Iodine deficiency disturbs the metabolic profile and elemental composition of human breast milk

[helvella]

Sometimes it appears that the thyroid world divides in two - on the one hand, those who avidly promote taking iodine, sometimes in prodigious quantities, and on the other hand, those who dismiss iodine out of hand.

What I consider necessary is an understanding of where you are in terms of iodine levels, and making careful, thoughtful, adjustments, if needed. It being important to take the individual fully into account. And being especially aware of iodine content of all sorts of things from salt, through seafood, medicines and even glace cherries.

This is made difficult by the cost of things like urinary iodine tests at anything like the frequency that would really help. And the lack of decent, low-dose iodine supplements which have well defined and consistent iodine content.

Seaweed products (kelp or others) vary considerably. Even iodised salt (assuming it starts out consistent) varies as the iodine sublimes during storage (a huge problem in hot countries).

Iodine deficiency disturbs the metabolic profile and elemental composition of human breast milk

A.Arias-BorregoaI.VelascobJ.L.Gómez-ArizaaT.García-Barreraa

doi.org/10.1016/j.foodchem.... rights and content

Under a Creative Commons license

open access

Highlights

• First metabolomic analysis of human breast milk of iodine deficient women.

• 31 metabolites were found altered in human milk of iodine deficient women.

• Se, Cu and Zn were significantly lower in human milk of iodine deficient women.

• Elements and metabolites could be used to predict iodine deficient lactating women.

Abstract

Human breast milk (HBM) has a beneficial impact on health programming, growth and neurodevelopment of newborns. Increase in iodine intake is recommended for pregnant women in order to produce enough thyroid hormones to meet foetal requirements. In this work, a combined analytical multiplatform based on gas chromatography coupled to mass spectrometry and ultra-high performance liquid chromatography coupled to quadrupole-time-of-flight mass spectrometry has been applied in the first metabolomic study of HBM of iodine-deficient women. In addition, the elemental composition of HBM has been determined by inductively coupled plasma triple quadrupole mass spectrometry. Remarkably, 31 metabolites with important biological roles (e.g. glycerophospholipids for neurodevelopment) were seen to be altered in the HBM of iodine-deficient women. The main metabolic pathways altered include lipid metabolism, amino acid cycle, the tricarboxylic acid cycle and glycolysis. Additionally, the concentration of selenium, zinc and copper were seen to be significantly lower in HBM of iodine-deficient women.

Keywords

Human breast milk

Iodine

Inductively coupled plasma mass spectrometry

Metabolomics

Trace elements

Full paper freely accessible here:

sciencedirect.com/science/a...

[yesendi]

Thanks for posting this. I am still so confused as to whether add iodine to my diet or not. Currently, I use sea salt for cooking but it doesn’t have iodine in it and I don’t know if my levo provides enough of it. My hope is that I, perhaps am getting some iodine from the foods I eat.

[helvella in reply to yesendi]

I think the only way of knowing is by doing a test - probably a urinary iodine test (non-loading).

However, you could carefully assess your intake across all your foods/drinks. And use that as a guide.

You can work out the iodine content by referring to my document:

helvella - Vade Mecum for Thyroid

The term vade mecum means:

1. A referential book such as a handbook or manual.

2. A useful object, constantly carried on one’s person.

Please don't get put off by the number of pages!

Not everything is in this one document - my major medicines document is still separate!

From Dropbox:

dropbox.com/s/vp5ct1cwc03bl...

From Google Drive:

drive.google.com/file/d/1ZW...

[MillyP]

Thank you for posting this! As a breastfeeding mum and breastfeeding peer supporter this is really interesting (and a bit worrying).I found a thyroid nodule 3 years ago which I was told was totally benign and 'boring' but it grew by more than 50% while I was pregnant and I believe had continued to grow since. I have been vegan my whole life and asked if this could be happening due to iodine deficiency but this concern was dismissed and repeated requests for iodine levels tests were rejected by the NHS doctors I spoke to. I have been taking multivitamins most (but not all as I'm a bit forgetful) of that time and my son seems to be well, but it still concerns me that any deficiency I have had will be made worse by pregnancy and breastfeeding and I don't know if I'm taking enough to get to a sufficient level.

To make matters worse, out of sheer bad luck it seems I developed vocal cord paralysis on my left side (the majority of my fluid filled thyroid nodules are on the right side) after my son was born, so I'll never have use of my left vocal cord again. My hormone levels are normal, with somewhat elevated TSH at all tests but T3 and T4 normal. All I've been offered is thyroid surgery to remove half the thyroid but I'm aware this comes with a legitimate risk of vocal cord paralysis on the only side that currently gives me voice/breathing/swallowing!!! Plus I would then need lifelong hormone replacement as my thyroid currently works normally. My sister believes she had a nodule and it went away when she took high doses of iodine, but I don't want to gamble when I'm still breastfeeding.

I'm really struggling to know who I can speak to that will properly look at me as a person, look into the iodine question, take my paralysis seriously as a factor in treatment options and basically just give a s***! I've found every doctor I've seen so far to be really dismissive. Lately I've been habing pain in the nodule and was refused a checkup because it's been diagnosed as benign already. Have you got any ideas on where I could turn for some new information/support? My lump is aesthetically an issue for me, and I have a great deal of anxiety about the future of my only vocal cord so I feel like I need to take action before the nodules grow and impact upon the vocal nerve on that side.

Sorry for the long ramble, I've just found this page and I'm a bit desperate!

[helvella in reply to MillyP]

I wish I could point you at someone who would listen, look and understand.

Would you be in a position to get an iodine test done?

Preferable also TSH, Free T4 and Free T3.

[MillyP in reply to helvella]

The GP was getting TSH, T3 and T4 done every 6-8 weeks when I was pregnant, then twice after my son was born. The TSH was always high but the others normal. They said as it was less high TSH at the latest blood test they assumed it was pregnancy related and on its way down. I could probably request another blood test but they refused to test my iodine when I was pregnant, despite my fears that low iodine could cause problems for my baby. They said if I was taking a multi vit there was no point testing it. Are you aware of private iodine test providers? I think they weren't keen to do it because it required a urine test which goes to a lab, and to be honest I don't think they could be bothered.

[helvella in reply to MillyP]

Normal for you is a small part of the full reference interval for the population. Poor interpretation seems likely.

Not sure who does iodine tests but have a look here:

thyroiduk.org/help-and-supp...

I've posted this a few times!

You just might find the article below (and the full paper which you can access) interesting and/or useful.

The normal range: it is not normal and it is not a range

1. Martin Brunel Whyte

2. Philip Kelly

Abstract

The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.

dx.doi.org/10.1136/postgrad...

pmj.bmj.com/content/94/1117...

[tattybogle in reply to MillyP]

SeasideSusie replied to someone else asking for iodine testing with this :

" if you want to do a test then Genova Diagnostics do one, you would need to use ThyroidUK as your "practioner".

Details here :

thyroiduk.org/help-and-supp...

Test details on page 3 of the pdf linked to :

Urine Iodine Test:

Specimen requirements: Urine

Cost: £71.00

Order Code: END25

Turnaround time: 5 - 10 days

"Iodine is an essential trace element, vital for healthy thyroid function. Adequate levels are required to enable the production of T3 and T4 thyroid hormones, whilst also being required in other areas of health.

Deficiencies can lead to impaired heat and energy production, mental function and slow metabolism. Urine iodine is one of the best measures of iodine status. This test is not performed as a loading test, but can be used to establish existing levels or to monitor iodine supplementation".