Iodine deficiency in nutrition as a multidisciplinary problem

Article 2 (Calculation of daily iodine intake)

A little about the purpose of iodine in the life of the body. Iodine is an integral part of thyroid hormones. Entering the body with food and water, iodine is actively captured by the thyroid gland from the blood and is used to form hormones that are involved in the development and regulation of: the psyche and nervous system, thyroid gland, cardiovascular system, gastrointestinal tract, reproductive function, skin and hair, musculoskeletal system. For the formation of a sufficient amount of hormones, a sufficient supply of iodine in the body is also necessary.

World medicine has recognized iodine deficiency as a major threat to human intelligence and development. It is a daily microdose of iodine that ensures a person’s ability to learn, determines the success of any activity and is the basis for the development of other abilities.

Each area has different iodine content in food and water. Almost throughout the entire territory of Russia there is an endemic iodine deficiency of varying severity. Iodine deficiency is most pronounced in mountainous and foothill regions (North Caucasus, Altai, Siberian Plateau, Far East). This is not the case all over the world. The average daily iodine consumption in different countries of the world is shown in table No. 1

Table 1. Average daily iodine intake in various countries.

Based on the above data, it is clear that Russian residents need an additional source of iodine.

Iodine consumption standards. The daily iodine requirement depends on age and physiological state. The World Health Organization (WHO) recommends the following daily intakes of iodine:

Table 2. Physiological daily requirement for iodine (in micrograms)

On average, iodine consumption in Russia is 40–80 mcg per day, with the recommended norm being 150 mcg per day, that is, 2–3 times lower than physiological needs. And if the recommended need for iodine during pregnancy is 200 mcg per day, then it turns out that pregnant women in Russia receive 2.5 - 5 times less iodine than needed. Thus, first of all, we need to take care of solving this problem for children, young people and, of course, pregnant women, that is, those on whom the intellectual and creative potential of the nation directly depends.

Everything is good in moderation! It must be remembered that iodine intake should be dosed. Excessive intake of iodine into the body, hundreds and thousands of times higher than recommended physiological norms, as well as iodine deficiency, can lead to the development of thyroid diseases. Over the course of a lifetime, a person consumes only 3-5 grams of iodine. This is about one teaspoon of this substance.

Ways to combat iodine deficiency. There are three options for iodine prophylaxis: mass, group and individual. The most effective is mass iodine prophylaxis, which consists of adding iodine salts to the most common foods (salt, bread, water). To implement this option, support at the legislative level is required. But over the past few decades, unfortunately, iodine prophylaxis programs have been practically curtailed. Therefore, Russol LLC wants to inform the population of Russia about how to solve the problem correctly and effectively.

As part of individual prevention, each person should choose an additional source of iodine for themselves. The most versatile is iodized salt.

Why salt? Because:

- almost everyone uses it;

- this is a cheap product that is available to everyone;

— salt is consumed in small quantities, so you can add more iodine to it than to other products;

— the cost of iodized table salt is practically no different from non-iodized salt.

Salt fortified with iodine is a safe food product.

Iodized salt is not a medicine that should be prescribed by a doctor. It does not contain pharmacological doses of iodine and is a common food product that is rich in iodine - such as seaweed.

Iodized salt is suitable for long-term storage, cooking and canning: iodine does not evaporate from it in large quantities, does not evaporate under the influence of temperature and does not change the taste or color of food. This is achieved thanks to a new standard for salt iodization - potassium iodate, a compound much more stable than iodide.

Iodine is necessary for a person throughout his life . As we have already found out, the daily intake of iodine for an adult is 150 mcg. The iodine content in iodized salt produced by Russol LLC is 40.0±15 mcg per gram of salt. With a maximum allowable salt intake of 10 grams, a person can receive up to 400 mcg of iodine per day. With a recommended salt intake of 5-6 grams - up to 200 mcg per day.

Thus, the use of iodized salt is an effective method of combating iodine deficiency. It is enough just to replace regular salt with iodized salt, and the Russian population will be able to prevent the development of thyroid diseases, maintain health and overcome the decline in intelligence.

Article 1 (On the problem of iodine deficiency in Russia)

Article 3 (Laboratory evidence)

Iodine deficiency: symptoms, diagnosis and treatment

Has your mood become changeable? Has your memory deteriorated? Are you worried about drowsiness?

Such manifestations can be associated with a large number of ailments. Meanwhile, the reason often lies on the surface.

With questions about such a common condition as iodine deficiency, we went to an appointment with Olga Arkadyevna Kalinina, an endocrinologist at Clinic Expert Borisoglebsk LLC.

－ Olga Arkadyevna, how common is iodine deficiency among Russians? Are there any regions where iodine deficiency is particularly significant?

We can say that the entire territory of our country is characterized by predominantly mild and moderate iodine deficiency, i.e. All regions in Russia are iodine deficient without any significant difference between them. In fact, Russians' iodine consumption averages about 40-80 mcg per day - this is 2-3 times less than the normal requirement. Its absorption can also be hampered by chlorination and fluoridation of water.

