). Cognitive and motor function was assessed in 1803 children using the McCarthy Scales of Children’s Abilities. Dietary iodine and supplementation were measured through questionnaires twice during pregnancy. Urinary iodine concentration (UIC) was measured in spot samples. The residuals of a regression of UIC against creatinine were used to define a variable corrected for creatinine (UIC~Cr).ResultsNeither iodine supplements nor iodised salt consumption or maternal UIC were associated with cognitive or motor function. After adjusting for creatinine, children of women with UIC~Cr ConclusionsWe found an association between low maternal urinary iodine and lower cognitive scores in childhood, although only when corrected for creatinine, adding to the evidence that iodine deficiency may have potential harmful effects on neurodevelopment. Iodine supplementation does not appear to improve child’s neurodevelopment at 4–5 years.

A Standard Reference Material (SRM) of seaweed, SRM 3232 Kelp Powder (Thallus laminariae) has been developed to support food and dietary supplement measurements in compliance with the Food Safety Modernization Act (FSMA) and the Dietary Supplement Health and Education Act of 1994 (DSHEA). The material was characterized for nutritional minerals, arsenic species, isomers of vitamin K1, proximates, and toxic elements. Kelp is a rich source of vitamins and minerals, and it is an excellent source of dietary iodine. Kelp also contains a large amount of arsenic, which is toxic as inorganic species but much less so as organic species. To capture the dietary profile of kelp, certified values were issued for As, Ca, Cd, Cr, Cu, Fe, Hg, I, K, Mg, Mn, Mo, Na, Pb, and Zn. Reference values for proximates were assigned. For the first time, a certified value for iodine, reference values for isomers of vitamin K1, and reference values for arsenic species including arsenosugars were assigned in a seaweed. SRM 3232 fills a gap in Certified Reference Materials (CRMs) needed for quality assurance and method validation in the compositional measurements of kelp and similar seaweeds used as food and as dietary supplements. Graphical Absract Arsenic species and isomers of vitamin K1 were determined in the development of SRM 3232 Kelp Powder (Thallus laminariae).

Iodine is an essential component of thyroid hormones, but excessive iodine intake can lead to thyroid dysfunction. Traditionally, Korean mothers consume brown seaweed soup (miyeokguk), a high source of iodine, after childbirth. There is controversy regarding the effects of excessive postpartum iodine intake on the health of mothers and infants. Thus far, there have been no nationwide large-scale surveys regarding the status of iodine intake among postpartum women in Korea. Therefore, we conducted a nationwide survey of postpartum dietary iodine intake among Korean women. In total, 1054 Korean women aged ≥19 years, at less than 8 weeks postpartum, participated in this survey. Dietary data were collected using self-reported 2-day dietary records, along with before-and-after meal photos. To evaluate the correlation between dietary iodine and urinary iodine excretion (UIE), spot urine, and 24 h urine samples were collected from 98 and 29 participants, respectively. The mean daily iodine intake among all participants was 2945.6 μg, and it gradually decreased over time after childbirth. Dietary iodine intake was significantly correlated with 24 h UIE (r = 0.396, p &lt, 0.05) and spot urine UIE (r = 0.312, p &lt, 0.05). Follow-up studies are required to examine the influence of excessive postpartum iodine intake on thyroid health in mothers and their infants.

The association between iodine levels and the risk of papillary thyroid cancer (PTC) has been suggested, but not definitively established. This study is to compare the iodine status of a group of patients with PTC (with and without BRAF V600E) with that of a healthy population cohort. A cohort of patients scheduled for thyroidectomy was enrolled, along with a community-based health-screening cohort with no known history of thyroid disease. Median urinary iodine (UI) levels, creatinine-adjusted median UI levels, and food frequency questionnaire (FFQ) scores (mean ± SD) were compared. In a subgroup analysis, these values were compared between BRAF V600E-positive and BRAF V600E-negative patients in the PTC group. The PTC group consisted of 210 patients, and the control group consisted of 90 healthy individuals. Among the 191 PTC patients whose BRAF V600E mutational status was reported, 169 (88.5%) were revealed positive for the mutation. The median UI levels were significantly higher in the PTC group (786.0 μg/l) than the control group (112.0 μg/l; p

