As you hear the term iodine, you may immediately associate it with salt. That’s unsurprising, given that nearly three-quarters of families in the United States consume iodized salt to enhance the taste of their meals, according to a prior study. Given that many individuals consume an excessive amount of salt, how could a person acquire an iodine deficiency? The response may astound you. Because your body is not able to make iodine naturally, you must get it via your food. Adults need about 150 micrograms (mcg) each day. Women who are pregnant or nursing need 200 mcg each day.

A recent thorough study of many brands of widely viable salt revealed that iodine is quickly lost from the item once it is opened. By 4 weeks of opening the jar and exposing it to air, the iodine concentration is virtually depleted (even faster when there are higher levels of humidity). The research indicates that amongst those who regularly are using the salt shaker for preparing meals, daily iodine consumption may be less than the daily requirement.

Iodine is naturally found in soil and saltwater. Iodine availability in meals varies by location of the globe. Individuals may maintain an appropriate iodine level in their diets using the iodized table salt, consuming foods rich in iodine, such as dairy foods, shellfish, meat, certain bread, as well as eggs, and taking an iodine-containing multivitamin. However, the quantity of iodine in meals is not stated on food packaging, making it impossible to locate the source of iodine in foodstuffs.

Iodine Deficiency Disorders and Complications

Around 2 billion individuals worldwide suffer from iodine deficiency. It is more prevalent in poorer nations, where individuals might lack access to sufficient nutritious meals. However, it may also harm individuals in industrialized nations who do not consume a sufficient amount of iodine or whose systems do not absorb it properly.

Pregnant women need the highest amount of iodine of any group of individuals. As a result, individuals are more prone to develop a deficit if they do not make a deliberate effort to eat foods rich in iodine. When left untreated, iodine deficiency can lead to severe hypothyroidism. Complications may include:

1. Heart disease and related disorders, such as an enlarged heart and heart failure.

2. Mental health issues such as depression and cognitive impairment

3. Damage to the body’s peripheral nerves, known as peripheral neuropathy.

4. impaired ovulation, which may cause infertility in women.

5. Problems with the Thyroid gland to produce the T4 and T3 hormones.

6. Lowered IQ levels in children.

How do you know if you’re Iodine Deficient?

Have you noticed an unusual weight gain? You feel lethargic and your skin is not getting any softer despite all the moisturizers and remedies. Well, chances are you might be having an iodine deficiency!

Iodine deficiency can manifest through various signs and symptoms. Here are some common indicators:

1. Goiter (Swelling of the Neck): The most recognizable sign of iodine deficiency is a goiter, which is an enlarged thyroid gland. This can cause a noticeable swelling in the neck.

2. Fatigue and Weakness: Iodine is essential for thyroid hormone production, which regulates energy levels. A deficiency can result in feelings of extreme tiredness and weakness.

3. Weight Gain: If your metabolism slows due to insufficient iodine, it can lead to unexplained weight gain.

4. Dry Skin and Hair: A lack of iodine can cause dry, rough skin, and brittle or thinning hair.

5. Cold Sensitivity: People with iodine deficiency often feel unusually cold, even in mild temperatures, due to the impact on thyroid function, which helps regulate body temperature.

6. Constipation: A sluggish thyroid due to iodine deficiency can lead to digestive issues like constipation.

7. Mental Fog and Poor Concentration: Low levels of iodine can affect brain function, leading to difficulty concentrating, poor memory, and mental fatigue.

8. Irregular Menstrual Cycles: Women may experience heavier or more irregular menstrual cycles due to hormonal imbalances caused by iodine deficiency.

9. Elevated Cholesterol: Iodine deficiency can contribute to increased cholesterol levels, which can have further health implications.

If you suspect you have an iodine deficiency, it’s important to visit a healthcare provider. They may order blood tests to assess your thyroid function and iodine levels.

Should You Get Tested for Iodine Deficiency?

If you or your doctor suspects you have an iodine deficiency, they will usually check your iodine levels in one of four ways:

1. Indirect Assessment by Looking at Thyroid Symptoms

Because it is difficult to evaluate an individual’s iodine level directly, an indirect evaluation may be performed by searching for symptoms of hypothyroidism. Iodine deficiency impairs thyroid hormone manufacturing, resulting in hypothyroidism. Common Symptoms are;

• Excessive tiredness
• Sensitivity to cold
• Cold hands and feet
• Cloudy thinking or trouble focusing
• Increased sleepiness
• Dry skin
• Hair loss
• Constipation

Any of these symptoms may indicate decreased thyroid hormone levels and/or low iodine levels.

