Iodine deficiency: these are the signs

Iodine deficiency is still widespread today. Germany is no exception with its iodine-poor soils. We’ll show you how to recognize a deficiency and how to effectively prevent it.

Iodine is a vital trace element that we consume through food. Our thyroid needs it to produce the hormones thyroxine (T4) and triiodothyronine (T3). These hormones are crucial for brain development in newborns and young children.

An iodine deficiency is therefore particularly dangerous during pregnancy and while breastfeeding. According to a study, if you don’t eat enough foods containing iodine during this time, this can impair your child’s cognitive abilities and/or cause intellectual disability.

Iodine deficiency – what’s behind it?

But iodine deficiency can also be very unpleasant outside of pregnancy, as it contributes to hypothyroidism. It is accompanied by symptoms such as extreme fatigue, depressive moods and difficulty concentrating and also makes people more susceptible to thyroid diseases, according to the German Thyroid Center.

Iodine is naturally present in soils and seas. However, many soils, as well as the majority of arable land in Central Europe, are low in iodine. This is particularly true for regions and mountains far from the sea. While entire population groups used to suffer from iodine deficiency, this is now quite well under control – not least thanks to the use of iodized salt.

According to a study from 2017, around two billion people consume too little iodine every day. Germany is no longer one of the iodine deficient areas, albeit just barely – this is how the NCBI summarizes the WHO’s information.

How much iodine does the body need per day?

The German Society for Nutrition (DGE) recommends the following values:

• Infants: 40-80 micrograms of iodine per day

• Children: 100-200 micrograms of iodine per day

• Adults: 180-200 micrograms of iodine per day

• Pregnant and breastfeeding women: 230-260 micrograms of iodine per day

However, the actual iodine intake in adults is only around 125 micrograms daily, as the DEGS study commissioned by the Federal Ministry of Food and Agriculture showed.

How is iodine supply measured? The thyroid absorbs around 40 percent of the iodine supplied through food directly from the blood. The rest is excreted in the urine. The iodine content in the urine provides information about how much iodine the body has actually absorbed. Specifically, this is measured based on the creatinine it contains, a waste product of metabolism. In this way, an iodine deficiency can also be determined

First signs of iodine deficiency

The first signs of iodine deficiency are constant tiredness, dry skin and listlessness. However, since these symptoms are not very specific and are side effects of many diseases, an iodine deficiency is initially difficult to recognize.

However, if a goiter forms on the neck (technically goiter), this is a typical sign of iodine deficiency. This is an overgrowth of the thyroid gland that reacts to insufficient iodine intake with growth. To diagnose iodine deficiency, the neck is palpated because the thyroid gland is located just below the larynx.

If iodine deficiency persists, the thyroid gland becomes underactive (hypothyroidism), which is hardly noticeable at first. According to the German Thyroid Center, if there is a long-term lack of sufficient iodine supply, the following symptoms can occur:

• fatigue
• Lack of motivation
• Difficulty concentrating
• Sensitivity to cold
• cool and dry skin
• swollen eyelids
• pale, puffy skin
• rough to hotter voice (due to swollen vocal cords)
• slurred speech

Iodine deficiency is particularly dangerous during pregnancy and in infancy. The hormones T3 and T4, which are produced with the help of iodine, are important for brain development. Babies are therefore routinely checked for hypothyroidism, as early detection of the disease is crucial for further treatment. In the worst case, inadequate iodine supply leads to cretinism.

Iodine deficiency and cretinism

Cretinism is the most severe form of iodine deficiency. This is a congenital hypothyroidism – due to a lack of iodine intake during pregnancy. As a result, the child’s thyroid produces too little thyroxine, which is why the entire metabolism slows down. Symptoms include:

• Dwarfism
• obesity
• puffy face
• Speech disorders
• hearing loss
• thick tongue
• dry skin

However, according to DocCheck, this congenital iodine deficiency syndrome is very rare.

Prevent iodine deficiency – foods with lots of iodine

Since iodized salt has been used more and more frequently in recent decades, the iodine supply in Germany has improved enormously since the 1980s. The majority of all private households in Germany use iodized salt and it is also used in the catering industry.

However, conventional table salt is largely used in the food industry. If you have to pay attention to your iodine intake, you should use less ready meals and cook more yourself. Or consciously check the ingredients when buying – because if iodized salt was used in a product, this must be stated on the packaging.

Even though Germany is no longer an iodine deficiency area, there is still a tendency to consume too little iodine through food, according to the Federal Association of Food Inspectors in Germany. It’s easy to increase your iodine intake. The most important thing is to use iodized salt consistently. Iodized salt contains around 15 to 25 micrograms of iodine per gram of salt – making an iodine overdose from iodized salt practically impossible.

The following foods contain particularly high amounts of iodine:

• Haddock
• herring
• Pollock
• cod
• plaice
• tuna
• Seafood (lobster, shrimp, mussels)
• Meat and dairy products
• Algae (caution: risk of overdose)

In general, fish and seafood contain a lot of iodine. The problem with fish: The seas are already heavily overfished, the fishing methods are destructive and aquaculture is not particularly sustainable. More information about this: 5 arguments against fish.

You should be careful with algae because their iodine content can vary greatly and can sometimes be extremely high. Then there is a risk of an iodine overdose, which is also associated with health risks (e.g. iodine acne). The maximum amount of iodine in adults should not exceed 500 micrograms per day, according to the Federal Office for Risk Assessment (BfR).

Due to the addition of iodine in feed, most animal products now also contain iodine. However, the addition of iodine is not required by law, which means that farmers decide for themselves whether and how much iodine is added. Organic products tend to contain less iodine. Your iodine supply can vary greatly depending on which foods you buy and where.

Avoid fish: Iodine from plant foods

If you want to avoid fish, you can also use purely plant-based foods to prevent iodine deficiency. Although they contain less iodine than fish, they are still sources of iodine. Vebu recommends the following foods containing iodine as an alternative to fish:

• Mushrooms: 18 micrograms / 100 grams

• Broccoli: 15 micrograms / 100 grams

• Peanuts: 13 micrograms / 100 grams

• Spinach: 12 micrograms / 100 grams

• Pumpkin seeds: 12 micrograms / 100 grams

For comparison: Cod contains around 280 micrograms of iodine per 100 grams. If you want to avoid fish despite an iodine deficiency, you can also talk to your doctor about the option of iodine tablets. This is particularly recommended for pregnant and breastfeeding people. Further valuable information: Iodine: the trace element for the thyroid.

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Edited by Freya Petersen

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