－ Why does the body need iodine?

Its main physiological significance is that it is part of the molecules of thyroid hormones (triiodothyronine and thyroxine), which, in turn, affect almost all the main biochemical processes associated with metabolism, growth and development of organs and tissues.

－What is the daily iodine requirement of an adult?

The answer to the question “How much iodine does a person need per day” depends on age: normally, the daily requirement ranges from 100 to 200 mcg; in pregnant women, the need is always higher - from 200 to 300 mcg.

－ Tell us, by what symptoms can a person determine that there is a lack of iodine in his body?

The most obvious sign is the appearance of a so-called goiter - an enlargement of the thyroid gland, in advanced cases clearly visible to the eye and deforming the contours of the neck. But nonspecific symptoms can be: decreased performance, drowsiness, memory impairment, various mental disorders (apathy, depression), dry skin, pallor. Patients may be bothered by a feeling of chilliness, shortness of breath, a rare pulse, and weight gain. Most people attribute all this to general busyness, age and stress, so they do not consult a doctor on time.

Iodine deficiency in women leads to disruption of their reproductive function. Its symptoms may include miscarriage, premature birth, stillbirth, anomalies of intrauterine development of the fetus, congenital insufficiency of the thyroid gland in the fetus.

Iodine deficiency in men also affects the sexual sphere and can be expressed by symptoms such as decreased libido and decreased sperm motility. In some cases, this can lead to the development of male infertility.

How to break out of the vicious circle of male infertility? The urologist-andrologist tells

"Clinic Expert Tula" Artem Sergeevich Shishkin

－ Are there methods to determine iodine deficiency without leaving home, using some simple and affordable tests?

No. There is an opinion in everyday life that a deficiency of this microelement can be determined by applying an iodine grid to the skin of various parts of the body and measuring the rate of its absorption into the skin. This method has no scientific basis and can mislead people.

Therefore, it is necessary to remember: there are no methods that can reliably determine iodine deficiency in the body at home.

I would like to remind you that most of our country experiences at least a mild iodine deficiency, and therefore iodine deficiency “by default” is present in many people (especially if there is no regular replenishment in the form of the use of iodized salt or other foods in the diet, containing this element).

－ Olga Arkadyevna, is it always possible to judge iodine deficiency by the level of thyroid hormones?

No. If the lack of iodine is not very pronounced, hormone levels can remain normal for quite a long time. However, this does not mean that such iodine deficiency does not have a negative effect on the body. It also requires mandatory correction and requires consultation with a doctor.

－ For whom is iodine deficiency most dangerous: adults or children?

It is dangerous for everyone, but the changes that occur in children have even more pronounced consequences. This is due to the greater sensitivity of the child’s body to iodine deficiency due to more intense metabolism, growth and development.

－ What can be the consequences of iodine deficiency in the body?

In adults, metabolic processes are disrupted and the symptoms that I mentioned earlier appear. The consequences of iodine deficiency can be significantly expressed in children, manifested by the development of cretinism in them.

－ Could you give advice on how to compensate for iodine deficiency in the body? What foods should you eat and in what quantity to avoid this condition?

In case of severe deficiency, medications containing iodine in therapeutic dosages may be needed. This issue is resolved by the attending physician.

The main means of preventing iodine deficiency is iodized salt. It retains its beneficial properties in this regard for four months. The product should be stored in airtight packaging and added to food after cooking.

There is a lot of iodine in seafood - for example, fish (salmon, flounder, halibut, tuna, herring), squid, shrimp, crab, seaweed. However, it must be remembered that during heat treatment up to 65% of the iodine contained in them can be lost.

－ What should those who suspect they have an iodine deficiency do? Which doctor should I contact?

To an endocrinologist.

You can make an appointment with an endocrinologist in your city here

Please note: the service is not available in all cities

For reference:

Kalinina Olga Arkadyevna

Graduate of the Faculty of Medicine of the Voronezh State Medical Academy named after N.N. Burdenko 2001.

In 2002, she completed her internship in the specialty “Therapy”.

In 2005, she underwent primary retraining in the specialty “Endocrinology”.

Currently works at Clinic Expert Borisoglebsk LLC, consulting in the field of therapy, endocrinology, and dietetics. He is the deputy chief physician for clinical expert work.

Do you have iodine?

According to statistics, about 35% of Russians have severe iodine deficiency, while the rest have mild to moderate deficiency. Thyroid diseases associated with iodine deficiency take years to develop, their consequences are severe and in some cases can lead to disability. Treating them is expensive, preventing their development is effective and cheap.

The fight against iodine deficiency began back in 1927 in the USSR. Soviet scientists traveled around the country and measured iodine levels in water and soil to identify iodine-deficient regions. And after they discovered it, they replaced regular table salt with iodized salt. This measure was borrowed from Switzerland, where it was possible to eliminate iodine deficiency and associated diseases - endemic goiter (overgrowth of thyroid tissue) and congenital cretinism. Antigoiter dispensaries operated throughout the USSR even in the difficult post-war years. In addition to iodized salt, children from iodine-deficient regions also received potassium iodide preparations.

