Skip to main content
SpringerLink
Log in

Iodine Deficiency from Pregnancy to Childhood

  • Chapter
Thyroid Diseases in Childhood

  • 941 Accesses

Abstract

Iodine is a micronutrient essential for mammalian life because it is critical for the synthesis of thyroid hormones, thyroxine (T4), and triiodothyronine (T3), which contain in their molecules four and three atoms of iodine, respectively. Thyroid hormones (TH) are important for the growth and development of different tissues, especially the central nervous system and the skeleton, for the cardiac and gastrointestinal function, and for the regulation of the energy homeostasis throughout life. Disturbances in TH availability during early embryonic development, as in maternal iodine deficiency, cause severe neurological abnormalities in the newborns [1]. The World Health Organization (WHO) considers iodine deficiency to be “the single most important preventable cause of brain damage” worldwide [2]. Despite the great improvements in global iodine nutrition in the last century, it is currently estimated that iodine deficiency still affects 241 million school-aged children [3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. de Escobar GM, Obregon MJ, del Rey FE (2004) Maternal thyroid hormones early in pregnancy and fetal brain development. Best Pract Res Clin Endocrinol Metab 18:225–248

    Article  PubMed  Google Scholar 

  2. WHO UI (2007) Assessment of iodine deficiency disorders and monitoring their elimination, 3rd edn. World Health Organization, Geneva

    Google Scholar 

  3. Andersson M, Karumbunathan V, Zimmermann MB (2012) Global iodine status in 2011 and trends over the past decade. J Nutr 142:744–750

    Article  CAS  PubMed  Google Scholar 

  4. Alexander WD, Harden RM, Harrison MT, Shimmins J (1967) Some aspects of the absorption and concentration of iodide by the alimentary tract in man. Proc Nutr Soc 26:62–66

    Article  CAS  PubMed  Google Scholar 

  5. Fisher DA, Oddie TH (1969) Thyroid iodine content and turnover in euthyroid subjects: validity of estimation of thyroid iodine accumulation from short-term clearance studies. J Clin Endocrinol Metab 29:721–727

    Article  CAS  PubMed  Google Scholar 

  6. De La Vieja A, Dohan O, Levy O, Carrasco N (2000) Molecular analysis of the sodium/iodide symporter: impact on thyroid and extrathyroid pathophysiology. Physiol Rev 80:1083–1105

    Google Scholar 

  7. Glinoer D (2004) The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status. Best Pract Res Clin Endocrinol Metab 18:133–152

    Article  CAS  PubMed  Google Scholar 

  8. Institute of Medicine AoS (2001) Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc. National Academy Press, Washington, DC

    Google Scholar 

  9. Aghini-Lombardi F, Antonangeli L, Pinchera A, Leoli F, Rago T, Bartolomei AM, Vitti P (1997) Effect of iodized salt on thyroid volume of children living in an area previously characterized by moderate iodine deficiency. J Clin Endocrinol Metab 82:1136–1139

    CAS  PubMed  Google Scholar 

  10. International Council for Control of Iodine Deficiency disorders (2008) UNICEF REPORT 2008. In IDD Newsletter 30(4):1–20

    Google Scholar 

  11. Andersson M, Takkouche B, Egli I, Allen HE, de Benoist B (2005) Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. Bull World Health Organ 83:518–525

    PubMed Central  PubMed  Google Scholar 

  12. Delange F (2007) Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition. Public Health Nutr 10:1571–1580; discussion 1581–1583

    Article  PubMed  Google Scholar 

  13. Becker DV, Braverman LE, Delange F, Dunn JT, Franklyn JA, Hollowell JG, Lamm SH, Mitchell ML, Pearce E, Robbins J, Rovet JF (2006) Iodine supplementation for pregnancy and lactation-United States and Canada: recommendations of the American Thyroid Association. Thyroid 16:949–951

    Article  CAS  PubMed  Google Scholar 

  14. WHO Secretariat, Andersson M, de Benoist B, Delange F, Zupan J (2007) Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation. Public Health Nutr 10(12A):1606–1611

    Article  Google Scholar 

  15. Zimmermann MB, Aeberli I, Torresani T, Burgi H (2005) Increasing the iodine concentration in the Swiss iodized salt program markedly improved iodine status in pregnant women and children: a 5-y prospective national study. Am J Clin Nutr 82:388–392

