Dietary restriction causing iodine-deficient goitre

Don't know what anyone else will make of this, but I find it very odd. Salt iodisation is fairly rare in the UK. (Anyone got the figures?) It says: Many contemporary salt preparations do not contain much iodine - but actually most salt in the UK is not iodised and contains next to no iodine. Nonetheless, the important message is that a sufficiency of iodine is vital - though we have endless discussion, including frank disagreement, about how much really is needed. It is also a specific warning about elimination diets - in addition to what we are intending to eliminate, and however important that elimination may be, what else might we forfeit?

Arch Dis Child doi:10.1136/archdischild-2015-308567

• Case report

Dietary restriction causing iodine-deficient goitre

1. Tim Cheetham1,

2. Emma Plumb2,

3. James Callaghan3,

4. Michael Jackson4,

5. Louise Michaelis5

6. 1Department of Paediatric Endocrinology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

7. 2Department of Dietetics, North Tyneside General Hospital, Tyne and Wear, UK

8. 3Department of Dietetics, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

9. 4Department of Radiology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

10. 5Department of Paediatric Immunology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

11. Correspondence to Dr Tim Cheetham, Department of Paediatric Endocrinology, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP, UK; tim.cheetham{at}

• Received 10 March 2015

• Revised 18 May 2015

• Accepted 21 May 2015

• Published Online First 11 June 2015


Iodine-deficient goitre was common in some parts of the UK prior to the introduction of salt iodisation. Many contemporary salt preparations do not contain much iodine, and there are renewed concerns about the iodine status of the population. We present a boy with severe allergy who developed goitre and significant thyroid dysfunction in association with an iodine-deficient ‘food-restricted’ diet. The case highlights the importance of a comprehensive nutritional assessment in all children on multiple food restrictions.

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27 Replies

  • Helvella, Very odd. Unless salt's been iodised on the sly.

  • Aha!

    Doesn't answer much except the amounts. But not the history - I remember occasionally seeing it back in the 1960s.

  • I remember the salt being used in my family in the 60s was iodised.

  • Helvella, as low salt campaigns seem to have ruled out iodised salt, perhaps they should iodise sugar.

  • Clutter,

    Judging by the litter, the spam leaflets, the adverts, the delivery bikes, the people standing on street corners in silly box-like costumes, the contents of freezers and chillers in every supermarket and corner shop, I think I'd suggest iodised pizza. :-)

  • There's a lot of salt in those pizzas! If they used sea salt or hymalayan they wouldn't need iodinising

  • Sea salt contains minerals from sea-water.

    Most of the iodine that gets into sea-water gets absorbed by the things living in the sea - that is why seaweed has its high iodine content. But it leaves very little in sea salt.

    You'd have to take an awful lot in to get even the recommended 150 micrograms a day.

    Himalayan salt is around 98% sodium chloride. There really is not a large amount of any other substance. I can't rememebr the amount of iodine but, as with sea-salt, you need to consume quite a lot to get to 150 micrograms.

  • Sea salt also contains a lot of bromine which is not good for thyroid. I don't understand this celtic sea salt business because of this.

  • I mention that on another response further down. But if the bromine content is bad, then yes, it certainly has more bromine than iodine.

  • Most people get most of their salt in manufactured foods these days, practically none of which is made with iodised salt.

    There was a report, not many years ago, about the poor iodine status of teenage girls, who were restricting their milk consumption to try and avoid weight gain. Milk is/was a valuable source of iodine, due to the product used to sterilize cows' udders (though it may be being phased-out).

    Ages ago, I used to have a teaspoonful of powdered kelp per day, which I no longer think was a good idea.

  • Not entirely true now.

    Have a look round the shelves and look very carefully - many German products use iodised salt. Hence, in Aldi and Lidl, quite a number of products were made with iodised salt. Some products in other shops are also made with iodised salt.

  • That's interesting, though I haven't a store near enough to be able to check. I could only find Brown Bread Rolls, Ciabatta Rolls and Part Baked Brown Baguettes stated as being made with iodised/iodated salt on the Aldi website. Neither Aldi nor Lidl offer much product information online, unfortunately.

