Iodine Supplementation In Women Research Articles

Greetings From the Editor of Clinical Thyroidology

Clinical ThyroidologyVol. 33, No. 6 Greetings from the EditorFree AccessGreetings From the Editor of Clinical ThyroidologyPublished Online:8 Jun 2021https://doi.org/10.1089/ct.2021;33.252-253AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail DEAR COLLEAGUES,Welcome to another issue of Clinical Thyroidology. This issue contains yet another exciting look at the latest research on a variety of clinical thyroid topics. We begin the issue with a review by Drs. Sofie Bliddal, Marianne Klose, and Ulla Feldt-Rasmussen summarizing an Italian study of patients with COVID-19 infection evaluated by various thyroid parameters during intensive care hospitalization. Dr. Soumya Thumma and Spyridoula Maraka examine a study assessing the safety of routine iodine supplementation in women with Hashimoto's thyroiditis.On the topic of Graves’ disease, Dr. Benjamin Gigliotti reviews a large Japanese study of patients with Graves’ disease analyzing the predictive factors for achieving remission. On a related note, Drs. Anand Gandhi and Ricardo Correa summarize a study assessing risk factor for the development of thyroid eye disease in those with Graves’ hyperthyroidism. And Drs. Jennifer Clark and Marius Stan share their commentary on a study investigating the potentially protective role of statins in those with newly diagnosed thyroid eye disease.Turning to thyroid nodules and thyroid cancer, Dr. Trevor Angell reviews a study examining the thyroid nodule cytology results in which the Afirma molecular tests might be most useful. Drs. Matthew Balcerek and Donald McLeod provide their perspective on an interesting study that asks: What are the competing risks of death in an older individual who is diagnosed with thyroid cancer? For low-risk papillary thyroid cancers, Dr. Jesse Pasternak summarizes a study of U.S. surgeons surveyed on the appropriate extent of thyroid surgery, while Dr. Maria Papaleontiou reviews a study examining the frequency of thyroid hormone supplementation after thyroid lobectomy. Finally, Dr. Brian Kim provides his expert commentary on a study examining the promise of liquid-based biopsies assessing the molecular signatures in anaplastic thyroid cancers.As always, thank you to all our readers who are connecting with us through our social media platforms. I invite everyone to join the conversations regarding the content covered in each month's issue and other related topics:Twitter:https://twitter.com/clinicalthyroid(@clinicalthyroid)Facebook:https://www.facebook.com/ThyroidAssociationLinkedIn:https://www.linkedin.com/company/american-thyroid-associationYoutube:https://www.youtube.com/user/thyroidorgAlso, remember that most of the material covered in Clinical Thyroidology is also translated into shorter lay summaries in our sister journal, Clinical Thyroidology for the Public [CTFP] (https://www.thyroid.org/patient-thyroid-information/ct-for-patients), that is edited by Dr. Alan Farwell and his team each month. The summaries in CTFP may be of use to patients and the public who are interested in reading more about recently published studies in the clinical thyroid literature.I hope that each issue provides helpful reviews, commentaries, editorials, and perspectives regarding how best to treat patients with thyroid disease. Guidelines for submitting Letters to the Editor and select Guest Editorials that cover timely and innovative aspects of clinical thyroid disease management may be found at https://home.liebertpub.com/publications/clinical-thyroidologyand174/623/for-authors.Thank you again for your interest in Clinical Thyroidology. Please feel free to send me any questions or comments at clinicalthyroidology@thyroid.org.Warmest regards,Angela M. Leung, MD, MSc Editor-in-Chief, Clinical ThyroidologyFiguresReferencesRelatedDetails Volume 33Issue 6Jun 2021 InformationCopyright 2021 American Thyroid Association, Inc.To cite this article:Clinical Thyroidology.Jun 2021.252-253.http://doi.org/10.1089/ct.2021;33.252-253Published in Volume: 33 Issue 6: June 8, 2021PDF download

Iodine supplementation: is there a need?