    CAS  PubMed  Google Scholar 

  16. Zimmermann MB, Aeberli I, Andersson M, Assey V, Yorg JA, Jooste P, Jukic T, Kartono D, Kusic Z, Pretell E, San Luis TO Jr, Untoro J, Timmer A (2013) Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100–299 mug/L: a UNICEF/ICCIDD study group report. J Clin Endocrinol Metab 98:1271–1280

    Article  CAS  PubMed  Google Scholar 

  17. Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Carle A, Pedersen IB, Rasmussen LB, Ovesen L, Jorgensen T (2009) Thyroglobulin as a marker of iodine nutrition status in the general population. Eur J Endocrinol 161:475–481

    Article  CAS  PubMed  Google Scholar 

  18. Zimmermann MB, Jooste PL, Pandav CS (2008) Iodine-deficiency disorders. Lancet 372:1251–1262

    Article  CAS  PubMed  Google Scholar 

  19. Zimmermann MB, Wegmuller R, Zeder C, Chaouki N, Torresani T (2004) The effects of vitamin A deficiency and vitamin A supplementation on thyroid function in goitrous children. J Clin Endocrinol Metab 89:5441–5447

    Article  CAS  PubMed  Google Scholar 

  20. Bernal J (2007) Thyroid hormone receptors in brain development and function. Nat Clin Pract Endocrinol Metab 3:249–259

    Article  CAS  PubMed  Google Scholar 

  21. Zoeller RT, Rovet J (2004) Timing of thyroid hormone action in the developing brain: clinical observations and experimental findings. J Neuroendocrinol 16:809–818

    Article  CAS  PubMed  Google Scholar 

  22. Obregon MJ, Calvo RM, Del Rey FE, de Escobar GM (2007) Ontogenesis of thyroid function and interactions with maternal function. Endocr Dev 10:86–98

    Article  CAS  PubMed  Google Scholar 

  23. Auso E, Lavado-Autric R, Cuevas E, Del Rey FE, Morreale De Escobar G, Berbel P (2004) A moderate and transient deficiency of maternal thyroid function at the beginning of fetal neocorticogenesis alters neuronal migration. Endocrinology 145:4037–4047

    Article  CAS  PubMed  Google Scholar 

  24. Cuevas E, Auso E, Telefont M, Morreale de Escobar G, Sotelo C, Berbel P (2005) Transient maternal hypothyroxinemia at onset of corticogenesis alters tangential migration of medial ganglionic eminence-derived neurons. Eur J Neurosci 22:541–551

    Article  PubMed  Google Scholar 

  25. Bernal J, Guadano-Ferraz A, Morte B (2003) Perspectives in the study of thyroid hormone action on brain development and function. Thyroid 13:1005–1012

    Article  CAS  PubMed  Google Scholar 

  26. McCarrison R (1909) Observations on endemic cretinism in the chitral and gilgit valleys. Proc R Soc Med 2:1–36

    CAS  PubMed Central  PubMed  Google Scholar 

  27. Boyages SC, Halpern JP, Maberly GF, Eastman CJ, Morris J, Collins J, Jupp JJ, Jin CE, Wang ZH, You CY (1988) A comparative study of neurological and myxedematous endemic cretinism in western China. J Clin Endocrinol Metab 67:1262–1271

    Article  CAS  PubMed  Google Scholar 

  28. Zimmermann MB, Kohrle J (2002) The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid 12:867–878

    Article  CAS  PubMed  Google Scholar 

  29. Cao XY, Jiang XM, Dou ZH, Rakeman MA, Zhang ML, O'Donnell K, Ma T, Amette K, DeLong N, DeLong GR (1994) Timing of vulnerability of the brain to iodine deficiency in endemic cretinism. N Engl J Med 331:1739–1744

    Article  CAS  PubMed  Google Scholar 

  30. Pharoah PO, Connolly KJ (1987) A controlled trial of iodinated oil for the prevention of endemic cretinism: a long-term follow-up. Int J Epidemiol 16:68–73

    Article  CAS  PubMed  Google Scholar 

  31. Qian M, Wang D, Watkins WE, Gebski V, Yan YQ, Li M, Chen ZP (2005) The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pac J Clin Nutr 14:32–42

