Iodine Deficiency Dr Ben Balzer, General Practitioner Beverly Hills Medical Service, Sydney For Iodine Australia

Iodine Iodine is one of the most important brain nutrients and affects peak brain development. Iodine deficiency is rampant at present is Sydney. There is no data on the elderly. Iodine Australia

What is Iodine? A chemical element, it cannot be created nor destroyed (outside of a nuclear reaction). If it is not in the soil it is not in the food from the land. The sea is rich in iodine so seafood has some iodine and seaweed has a lot. (But seafood is not the answer for most people). Iodine Australia

What does Iodine do? An essential component of Thyroid hormone T3 T4 which is how it acts on the body. In the foetus it has a profound effect upon brain development via maternal and foetal thyroid hormone. It appears that iodine does not have a direct effect on the brain apart from via thyroid hormones. Iodine Australia

What affects our IQ? Genes Diet- Iodine 13.5 points Diet- Omega-3 5 points Diet- Breastfeeding 5 points Lead poisoning Minus 7 to 20 points Other Iodine Australia

What affects our IQ? Other: Birth weight Birth order Number of years in school Social group of parental home Father's profession Father's economic status Parental ambition Mother's education Average book-reading Emotional adaptation Self-confidence according to attitude scale measurement Age (negative relationship in adults) Degree of authority in parental home (-ve)Criminality (-ve) Average TV viewing (-ve) Height Number of siblings (-ve) Infant malnutrition (-ve) Degree of parental rigidity (-ve) Alcoholism (-ve) Mental disease (-ve) http://www.wilderdom.com/personality/L4-1IntelligenceNatureVsNurture.html Iodine Australia

What effect does ID have on IQ?     Minus 13.5 points (ref)  http://members.aol.com/svennord/ed/normal.htm arbitrary average of 100 and standard deviation of 15. Iodine Australia

What effect does ID have on IQ?     Minus 5 points doubles developmental delay Iodine Australia

What effect does ID have on IQ?     Minus 13.5 points!!!! 3 times increase in mild developmental delay IQ <85 7 times increase in severe developmental delay IQ <70 bright (IQ>115) and gifted children (IQ>130) plummet from (bright) 16% to 2.3%, and the gifted from 2.3% to 0.13% = 1/18th i.e almost totally absent.  Note that the definitions may vary for delay and giftedness but the statistics are accurate for the IQ number. Iodine Australia

A general diminution in intelligence in iodine-deficient communities such that iodine deficiency is considered to be the commonest cause of preventable intellectual disability worldwide. Further, there is now very good evidence that a small decrease in serum free thyroxine level during pregnancy, either because of iodine deficiency or thyroid disease, is an important risk factor for impaired psychomotor development in infants. The recent demonstration of intellectual impairment in the children of American women who had mild hypothyroidism in pregnancy highlights the need for better detection and treatment of hypothyroidism in early pregnancy, irrespective of its cause. Recent Italian work demonstrates increase in ADHD in children born in an area with reduced iodine intake Iodine Australia

WHO daily intake: optimal iodine nutrition Adults 150 µg/day Pregnancy and Lactation 200 µg/day Children (6-12 years) 120 µg/day Infants (0-5 years) 90 µg/day http://www.nutritionaustralia.org/Food_Facts/FAQ/what_is_iodine_faq.asp  Iodine Australia

Iodine deficiency in Australia is a severe public health problem (Ref 1,2,3,4). Iodine intake continues to fall. WHO is in the process off increasing the reference intakes for iodine, so the level of deficiency from current published estimates is a significant underestimate.  Iodine Australia

ID in Australia 1 Iodine deficiency and goitre in schoolchildren in Melbourne, 2001 Ciara M McDonnell, Mark Harris and Margaret R Zacharin 76% (439/577) of students had abnormal urinary iodine values, with 27% (156/577) having values consistent with moderate–severe deficiency. The median urinary iodine excretion for the total group was 70μg/L, with values for school years 5–12 ranging from 62 μg/L (Year 12) to 76 μg/L (Year 9). The median urinary iodine value in girls was lower than that in boys (64μg/L v 82 μg/L), and girls had significantly lower urinary iodine values overall (P < 0.002). There was no association between goitre grade and moderate–severe (< 50 μg/L; P = 0.39) or mild (50–99 μg/L; P = 0.07) urinary iodine deficiency. http://www.mja.com.au/public/issues/178_04_170203/mcd10274_fm.html Iodine Australia