In 1957, despite the accession to the country of a large number of regions deficient in iodine (Western Ukraine, Belarus), where cases of cretinism and endemic goiter were common, the USSR Minister of Health stated that iodine deficiency had been eliminated throughout the entire Soviet Union. In the 1980s, goiter dispensaries were also liquidated.

Chernobyl showed the whole world that iodine deficiency can be not only severe (up to 20 mcg per day), but also moderate and mild (80 mcg per day). A slight lack of iodine in the body caused the thyroid gland to actively absorb radioactive iodine, which was released during the nuclear power plant accident. Which led to an 80-fold increase in the incidence of thyroid cancer. “First of all, children and women of reproductive age suffered from this,” notes Larisa Zhukova, chairman of the Kursk regional branch of the Russian Association of Endocrinologists, head of the department of endocrinology at KSMU. Children, because the thyroid gland regulates all types of metabolism in the body through the hormones it produces. The thyroid gland needs iodine to synthesize them. Women, because their thyroid gland works with increased load during pregnancy and lactation in order to provide for themselves and the child in the first months of intrauterine development and infancy.

Further research has shown that mild deficiency is dangerous not only during man-made disasters - it contributes to a decrease in IQ levels. According to epidemiological studies, the gap in iodine-deficient regions is 10-15 points compared to residents of regions where there is no such deficiency.

The fight against iodine deficiency was resumed only in modern Russia. Its peak occurred in 1997-1998. Then the economic crisis happened - and iodine faded into the background. Over the past 15 years, the incidence of endemic goiter in children has increased by almost 10% and is diagnosed in a quarter of children. In addition, the incidence of congenital mental retardation (cretinism) continues to increase in the country. According to rough estimates, the number of Russians with mental retardation due to iodine deficiency may reach 1.5 million.

The daily intake of iodine is 150-200 mcg, for pregnant and lactating women 250 mcg, recalls Larisa Zhukova. According to the latest data, Muscovites consume from 40 to 80 mcg of iodine per day, and this is with an optimum of 100 mcg outside pregnancy and breastfeeding. The situation is a little better in St. Petersburg and Primorye, worse in the mountainous regions of the Caucasus. “To replenish the daily dose of iodine, it is enough to replace regular salt with iodized salt. A daily salt norm of 5-7 grams a day will be enough to fill the body with iodine,” explains Galina Melnichenko, director of the Institute of Clinical Endocrinology of the Federal State Budgetary Institution “Endocrinological Research Center” of the Russian Ministry of Health, vice-chairman of the Russian Association of Endocrinologists.

This fall, State Duma deputies became concerned about resolving the issue of iodine deficiency at the state level and took the initiative to adopt a law on mandatory salt iodization. This bill is supported by the Ministry of Health, but representatives of the food industry and agriculture oppose it. Their main argument is that the taste of the food will deteriorate. As the practice of Switzerland and 113 other countries, including France and Germany, known throughout the world for their gastronomic culture, shows, salt iodization has no effect on the quality or taste of the food products produced. The second argument of opponents of the law is the increase in the cost of food products. The difference in the cost of 1 kg of iodized and regular salt at retail, depending on the manufacturer, is 3-20 rubles, and the state annually spends about 275 billion rubles on the treatment and rehabilitation of patients with diseases caused by iodine deficiency.

How to compensate for iodine deficiency in the body?

Iodine is one of the most important microelements necessary to maintain the health of our body. First of all, it is necessary for the normal functioning of the thyroid gland.

A lack of iodine in the body is not always a consequence of poor nutrition, since food is not the only source of this trace element for our body. We get iodine from water and air, so the problem of iodine deficiency is relevant in areas where soil and water are poor in this substance. The need for iodine is increased in children, pregnant women and nursing mothers.

IF IODINE IS NOT ENOUGH

If the body does not receive enough iodine from food, the thyroid gland produces few hormones (thyroxine and triiodothyronine). This condition is called iodine deficiency. Gradually, this leads to an enlargement of the thyroid gland (development of diffuse goiter). Hormone deficiency manifests itself as hypothyroidism syndrome.

Most often, iodine deficiency is the first to affect the functioning of the nervous system: a person becomes forgetful, his attention and reaction decrease, irritability and drowsiness appear, and his immune system weakens. Problems with the heart and blood vessels appear: arrhythmia, increased blood pressure, decreased hemoglobin levels in the blood.

Body weight also increases - after all, there is too little thyroxine for the process of energy consumption to proceed in a normal way, and it is deposited in the form of fat reserves.

A lack of iodine is indicated by the condition of the skin: it becomes dry, loses elasticity, and acquires a waxy tint.

HOW TO COMPLETE IODINE DEFICIT?

