The importance of iodine nutrition during pregnancy – clinical aspect
Authors:
Kristýna Žabková; Jan Krátký; Jan Jiskra; Hana Vítková
Authors‘ workplace:
3. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in:
Čas. Lék. čes. 2021; 160: 224-228
Category:
Review Article
Overview
Iodine is an essential constituent of thyroid hormones. Thyroid hormones regulate brain development, growth and metabolism of the human body. Inadequately low iodine intake and decreased thyroid hormone synthesis can lead to iodine deficiency disorders. The severity of disorders depends not only on the degree of iodine deficiency, but also on the stage of the human development.
Many areas of the world, including the Czech Republic, have been affected by natural iodine deficiency and the incidence of iodine deficiency disorders has been historically high. Fortification of food-grade salt was an effective step towards reduction of iodine deficiency impact. Although the Czech Republic has been considered to be an iodine sufficient area since 2004, iodine deficiency is still a threat to subgroups of population with an increased demand for iodine, such as pregnant women and newborns.
Moreover, these groups are particularly sensitive to even mild iodine deficiency, because it could permanently affect the cognitive development of the fetus and have a negative effect on the course of pregnancy. Conversely, in other groups of the population steps taken to prevent iodine deficiency diseases may lead to excessive iodine intake with potential risks. It is necessary to control the iodine fortification and regularly monitor the iodine status of the population considering the individual risk groups.
Keywords:
hyperthyroidism – Thyroid-stimulating hormone – Iodine – thyroid gland – Hypothyroidism – autoimmune thyroiditis – pregnancy – thyroid hormone – thyroid peroxidase antibodies
Sources
- Zimmermann MB. Iodine deficiency. Endocr Rev 2009; 30: 376–408.
- Yarrington C, Pearce EN. Iodine and pregnancy. J Thyroid Res 2011; 2011: 934104.
- Zamrazil V, Čeřovská J. Jod a štítná žláza. Mladá fronta, Praha, 2014.
- Jiskra J, Límanová Z. Doporučení pro prevenci, časný záchyt a léčbu tyreopatií v těhotenství. Česká endokrinologická společnost ČLS JEP, Praha, 2018.
- Burrow GN, Fisher DA, Larsen PR. Maternal and fetal thyroid function. N Engl J Med 1994; 331: 1072–1078.
- Ryšavá L, Kříž J. Řešení jodového deficitu v České republice – historie a současný stav. 20 let práce prof. MUDr. Václava Zamrazila v Meziresortní komisi pro řešení jodového deficitu. Vnitřní lékařství 2016; 62 (Suppl. 3): 103–106.
- Límanová Z. Štítná žláza a gravidita – souhrn důležitých poznatků. Vnitřní lékařství 2015; 61: 862–867.
- WHO, UNICEF, ICCID. Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers. WHO, Ženeva, 2007.
- Dvořáková M, Bílek R, Cerovská J a kol. Volumy štítné žlázy u dospělé populace ve věku 18-65 let v České republice – stanovení norem. Vnitřní lékařství 2006; 52: 57–63.
- Wang C, Li Y, Teng D et al. Hyperthyroidism Prevalence in China After Universal Salt Iodization. Front Endocrinol (Lausanne) 2021; 12: 651534.
- Haddow JE, Craig WY, Neveux LM et al.; First and Second Trimester Risk of Aneuploidy (FaSTER) Research Consortium. Free thyroxine during early pregnancy and risk for gestational diabetes. PLoS One 2016; 11: e0149065.
- Tudela CM, Casey BM, McIntire DD, Cunningham FG. Relationship of subclinical thyroid disease to the incidence of gestational diabetes. Obstet Gynecol 2012; 119: 983–988.
- Sudre P, Mathieu F. Kashin-Beck disease: from etiology to prevention or from prevention to etiology? Int Orthop 2001; 25: 175–179.
- Haddow EJ, Glenn E, Palomaki F et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development on the child. N Engl J Med 1999; 341: 549–555.
- Wolff J, Chaikoff IL, Goldberg RC, Meier JR. The temporary nature of the inhibitory action of excess iodine on organic iodine synthesis in the normal thyroid. Endocrinology 1949; 45: 504501.
- Bürgi H, Kohler M, Morselli B. Thyrotoxicosis incidence in Switzerland and benefit of improved iodine supply. Lancet 1998; 352: 1034.
- Lind P, Kumnig G, Heinisch M et al. Iodine supplementation in Austria: methods and results. Thyroid 2002; 12(10): 903–907.
- Pedersen IB, Knudsen N, Jørgensen T et al. Thyroid peroxidase and thyroglobulin autoantibodies in a large survey of populations with mild and moderate iodine deficiency. Clin Endocrinol (Oxford) 2003; 58: 36–42.
- Hníková O, Vinohradská H, Dejmek P, Al Taji E. Dlouhodobé zkušenosti z monitorování jódového zásobení novorozenecké populace v České republice. Česko-slovenská pediatrie 2014; 69: 228–233.
- Ma ZF, Skeaff SA. Thyroglobulin as a biomarker of iodine deficiency: a review. Thyroid 2014; 24: 1195–1209.
- Stinca S, Andersson M, Weibel S et al. Dried blood spot thyroglobulin as a biomarker of iodine status in pregnant women. J Clin Endocrinol Metab 2017; 102: 23–32.
- Zimmermann MB, de Benoist B, Corigliano S et al. Assessment of iodine status using dried blood spot thyroglobulin: development of reference material and establishment of an international reference range in iodine-sufficient children. J Clin Endocrinol Metab 2006; 91: 4881–4887.
- Cogswell ME, Mugavero K, Bowman BA, Frieden TR. Dietary sodium and cardiovascular disease risk--measurement matters. N Engl J Med 2016; 375: 580–586.
- Bath S, Walter A, Taylor A, Rayman M. Iodine status of UK women of childbearing age. J Hum Nutr Diet 2008; 21: 379–380.
- The Iodine Global Network. Global scorecard of iodine nutrition in 2021 in the general population based on school-age children (SAC). IGN, Ottawa, 2021.
- Gizak M, Rogers L, Gorstein J et al. Global iodine status in school-age children, women of reproductive age, and pregnant women in 2017. Nutrition 2018, Boston, 2018 Jun 9–12.
- Bílek R, Kaňová N, Mindžáková V a kol. Zásobení jodem u těhotných žen v České republice. Vnitřní lékařství 2016; 62 (Suppl. 3): 10–16.
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
2021 Issue 6
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