ID in Australia 2 Iodine deficiency in urban primary school children: a cross-sectional analysis Kamala Guttikonda, Cheryl A Travers, Peter R Lewis and Steven Boyages MJA 2003; 179 (7): 346-34 http://www.mja.com.au/public/issues/179_07_061003/gut10121_fm.html Iodine Australia

ID in Australia 3 Iodine deficiency in ambulatory participants at a Sydney teaching hospital: is Australia truly iodine replete? Jenny E Gunton, Graham Hams, Marcelle Fiegert and Aidan McElduf  MJA 1999; 171: 467-470 http://www.mja.com.au/public/issues/171_9_011199/gunton/gunton.html  Results: Moderate to severe iodine deficiency was found in 16 pregnant women (19.8%), five postpartum women (19.2%), 46 patients with diabetes (34.1%) and five volunteers (26.3%). Mild iodine deficiency was found in an additional 24 pregnant women (29.6%), nine postpartum women (34.6%), 51 patients with diabetes (37.8%) and 9 normal volunteers (47.4%). Median urinary iodine concentration was 104 µg/L in pregnant women, 79 µg/L in postpartum women, 65 µg/L in patients with diabetes mellitus and 64 µg/L in volunteers. Iodine Australia

ID in Australia 4 Where has all our iodine gone? The possible re-emergence of iodine deficiency in Australia needs to be investigated in national surveys Creswell J Eastman AM (Editorial)MJA 1999; 171: 455-456 http://www.mja.com.au/public/issues/171_9_011199/eastman/eastman.html It was predicted by a speaker at the Nutrition Society of Australia Annual Scientific Meeting in Brisbane 2004 that he expected to see cretinism emerge again in Australian neonates if the problem of iodine intake is not addressed. Iodine Australia

WHO daily intake: optimal iodine nutrition Adults 150 µg/day Pregnancy and Lactation 200 µg/day Children (6-12 years) 120 µg/day Infants (0-5 years) 90 µg/day Iodine Australia

WHO daily intake: optimal iodine nutrition Adults 150 µg/day Pregnancy and Lactation 200 µg/day Children (6-12 years) 120 µg/day Infants (0-5 years) 90 µg/day Iodine Australia

Iodine Deficiency Australian Style? The irony: Australians receive international accolades for helping 3rd world countries beat iodine deficiency! Iodine Australia

Iodine Deficiency Australian Style? Iodine Australia

Myths about nutrient supplements Myth 1. Vitamins just give you expensive urine Fact 1. All drugs etc give you expensive urine, it it what they do before they enter the urine that matters. Many vitamins have measurable physiological effects. A good explanation for this is that the Western diet has on 1/7 to 1/3 of the vitamins and minerals of hunter-gatherer diets. Iodine Australia

Myths about nutrient supplements Myth 2. Australia's food supply is so good that nobody needs supplements. Fact 2. The physiological effects of vitamin supplements are so clearly demonstrated that, by law many foods must be supplemented with vitamins. Eg B1 and B3 in rice and flour, folic acid supplements etc. Iodine Australia

Iodine Supplements Adults. Centrum Iodine Australia

Iodine Supplements Blackmore's Pregnancy and Breastfeeding Formula Sun-Herald 5-12-04 Iodine Australia

Iodine Supplements 4 to 12 years. Blackmore’s Kids Multivitamin and Minerals Chewable Iodine Australia

Iodine Supplements Under 4 years. Consider iodine solution. NB Most infant formulae are mildly deficient in iodine Iodine Australia

Eastman’s 7 point strategy 1. ANZ education strategy 2. Encourage intake of cows milk (still a good source despite lack of standardisation)[and lack of commitment from Dairy Australia in my opinion] 3. Only iodised salt should be used for cooking and seasoning except for people with nodular goitres or overactive thyroid disease). 4. Increase seafood consumption where possible. 5. Supplement iodine before & during pregnancy and during lactation. 6. Encourage mothers to choose infant formula with higher level of iodine. NB some criticisms of FSANZ's current standard 2.9.1 of 1.2 ug iodine/ 100 kJ as too low. (Ben- calculation 4000 kJ= 48 ug iodine cf RDI= 90 ug/day. Whoops! ). 7. Develop a national policy (Heinz newsletter) Iodine Australia