The iodine content in food depends on many factors, but the main thing is that the iodine requirement is quite easy to obtain even far from the sea. Products containing iodine will be quite unexpected and can be found in every kitchen!

1. Cranberry

The small sour berry contains a huge amount of antioxidants, valuable vitamins, elements and substances, including vitamin C, vitamin K, which promote better absorption of calcium, fiber and iodine. 100 grams of cranberries contain approximately 350 mcg of iodine. Add cranberries to baked goods, salads and sauces - and your daily requirement of iodine will be provided.

1. Strawberry

This sweet red berry has a good amount of iodine - one cup contains almost 10% of the daily value, about 13 mcg. In addition, strawberries strengthen the immune system due to vitamin C, regulate blood pressure, and also, according to research, reduce the level of “bad cholesterol.”

1. Shrimps

Most seafood is high in iodine, and among all the inhabitants of the vast marine world, shrimp can be distinguished. 100 grams of these crustaceans contain about 40 mcg of iodine. But shrimp will be an excellent dinner option not only because of this - they are almost the only source of the powerful antioxidant astaxanthin. Astaxanthin was especially good at improving the functioning of the brain and central nervous system. According to research, astaxanthin has a positive effect on human memory and reduces the risk of brain diseases.

1. Turkey breast

Another excellent and healthy source of iodine. Everyone loves turkey: both athletes for the higher amount of protein, and those losing weight for the small percentage of fat. But it’s also worth loving for its high concentration of nutrients: calcium, potassium, zinc, iron, phosphorus, iodine (about 37 mcg per 100 grams) and B vitamins.

1. Potato

Many people try to protect themselves from consuming potatoes, because they contain a lot of starch, which can bring extra pounds. But sometimes you still need to include potatoes in your diet: they contain iron, phosphorus, calcium and zinc - all of them together help improve bone health; vitamin B6, which properly absorbs proteins and fats and prevents nervous disorders; as well as potassium, magnesium and iodine. One medium potato contains about 60 mcg of iodine, which is almost half the daily requirement. But it is better to eat potatoes baked than in the form of mashed potatoes, to which butter and full-fat milk are also added.

1. White beans

Bean dishes are not only tasty and rich in iodine, but also very healthy: beans are full of fiber, the benefits of consumption of which we are already well aware. At the same time, beans have a low glycemic index, which is extremely important for diabetics, since the GI level helps to increase/decrease blood sugar levels. In addition to fiber and protein, white beans are rich in magnesium, copper, zinc, folic acid, which is necessary for creating new cells in the body and maintaining them in normal condition, and, of course, iodine - 100 grams of beans contain a little more than 30 mcg.

1. Sea kale

It is a real record holder for iodine content on par with cranberries - 300 mcg per 100 grams, which is twice the daily requirement! In addition, sea kale has only 25 calories (per 100 grams), almost no fats and carbohydrates - a real godsend for those who are always losing weight. But when buying ready-made salads from such cabbage in the store, you need to pay attention to the composition - mayonnaise sauces will not leave a trace of low-calorie content.

If there is a clear lack of iodine in the diet, an endocrinologist may prescribe special vitamin and mineral preparations containing iodine.

In order to enrich the diet with iodine, specially labeled food products are now produced, to which 10 to 30 percent of the daily requirement of this microelement is added. The most popular among them is iodized table salt, which contains about 45 mcg/g of iodine. If you use it in food instead of regular food, you can get the entire daily requirement of iodine. Information about added iodine should be included on the salt package. Iodized salt retains its properties for no longer than 3–4 months, even in a closed container. Very much iodine evaporates from such salt during intense boiling.

There is an opinion that an iodine grid will help determine whether there is a lack of iodine in the body. This is wrong. There is a common belief that if you draw an iodine grid on your body and it fades within 30 minutes, then you have iodine deficiency. But in reality, there is no connection between iodine deficiency and the rate of fading of the skin mesh. The rate of absorption depends only on the individual characteristics of the skin and the thickness of the subcutaneous fat tissue. And iodine deficiency can only be detected by taking a special urine test, since up to 90% of iodine ingested from food is excreted in the urine.

Endocrinologist A.I. Grigoriev

Iodine is the head of everything

05/22/2018 Last week, State Duma deputy and head of the health protection committee Dmitry Morozov said that it is time to address the problem of iodine deficiency at the state level.
Why is iodine deficiency so dangerous and how can it be overcome? - says Galina Melnichenko, director of the Institute of Clinical Endocrinology of the Federal State Budgetary Institution "Endocrinological Research Center" of the Russian Ministry of Health, vice-chairman of the Russian Association of Endocrinologists. — Galina Afanasyevna, in which regions do residents lack iodine?

— Yoda is not enough for all residents of Russia. All Russians have iodine deficiency to one degree or another. Let's take Moscow, for example. According to recent studies, Muscovites consume from 40 to 80 mcg of iodine per day, and this is with an optimum of 100 mcg outside pregnancy and breastfeeding. Iodine consumption can be considered close to sufficient in St. Petersburg and in some regions of the Far East. However, even there, Russians prefer to eat not what they have in abundance - fish and seafood, but pasta and potatoes.