Serum thyroid-stimulating hormone level was influenced by several factors, including age, gender, thyroid auto-antibodies, race, and intake of dietary iodine. We evaluated age-specific reference interval of serum thyroid-stimulating hormone levels in Korea, an iodine excess area. This nationwide population-based cross-sectional study included representative civilian, non-institutional population (n = 6564) who underwent thyroid function tests from Korea National Health and Nutrition Examination Survey VI (2013–2015). The reference interval of serum thyroid-stimulating hormone levels was defined between the 2.5th and 97.5th percentiles in the reference population. The geometric mean of serum thyroid-stimulating hormone levels in the reference population was 2.17 mIU/L with a reference interval of 0.62–6.84 mIU/L. In the reference population, the geometric mean of serum TSH levels in each age group of 10–18, 19–29, 30–39, 40–49, 50–59, 60–69, and equal or older than 70 years was 2.47, 2.20, 2.07, 2.04, 2.23, 2.12, and 2.27 mIU/L, with a reference interval of 0.74–7.35, 0.67–6.42, 0.63–6.04, 0.62–6.20, 0.56–7.37, 0.57–6.90, and 0.42–6.58 mIU/L, respectively. In the reference population, the urinary iodine concentrations were consistently high in all age groups (median 298.5 μg/L). Subjects aged 10–18 years had the highest urinary iodine concentrations. There was no shift toward higher levels with age in the distribution of serum thyroid-stimulating hormone levels. The reference interval of serum thyroid-stimulating hormone levels was consistently high in all age group, especially from adolescence 10–18 years in a Korean population who had excessive intake of dietary iodine.

Laboratory medicine approaches the evaluation of thyroid function mostly through the single determination of the blood level of thyroid stimulating hormone (TSH). Some authors have suggested an upper reference value for TSH of 2.5 mIU/L. This suggestion has not been confirmed by recent clinical studies. These studies have delivered a clinically valid reference range going from 0.3 to 3.5 mIU/L. These values are valid for both for the general population as well as in the setting of fertility and pregnancy. Current biochemical evidence about the elements required to maintain thyroid function shows that these not only include dietary iodine but also magnesium, iron, selenium and coenzyme Q10. Iron is important for the synthesis of thyroid peroxidase; magnesium-ATP contributes to the active process of iodine uptake; iodine has to be sufficiently present in the diet; selenium acts through selenoproteins to protect the thyroid cell during hormone synthesis and in deiodination of thyroxine; coenzyme Q10 influences thyroid vascularity. As a consequence, good clinical practice requires additional biochemical information on the blood levels of magnesium, selenium, coenzyme Q10 as well as iron status. Since these elements are also important for the maintenance of reproductive function, we postulate that they constitute the connecting link between both endocrine systems., Graphical abstract Image 1

Pregnancy sickness is widespread yet its etiology is poorly understood. It is almost certainly endocrine in origin and most likely a product of placental hormones, with human chorionic gonadotropin being the strongest candidate. It has long been known that greater levels of nausea and vomiting during pregnancy are associated with a lower incidence of spontaneous abortion, yet the causal mechanisms remain unclear. One current popular explanation is that nausea and vomiting during pregnancy is fetoprotective, inducing aversions to foods, especially meat, dairy and seafoods, which may carry toxins, pathogens or mutagens. However, most spontaneous abortions arise from genetic or epigenetic defects that are present at or near conception. Moreover, measurements of human chorionic gonadotropin (hCG) at the time of implantation, particularly its hyperglycosylated isoform, accurately predict subsequent spontaneous abortion. Thus the developmental fate of most embryos is fixed before the onset of the symptoms of pregnancy sickness. An alternative explanation for the link between pregnancy sickness and spontaneous abortion is the embryo quality hypothesis: high quality embryos are both more likely to produce the biochemical antecedents of pregnancy sickness and avoid spontaneous abortion. Recent work has shown that the link between pregnancy sickness and spontaneous abortion grows stronger with maternal age, dramatically so in mothers 35 or older. This reflects the parallel rise in the incidence of autosomal aneuploidies with maternal age. The link between pregnancy sickness and spontaneous abortion exists not because nausea and vomiting during pregnancy is fetoprotective, but because nausea and vomiting is an index of a high quality embryo. Pregnancy sickness is not adaptive per se, but the result of an antagonistic pleiotropy over thyroid function, where embryos use hCG to modulate maternal thyroid hormone production during gestation. Embryos benefit from the thyroid hormone production that is key to neurodevelopment, but produce maternal nausea and vomiting as a by-product. Pregnancy sickness, however, may still serve to protect embryo quality but by a different mechanism that posited under the MEPH. Embryo quality is protected by calibrating the dietary intake of a micronutrient – iodine – critical to neuromotor development. For most humans over most of our evolutionary history, iodine has been in short supply, and iodine deficiency is still the most common source of cognitive impairment across the globe. Thus it is of interest that the food aversions most commonly associated with pregnancy sickness, to meat, dairy and seafoods, are also the chief dietary sources of iodine. There is a further intriguing property about iodine: both too little and too much during early pregnancy are damaging to embryo brain development. Given that pregnancy sickness is closely linked to iodine intake and thyroid function (hypothyroidism is associated with lower levels of nausea and vomiting, hyperthyroidism with more), an obvious interpretation emerges. The previously described link between diet and pregnancy sickness – pregnancy sickness is less likely when plants and particularly corn/maize are the sole food staples – arises not because plant food staples are safe, as previously suggested, but because these foods are iodine poor and may, in addition, be goitrogenic. Pregnancy sickness, which reduces the dietary intake of iodine, is clearly maladaptive under conditions of iodine deficiency and hypothyroidism. Conversely, higher levels of pregnancy sickness induced by hyperthyroidism may protect embryos from the inimical effects of excessive dietary iodine during early gestation by reducing the intake of iodine rich foods.

