Iodine – Beyond the Salt Shaker: Heads Up To Vegetarians In The Goiter Belt

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Do you live in an area known as the “goiter belt”? Are you a vegetarian, or have you switched to sea salt, or perhaps cut back on salt altogether for health reasons? If so, your iodine intake may be more important than you realize.

Iodine is essential for healthy thyroid function, yet modern diets and lifestyle changes can sometimes lead to insufficient intake. Understanding when and how to supplement can help you protect your thyroid and overall well-being.

In this article, we’ll look at why iodine matters, the potential benefits of supplementation, and how to know if adding iodine to your routine might be right for you.

What Is Iodine?

Iodine is an essential micronutrient your body cannot produce on its own, yet it plays a central role in thyroid function and overall health. The thyroid gland uses iodine to create the hormones thyroxine (T4) and triiodothyronine (T3), which regulate metabolism, growth, and development. Although most of the iodine you consume is absorbed in the gut and concentrated in the thyroid (which holds about 70–80% of the body’s 15–20 mg supply), excess iodine is excreted primarily through urine, with smaller amounts lost in sweat and stool.

Inside the thyroid, iodine is attached to tyrosine residues of thyroglobulin to form monoiodotyrosine and diiodotyrosine, which combine to produce T3 and T4. T3 is the active hormone and can also be formed from T4 through de-iodinase enzymes. Thyroid hormone levels are tightly controlled by the hypothalamic-pituitary-thyroid axis: low hormone levels stimulate thyrotropin-releasing hormone (TRH) and thyroid-stimulating hormone (TSH) release, prompting the thyroid to trap more iodine and synthesize more hormones. Conversely, very high iodine levels can suppress this process and even lead to a temporary shutdown of thyroid hormone production, known as the Wolff-Chaikoff effect.

Deficiency of iodine, while often associated with goiter, can also lead to a range of other problems collectively called iodine deficiency disorders (IDDs). These range from mild, reversible changes in thyroid size to severe, permanent effects on growth and development. For example, severe deficiency in pregnant women can result in congenital iodine deficiency syndrome (cretinism) in their children, characterized by irreversible mental impairment and physical abnormalities.

Most people can meet their iodine needs through foods such as seafood, dairy products, and iodized salt. However, individuals who avoid these foods, live in low-iodine regions, or follow certain diets may be at higher risk of deficiency. In such cases, iodine supplements can provide an effective alternative to ensure adequate intake. ~PMC10844808

What Are the Benefits of Iodine?

• Fetal and Neonatal Development: Adequate iodine intake during pregnancy is crucial for the development of the baby’s brain and nervous system, reduces the risk of stillbirth and infant mortality, and prevents cretinism, characterized by stunted physical and intellectual growth. [*] The recommended daily intake of iodine for pregnant women is 220 mcg daily. ~PMC3266621 A study in Papua New Guinea found that giving iodized oil to women before or early in pregnancy reduced cretinism. ~PMC3257674
• Thyroid Function: Iodine is essential for the production of thyroid hormones, which regulate metabolism and influence energy levels and body temperature. Not enough iodine can cause hypothyroidism with symptoms like fatigue, weight gain, and feeling cold. [*] However, both too much and too little iodine can disrupt thyroid function. ~PMC4049553 
• Cognitive Development and Function: Necessary for the development of the brain and nervous system, especially during pregnancy and early childhood, iodine is linked to better cognitive outcomes in children. Its deficiency may result in learning difficulties and reduced mental function. [*] Several studies have explored the impact of iodine deficiency on intellectual abilities. ~PMID: 16400058 One study discovered that schoolchildren aged 7-11 with moderate iodine deficiency have different cognitive abilities compared to those with sufficient iodine levels. ~PMC9599038 
• Preventing Iodine Deficiency Disorders: Iodine supplementation helps prevent conditions such as goiter, which is the enlargement of the thyroid gland, as well as other health problems that arise from low iodine levels, including certain developmental issues. [*] For populations, using iodized salt and water has been an effective way to improve iodine intake. On an individual level, iodized oil or supplements can raise iodine levels more directly. It is important to ensure that iodine intake is sufficient to prevent iodine deficiency disorders (IDD), particularly during pregnancy, while also avoiding excessive amounts. ~PMC9459956  
• Breast Health: It may influence breast tissue health and help manage symptoms of fibrocystic breast disease, leading to less painful and lumpy breasts. [*], and in reducing the risk for breast cancer. [PMC5327366]
• Immune System Support: Iodine plays a role in the body’s defense mechanisms, boosts antioxidant activity, and supports detoxification, all of which are vital for a well-functioning immune system. [PMC7865438]

Who Might Need an Iodine Supplement?

• Pregnant and Breastfeeding Women: During pregnancy and breastfeeding, women need more iodine to support fetal and newborn brain development. Adequate iodine levels are essential to prevent developmental issues and congenital hypothyroidism in babies. ~PMID: 19178515
• People Living In Iodine-Deficient Areas: Those who live in areas with iodine-depleted soil may not get enough iodine from local food and may not use iodized salt. ~PMID: 1831913 Supplementation can prevent iodine deficiency disorders such as goiter and hypothyroidism. ~PMC9646315  
• Vegetarians and Vegans: Since plant-based diets can lack sufficient iodine, especially if foods like seaweed are not regularly consumed, vegetarians and vegans could need a supplemental source of this nutrient. ~PMID: 12748410
• Individuals with Certain Health Conditions: Conditions that affect the thyroid, gastrointestinal tract, or overall nutrition absorption might necessitate iodine supplements to ensure adequate levels for thyroid hormone production and metabolic balance.