2. Direct Methods for Assessing Iodine Levels

1. Thyroglobulin Levels

When thyroglobulin (Tgbn) levels are elevated in an otherwise functioning thyroid, it is likely that the thyroid is attempting to compensate for an iodine shortage. The less iodide available to the thyroid, the more the thyroid gland expands in response to increased TSH stimulation.

The more thyroid tissue there is, the higher the thyroglobulin levels. Conversely, when thyroglobulin levels are optimal (3–10 ng/mL), sufficient iodine is available for proper thyroid hormone synthesis, and any changes in dietary iodine consumption are likely to be well-absorbed by the thyroid.

2. Urine Test

This is the simplest and fastest test. While urinary tests (“spot”/urine samples) are often used in epidemiological studies to determine iodine sufficiency in a population, the method is subject to significant day-to-day variation in individuals and is therefore not routinely used in everyday practice.

3. Blood Test

Unfortunately, the iodine blood test that your doctor may perform is not particularly accurate. Blood tests for iodine are usually combined with a 24-hour urine test for better results.

4. Iodine Patch Test

The iodine patch test involves painting a patch of iodine on your skin and observing how it looks after 24 hours. In people who are not iodine deficient, the patch fades no sooner than 24 hours. However, a deficiency may cause the iodine to be absorbed more quickly. Despite its historical use, the iodine patch test has been debunked and is no longer considered accurate.

5. Iodine Loading Test

This test measures how much iodine you excrete in your urine over a 24-hour period. It is neither the fastest nor the most convenient method, as it requires collecting every urine sample over a full day.

The iodine loading test is no longer widely recommended because its concept is based on a misapplication of earlier research. It has extremely poor sensitivity and is not considered reliable.

6. Iodine and Bromine Levels in the Urine

Urinary iodine measurement provides a simple and straightforward way to assess recent iodine sufficiency. However, this method alone cannot reliably determine long-term iodine status without additional thyroid test results.

Urinary bromine analysis complements iodine measurement, as bromine inhibits iodine uptake by the thyroid gland. This means that even if urinary iodine levels appear adequate, high bromine levels may indicate insufficient tissue iodine. For an accurate evaluation, iodine and bromine levels must always be compared.

Look Out for Medicines You Take

Certain medications can increase the amount of iodine in your system. Because there is often a discrepancy between traditional and holistic medicine approaches and government guidelines, the appropriate iodine intake should be personalized based on an individual’s health needs. This determination should be guided by an experienced doctor or holistic practitioner.

In today’s environment of endocrine disruptors, poor dietary habits, and daily stressors, it is easy for individuals to fall below their unique nutritional requirements. Given iodine’s critical role in thyroid function and overall health, ensuring adequate levels is essential.

When signs of iodine deficiency start to appear, these guidelines can help initiate an investigation. Once a diagnostic pattern aligns with the symptoms, the next step is to develop an iodine supplementation plan in consultation with an expert.

My Experience with Iodine

I’ve struggled for at least 15 years to maintain my iodine levels within the optimal range. This was one of several factors that affected my thyroid and ultimately led to my diagnosis of hypothyroidism.

My first introduction to iodine came from reading Dr. Brownstein’s book Iodine: Why You Need It, Why You Can’t Live Without It. After reading the book, I asked my holistic doctor about using a patch test to check for iodine deficiency. This test involved painting a patch of iodine on my skin and observing how long it took to disappear within 24 hours. The results showed that my skin absorbed the iodine tint almost immediately, indicating a deficiency in this essential mineral.

My doctor recommended painting parts of my legs, stomach, or arms with a Lugo’s 2% solution daily, rotating the location to address the iodine deficiency. I followed this method for nearly a year. However, it was messy and uncomfortable, particularly when traveling. It was also frustrating when drops of the iodine solution stained my clothes or countertops by accident.

To find a more convenient alternative, I began supplementing my diet with Iodoral pills, taking 12.5 mg twice a week. This was a much higher dose than the recommended dietary allowance (RDA) of 150 mcg/day for people aged 14 and older, as established by government guidelines and the World Health Organization (WHO).

