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February 15, 2025 • 18 mins
Karen explores the importance of iodine and how its deficiency can impact overall health. She discusses the essential role iodine plays in thyroid function, metabolism, and cognitive development, particularly in pregnant women. Karen explains why iodine deficiency is on the rise, how to test for it, and the best ways to ensure adequate intake through diet and supplements.

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Episode Transcript

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Speaker 1 (00:00):
The content of this podcast is provided for general informational
purposes only and is not intended as nor should it
be considered a substitute for professional medical advice. Hello everyone,

(00:22):
This is Karen Nicol, family nurse practitioner, and this is
Itchy and Bitchy, a podcast that provides answers to your
many unanswered health questions. I'm going to remind you again
about my course called the Perimenopause Answer. If you are
going through this phase of life called perimenopause, or if
you don't know if you're in perimenopause, I would love

(00:42):
to have the opportunity to talk to you about the
course and see if it is a right fit for you.
There is a link on our website Itchyanbitchi dot com
and our Facebook page I n B Podcast where you
can schedule an appointment for a zoom call with me.
This is a zoom call with me. When you make
an appointment, I will be sitting at my desk waiting

(01:03):
for you to join the one on one zoom call.
I'm going to talk to you today about iodine. What
is iodine and what does it do? And Karen, why
are we talking about it? Well, one of the members
in my course, the perimenopause answer asked me about iodine
and how would she know if she has low levels

(01:26):
of iodine. Iodine deficiency is one of the four major
deficiency diseases in the world. However, it is the easiest
to control. Iodine deficiency effects about two point two billion
people worldwide. It's most common in developing countries where there

(01:46):
is less access to enough healthy food. In the United States,
iodine deficiency disorders such as goiter cretanism, stillbirth, spontaneous abortion,
and delayed physical and intellectual development have been greatly reduced
through the iodization of salt. Recent surveys, however, have indicated

(02:07):
that the proportion of the US population with low urinary
iodine levels is increasing. Based on a recent study, it
appears that there is a re emerging issue of iodine
deficiency globally, and specifically, declining intake is being seen among
populations in developed countries like the US. In the US,

(02:32):
this is in part due to changing dietary patterns and
food manufacturing practices. Changes in these practices include decreased levels
of iodine in milk due to the reduced use of
iodine containing feed supplements, and iodine based sanitizing agents in
the dairy industry, as well as the reduced use of

(02:55):
iodate dough conditioners by commercial bakers. Of Erythracine, an iodine
containing food dye commonly used in fruit flavored breakfast cereals,
has also decreased. Iodine, a trace element that is an
essential component of thyroid hormones, thyroxine which is T four,

(03:16):
and triodothyronine which is T three, which regulate the metabolism
of every cell in your body, including the liver, kidney, muscle, brain,
and central nervous system. Iodine plays a critical role in
the development of the nervous system, organs, and tissue function,
in the growing fetus and in growing children. A healthy

(03:40):
adult body contains fifteen to twenty milligrams of iodine. Seventy
to eighty percent of it is stored in the thyroid gland.
Without proper iodine consumption, the human body simply doesn't work
normally for the developing fetus. Deficiency is one of the

(04:00):
greatest causes of preventable intellectual disability, so knowing the iodine
status of pregnant women and women of reproductive age is
very important. Surprisingly, routine iodine testing is generally not considered
necessary during pregnancy, as most healthcare providers recommend supplementing with

(04:23):
iodine through prenatal vitamins rather than routinely testing the levels,
especially in areas where iodine deficiency is not prevalent. The
recommended amount of iodine in prenatal vitamins is one hundred
and fifty micrograms daily. However, the amount of iodine in
prenatal vitamins can vary widely, and some vitamins may not

(04:46):
contain iodine at all. Recently, it was reported that twenty
three percent of a sample of pregnant women twenty three
percent of a sample in pregnant women in Michigan had
inca adequate intake of iodine, startling if testing is not
routinely done during pregnancy. Ideally, the pregnant woman's ob would

(05:09):
recommend a specific brand of prenatal vitamin or vitamins that
contain an appropriate amount of iodine. Garden of Life brand
makes prenatal tabs and capsules that have an appropriate amount
of daily iodine. However, the Garden of Life prenatal gummies
do not contain iodine. Checking the label is super important.