    CAS  PubMed  Google Scholar 

  32. Lazarus JH (2014) Iodine status in Europe in 2014. Eur Thyroid J 3:3–6

    Article  PubMed Central  PubMed  Google Scholar 

  33. Aghini Lombardi FA, Pinchera A, Antonangeli L, Rago T, Chiovato L, Bargagna S, Bertucelli B, Ferretti G, Sbrana B, Marcheschi M et al (1995) Mild iodine deficiency during fetal/neonatal life and neuropsychological impairment in Tuscany. J Endocrinol Invest 18:57–62

    Article  CAS  PubMed  Google Scholar 

  34. Vermiglio F, Sidoti M, Finocchiaro MD, Battiato S, Lo Presti VP, Benvenga S, Trimarchi F (1990) Defective neuromotor and cognitive ability in iodine-deficient schoolchildren of an endemic goiter region in Sicily. J Clin Endocrinol Metab 70:379–384

    Article  CAS  PubMed  Google Scholar 

  35. Zimmermann MB (2007) The adverse effects of mild-to-moderate iodine deficiency during pregnancy and childhood: a review. Thyroid 17:829–835

    Article  CAS  PubMed  Google Scholar 

  36. Romano R, Jannini EA, Pepe M, Grimaldi A, Olivieri M, Spennati P, Cappa F, D'Armiento M (1991) The effects of iodoprophylaxis on thyroid size during pregnancy. Am J Obstet Gynecol 164:482–485

    Article  CAS  PubMed  Google Scholar 

  37. Antonangeli L, Maccherini D, Cavaliere R, Di Giulio C, Reinhardt B, Pinchera A, Aghini-Lombardi F (2002) Comparison of two different doses of iodide in the prevention of gestational goiter in marginal iodine deficiency: a longitudinal study. Eur J Endocrinol 147:29–34

    Article  CAS  PubMed  Google Scholar 

  38. Soriguer F, Millon MC, Munoz R, Mancha I, Lopez Siguero JP, Martinez Aedo MJ, Gomez-Huelga R, Garriga MJ, Rojo-Martinez G, Esteva I, Tinahones FJ (2000) The auditory threshold in a school-age population is related to iodine intake and thyroid function. Thyroid 10:991–999

    Article  CAS  PubMed  Google Scholar 

  39. Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, O'Heir CE, Mitchell ML, Hermos RJ, Waisbren SE, Faix JD, Klein RZ (1999) Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 341:549–555

    Article  CAS  PubMed  Google Scholar 

  40. Pop VJ, Kuijpens JL, van Baar AL, Verkerk G, van Son MM, de Vijlder JJ, Vulsma T, Wiersinga WM, Drexhage HA, Vader HL (1999) Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clin Endocrinol (Oxf) 50:149–155

    Article  CAS  Google Scholar 

  41. Lavado-Autric R, Auso E, Garcia-Velasco JV, Arufe Mdel C, Escobar del Rey F, Berbel P, Morreale de Escobar G (2003) Early maternal hypothyroxinemia alters histogenesis and cerebral cortex cytoarchitecture of the progeny. J Clin Invest 111:1073–1082

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Berbel P, Mestre JL, Santamaria A, Palazon I, Franco A, Graells M, Gonzalez-Torga A, de Escobar GM (2009) Delayed neurobehavioral development in children born to pregnant women with mild hypothyroxinemia during the first month of gestation: the importance of early iodine supplementation. Thyroid 19:511–519

    Article  CAS  PubMed  Google Scholar 

  43. Velasco I, Carreira M, Santiago P, Muela JA, Garcia-Fuentes E, Sanchez-Munoz B, Garriga MJ, Gonzalez-Fernandez MC, Rodriguez A, Caballero FF, Machado A, Gonzalez-Romero S, Anarte MT, Soriguer F (2009) Effect of iodine prophylaxis during pregnancy on neurocognitive development of children during the first two years of life. J Clin Endocrinol Metab 94:3234–3241

