Iodine deficiency – an important topic in Germany, among other things, due to iodine-poor arable soils. With the appropriate measures, iodine deficiency and associated physical complaints can usually be prevented at an early stage.
What is iodine deficiency?
The physician examines the thyroid glands, especially if iodine deficiency is prevalent. Iodine deficiency is an undersupply of iodine to the body. To avoid iodine deficiency, sufficient intake of iodine through food is necessary, because iodine cannot be produced independently in the body. If there is an iodine deficiency, this has a negative effect on various thyroid hormones, among other things. The latter are responsible, for example, for intact metabolic processes. Thus, a loss of energy, frequent freezing and also concentration difficulties can be associated with an existing iodine deficiency. One speaks of an iodine deficiency when the iodine supply is below a recommended minimum amount. The German Nutrition Society (DGE), for example, recommends a daily intake of about 200 micrograms of iodine for male and female adults. Children require a lower dose according to their size and age.
Causes
The cause of iodine deficiency is usually due to the supply of foods that have insufficient iodine fortification. Iodine deficiency caused in this way can be due to geographical factors, among others: for example, according to the German Society for Nutrition, large parts of Germany are iodine-deficient areas. In southern Germany, an iodine deficiency in the diet is more apparent than in northern Germany – this is due, among other things, to the increasing distance from the sea: Frequently, arable soils in Germany are not sufficiently enriched with iodine, which can promote iodine deficiency – even if cultivated foods are consumed that are in principle rich in iodine. Furthermore, southern areas of Germany also tend to consume less seafood and saltwater fish, which are high in iodine.
Symptoms, complaints and signs
Iodine deficiency can lead to many symptoms. First, too little thyroid hormone is produced, and hypothyroidism develops with fatigue, listlessness, sensitivity to cold, difficulty concentrating, and increased need for sleep. The most common symptom of a prolonged iodine deficiency is enlargement of the thyroid gland in the form of goiter. The thyroid gland tries to compensate for the iodine deficiency by producing more hormone-forming thyroid tissue. Therefore, normal thyroid function may well be present in a goiter. However, the goiter often grows unevenly and forms nodules that can turn into both autonomous adenomas and, less commonly, carcinomas. If autonomous adenomas exist, normal iodine supply suddenly results in hyperthyroidism with increased basal metabolic rate, nervousness, palpitations, and diarrhea. Permanent hypothyroidism due to iodine deficiency restricts mental development and often leads to obesity due to low basal metabolic rate. Iodine deficiency during pregnancy is particularly dangerous. This has serious effects on the development of the fetus. Miscarriages often occur. Newborns in iodine-deficient areas often suffer not only from goiter with breathing and swallowing difficulties, but also from a reduction in the development of intelligence. If the iodine deficiency is not corrected in time, so-called cretinism occurs with complete mental retardation, growth disorders and obesity. Even with a milder iodine deficiency during pregnancy, children often suffer from psychomotor development disorders and learning disabilities.
Diagnosis and course
If symptoms such as lack of energy or chronic fatigue are present that may indicate iodine deficiency, the suspicion of iodine deficiency can be confirmed by a blood test, among other tests. However, iodine deficiency can also lead to sequelae that are accompanied by visible symptoms. Such symptoms can also lead to a suspected diagnosis of iodine deficiency. Corresponding symptoms are, for example, enlargements of the thyroid gland; in this context, one also speaks of the development of a so-called goiter (a formation of a goiter due to iodine deficiency). A longstanding iodine deficiency can be indicated by altered thyroid tissue or the formation of nodules on the thyroid gland.Enlargement of the thyroid gland due to iodine deficiency may also cause discomfort in swallowing and breathing as it progresses.
Complications
In most cases, iodine deficiency can be relatively well prevented or directly treated, so that there are no particular symptoms or complications. However, if iodine deficiency does occur, those affected will suffer from severe fatigue and also reduced exercise tolerance. Likewise, the patient’s thyroid gland can become greatly enlarged due to the lack of iodine. The symptoms of the thyroid gland can also lead to difficulty swallowing or breathing and generally reduce the patient’s quality of life. Without treatment, iodine deficiency has a very negative effect on the general condition of the patient and can lead to severe complications or other ailments. The treatment usually proceeds without any particular complications. The iodine deficiency can be controlled and limited with the help of suitable food or dietary supplements. Furthermore, with early and successful treatment, there is no reduction in life expectancy. However, the affected person is dependent on a healthy diet and may need to be examined regularly to prevent the recurrence of these symptoms. In older people, surgical intervention may also be necessary to remove a possible goiter.
When should you see a doctor?