In holistic medicine, the RDA is often considered too low, and higher doses are recommended, depending on individual needs and under medical supervision. Iodine is a crucial mineral for thyroid health and overall well-being, as every cell in the body requires iodine to function properly.

Initially, my weekly intake of 12.5 mg (equivalent to 25,000 mcg) did not significantly raise my iodine levels. My doctor then gradually increased my dosage to 3 pills per week, eventually raising it to 5 pills weekly, equating to 62.5 mg (62,500 mcg). Despite this high dose, my iodine levels in blood tests only increased slightly from 36 ug/L to 42 ug/L while the normal range is 40.0–92.0 ug/L.

I monitored my iodine levels with annual blood tests, but in retrospect, I should have relied on 24-hour urine tests instead. Also, I researched potential factors that might have inhibited my body from processing iodine, such as bromide, fluoride, and plastic exposure, and eliminated them from my environment.

I also adjusted my diet, eating small portions of cooked cruciferous vegetables and incorporating iodine-rich foods like cheese, yogurt, organic chicken, grass-fed meats, wild Alaskan salmon, and sushi. Yet, my body still failed to effectively absorb and process the iodine from food and supplements.

To address this, my doctor increased my Iodoral dosage to 6 pills per week, raising my iodine intake to 75 mg (75,000 mcg). This extremely high dose was prescribed for only three months to address my persistently low iodine levels.

After three months, I conducted a 24-hour urine iodine test, a standard urine iodine test, and a thyroid panel to evaluate the impact of the higher dose on my T4 and T3 levels. The results were surprising:

• 24-hour urine iodine test: 1,003.8 ug/24 hr (significantly elevated).
• Regular urine iodine test: 344.5 ug/dL (normal range: 28.0–544.0 ug/dL).
• Blood iodine test: 47.2 ug/L (normal range: 40.0–92.0 ug/L), slightly higher than my previous result of 42 ug/L.

These results were confusing because the same urine sample from the 24-hour collection was used for both the regular and 24-hour iodine tests, yet they produced different outcomes.

How Have the Results of My Iodine Tests Affected My Thyroid Hormone Levels?

When comparing my most recent test results to the previous one taken before adding the extra Iodoral pill, I observed the following changes:

• My Free T4 (FT4) decreased from 1.37 to 1.10 ng/dL (normal range: 0.82–1.77 ng/dL).
• My Free T3 (FT3) dropped from 4.0 to 3.4 pg/mL (normal range: 2.9–4.4 pg/mL).

Although these levels are within the “normal” range, they are low for me, which explains why I began experiencing hypothyroidism symptoms again.

My symptoms returned, including mental fog, low concentration, weight gain, and decreased energy levels. With the decline in my FT4 and FT3, my thyroid medication had to be adjusted:

• T4 medication was increased from 75 mcg to 90 mcg.
• T3 medication (compounded slow-release) was increased from 20 mcg to 30 mcg.

After three months, my symptoms disappeared. However, it has been more challenging to return to my pre-treatment weight. While my weight is still within the normal range, I aim to lose at least 3 pounds to reach my optimal weight rather than adhering strictly to government-defined guidelines. I am actively working toward this goal with a combination of exercise, diet, vitamins, and supplements.

Lessons from This Experience

1. Testing Reliability

I learned that blood tests and regular urine tests for iodine are not as reliable as 24-hour urine iodine tests. A 24-hour urine test is better for determining whether you are consuming too much iodine from supplements or diet or whether you are iodine-deficient.

2. Current Approach

Currently, I have reduced my intake to 2 Iodoral pills (12.5 mg each), cut in half to lower the dosage to 6.25 mg per day. I plan to take another 24-hour urine test in 6–12 months. Additionally, I will recheck my thyroid hormones in three months to ensure my FT4 and FT3 levels return to my optimal range.

3. Periodic Monitoring

This experience has reinforced the importance of regular blood tests to monitor thyroid function and overall health. It is also beneficial to check for food allergies, heavy metals, and vitamin and nutrient deficiencies.

By consistently using 24-hour urine iodine tests to monitor iodine levels and addressing deficiencies every 6–12 months, I hope to achieve better thyroid health and overall well-being.

