Iodine deficiency during pregnancy

A diagnosis of iodine deficiency is confirmed upon urine tests. However, it can primarily be noted when the body starts showing symptoms of low thyroid or hypothyroid. These symptoms include:

• Weight gain
• Feeling cold even in normal temperature (read more: cold intolerance)
• Malaise
• Hair loss
• Swelling in the neck
• Depression
• Difficulty in remembering things (read more: Brain fog: causes, symptoms)

The World Health Organization and UNICEF recommend that pregnant and lactating women get iodine supplements in countries where fewer than one in five residents have access to iodised salt.

While India has a robust programme to make iodized table salt available to everyone, a rising trend towards using rock salt or pink salt or other alternatives that are not iodized could create problems.

If you are pregnant and using alternative salts, make sure to inform your doctor about this and ask whether you need iodine supplements. Remember, the iodine you eat during pregnancy and breastfeeding gets shared with the baby. And the baby needs it for proper brain development.

Dietary iodine is an essential micronutrient. It keeps the thyroid gland healthy by helping regulate the production of hormones. It is these hormones that are responsible for heart health and metabolism, among other things. (Read more: What is metabolism and how to boost metabolism)

Studies have also shown that iodine supplements could help in the treatment of fibrocystic breast disease, which is a common condition in women of reproductive age. It causes non-cancerous, painful lumps in the breasts.

Pregnant women are very prone to becoming iodine deficient. This is due to the increase in the requirement of iodine. Not only do they need enough iodine to meet their own daily needs but also those of their baby’s. The US National Institutes of Health (NIH) recommends 220 mcg (micrograms) to meet the daily requirement in pregnant women. This supply is met from the diet or through supplemental iodine.

One of the reasons for an increased demand of iodine during pregnancy is the higher levels of estrogen circulation. This is because it ultimately results in increased maternal renal iodine excretion. Until 20 weeks after conception, the fetus is fully dependent on maternal thyroid hormones/ iodine supply.
Iodine plays a very important role in fetal neurodevelopment. A study has also found that iodine deficiency in the mother during pregnancy could result in intellectual delays as well as lower IQ in the offspring.

Furthermore, a study also showed women with sufficient iodine had a decreased rate of preeclampsia which is a pregnancy complication that causes damage to liver or kidneys. Sufficient iodine is also likely to reduce the chances of stillbirth or premature birth.

An inadequacy of iodine can have significant adverse effects both in the women and their offspring. A severe deficiency also increases the risk of stillbirth.

Iodine deficiency after birth

In infants, adequate iodine is linked to a reduced risk of microcephaly which is a condition wherein the newborn’s head is much smaller than expected. Since these are critical periods of brain development, a shortage of iodine at any point could result in irreversible brain damage which could further lead to neurological inabilities.

Along with foetal brain development, iodine is crucial to improve a child’s birth weight. Severe cases result in hyperthyroxinemia, that is, higher levels of thyroxine (a thyroid hormone) than expected.

Around 4-10% of iodine-deficient women give birth to children with cretinism which is a condition characterized by various complications such as sparse hair, sexual retardation, dwarfism, squint and neurocognitive delays.

Moreover, studies have found that a sufficient supply of iodine is associated with a significant reduction of neonatal as well as infant mortality.

Iodine deficiency is common worldwide. It is a good idea to ask your doctor about iodine supplements when you’re pregnant, even more so if the prenatal vitamin prescribed to you doesn’t have iodine. (Read more: Vitamins and minerals you need during pregnancy)

To diagnose iodine deficiency, your doctor will recommend a urine test. Median urinary iodine concentration below 150 mcg/L during pregnancy indicates iodine deficiency, according to the WHO, UNICEF and International Council for Control of Iodine Deficiency Disorders. Urinary iodine concentration below 100 mcg/L while nursing indicates iodine deficiency.

Iodine intake needs to be continually monitored, at least up until you are breastfeeding the infant. The recommended daily amount of iodine during pregnancy is 200-250 mcg (it should not exceed 500 mcg a day). It goes up to 290 mcg per day while nursing. Children under two years of age need 90-180 mcg of iodine a day.

Good dietary sources of iodine include eggs, yoghurt and seaweed. Further, iodine fortified salt is available almost everywhere. Taking care of your iodine levels can go a long way in ensuring a safe pregnancy. (Read more: Is it safe to eat fish during pregnancy?)