    Article  CAS  PubMed  Google Scholar 

  44. Henrichs J, Bongers-Schokking JJ, Schenk JJ, Ghassabian A, Schmidt HG, Visser TJ, Hooijkaas H, de Muinck Keizer-Schrama SM, Hofman A, Jaddoe VV, Visser W, Steegers EA, Verhulst FC, de Rijke YB, Tiemeier H (2010) Maternal thyroid function during early pregnancy and cognitive functioning in early childhood: the generation R study. J Clin Endocrinol Metab 95:4227–4234

    Article  CAS  PubMed  Google Scholar 

  45. Chaouki ML, Benmiloud M (1994) Prevention of iodine deficiency disorders by oral administration of lipiodol during pregnancy. Eur J Endocrinol 130:547–551

    Article  CAS  PubMed  Google Scholar 

  46. Thilly C, Swennen B, Moreno-Reyes R et al (1994) Maternal, fetal and juvenile hypothyroidism, birthweight and infant mortality in the etiopathogenesis of the IDD spectrum in Zaire and Malawi. In: The damaged brain of iodine deficiency. Cognizant Communication Corporation, New York

    Google Scholar 

  47. DeLong GR, Leslie PW, Wang SH, Jiang XM, Zhang ML, Rakeman M, Jiang JY, Ma T, Cao XY (1997) Effect on infant mortality of iodination of irrigation water in a severely iodine-deficient area of China. Lancet 350:771–773

    Article  CAS  PubMed  Google Scholar 

  48. Bleichrodt N, Born M (1994) A metaanalysis of research on iodine and its relationship to cognitive development. In: The damaged brain of iodine deficiency. Cognizant Communication Corporation, New York, p 195

    Google Scholar 

  49. Bath SC, Steer CD, Golding J, Emmett P, Rayman MP (2013) Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: results from the Avon Longitudinal Study of Parents and Children (ALSPAC). Lancet 382:331–337

    Article  CAS  PubMed  Google Scholar 

  50. Santiago-Fernandez P, Torres-Barahona R, Muela-Martinez JA, Rojo-Martinez G, Garcia-Fuentes E, Garriga MJ, Leon AG, Soriguer F (2004) Intelligence quotient and iodine intake: a cross-sectional study in children. J Clin Endocrinol Metab 89:3851–3857

    Article  CAS  PubMed  Google Scholar 

  51. Hynes KL, Otahal P, Hay I, Burgess JR (2013) Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort. J Clin Endocrinol Metab 98:1954–1962

    Article  CAS  PubMed  Google Scholar 

  52. van den Briel T, West CE, Bleichrodt N, van de Vijver FJ, Ategbo EA, Hautvast JG (2000) Improved iodine status is associated with improved mental performance of schoolchildren in Benin. Am J Clin Nutr 72:1179–1185

    PubMed  Google Scholar 

  53. Zimmermann MB, Connolly K, Bozo M, Bridson J, Rohner F, Grimci L (2006) Iodine supplementation improves cognition in iodine-deficient schoolchildren in Albania: a randomized, controlled, double-blind study. Am J Clin Nutr 83:108–114

    CAS  PubMed  Google Scholar 

  54. Crew MD, Spindler SR (1986) Thyroid hormone regulation of the transfected rat growth hormone promoter. J Biol Chem 261:5018–5022

    CAS  PubMed  Google Scholar 

  55. Hochberg Z, Bick T, Harel Z (1990) Alterations of human growth hormone binding by rat liver membranes during hypo- and hyperthyroidism. Endocrinology 126:325–329

    Article  CAS  PubMed  Google Scholar 

  56. Miell JP, Zini M, Quin JD, Jones J, Portioli I, Valcavi R (1994) Reversible effects of cessation and recommencement of thyroxine treatment on insulin-like growth factors (IGFs) and IGF-binding proteins in patients with total thyroidectomy. J Clin Endocrinol Metab 79:1507–1512

    CAS  PubMed  Google Scholar 

  57. Iglesias P, Bayon C, Mendez J, Gancedo PG, Grande C, Diez JJ (2001) Serum insulin-like growth factor type 1, insulin-like growth factor-binding protein-1, and insulin-like growth factor-binding protein-3 concentrations in patients with thyroid dysfunction. Thyroid 11:1043–1048