    "The prevalence of autoimmune thyroiditis is higher in populations with a high intake of iodine than in populations with a low intake. Other data indicate that iodine supplementation in populations with low iodine intake can increase the incidence of thyroiditis." p.86 Thyroid Disease in Adults, Ernst Nyström et al, 2011.

  • That thing about iodine supplementation: they didn't supplement selenium as well and these people are low in both.

  • Here in Australia you have a choice.

  • You have a choice in terms of buying iodised or non-iodised salt here in the UK. Both are widely available, though smaller shops (including smaller branches of large supermarkets) tend not to stock the iodised products.

  • Does sea salt contain iodine?

  • I have recently read that sea salt does not contain iodine.

  • My understanding is that it does it naturally contains minerals from the sea.

  • Sea salt contains minerals from sea-water.

    Most of the iodine that gets into sea-water gets absorbed by the things living in the sea - that is why seaweed has its high iodine content. But it leaves very little in sea salt.

    You'd have to take an awful lot in order to get even the recommended 150 micrograms a day.

  • If you google 'does sea salt contain iodine' there's lots of info. In general you have to find a sea salt fortified with iodine, it has less iodine than ordinary table salt.

  • And if you go to the Celtic sea salt site it tells you that ordinary table salt has iodine bonded on whereas there's has it from the sea and gives the amounts. Or use hymalayan that has lots of minerals.

  • Does it tell you how much iodine is in the Celtic sea salt?

    The site I went to says it has, in the usual "limit" for salt intake in the UK of 6 grams, just 12 micrograms of iodine. That is 8% of the standard daily requirement.

    Bear in mind that it contains considerably more bromine and aluminium - two substances that others on this forum say, in strong terms, should be avoided.

    (My figures are based on the sea salt actually containing the amount indicated as a "contains less than" amount.)

  • It's hopeless without access to the full report. What foods was this child eating? It sounds as though his mother had restricted some foods because of allergies - not unreasonable if they were real allergies and not some imaginary condition some shyster had conned her over with a nonsense test - or was it that the child was restricting its own diet, like mine? I guess if it wasn't eating fish fingers because of gluten, the poor woman just hadn't discovered the Sainsbury's free-from frozen food cabinet.

    My experience of hospital paediatric dieticians is that though personally delightful, they are nearly as useful as endocrinologists.

  • My lyme disease doctor recommended me to have iodine supplements, but a GP told me to stop them - so to make up my own mind, I have ''studied'' long and large the issue of iodine supplements (to take or not to take) even after having a loading test that showed me to be deficient.

    Japanese get about 13mg from their daily diet, so my maintenace dose has been 12.5mg, which I doubled when hyper symptoms aggravated = 25mg.

    To treat medical conditions, the dose needs to be higher (for further study see for example the books on Iodine –

    Why You Need It, Why You Can’t Live Without It (5th edition) by David Brownstein, M.D.

    Autoimmune Disease, Cancer, Detoxification, Fatigue, Thyroid Disease

    Dr Brownstein is the Medical Director of the Center for Holistic Medicine in West Bloomfield, Michigan ( The rising incidence of Hashimoto’s and Graves’ disease correlates with falling iodine levels.

    The Iodine Crisis – What You Don’t Know About Iodine Can Wreck Your Life by Lynne Farrow. Her own experience with breast cancer lead her to extensive research; currently serving as Director of Breast Cancer Choices, Inc – a non-profit organization. She is also the founder of Breast Cancer Think Tank and editor of (

    Iodine consumption has dropped 50% since 1970s – and the drop has corresponded with the dramatic increase in breast disease and cancer, prostate cancer and thyroid disease.

    With iodine complex supplementing my cold nodule (thyroid area) has become a hot one (no longer a concern that needs to be monitored), my breast calcification has disappeared!!, and for example TSH has become from hyperthyroid (so low that could not be measured) to 1.0-1.5 (sometimes lower but measurable) .

    I hope this helps.

  • Fascinating reply, thank you. Especially as I've been recalled for a biopsy because my breast calcification has spread! Can you pm me with the brand of iodine that you take? Thank you LB

  • how do I send a pm from here to you LB?

  • If you click on my photo, my page should come up. Thanks LB

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