— How long has humanity been familiar with the problem of iodine deficiency?

— European artists recorded the most obvious manifestations of iodine deficiency (goiters and cretinism) throughout human history. Spanish and French palaces, houses of wealthy Swiss merchant and banking families were “decorated” with paintings with goiters. The range of lesions was incredibly wide - from diffuse and nodular goiters to realistic images of cretins from regions with severe iodine deficiency. By the early 20th century, it became clear that a variety of symptoms with a combination of low intelligence, poor motor skills and large goiters were associated with iodine deficiency. Soon it was possible to establish the optimal iodine intake, as well as the geography of regions with iodine deficiency.

— When did people start struggling with iodine deficiency?

— At the beginning of the 20th century, the fact of iodine deficiency was established in those regions in which, according to today’s ideas, there is severe iodine deficiency (that is, iodine intake is equal to or less than 20 mcg per day). The Swiss Alps were the most severe example of iodine deficiency and were the first to use iodized salt to prevent iodine deficiency. Since then, salt in Switzerland, and then throughout the world, has become a “silent carrier” of iodine. This cheap and effective measure made it possible to easily eliminate socially significant developmental delays, including cretinism, and also prevent many diseases associated with iodine deficiency (functionally autonomous nodular and diffuse goiters). Young Soviet Russia was one of the first to take up the Swiss experience. In 1927, the first trips across the country were made to identify regions with low iodine levels. At that time, the fact of iodine deficiency was determined by assessing water resources, soil, plants and recording the frequency of goiters in the population. And from the point of view of the logic of that time, everything was clear: if people live here, that means they use this water, eat what is grown here, etc. The fight against iodine deficiency began quite energetically and by the beginning of the 50s, goiter dispensaries were actively working - iodine deficiency was eliminated, including in regions that were particularly difficult in this regard. The method was the same as in Switzerland - iodized salt was included in the diet, and the children were additionally given potassium iodide preparations. In 1957, despite the accession to the country of a large number of regions with severe cretinism caused by iodine deficiency (Western Ukraine, Belarus), the USSR Minister of Health stated that iodine deficiency had been eliminated throughout the entire Soviet Union (and in accordance with the method adopted at that time registration of iodine deficiency - according to the frequency of enlarged thyroid glands in the region). Later, already in the 80s, goiter dispensaries were also liquidated. Since then, the problem of iodine deficiency has received less and less attention.

— If iodine deficiency was eliminated in the 80s, why does this issue still need to be addressed at the state level?

— Around the 80s, European scientists found out that it is important not how much iodine is contained in the river waters or soil in the region of residence, but how much iodine enters our body. It became clear that iodine deficiency in the form that the world fought so diligently is severe iodine deficiency. But there is also a slight iodine deficiency. Such as in Moscow, for example. All these discoveries may not have been so important if the atomic explosion in Chernobyl had not occurred in 1986. 5 years after this nuclear disaster, a new line appeared in Soviet medical statistics - thyroid cancer in children began to be identified separately; before that, its frequency was so low that this disease was taken into account under the general heading “malignant formations of the neck organs.” The cause of the disease was hidden in the more active absorption of radioactive iodine by goitrous-altered children's thyroid glands in the conditions of the Chernobyl disaster. The risk of radioiodine-induced cancer increases fourfold in conditions of even mild iodine deficiency. Thus, the fight against iodine deficiency has become a matter of national security.

— How can the issue of iodine deficiency be resolved at the state level?

— Russia has adopted a model of voluntary, rather than mandatory, use of iodized salt. There is iodized salt on store shelves, but so far only a minority buy it. At some point, the country's chief sanitary doctor decided to have food prepared with iodized salt in school canteens. Now the state is faced with a more global task - it is necessary that products on an industrial scale, primarily bread, be prepared with iodized salt, and only iodized salt should be on the tables. At the same time, it is fundamentally important that iodized and non-iodized salt be in the same price range. Many countries did the following: they lowered non-iodized salt to a lower shelf or began selling it in pharmacies.

— How much salt should you eat per day to satisfy your body’s need for iodine? Are there cases of overdose?

— It is enough to replace regular salt with iodized salt. The daily salt intake - 5-7 g per day - is enough to fill the body with iodine. We cannot eat so much salt that we need to overdose on iodine by eating 100 g of iodized salt per day. Therefore, there is nothing to fear here.

— What happens if you don’t prevent iodine deficiency?