Iodine is an essential trace element for human health. Its deficiency in biogeochemical environment affects about two billion people worldwide. Besides universal salt iodization, the biofortification of crops with iodine has been proposed as a strategy for improving human nutrition. This study aims at exploring the effects of iodine biofortification on the fruit quality of the pepper plants. The contents of iodine, ascorbic acid, soluble sugar and total acidity of the pepper fruits grown in solution at various iodide concentration levels were measured. Furthermore, in order to reveal the mechanism of fruit quality change, the variations in Chl-a, malondialdehyde (MDA), catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD) of the pepper leaves at various growth periods in response to various iodine treatments were determined. The results indicated that the iodine content of the pepper fruits grown in 0.25–5.0 mg L −1 KI solutions can amount to 350–1330 μg kg −1 FW, matching the 150 μg d −1 dietary iodine allowance recommended by WHO. Thus, the pepper can be used as a candidate crop for iodine biofortification. In addition, low-moderate levels (0.25–1.0 mg L −1 ) of iodine application improved the fruit quality by enhancing the ascorbic acid and soluble sugar contents, and by reducing the total acidity of pepper fruits as well. Generally, after iodine treatments, the Chl-a concentration, and CAT, POD, SOD activities of the pepper leaves increased, while the MDA concentration decreased. The changes in photosynthetic and antioxidant capacities of the plants promoted the improvement of the pepper fruit quality.

Despite a beneficial role of iodine and seaweed consumption against metabolic syndrome (MetS), which is high in postmenopausal women, few studies investigated such associations in a prospective study. This study aimed to investigate the association of dietary iodine and seaweed consumption with the incidence of MetS and its components in postmenopausal women. A total of 2588 postmenopausal women aged ≥ 40 years were recruited between 2005 and 2011 in the Multi-Rural Communities Cohort (MRCohort). A validated semiquantitative food frequency questionnaire was used to collect dietary intake data. MetS was defined as three of five components [abdominal obesity, elevated blood pressure, glucose, triglyceride, and low-high density lipoprotein cholesterol (HDL-C)] and the incidence of MetS was checked every 2–4 years. The incidence rate ratio (IRR) was estimated using a modified Poisson regression model with a robust error estimator. During the mean follow-up period (3.4 ± 2.1 years), MetS occurred in 481 participants. The median cumulative average iodine intake was 108.9 µg/day (interquartile range, 60.8–190.2 µg/day). In multivariable analyses, average iodine and seaweed consumption were inversely associated with MetS (IRR = 0.61, 95% CI 0.47–0.78 in the highest quartile of iodine intake, P for trend = 0.0018; IRR = 0.52, 95% CI 0.39–0.69 in the highest quartile of seaweed consumption, P for trend = 0.0004). Among MetS components, blood glucose (> 100 mg/dL), blood pressure (≥ 130/85 mmHg), and lipid profiles (triglyceride, ≥ 150 mg/dL and HDL-C