(05:34):
Iodine levels can be tested and I'll talk about testing
options for iodine status up ahead. Also, obgyns will check
a thyroid stimulating hormone a TSH as an indirect way
of checking iodine. In other words, if the TSH is normal,
it is thought and assumed that iodine levels must also

(05:58):
be normal. You can get iodine from several dietary sources,
but iodine deficiency was common in the US until table
salt was fortified with iodine beginning in the nineteen twenties.
Deficiency was especially common in areas of the country where
the top soil is either depleted of iodine or it's

(06:19):
not present at all. Land that is on or near
the ocean has soil that contains iodine that comes from
vaporized ocean water. When iodide is present in soil, the
produce that is grown in that soil contains iodine. I
grew up in Kansas, which is basically as far as

(06:39):
you can get from either the Pacific or Atlantic Ocean,
so our soil is definitely free of iodine, even though
they started putting iodine in the form of potassium iodide
in the salt in the nineteen twenties. I grew up
seeing lots of adults walking around with big goiters on
their necks. I remember asking my parents what is up

(07:00):
with that? But I'll talk about goiters later. Foods that
contain iodine include iodized table salts and any foods that
are prepared with it, such as pasta boiled in water
with iodized salt. However, iodized table salt has often been
replaced with sea salt, which contains very little iodine. Also,

(07:24):
many people no longer regularly salt their food. You know,
it used to be we always had a salt pepper
shaker on the table, and everybody salted their food before
they even tasted it. We don't do that so much anymore.
Additional iodine containing foods are fish, seafood, seaweed, eggs, dairy products,
and meats. Signs and symptoms, testing and supplementation for iodine

(07:49):
deficiency is up next after this quick break, so please
stay with me Welcome back. Signs and symptoms of iodine

(08:11):
deficiency can include swelling of the thyroid glands in the neck.
This can cause a visible lump called a goiter to
form on your neck the front of your neck. This
is what I talked about earlier that I saw all
over the place. In Kansas, low levels of thyroid hormones,
which is called hypothyroidism, can happen when we don't have

(08:32):
enough iodine in our body, and typically hypothyroidism causes symptoms
that include fatigue, increased sensitivity to cold, constipation, dry skin,
weight gain, puffy face, muscle weakness, elevated blood cholesterol levels,
pain or stiffness in the muscles or joints, slowed heart rate, thinning,

(08:53):
hair depression, poor memory, or a heavier than normal period
in women who are men. In infants, hypothyroidism can cause
symptoms like frequent choking, large tongue, puffy face, constipation, poor
muscle tone, extreme sleepiness. In children and teens, we can

(09:15):
see poor growth, delayed tooth development, delayed puberty, poor mental development,
and cognitive issues can also occur, including low IQ, trouble learning,
mental disabilities, especially in children. If the birthing parent had
an iodine deficiency while pregnant or nursing. Signs and symptoms

(09:36):
of iodine deficiency in pregnant people can include enlarge thyroid
or goiter. Iodine deficiency is the most common cause of goiter.
Elevated levels of the two thyroid hormones T four and
T three elevated instead of low levels and elevated levels
of thyroid stimulating hormone. Earlier, I mentioned the iodine form

(10:01):
called iodide. There is a difference between these two forms
of iodine. In nature, iodine exists as what we call
elemental iodine, or it can be present in the form
of iodide. Elemental iodine is made up of two iodine
atoms that are bonded together. In this form, iodine should

(10:23):
never be ingested or applied directly to the skin or
tissue because it is highly corrosive and will cause severe
damage to tissue on contact. The good news is that
unless you work in a laboratory setting, it is unlikely
that you will come into contact with elemental iodine. Iodide

(10:44):
is the form created when iodine bonds with another element,
such as potassium. In this form, iodine can be taken
by mouth or applied topically. Dietary iodine also occurs naturally
as an iodide, such as potassium iodide or sodium iodide.
For example, seaweed contains iodide. When you purchase iodine from

(11:08):
a local drug store, it's usually an iodide solution. This
combination allows the body to absorb and use it safely,
So iodine and iodide are simply different expressions of the
same element. Iodides simply represent a safe form of iodine

(11:29):
for ingestion. The main drawback to supplementing with iodide is
that it does require additional energy from the body to
break the potassium or sodium that is bonded to the
iodide so that it can be used as iodine. Another
option for supplementation is the use of a form called

(11:50):
nascent iodine that's nascint nacent iodine. In fact, this form
of iodine contains a single iodine atom rather than the
two bonded atoms that are so corrosive, so it does
not cause severe damage to tissue because it's a single