— Pregnant and nursing mothers are at greater risk than others. Lack of iodine provokes miscarriages, stillbirths, and the likelihood of congenital anomalies in children. After all, the fetus does not have its own thyroid gland until the 16th week, and the mother’s hormone, thyroxine, is consumed literally from the first days of the embryo’s life. The lack of the required amount of this hormone in a pregnant woman affects, first of all, the development of the nervous system of the unborn child, namely vision and hearing. Not getting enough iodine can play a bad joke on a child’s future performance at school and generally provoke an inability to perform skilled work. Deficiency of iodine and thyroid hormones in its extreme manifestations

- this is cretinism, which is detected from birth, but this happens rarely and with severe deficiency. If you have a mild iodine deficiency, your IQ or your child's IQ will be 10-15 points lower than those who live in an iodine-sufficient region. Most often we are talking about an IQ below 100, which, you see, will significantly reduce the opportunities for social fulfillment. The consequences of iodine deficiency in children from regions with mild and moderate severity can be deviant behavior, absent-mindedness, attention deficit, and lethargy.

— Are there any countries today that have overcome iodine deficiency? Which?

— Today, 113 countries around the world have in one form or another adopted a law on the prevention of iodine deficiency associated with the use of iodized salt. This means that in the food industry, at enterprises, food is prepared with iodized salt, it is sold in stores, which means it is on the table. Among our neighbors, Belarus and Kazakhstan can now be considered among the states free from iodine deficiency.

Iodine is as essential as air

The Japanese are one of the smartest nations in the world. The average IQ of a resident of the Land of the Rising Sun is 105 points. For comparison, Russia ranks only 25th in this indicator with a mark of 97 points. There are hypotheses that the Japanese are smarter because their diet is rich in iodine. Larisa Zhukova, Chairman of the Kursk Regional Branch of the Russian Association of Endocrinologists, Head of the Department of Endocrinology of Kursk State Medical University, talks about the connection between iodine and the intelligence of the nation, symptoms of its deficiency and effective ways to combat it, as well as the consequences of its overdose.

— Larisa Alekseevna, is it true that a lack of iodine affects brain function? During what periods of life is iodine deficiency critical?

— Iodine deficiency, especially if it is registered throughout the country, can contribute to a decrease in the mental potential of the entire nation. That is why pregnant women are recommended to take iodine supplements, thereby preventing congenital mental retardation in children. After all, iodine takes part in the formation of the nervous system, its growth and development. Therefore, in addition to pregnant women, the most vulnerable categories also include children of preschool and school age and nursing women.

— Have epidemiological studies been conducted on iodine consumption in Kursk and the region? What are their results?

— In the early 2000s, the Tiromobile project was implemented on the basis of the Kursk State Medical University, which was carried out with the assistance of the Russian Ministry of Health under the auspices of UNESCO. Then we examined 700 children from 9 to 12 years old in Kursk, visited almost all Kursk schools, as well as 300 patients in Zheleznogorsk, Kursk region. The main objective of the study was to understand how much iodine is consumed per day in food. We sent the obtained data to the Federal State Budgetary Institution “Endocrinological Research Center” of the Russian Ministry of Health, where they were statistically processed. In response, we received information that there is a mild form of iodine deficiency in Kursk.

— Do ordinary citizens know about the problem of iodine deficiency?

— At the end of the 90s. At the Department of Endocrinology of Kursk Medical University, we actively promoted iodine prophylaxis, including launching a large-scale information campaign in the press. For several years, a thyroschool operated free of charge at the emergency hospital, where endocrinologists referred patients. We developed this program for the tyroschool ourselves, it is still available, and most importantly, it is still relevant. It must be said that not only in Kursk in those years they were actively involved in the prevention of iodine deficiency. Similar actions took place throughout the country. Therefore, it is not necessary to say that the population does not know about such a problem at all: there was a lot of information, and it was conveyed in an accessible and massive way. People also know about this because even now they actively buy iodized products.

And it’s not just bread and salt, it’s also iodized dairy products. In general, foods that everyone eats need to be iodized.

— How does iodine deficiency manifest itself in the body? Will the average citizen be able to notice the changes or can only a specialist do it?

— First of all, the brain and thyroid gland react to iodine deficiency. If there are changes in the thyroid gland due to iodine deficiency, they can be easily identified at an appointment with an endocrinologist - small cysts and nodes appear, and the gland itself increases in size. Changes in brain function are less obvious. This was the reason that endocrinologists around the world sounded the alarm. In the 80s it was announced that endemic goiter had been eliminated in the USSR (note: an enlargement of the thyroid gland associated with iodine deficiency in the environment). From that moment on, the authorities stopped providing iodine prophylaxis to him. The subsequent explosion at the Chernobyl nuclear power plant 6 years later led to the massive spread of radioactive iodine, which was released into the atmosphere at the time of the explosion (note - when there is a deficiency in the environment, the thyroid gland actively absorbs it). This led to massive disruption of the thyroid gland, and the incidence of thyroid cancer increased almost 80-fold. Children and women of reproductive age were primarily affected by this. They began to work on eliminating iodine deficiency again only in the 90s; the peak of this activity occurred in 97-98.

— How to prevent iodine deficiency? What specialists should you contact for this?