To review the recent data on iodine deficiency, the impact of iodine deficiency on health outcomes and the need for iodine supplementation in at-risk populations, that is, pregnant and lactating women, infants and young children. The 2019 Iodine Global Network Annual Report highlighted that only 23 countries worldwide (including Finland, Germany, and Norway in Europe) were classified as having insufficient iodine intake in 2019, down from 54 in 2003 and 113 in 1993. Even if severe iodine deficiency during pregnancy has a negative impact on cognitive outcomes later in life, the consequences of mild-to-moderate iodine deficiency on child neurodevelopment are controversial. Two 2017 and 2019 Cochrane Systematic Reviews found no evidence that iodine supplementation in women before, during or after pregnancy improved infant and child cognitive development in areas with mild-to-moderate iodine deficiency. Likewise, a 2019 Cochrane systematic review concluded that there was no evidence of a positive impact of iodine supplementation on morbidity, including cognitive impairment, and mortality in preterm infants. There is no scientific evidence to support generalized iodine supplementation in mildly to moderately deficient settings not only in pregnant and lactating women but also in infants, either preterm or term, and in young children.

Assessment of students' knowledge on iodine supplementation by women planning pregnancy

Introduction: Iodine is essential for the synthesis of the thyroid hormones. Proper thyroid function in a pregnant woman depends on the accumulated reserves of iodine in the pre-pregnancy period. If they are sufficient, the production of thyroid hormones is adequate even in the case of increased demand. Adequate iodine status during pregnancy is crucial for maternal health and foetal growth. Severe iodine deficiency causes maternal and foetal hypothyroxinaemia, leading to irreversible brain damage, manifested by mental retardation and neurological disorders. The daily requirement for iodine for pregnant women has been determined by The World Health Organization (WHO) at 250 µg. Most likely, the demand for it cannot be covered only by dietary iodine intake, so iodine should be supplemented in the form of tablets at a dose of 150-200 µg daily.Purpose: The aim of the study is to assess students' knowledge on iodine supplementation by women planning pregnancy and pregnant women.Material and method: Students' knowledge regarding the importance of iodine supplementation was verified using anonymous Internet questionnaire. The obtained results were analysed and checked on the basis of scientific literature.Results: The percentage of students who think iodine supplementation should be recommended is 22.7%, and 9.7% believe it is not necessary. Only 8.8% of the respondents chose the correct recommended dose of iodine. Surprisingly, most of the respondents do not know the recommended iodine dose, as much as 71.7% of them.Conclusions: The proper supply of iodine has a decisive impact on the proper functioning of the body, and its deficiency has serious consequences, especially in the womb. The problem of iodine deficiency is serious. This is also confirmed by the results of our surveys. It is important to educate students on the recommendations for iodine supplementation in women of childbearing age.

Effects of iodine nutrition during pregnancy and lactation on postpartum thyroid function in women with subclinical hypothyroidism

Objective To evaluate the effects of maternal iodine nutrition levels on postpartum thyroid function, and to provide clinical evidence for accurate iodine supplementation in women with subclinical hypothyroidism during pregnancy. Methods This study collected single-pregnant women who had no history of thyroid diseases before pregnancy in our city. Thyroid function and urinary iodine results were continuously recorded during pregnancy and lactation. All subjects were divided into subclinical hypothyroidism group and euthyroidism group according to their thyroid function during pregnancy. The relationship between urinary iodine levels during pregnancy and lactation with postpartum thyroid function were analyzed. Results A total of 148 maternal women were collected, including 41 cases of subclinical hypothyroidism group and 107 cases of euthyroidism group. The urinary iodine level in pregnant women was higher than that in lactation(median 174.75 vs 149.89 μg/L, P<0.05). However, the iodine deficiency ratio(23.6%)during pregnancy was higher than that during lactation(5.4%). There were significant differences in the change of urinary iodine in each time interval during pregnancy and lactation(P<0.05). A total of 56 maternal women developed postpartum thyroiditis(PPT). The incidence of PPT in pregnant women with TPOAb-positive in early pregnancy was higher than that in TPOAb-negative patients(χ2=10.811, P=0.001). The urinary iodine concentration in the 12-month postpartum period was lower in women with PPT than that in women without PPT(P<0.05). Cox regression analysis showed that iodine deficiency during lactation(HR=3.870, 95% CI 1.595-9.392, P=0.003)and TPOAb positive in early pregnancy(HR=3.679, 95% CI 1.466-9.233, P<0.05)increased the risk of PPT. Subgroup analysis also showed a similar risk increase of PPT in women with hypothyroidism during pregnancy(HR=8.318, 95% CI 2.383-29.029, P<0.05). However, this association was not found in euthyroidism group. Conclusion The urinary iodine level of women during pregnancy and lactation in our iodine suitable areas is within normal range, but attention should still be paid to the effect of iodine deficiency on breast-feeding women, especially among those with subclinical hypothyroidism. Key words: Pregnancy; Lactation; Iodine; Thyroid function

Association of Maternal Iodine Status With Child IQ: A Meta-Analysis of Individual Participant Data.