(12:12):
atom of iodine. In fact, it provides the body with
an easily absorbable and available form of iodine. Iodine status
is typically assessed using urinary iodine measurements. Urinary iodine reflects
dietary iodine intake directly because people excrete more than ninety

(12:34):
percent of dietary iodine in their urine. Spot Urine iodine measurements,
which means that you collect a single urine sample at
any time of the day. The sample is usually collected
at your provider's office or at a medical lab. A
random urine sample can be a useful indicator of iodine status. However,

(12:55):
a twenty four hour urinary iodine or a multiple spot
urine measurements over one day are more accurate ways to
test for iodine levels in the body. They're harder to
do than a single sample, but they're much more accurate.
There is a blood test that can be done to
check iodine levels. However, because iodine in the blood is

(13:19):
rapidly taken up into the thyroid gland, a single blood
test cannot accurately reflect an individual's iodine status. A third
method is called a patch test. This is a test
that you do at home. In order to complete the test,
you will need to purchase an iodine tincture, which is

(13:39):
in liquid form. Iodine tinctures are available at most pharmacies
and drug stores, as well as online. Most iodine solutions
have an orange tint to them, but some are clear.
You want to bio tincture that has the orange tint
so that it shows up on your skin. Sometimes iodine
tinctures are kept behind the counter at the pharmacy, so

(14:02):
you may need to ask the pharmacist to get it
for you. Using a cotton swab, you apply the iodine
in a two inch or same as five centimeter square
of iodine on your inner forearm. The square doesn't need
to be precise in terms of shape or dimensions, but
the square should be completely filled in and dark enough

(14:25):
to be obvious. If you do not want to put
the iodine on your forearm, you can also put it
on your abdomen or inner thigh. Be sure to let
the iodine drive for at least twenty minutes before covering
it or letting it touch anything, since it will stain.
Monitor the iodine for twenty four hours to watch for

(14:46):
any color fading. Check the patch every three hours or
so to monitor how long it takes to disappear. If
the patch is still fully visible after twenty four hours,
you likely don't have a deficiency. If the patch disappears
or fades significantly over twenty four hours, you may have

(15:07):
a minor to moderate iodine deficiency. If the patch disappears
in under eighteen hours, you may have a moderate to
severe iodine deficiency. I must tell you that this isn't
the most accurate test, even though it isn't accurate, it
can help to give a general idea as to whether

(15:27):
or not you could be deficient in iodine and need
to supplement with iodine. While someone can start off with
this test, eventually it is recommended that you get more
accurate testing done, like a twenty four hour urine test.
So if it's suspicious for iodine deficiency using the patch test,
it really should be followed up with a more accurate

(15:48):
test to confirm the diagnosis. When looking at dietary supplements,
iodine is often in the form of potassium iodide or
sodium iodide containing KELP. A seaweed that contains iodide is
also an option. A small study found that people absorb
potassium iodide almost completely at ninety six point four percent. Again,

(16:14):
once absorbed, the body has to separate the potassium from
the iodide in order for the body to use it.
Life Extension has a third party tested and approved potassium
iodide supplement in tablet form. Each tab contains one hundred
and thirty milligrams of potassium iodide and adult dosing is

(16:34):
one tablet daily. Again, that's a Life Extension product. Nascent
Iodine can also be used as replacement. This is always
in liquid form and in terms of absorption, this is
the optimal choice. One brand that is third party tested
and is water based versus alcohol based is Mary Ruth's

(16:56):
Nascent Iodine, which contains two hundred and fifty microgram's perdos. Also,
it's a woman owned company. I love that, so I
hope this helps you understand what iodine does for you,
what iodine deficiency symptoms are, and what you can do
to test it and replace it. Thank you for listening.

(17:16):
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(17:37):
leave comments or questions for me. Our website is itchyandbitchi
dot com, where there are blogs with some of our
subjects available for you to read. On the Facebook page
and website, we have the information about how to schedule
an appointment with me so we can chat about how
my Pyramidopause Chorus can help you. If you are going
through this phase in life. As always, thanks to Forrest Winsel,

(18:00):
our producer and composer of our theme music and the
person who does all the behind the scenes work to
make this podcast possible. Thank you very much Forest for
us to start at his second of four semesters to
earn his master's degree in music composition at the prestigious
Peabody Music Conservatory. And if you want to listen to
some of his music other than by beloved Itchy and

(18:22):
Bitchy theme song, you can go to his website Forrestwinsel
dot com, f O R R E S t W
E N t z e l dot com. Please always
remember that your health is in your hands.
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