What happens if iodine is missing?

Iodine deficiency leads to various diseases of the thyroid gland and can cause serious health problems due to the important role of the thyroid gland in various bodily functions. Most frequently, iodine deficiency leads to an enlargement of the thyroid gland and thus to a swelling of the neck, which is called goiter or medically known as goiter. This can lead to necklaces and garments on the collar becoming too tight.

Furthermore, swallowing difficulties and in extreme cases even such an obstruction of breathing can occur when the growing thyroid gland tissue presses on the windpipe. This can lead to an even growth but also to the formation of single or multiple nodes on the neck. Another disease caused by insufficient iodine supply is thyroid autonomy.

This leads to an uncontrolled production of thyroid hormones and thus to hyperactivity.This hyperactivity can manifest itself through various symptoms such as inner restlessness, increased sweating, heat intolerance, trembling and diarrhoea. Particularly in older people, it can lead to heart problems and increased bone loss. Often, however, the hormone production of the autonomous thyroid gland tissue is not sufficient to lead to hyperactivity.

One speaks of a compensated autonomy and the disease can remain undiscovered for a long time. The risk of thyroid cancer is also increased with iodine deficiency. Iodine deficiency has particularly serious consequences in the development of newborns and infants. The physical and mental development can be impaired, in extreme cases with reduced intelligence, diminished growth and deafness. Fortunately, this aberration, known as cretinism, has become very rare in Germany today due to the examination of newborns for thyroid diseases and iodine prophylaxis in the diet.

How can iodine be measured in the body?

A direct measurement of iodine in the body is usually not performed. Only in large population studies on the supply of iodine is the iodine excretion in the urine measured in order to enable conclusions to be drawn about iodine uptake. Since too low or too high iodine levels almost exclusively affect the thyroid gland, it is easier and more meaningful to examine its function and structure.

If a physician suspects that symptoms and abnormalities expressed by a patient during physical examination could be caused by a malfunction of the thyroid gland, a thyroid-specific laboratory value called “TSH” is first determined. This value can be used to assess whether the thyroid gland is functioning normally. If this is not the case, a further determination can be made, for example of thyroid hormones or thyroid antibodies.

If thyroid disease is suspected, an assessment of thyroid size and structure is routinely performed using ultrasound. An enlarged thyroid gland as a sign of iodine deficiency can thus be detected early and treated with iodine tablets, for example, if necessary. In addition, ultrasound can also detect thyroid nodules that are often not noticeable during palpation.

Whether these are benign or malignant and whether a therapy should be carried out can be determined by further special examinations if necessary. In contrast to iodine deficiency, an excess is rather rare. In any case, iodine almost exclusively affects the thyroid gland, which has various mechanisms to protect itself in the event of an excess supply of iodine.

For these reasons, iodine does not need to be neutralized in the human body. Iodine is rather an important trace element which the body needs to maintain many functions. There are various regulatory mechanisms by which the body counteracts a deficiency or excess, for example through the absorption of iodine from food in the intestines or through excretion via the kidneys into the urine.

An excess of iodine often only occurs during a CT examination using a contrast medium containing iodine. However, treatment of an iodine excess is only necessary if there has been a previously unnoticed thyroid disease, which is caused by the large amount of iodine in the body. But even in this case, iodine is not directly neutralized, but the use of drugs slows down hormone production and thus treats the effects of the excess.