ContextAlthough the consequences of severe iodine deficiency are beyond doubt, the effects of mild to moderate iodine deficiency in pregnancy on child neurodevelopment are less well established.ObjectiveTo study the association between maternal iodine status during pregnancy and child IQ and identify vulnerable time windows of exposure to suboptimal iodine availability.DesignMeta-analysis of individual participant data from three prospective population-based birth cohorts: Generation R (Netherlands), INMA (Spain), and ALSPAC (United Kingdom); pregnant women were enrolled between 2002 and 2006, 2003 and 2008, and 1990 and 1992, respectively.SettingGeneral community.Participants6180 mother-child pairs with measures of urinary iodine and creatinine concentrations in pregnancy and child IQ. Exclusion criteria were multiple pregnancies, fertility treatment, medication affecting the thyroid, and preexisting thyroid disease.Main Outcome MeasureChild nonverbal and verbal IQ assessed at 1.5 to 8 years of age.ResultsThere was a positive curvilinear association of urinary iodine/creatinine ratio (UI/Creat) with mean verbal IQ only. UI/Creat <150 µg/g was not associated with lower nonverbal IQ (−0.6 point; 95% CI: −1.7 to 0.4 points; P = 0.246) or lower verbal IQ (−0.6 point; 95% CI: −1.3 to 0.1 points; P = 0.082). Stratified analyses showed that the association of UI/Creat with verbal IQ was only present up to 14 weeks of gestation.ConclusionsFetal brain development is vulnerable to mild to moderate iodine deficiency, particularly in the first trimester. Our results show that potential randomized controlled trials investigating the effect of iodine supplementation in women with mild to moderate iodine deficiency on child neurodevelopment should begin supplementation not later than the first trimester.

What are the effects of iodine supplementation for women during pregnancy and postpartum and for their children?

What are the effects of iodine supplementation for women during pregnancy and postpartum and for their children?

Iodine supplementation for women during the preconception, pregnancy and postpartum period.

Iodine supplementation for women during the preconception, pregnancy and postpartum period.

Iodine Supplementation in Women During Preconception, Pregnancy, and Lactation: Current Clinical Practice by U.S. Obstetricians and Midwives.

Iodine deficiency is a major public-health problem throughout the world, especially for pregnant women, and it is considered the most common cause of preventable intellectual impairment. In the United States, iodine status in pregnant women is considered mildly deficient. Therefore, the Endocrine Society, the American Thyroid Association, the Teratology Society, and the American Academy of Pediatrics recommend that women receive prenatal vitamins containing 150 μg of iodine daily during preconception, pregnancy, and lactation. The objectives of this study were to evaluate awareness of iodine nutrition among obstetricians and midwives in the United States, and to document current clinical practice regarding recommendations for iodine supplementation for women during preconception, pregnancy, and lactation. All midwife members of the American College of Nurse-Midwives (ACNM) and all obstetrician members of the American Medical Association (AMA) were invited to participate in a web-based survey. A total of 199 midwives and 277 obstetricians participated in the survey. One third of both obstetricians and midwives considered iodine status in U.S. pregnant women to be deficient. Although almost all obstetricians and midwives would recommend prenatal multivitamins, most reported rarely or never recommending iodine-containing multivitamins for women planning pregnancy (68.7% and 70.2%, respectively), pregnant women (66% and 67.1%), or lactating women (68.7% and 71.7%). Of the respondents who did report prescribing iodine-containing supplements, 85% recommended supplementation during the first trimester and 75-80% during the second and third trimesters. However, of those who did recommend iodine supplementation, only 45% would prescribe the recommended 150 μg of iodine daily during pregnancy. Overall, 75% of U.S. obstetricians and midwives do not recommend or would recommend an inadequate amount of iodine during preconception, pregnancy, and lactation. Despite the important consequences of iodine deficiency for pregnant women and the recommendations of many medical societies, the majority of U.S. obstetricians and midwives who participated in this survey do not recommend iodine-containing vitamins in women planning pregnancy, during pregnancy, and during lactation.