Dietary iodine is important to human health, and both low and high iodine intake levels increase the risk of disease. Seaweed is rich in iodine and it is a common component in both Asian and in Arctic cuisines. While the intake and impact are known for Asian people, data are lacking for Arctic people. We aimed to (1) measure iodine content of dietary seaweeds in Greenland, (2) estimate iodine absorption, and (3) assess the impact on iodine intake in Arctic people. A hunter in East Greenland donated household seaweed for (1) measurement of iodine content and (2) ingestion of 45 g by each of eight individuals with subsequent urine collections. (3) In Ammassalik, 96% of 50-69-year-old Inuit reported on the frequency of intake of seaweed and provided a spot urine sample for iodine measurement. Seaweed species provided were Chondrus crispus and Ascophyllum nodosum. (1) The iodine content was 47 and 102 mg/g, respectively. (2) An estimated 1.1 and 1.9 mg of the ingested 2.1 and 4.6 of iodine in seaweed were excreted in the urine within 2 days. (3) More than two in three Inuit reported some dietary use, and 41% (109 of 268) reported a weekly intake of dietary seaweed, which was associated with iodine excretion. In conclusion, the iodine content of edible seaweeds in the Arctic is very high and bioavailable. Dietary intake contributed to the recommended iodine intake level, but marked variation in iodine excretion calls for evaluation of the impact on thyroid function.

Dijabetes mellitus tipa 1 (DMT1) i bolesti štitnjače su dva najčešća endokrinološka poremećaja koja se često javljaju istovremeno. Ističu se Hashimoto tiroiditis (HT) odnosno stanje hipotireoze i Gravesova bolest (GB) koju odražava stanje hipertireoze. Specifičnost je ta što se ova dva stanja mogu međusobno izmjenjivati. Etiologija autoimune bolesti štitnjače vrlo je kompleksna i nedovoljno razjašnjena te stoga ne čudi što ne postoje službene smjernice za prehranu kod ovih stanja. Provedeno je opažajno istraživanje primjenom anonimnog upitnika koje je imalo za cilj analizirati karakteristike prehrane oboljelih od DMT1 s razvijenim HT (DMT1+HT, N=23) u odnosu na kontrolnu skupinu (samo DMT1, N=31). Samo jedan ispitanik je imao GB a 22 HT, 95,6 % su žene, a prosječna starost oboljelih 27,5 ± 10,1 godina. Pretilost je utvrđena samo kod DMT1+HT (10,5 %) što se može dovesti u vezu s usporenim metabolizmom kod hipotireoze. Nisu utvrđene značajne razlike u konzumaciji osnovnih šest skupina hrane, no DMT1+HT ispitanici su češće isključivali mlijeko i/ili gluten iz prehrane a kao rezultat vlastitog istraživanja na internetu. DMT1+HT ispitanici jedu više povrća pri tome se bazirajući uglavnom na zeleno lisnatom povrću koje je važan izvor goitrogena. Oni također češće dosoljavaju hranu i prije nego ju probaju (17,4 % u odnosu na 16,1 %; p=0,008), a kuhinjska sol predstavlja važan izvor joda u prehrani (mandatorno obogaćivanje). Stručna edukacija o izvorima joda i goitrogena u hrani za oboljele s bolesti štitnjače je prijeko potrebna kako bi se izbjeglo posezanje za alternativnim i često neprovjerenim informacijama. Type 1 diabetes mellitus (DMT1) and thyroid disease are the two most common endocrine disorders which often coexist in the same patient. Hashimoto's thyroiditis (HT), characterized with hypothyroidism and Graves' disease (GD), characterized by hypertiroidism are especially interesting due to the fact that they can interchange. Etiology of autoimmune thyroid disease is very complex and still not fully understood, therefore it is not surprising that we still do not have official nutrition recommendations. An observational study was conducted by using the anonymous questionnaire with the aim to assess dietary characteristics of DMT1 patients diagnosed with HT (DMT1+HT, N=23) in comparison to control (only DMT1, N=31). Only one patient had GD and 22 HT, 95.6 % are women, average age 27.5 ± 10.1 years. Obesity was detected only among DMT1+HT patients (10.5 %) which indicates potential role of slowed metabolism in hypothyroidism. No significant difference was found in dietary intake of six main food groups. However, DMT1+HT patients more often excluded milk and/or gluten from their diet as a result of self-education on the Internet. DMT1+HT patients eat more vegetables, especially green leafy vegetables which are important sources of goitrogens. They also tend to add salt to their food even before tying it more often (17.4 % in comparison to 16.1 %; p=0.008), and kitchen salt is important source of iodine (due to mandatory fortification). Professional education on dietary sources of iodine and goitrogens for people with thyroid disease is much needed in order to avoid search for alternative and often unverified information.