How Do Thyroid Disorders Affect Iodine Needs?

Thyroid conditions can greatly influence the body’s needs for iodine since this mineral is a key component of thyroid hormones that regulate metabolism.

• Hypothyroidism: This condition occurs when the thyroid gland doesn’t produce enough thyroid hormones. Iodine deficiency is a common cause of hypothyroidism because without enough iodine, the thyroid cannot make enough of these hormones. In such cases, increasing iodine intake, either through diet or supplements, can help manage hypothyroidism. However, if the hypothyroidism is not due to iodine deficiency, extra iodine may not help and could potentially worsen the condition.
• Hyperthyroidism: In contrast, hyperthyroidism is when the thyroid gland is overactive and produces too much thyroid hormone. In cases of hyperthyroidism, excess iodine can worsen the condition, as the thyroid may use the additional iodine to produce even more thyroid hormone.
• Autoimmune Thyroid Disease: Conditions such as Hashimoto’s thyroiditis (leading to hypothyroidism) or Graves’ disease (leading to hyperthyroidism) can affect how the body uses iodine. People with these conditions must be cautious with iodine intake, as it can trigger or worsen symptoms.

Because thyroid conditions can change how the body uses iodine, it’s crucial for people with these conditions to have their iodine status and thyroid function monitored by healthcare professionals. Adjustments to iodine intake should be made based on medical advice to avoid worsening any thyroid-related issues.

How Much Iodine Do We Need?

The Recommended Dietary Allowance (RDA) for iodine for adults is 150 micrograms per day. The RDA is defined as the amount considered sufficient to meet the nutrient requirements of nearly all (97-98%) healthy adults. However, intake can vary widely based on dietary habits and the use or avoidance of iodized salt. The Tolerable Upper Intake Level (UL) for iodine for adults is set at 1,100 micrograms per day. This is the maximum daily intake unlikely to cause adverse health effects in the general population. Intakes above this level could increase the risk of hyperthyroidism and other iodine-related health issues.

Food Sources of Iodine

Are Iodine Supplements Safe?

Iodine is safe for most people when taken in appropriate amounts, either through diet or supplements. It’s a naturally occurring element that our bodies need for essential functions like thyroid hormone production. When you stick to recommended daily doses, iodine has a low risk of side effects. However, excessive iodine supplementation can cause hyperthyroidism.

Medication Interactions with Iodine

• Antithyroid medications: Antithyroid medications, such as methimazole (Tapazole), are used to treat hyperthyroidism. Taking high doses of iodine with antithyroid medications can have an additive effect and could cause hypothyroidism.
• Angiotensin-converting enzyme inhibitors: Angiotensin-converting enzyme (ACE) inhibitors, such as benazepril (Lotensin), lisinopril (Prinivil and Zestril), and fosinopril (Monopril), are used primarily to treat high blood pressure. Taking potassium iodide with ACE inhibitors can increase the risk of hyperkalemia (elevated blood levels of potassium).
• Potassium-sparing diuretics: Taking potassium iodide with potassium-sparing diuretics, such as spironolactone (Aldactone) and amiloride (Midamor), can increase the risk of hyperkalemia.

Supplement Interactions with Iodine

• Selenium: Taking selenium with iodine may improve thyroid function, but excessive amounts of both can be harmful.
• Calcium: High doses of calcium may interfere with the body’s ability to absorb iodine, potentially reducing its effectiveness.
• Iron: Iron and iodine both contribute to thyroid health but taken together may interfere with each other’s absorption.
• Magnesium: Magnesium can potentially affect the efficacy of iodine in regulating thyroid hormones.
• Zinc: While both are crucial for thyroid function, zinc may inhibit the body’s ability to absorb iodine when taken together.
• Copper: Copper may interact with iodine, affecting thyroid hormone levels, though more research is needed.
• Vitamin C: High doses of Vitamin C may increase the excretion of iodine from the body, reducing its availability.
• Folic Acid: Folic acid and iodine both play a role in pregnancy and development, but excessive amounts of one may affect the metabolism of the other.
• B Vitamins: Some B vitamins like B12 are important for thyroid function but may interact with iodine absorption if taken together.

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To Sum It Up

Iodine plays a critical role in maintaining healthy thyroid function and is essential for cognitive development, especially in pregnancy and infancy. While iodine is available in various foods, certain populations, such as vegetarians and those who avoid iodized table salt, can easily fall short of their daily needs. This risk is greater for those living in northern regions of the US known as the ‘goiter belt,’ where the soil and, consequently, the food supply is naturally low in iodine. Supplementing with iodine can be a vital strategy to ensure adequate intake, supporting overall health, and preventing the negative outcomes associated with deficiency.

This Article is Not a Substitute for Medical Advice

This information is provided for educational purposes only and is not a substitute for medical advice. Supplement Sciences does not provide medical care and cannot ensure the safety or effectiveness of any product for your personal use. Always consult your physician before starting any supplement, especially if you are pregnant, breastfeeding, or managing a serious health condition such as cancer, liver disease, or kidney disease. Dietary supplements are not designed to diagnose, treat, cure, or prevent any disease.

* These statements have not been evaluated by the Food and Drug Administration.