Iodine supplementation during

INFLUENCE OF IODINE SUPPLEMENTATION DURING PREGNANCY AND LACTATION ON THYROID SIZE IN WOMEN. 

To evaluate if iodine supplementation during pregnant and lactation induced measurable effects on the thyroid a prospective randomized study was performed in the Randers area (9). Normal pregnant women (n=54) received +/- 200 Mg iodine supplementation per day from week 18 of pregnancy until 12 months after delivery. Thyroid volume was measured by sonography. 

Deficiency of iodine, a component of thyroid hormones, may result in goiter formation (see Chap. 73). However, not everyone with an iodine-deficient diet will develop a goiter. Thyroxine (T4) and triiodothyronine (T3) can be used to assess iodine status (see Table 135-8). Intravenous iodine supplements typically are not necessary except during long-term parenteral nutrition with minimal enteral intake. Iodine needs generally are met by cutaneous absorption of iodine from germicides (e.g., povidone-iodine) used in catheter care or consumption of iodized salt. " Use of povidone-iodine wiU likely decrease with the increased use of chlorhexidine for catheter care, and the need for iodine supplementation must be individualized. Iodine excess is rarely a clinical concern when thyroid function is normal. 

Without iodine supplements in the form of marine fishmeal or mineral mixtures, the farm animals of most countries worldwide would suffer of iodine deficiency. Germany and most industrially developed countries unconsciously supply farm animals (and in turn the population) with iodine by fertilizing the land with Chile saltpeter, which has a high iodine content. During World War I, the importation of Chile saltpeter to Europe was stopped, and thereafter synthetic nitrogen containing no iodine was produced worldwide. Consequently, iodine deficiencies in both animals and man reap-... 

It has been recommended that iodine be added to all prenatal vitamins (National Academy of Sciences, 2003) and that women receive 150pg iodine supplements daily during pregnancy and lactation (Becker et at, 2007 Zimmermann and Delange, 2004). 

Iodine deficiency at any degree of severity causes maternal and fetal hypothyroxinemia. As thyroid hormones of the mother and the fetus must be kept at optimal levels, iodine prophylaxis should be provided, especially in iodine deficient areas. To establish normal fetal brain development, iodine supplementation must be started before pregnancy and should be continued during the gestational period. 

The most important sources of iodine are fish from the sea (including the Baltic) and dairy products Swedish cows receive iodine-supplemented food during a large part of the year. 

The effect of iodine deficiency and its correction after iodine supplementation on socioeconomic development was studied in the rural village of Jixian in China during 1978-1986. It was observed that iodine supplementation was related to the socioeconomic development of the affected community. 

Another area of focus was pregnant women and their newborn (Pedersen et aL, 1990, 1993 Nohr et aL, 1993, 1994). Women not receiving iodine supplements had a gradual increase in serum TSH during pregnancy (Weeke et aL, 1982) that was prevented by iodine supplements (Pedersen ij /., 1993). 

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