— Preparations containing potassium iodide are available without a prescription and are recommended in principle to everyone, since we have mild iodine deficiency throughout the country. For example, it is a known fact that even in coastal regions where there is a lot of seafood, iodine deficiency still occurs. There is an opinion that to replenish iodine in the body you need to eat seafood, seaweed, and go to salt caves, but I still believe that it is more effective to consume iodine in the form of tablets, where the strict dose that you will consume is indicated. Because we still don’t know how many tons of seaweed to eat to make up for the daily iodine deficiency. If you love seafood, eat it with pleasure. For example, in the USSR there was fish day on Thursdays, and this clearly had some meaning. But you don’t need to reassure yourself that if you love and eat a lot of seafood, then you cannot avoid iodine deficiency.

— If there is a shortage, then logically there can be an overdose. Is this possible in our country? What should you do in this case?

— Overdoses happen, of course, but rarely. If we take the average daily dose for Russia at 150-200 mcg (for pregnant women - at least 250 mcg) and for comparison, the average daily iodine consumption in Japan, for example, then there it is several times higher than in Russia and equals approximately 1400 mcg per day. This affects the incidence: in Russia more malignant neoplasms are detected, but in Japan there are more autoimmune diseases of the thyroid gland. It is believed that an overdose of iodine leads to the activation of autoimmune processes in it. Since thyroid hormones are formed exclusively from the iodine that comes to us with food, since iodine is not synthesized inside the body. Theoretically, it can be assumed that excessive iodine consumption can lead to the formation of hormones and give so-called thyrotoxicosis (approx. - a complex of symptoms caused by excess production of thyroid hormones). This condition is fraught with heart rhythm disturbances for older people.

For reference: The thyroid gland produces hormones - triiodothyronine and thyroxine, which are 65% iodine. They affect the functioning of the nervous, immune, cardiovascular, respiratory systems, stimulate protein, fat, carbohydrate and mineral metabolism, and are also necessary for the normal functioning of the gonads. Therefore, with a lack of iodine in the human body, various disorders are observed, the severity of which directly depends on the degree of deficiency. Severe deficiency leads to the development of endemic goiter. Although the thyroid gland increases significantly in size, the amount of hormones it produces does not increase. Such patients develop symptoms characteristic of hypothyroidism: weight gain, fatigue, lethargy, apathy, dull hair, swelling of subcutaneous fat, decreased IQ. Moreover, deterioration of intellectual functions occurs even with a slight lack of iodine in the body. “Mild iodine deficiency leads to a decrease in cognitive abilities in children by about 10 IQ points, and then you can’t catch up,” notes Galina Melnichenko, director of the Institute of Clinical Endocrinology of the Federal State Institution Endocrinological Research Center of the Ministry of Health of the Russian Federation, academician of the Russian Academy of Medical Sciences.

QUESTION ANSWER

Is it possible to overeat with iodized salt?

I read that in France, only producers of classic national products - cheeses, baguettes - are allowed to choose salt at their own discretion, so as not to violate traditional recipes, and all other food producers are required to use iodized salt. Could excess iodine occur in the body if regular salt is completely replaced with iodized salt?

Marina.

Galina Melnichenko, Vice-Chairman of the Russian Association of Endocrinologists, Director of the Institute of Clinical Endocrinology of the Federal State Budgetary Institution “Endocrinological Research Center” of the Ministry of Health of Russia, answers:

— We cannot eat so much salt (about 100 grams daily) that there would be an “overdose” of iodine. Therefore, there is no need to worry about excess microelement intake through food.

Another thing is that we also receive iodine through the skin, that is, externally, for example, through an iodine mesh. And in this form, a colossal amount of iodine can really hit the body. A shock dose threatens to block the thyroid gland or, conversely, provoke increased production of hormones.

Many people are afraid of an allergy to iodine, but it is more correct to talk about the so-called “iodism” - that is, intolerance to large doses of iodine. This amount is contained in iodine tinctures and some medications, so they must be taken under the supervision of a specialist.

Ministry of Health reminds: iodine is good for health

According to the Ministry of Health of the Russian Federation, up to 70% of Russians experience a lack of iodine in the body to one degree or another. Thus, the average Muscovite consumes from 40 to 80 mcg of iodine per day instead of the norm of 100 mcg. In what cases does a lack of iodine become dangerous to health, and how to reduce the risk of diseases, “KP” learned from the vice-chairman of the Russian Association of Endocrinologists Galina Melnichenko.

LESS IODINE – LOWER IQ

The “storage” of iodine in our body, as well as the “producer” of iodine-containing hormones (thyroxine, triiodothyronine) is the thyroid gland. Iodine regulates metabolism and stimulates the functioning of immune system cells. Over the course of our entire lives, we consume no more than one teaspoon of iodine from the outside, but a deficiency of this microelement - depending on the level of deficiency - can cause irritability, fatigue, sweating, headaches, sudden weight changes, memory impairment, cardiovascular and respiratory problems. system.