People who suffer from persistent fatigue and exhaustion should see a doctor for a checkup. If there is a lack of drive, an increased need for sleep, or very rapid drowsiness despite adequate nighttime sleep, a visit to the doctor is recommended. If the affected person suffers from a disturbance of his concentration as well as his attention, if his performance level drops prematurely or if the motor function slows down a few hours after the start of the day, a check-up visit to a doctor should be made. If the sensation of cold is unusually strong compared to fellow men, if the affected person has a pale appearance or if there are hormonal disturbances, a doctor should be consulted. In case of menstrual irregularities, it is advisable for the affected woman to consult a doctor. If a raspy or hoarse voice sets in or if the eyelids are always swollen, these warning signs of the body should be examined more closely by a doctor. Swelling of the thyroid gland, difficulty swallowing or breathing disorders should also be evaluated by a physician. If a pregnant woman suffers from the symptoms described, a doctor should be consulted as soon as possible. Iodine deficiency leads to increased miscarriages or stillbirths, which can only be prevented by adequate medical care. In addition, children show developmental disorders later in life due to iodine deficiency during pregnancy.
Treatment and therapy
If a patient has an iodine deficiency that cannot be compensated by his or her food intake, there is the possibility of taking in additional iodine via so-called dietary supplements or medicines. If secondary diseases have already developed as a result of the iodine deficiency, treatment may also be necessary that goes beyond remedying the iodine deficiency:
For example, to treat a goiter caused by iodine deficiency, thyroid hormones can be administered by medication. These drugs are often supplemented with iodine. The aim of this therapy is to reduce or eliminate the iodine-deficiency goiter. Thyroid hormones are also frequently used to treat hypothyroidism due to iodine deficiency; the amount of thyroid hormone appropriate for an individual patient can be determined based on hormone blood levels. If iodine deficiency has led to the formation of a very large goiter, drug treatment is not always a sufficient measure; the consequences of iodine deficiency must occasionally be combated here by surgical measures. Such surgical intervention may be necessary, especially in the elderly.
Outlook and prognosis
The prognosis for iodine deficiency is usually favorable. The disorder can be well treated by medical measures but also by various self-help options. Without an adequate supply, the existing symptoms will persist and, in many people, will have an increasing character in the course of life.The quality of life is limited in these cases, but is not a serious condition. In the case of iodine deficiency, the affected person can do much to maintain his or her health by regulating his or her diet. With an increase in the consumption of products containing particularly high levels of iodine, any deficiency that has occurred can be regulated. The existing complaints are reduced or completely alleviated. With these concerning a complaint liberty occurs. In the case of a severe iodine deficiency, medical support should be sought to ensure a good prognosis. This will ensure an adequate supply of iodine based on individual readings. Iodine deficiency in pregnant women can lead to problems of the offspring. In this case, sufficient and timely medical care is imperative in order to avoid disturbances of intelligence or growth restriction. In order to achieve a good prognosis for the offspring, the pregnant woman must be supplied with a sufficient amount of iodine. Otherwise, lifelong impairments of the child are to be expected.
Prevention
Effective prevention of iodine deficiency is primarily through an adequate iodine-containing diet. Foods particularly rich in iodine include seafood and fish. However, iodine is also found proportionately in mushrooms, broccoli or peanuts. To prevent iodine deficiency, the use of iodine-containing salt in the kitchen is also recommended. In addition to food, so-called iodide tablets, for example, can also prevent iodine deficiency; however, this option is best discussed in advance with a medical professional.
Aftercare
The purpose of follow-up care is to prevent recurrence of the disease. After an initial diagnosis, this is best accomplished through an appropriate diet. Fish, seafood, peanuts and mushrooms, for example, can meet the body’s natural iodine requirements. The physician informs his patients about this during the initial diagnosis. The person concerned is responsible for the implementation of food consumption. Only pregnant women and other risk groups sometimes require further examinations. Suitable methods for determining a deficiency are blood analysis and ultrasound imaging. The above measures are usually quite sufficient to prevent complications. If the risk potential increases, physicians may prescribe dietary supplements and iodine-containing tablets. Follow-up care for iodine deficiency is not aimed at permanent medication. Rather, recurrent occurrence points to permanent hypothyroidism. Surgical intervention then becomes inevitable. Iodine deficiency is thus countered by patients through a balanced diet. The medical follow-up provides information and advice for this, which every patient can implement in his or her everyday life. Further scheduled examinations are not planned. High-risk groups, on the other hand, are called in additional times. Clear statements can be made about the progress of the disease via the thyroid gland. Iodine-containing medications also provide freedom from symptoms in everyday life.
What you can do yourself
Iodine is not produced by the body and must be supplied to the organism from the outside. A balanced diet is sufficient for optimal iodine supply. Walks in iodine-rich sea air supplement nutrient intake and replenish iodine reserves. The use of iodized table salt prevents deficiency symptoms, as does regular consumption of sea fish. However, an iodine deficiency that occurs cannot be compensated for by dietary intake alone. The pharmaceutical industry offers preparations to eliminate an iodine deficiency. In contrast to natural intake, iodine from fortified products can lead to overdose. It is essential to adhere to the recommended intake of the trace element, as regularly exceeding the daily maximum amount triggers thyroid dysfunction. If an iodine deficiency is accompanied by a low blood iron level, the iodine cannot be fully absorbed by the body. In the case of an unbalanced diet or in a phase of increased demand, a preparation with a sensible combination of minerals and trace elements is suitable.