Two most common, often coexisting autoimmune endocrine diseases are Type 1 Diabetes Mellitus (DMT1) and Hashimoto’s Thyroiditis (HT). Dietary recommendations for DMT1 are well known and establiched in the practice, but not for thyroid disorders. The lack of professional recommendations leaves room for self-proclaimed nutrition “experts” to share unverified advices without thinking about the consequences. Dietary practices of DMT1 patients with (DMT1+HT, N=23) and without HT (control group, DMT1, N=31) were assessed with anonymous, study-specific questionnaire. Two DMT1+HT patients excluded milk from their diet after reading about it on the Internet. Gluten-free diet is praciticized by 13.6% of DMT1+HT patients also as a result of the information found online. One DMT1+HT patient reported practicizing “autoimmune” protocol, again found on the Internet. Coexistence of coeliac disease in DMT1 is relatively low, but non-coeliac gluten/wheat sensitivity also increases the risk of autoimmune disease, mainly HT. However, besides shared autoimmune etiology, asymptomatic individuals should not practicize gluten-free diet because it poses a significant risk on individual’s long-term nutritional status. DMT1+HT patients eat more vegetables, especially green leafy vegetables which are important sources of goitrogens. They also tend to add salt to a meal even before tying it (17.4% vs 16.1% ; p=0.008), and kitchen salt is important source of iodine (due to mandatory fortification in Croatia). Professional nutritional advices are much needed to improve knowledge of goitrogens, sources of iodine and point out potentially detrimental dietary practices that can worsen patient’s condition.

Background Dairy products provide a crucial source of dietary iodine for the majority of the UK population, contributing approximately 30–40 % of daily intake. Fluctuations in the iodine content of purchased milk both seasonally and annually implies potential fragility of iodine supply likely through fluctuating supplementation practices in cow herds. We set out to establish the level of national variation in herds and identify factors which might impact milk iodine content. Methods Milk samples were obtained from 98 herds across the UK via the National Milk Laboratories in August and December 2016. Iodine concentration of samples was measured using ICP-MS. Milk samples and feed intake data were additionally taken from 22 cows from the University of Nottingham (UON) dairy herd. Results There was considerable variation in milk iodine content from Conclusions Regional differences in milk iodine concentration between summer and winter suggests that feeding practices are far from uniform across the country. The negative association observed between iodine concentration and milk yield in UON samples, suggests that reduced summer values may be influenced by dilution in addition to seasonal differences in concentrate feed provision.

Two experiments were designed to determine the effects of dietary iodine and teat-dipping on the iodine status of dairy cows and their milk. Eight mid-lactation Holstein dairy cows with an initial body weight of 642 ± 62 kg and 145 ± 21 d in milk were studied for 2 periods over 44 d. In period 1, all cows were fed a basal diet supplemented with potassium iodide (KI) (10 mg I/Kg DM) for 8 d with no teat-dipping. In period 2, a pre-milking teat-dipping was applied for 10 d followed by no teat-dipping before milking (udder wash without iodine) and then post-dipping treatment was applied for 5 d. Feeding KI increased concentrations of iodine in serum, urine, and milk (P0.05). Switching from the KI supplementation to no iodine addition resulted in an immediate decrease of iodine in serum, urine, and milk (P0.05). Post teat-dipping resulted in increased iodine levels in serum, urine, and milk (P0.05). However, pre-milking teat-dipping did not affect iodine concentration compared to post-dipping. A 250 mL cup of milk from the control and KI-supplemented diets would provide 29.4% and 68.4%, respectively, of the adult-recommended dietary allowance for iodine. In conclusion, milk iodine concentration could be effectively enhanced by KI supplementation and teat-dipping practices.