The most noticeable manifestations of iodine deficiency are when a goiter grows in the neck area (the thyroid gland becomes enlarged, and toxic nodes can form in it in old age), as well as low intelligence (cretinism).

“A special group is pregnant and nursing mothers: they need almost twice as much iodine as an ordinary adult,” explains Galina Melnichenko, vice-chairman of the Russian Association of Endocrinologists, director of the Institute of Clinical Endocrinology of the Federal State Budgetary Institution “Endocrinological Research Center” of the Russian Ministry of Health. –

Lack of iodine provokes miscarriages, stillbirths, and increases the risk that a child will be born with disabilities. Until the 16th week, the fetus does not have its own thyroid gland, but literally from the first days of life, the embryo needs the mother’s hormone - thyroxine. Otherwise, problems with the development of vision and hearing may occur. Severe iodine deficiency is fraught with mental retardation in the baby. Although even a mild degree of iodine deficiency leads to the fact that the child’s IQ level will be 10 - 15 points lower than that of peers from iodine-free regions. Most often we are talking about an IQ below 100, absent-mindedness, attention deficit, lethargy - thus, the lack of iodine can play a bad joke on the child’s future performance at school and, in general, on his success.

HOW MUCH IODINE DO YOU NEED?

Our body receives 90% of iodine from foods, the remaining 10% comes from water and air. Residents of coastal regions are most fortunate, because their water, soil, and plants are rich in iodine. In addition, it is easier for them to diversify their diet with seafood. Squid, mussels, crabs, seaweed - all this saturates the body with essential microelements. But what should, say, Muscovites do so as not to expose their health to undue risk?

“Of course, there is no need to calculate the amount of iodine consumed with a calculator,” our expert reassures. – To replenish the daily dose of iodine, it is enough to replace regular salt with iodized salt. The daily salt intake - 5-7 g per day (1 teaspoon) - is also enough to fill the body with iodine. Severe iodine deficiency is considered to be an intake of 20 mcg or less of iodine per day.

Also, for prevention, nutritionists advise including beets, carrots, potatoes, cabbage, lettuce, persimmons, apples, grapes, plums, buckwheat, millet, cheese, cottage cheese, and milk in the menu.

HISTORY LESSONS

Portraits of people with goiters can be found in the interiors of palaces where the Spanish and French nobility lived, and in the ancient houses of the Swiss rich. But it was only at the beginning of the 20th century that scientists began to specifically identify regions with iodine deficiency. In particular, experts identified the Swiss Alps as the zones with the most severe iodine deficiency, and it was there that iodized salt began to be used for disease prevention. The product turned out to be cheap and effective. Young Soviet Russia was one of the first to adopt useful experience.

Already in 1927, Soviet specialists made a series of trips around the country to identify regions with low iodine levels. As a result, goiter dispensaries were opened, iodized salt was introduced into the diet of workers and collective farmers, and children were additionally given potassium iodide preparations. By the beginning of the 50s, serious iodine deficiency was eliminated.

Currently, 113 countries have laws on the prevention of iodine deficiency with iodized salt. This salt is used in the food industry, cafes and restaurants. In a number of countries, it has even replaced ordinary salt on store shelves. And simple salt began to be sold in pharmacies, since in some situations patients are prescribed an iodine-free diet (for example, during treatment with radioactive iodine after surgery due to thyroid cancer). There are no similar laws in Russia yet, so consumers buy iodized salt based on their own knowledge and preferences.

In 2010, the President of the Russian Federation approved the Food Security Doctrine, which provides for the production of food products for mass consumption, enriched with vitamins, iodine and other minerals. Thanks to this, familiar products could become helpers in the fight against deficiency of important substances. Thus, 200-300 g of bread baked with iodized salt covers about 50% of the adult’s daily iodine requirement.

It is planned that by 2021 the share of fortified products will reach 40 - 50% of total production. But for now, such installations are voluntary for the market, so in reality the numbers are not the most rosy. Despite the recommendations of Rospotrebnadzor, only 14% of enterprises produce fortified food products.

For bread and bakery products, the volume of fortified products is 6.4%, for milk – 3.1%, for drinks – 8.1%.

FIGURES AND FACTS

According to the State report “On the state of sanitary and epidemiological well-being of the population in the Russian Federation in 2012,” more than 50% of the constituent entities of the Russian Federation are iodine deficient.

More than 60% of Russians live in regions with naturally occurring iodine deficiency. Risk zones include: Ingushetia, Dagestan, Kabardino-Balkaria, Karachay-Cherkessia, Chechnya, Nenets Autonomous Okrug, Astrakhan Region, Republic of Adygea, Tyva, Irkutsk Region, Republics of Altai and Buryatia, Altai Territory, Kemerovo, Tomsk, Amur, Ulyanovsk Regions , Chuvash Republic, Saratov, Bryansk, Oryol, Vladimir, Ivanovo regions, etc.

Every year, due to iodine deficiency, more than 1.5 million adult Russians and 650 thousand children with thyroid diseases need specialized endocrinological care.