How Iodine Deficiency Affects Thyroid Function

A deficiency in iodine can significantly disrupt thyroid function and lead to various health problems. Here’s how iodine deficiency affects the thyroid:

1. Reduced Production of Thyroid Hormones

The thyroid gland uses iodine to produce two primary hormones: thyroxine (T4) and triiodothyronine (T3). These hormones regulate various bodily functions, including metabolism and energy expenditure. Without enough iodine, the thyroid cannot produce sufficient T4 and T3, leading to hypothyroidism. Symptoms of hypothyroidism include:

• Fatigue
• Weight gain
• Cold intolerance
• Dry skin
• Depression

A lack of iodine can result in a significant decrease in thyroid hormone levels, causing the body’s metabolism to slow down. This can have a profound impact on various bodily systems, from digestion to the cardiovascular system. Individuals with hypothyroidism due to iodine deficiency may feel sluggish, experience difficulty concentrating, and struggle with maintaining normal body temperature.

2. Goiter Formation

In an attempt to compensate for the lack of iodine, the thyroid gland enlarges, a condition known as a goiter. The gland increases in size to absorb as much iodine as possible from the bloodstream. A goiter may cause swelling at the base of the neck, which can lead to difficulty swallowing or breathing if it becomes large enough. In severe cases, the size of the goiter can put pressure on the esophagus and windpipe, making it harder to breathe and swallow.

Goiters can be noticeable, especially in areas where iodine deficiency is common, but they are often reversible with iodine supplementation or dietary adjustments. However, in some cases, the goiter may require surgical intervention if it becomes too large or problematic.

3. Impaired Metabolism

Thyroid hormones are essential for maintaining a healthy metabolism. When iodine deficiency leads to insufficient thyroid hormone production, metabolic processes slow down. This can result in weight gain, decreased heart rate, constipation, and overall fatigue. Because metabolism is responsible for how the body converts food into energy, an iodine deficiency can lead to an overall sense of sluggishness, even with an otherwise healthy diet and lifestyle.

In addition to physical changes, such as weight gain, iodine deficiency can also cause disruptions in other metabolic functions, including the regulation of cholesterol levels, which can increase the risk of cardiovascular diseases.

4. Impact on Cognitive Function

Thyroid hormones also play a vital role in brain development and function. Inadequate iodine levels can impair cognitive development in children and result in developmental delays, learning difficulties, and reduced IQ. Even mild iodine deficiency during pregnancy can have lasting effects on the child’s mental and physical development.

Research has shown that iodine deficiency is one of the most common preventable causes of intellectual disability worldwide. For pregnant women, iodine deficiency can lead to irreversible damage to the developing fetus. Babies born to mothers with insufficient iodine levels during pregnancy may experience learning disabilities, speech delays, and reduced cognitive ability as they grow.

5. Pregnancy Complications

Iodine deficiency during pregnancy can lead to serious complications for both the mother and the baby. In addition to potential developmental issues for the child, the mother may experience an increased risk of miscarriage, preterm birth, and high blood pressure. Proper iodine levels are essential for fetal brain development.

Iodine deficiency in pregnancy has also been linked to an increased risk of goiter, thyroid dysfunction, and other thyroid-related diseases. This is why it’s important for women to ensure adequate iodine intake, especially when pregnant or planning to conceive.

6. Thyroid Dysfunction and Autoimmune Diseases

Long-term iodine deficiency can increase the risk of thyroid dysfunction, including autoimmune conditions such as Hashimoto’s thyroiditis and Graves’ disease. These disorders occur when the immune system mistakenly attacks the thyroid, leading to either underactive or overactive thyroid function.

Hashimoto’s thyroiditis is an autoimmune condition where the body attacks the thyroid gland, leading to hypothyroidism, while Graves’ disease causes the thyroid to become overactive, producing excessive hormones. Both conditions can lead to significant health issues, including cardiovascular problems, anxiety, and severe hormonal imbalances. Iodine deficiency can serve as a contributing factor, especially in areas where iodine intake is consistently low, triggering these autoimmune responses.

References

https://my.clevelandclinic.org/health/diseases/23417-iodine-deficiency

https://www.healthline.com/nutrition/iodine-deficiency-symptoms

https://pubmed.ncbi.nlm.nih.gov/25591468/

https://cvm.msu.edu/vdl/laboratory-sections/nutrition/iodine-testing