Iodine is an important trace element for human life. In order for the thyroid gland, located in the front of our neck, to secrete sufficient hormones, at least 150 micrograms (one teaspoon) of iodine must be taken daily with food and water. In Turkey, the rate of goiter (enlargement of the thyroid gland) occurs at a rate of 5-56%, depending on the region. Among the causes of endemic goiter, that is, frequent goiter without an epidemic in a certain region; Although some substances taken from the diet, some microorganisms or some trace elements other than iodine are blamed, the most important element whose effect is well known and shown to reduce the frequency of goiter with protective and preventive approaches is iodine deficiency (IE).
However, IE also has very important consequences other than endemic goiter, and these are called iodine deficiency diseases (IED). Contrary to popular belief, IEHs are not limited to goiter alone, but are very important diseases, including a wide variety of irreversible neurological disorders. On the other hand, iodine excess is also seen with increasing autoimmune thyroid diseases in society. In this case, keeping the iodine levels of societies within certain limits becomes of great importance.
Iodine is an important element in the production of thyroid hormones necessary for brain development. Exposure to IE in the womb and during early childhood negatively affects brain development. The most critical period for IE is between the second trimester of pregnancy and the age of three, when brain development is largely completed. Iodine deficiency is the most important cause of correctable mental retardation all over the world.
In 1960, the World Health Organization (WHO) published a report stating that goiter rates in the world were around 50 percent. After this report, in the screenings carried out in 110 countries and 655 million people in 1993, the prevalence of goiter was stated to be 12 percent, and IE was accepted as a public health problem in the world. At the national level, the fight against IE has begun by iodizing salts.
For Turkey, endemic goiter and IE are an important public health problem. The legal regulations required for the compulsory iodization of all table salt in our country were made in July 1999. It was completed in 2000 and the use of iodized salt became widespread in our country in the 2000s. While the rate of iodized salt usage in Eskişehir was 12.6 percent in 1996, it was determined to be 65.5 percent in 2002 as a result of the studies carried out. In studies conducted after the iodization of table salt became mandatory in 1999, it was shown that IE had significantly improved in many provincial centers among school-age children in our country, but it still continued at a mild-moderate level, especially in some predominantly rural areas.
IODINE IS ESSENTIAL DURING PREGNANCY
The need for iodine increases during pregnancy, breastfeeding and early childhood (<2 years). WHO recommends daily iodine intake during these periods as follows; It recommends 250, 250 and 90 µg/day. Severe IE during pregnancy; stillbirth, miscarriage, placenta (cord) anomalies, preeclampsia (pregnancy poisoning), postpartum hemorrhage (excessive bleeding after birth), anemia (anemia), hypothyroidism (thyroid hormone deficiency) in the baby, increased infant mortality rate, preterm (early ) birth, low birth weight, increases the risk of neonatal respiratory stress syndrome. Severe IE in the mother may cause a disease called "cretinism" in the child, which is characterized by mental retardation, short stature, deafness and spasticity (muscles remaining in constant contraction). In areas with severe IE, cretinism is known to affect 5-15 percent of the population. It has been shown that even mild to moderate IE in the mother can affect the intelligence development of children. A large study has shown that the IQ levels of seven- to nine-year-old children of mothers with mild hypothyroidism during pregnancy are on average seven points lower than those of children of mothers with normal thyroid function. Low maternal T4 levels have also been shown to negatively affect the baby's psychomotor development. For this reason, as it is recommended for pregnant women and breastfeeding women in all IE regions of the world, in our country, it is important for pregnant women to take an iodine supplement of around 100-200 µg/day in addition to iodized salt for the motor development of the pregnant woman, the fetus and the newborn. It is recommended to keep in mind that breast milk is the baby's only source of iodine until breastfeeding is completed, and to continue iodine supplementation in addition to iodized salt. It is stated. If the mother smokes, iodine transfer to the baby through milk decreases. Therefore, smoking while breastfeeding is harmful to your child as well as to you. If you smoke, you need to take more iodine. For mothers who cannot breastfeed, the baby should be supported with iodine formulas. If the mother is breastfeeding, but iodine intake is restricted due to hyperthyroidism (excess thyroid hormone production), the baby should receive iodine supplement.
WHO SHOULD NOT USE IODIZED SALT?
Iodization of salt prevents the occurrence of goiter disease, but in some people it causes harmful side effects or diseases due to excessive iodine intake. Since 1999, when the salts on the market were iodinated, the disease characterized by overactivity of the thyroid gland, which we call hyperthyroidism (also known as toxic goiter among the public), has started to appear with increasing frequency. In patients with underactive thyroid gland (those with hypothyroidism), iodized salt causes this disease to become more severe. For this reason, whether the salt used in our meals is iodized or non-iodized is of great importance for some patients or people. Patients with hyperthyroidism (an overactive thyroid gland) or patients with hypothyroidism (an underactive thyroid gland) and suffering from an autoimmune disease should definitely consume non-iodized salt. If such patients eat iodized salt, their diseases become worse.
Last word: To prevent goiter disease, children, adults and pregnant women who do not have a known thyroid disease should eat iodized salt. Patients with hyperthyroidism (an overactive thyroid gland) or patients with hypothyroidism (an underactive thyroid gland) and suffering from an autoimmune disease should definitely consume non-iodized salt. Non-iodized salt is sold in a salt shaker form. It is written on the label or on the label of these salts that they are iodine-free. You should pay attention to this when purchasing. Those who cannot find these salts should eat rock salt. If one person in the family will eat non-iodized salt, meals should be cooked without salt and everyone should use their own salt. Stay cheerful and well-being.
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