    Article  CAS  PubMed  Google Scholar 

  58. Zimmermann MB, Jooste PL, Mabapa NS, Mbhenyane X, Schoeman S, Biebinger R, Chaouki N, Bozo M, Grimci L, Bridson J (2007) Treatment of iodine deficiency in school-age children increases insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations and improves somatic growth. J Clin Endocrinol Metab 92:437–442

    Article  CAS  PubMed  Google Scholar 

  59. Biondi B, Cooper DS (2008) The clinical significance of subclinical thyroid dysfunction. Endocr Rev 29:76–131

    Article  CAS  PubMed  Google Scholar 

  60. Zimmermann MB, Aeberli I, Melse-Boonstra A, Grimci L, Bridson J, Chaouki N, Mbhenyane X, Jooste PL (2009) Iodine treatment in children with subclinical hypothyroidism due to chronic iodine deficiency decreases thyrotropin and C-peptide concentrations and improves the lipid profile. Thyroid 19:1099–1104

    Article  CAS  PubMed  Google Scholar 

  61. Benmiloud M, Chaouki ML, Gutekunst R, Teichert HM, Wood WG, Dunn JT (1994) Oral iodized oil for correcting iodine deficiency: optimal dosing and outcome indicator selection. J Clin Endocrinol Metab 79:20–24

    CAS  PubMed  Google Scholar 

  62. Weng HX, Yan AL, Hong CL, Xie LL, Qin YC, Cheng CQ (2008) Uptake of different species of iodine by water spinach and its effect to growth. Biol Trace Elem Res 124:184–194

    Article  CAS  PubMed  Google Scholar 

  63. Tonacchera M, Dimida A, De Servi M, Frigeri M, Ferrarini E, De Marco G, Grasso L, Agretti P, Piaggi P, Aghini-Lombardi F, Perata P, Pinchera A, Vitti P (2013) Iodine fortification of vegetables improves human iodine nutrition: in vivo evidence for a new model of iodine prophylaxis. J Clin Endocrinol Metab 98:E694–E697

    Article  CAS  PubMed  Google Scholar 

  64. Sullivan KM, Perrine CG, Pearce EN, Caldwell KL (2013) Monitoring the iodine status of pregnant women in the United States. Thyroid 23:520–521

    Article  CAS  PubMed  Google Scholar 

  65. Martins MC, Lima N, Knobel M, Medeiros-Neto G (1989) Natural course of iodine-induced thyrotoxicosis (Jodbasedow) in endemic goiter area: a 5 year follow-up. J Endocrinol Invest 12:239–244

    Article  CAS  PubMed  Google Scholar 

  66. Pedersen IB, Laurberg P, Knudsen N, Jorgensen T, Perrild H, Ovesen L, Rasmussen LB (2007) An increased incidence of overt hypothyroidism after iodine fortification of salt in Denmark: a prospective population study. J Clin Endocrinol Metab 92:3122–3127

    Article  CAS  PubMed  Google Scholar 

  67. Wolff J, Chaikoff IL (1948) Plasma inorganic iodide as a homeostatic regulator of thyroid function. J Biol Chem 174:555–564

    CAS  PubMed  Google Scholar 

  68. HaCPD-GSCoF EC (2002) Opinion of the Scientific Committee on Food on the tolerable upper level of intake of iodine. European Commission, Brussels

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Endocrinology Unit, University Hospital, University of Pisa, Pisa, Italy

    Caterina Di Cosmo & Massimo Tonacchera

  2. Department of Clinical and Experimental Medicine, Endocrinology Unit, University Hospital, University of Pisa, Via Paradisa 2, Pisa, 56124, Italy

    Paolo Vitti

Authors
  1. Caterina Di Cosmo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Massimo Tonacchera
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paolo Vitti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Vitti .

Editor information

Editors and Affiliations

  1. Novara, Italy

    Gianni Bona

  2. Messina, Italy

    Filippo De Luca

  3. Division of Pediatrics, Piedemonte Hospital, Novara, Italy

    Alice Monzani

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Di Cosmo, C., Tonacchera, M., Vitti, P. (2015). Iodine Deficiency from Pregnancy to Childhood. In: Bona, G., De Luca, F., Monzani, A. (eds) Thyroid Diseases in Childhood. Springer, Cham. https://doi.org/10.1007/978-3-319-19213-0_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-19213-0_13

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19212-3

  • Online ISBN: 978-3-319-19213-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation