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Iodine Deficiency
Dr Ben Balzer, General Practitioner
Beverly Hills Medical Service, Sydney
For Iodine Australia
Iodine
 Iodine is one of the most important
brain nutrients and affects peak brain
development.
 Iodine deficiency is rampant at present
is Sydney. There is no data on the
elderly.
Iodine Australia
What is Iodine?
 A chemical element, it cannot be
created nor destroyed (outside of a
nuclear reaction).
 If it is not in the soil it is not in the food
from the land. The sea is rich in iodine
so seafood has some iodine and
seaweed has a lot. (But seafood is not
the answer for most people).
Iodine Australia
What does Iodine do?
 An essential component of Thyroid
hormone T3 T4 which is how it acts on
the body.
 In the foetus it has a profound effect
upon brain development via maternal
and foetal thyroid hormone.
 It appears that iodine does not have a
direct effect on the brain apart from via
thyroid hormones.
Iodine Australia
What affects our IQ?

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Genes
Diet- Iodine
13.5 points
Diet- Omega-3
5 points
Diet- Breastfeeding
5 points
Lead poisoning
Minus 7 to 20 points
Other
Iodine Australia
What affects our IQ? Other:
 Birth weight Birth order Number of years in school
Social group of parental home
Father's profession Father's economic status
Parental ambition Mother's education
Average book-reading Emotional adaptation
Self-confidence according to attitude scale measurement
Age (negative relationship in adults)
Degree of authority in parental home (-ve)Criminality (-ve)
Average TV viewing (-ve) Height Number of siblings (-ve)
Infant malnutrition (-ve) Degree of parental rigidity (-ve)
Alcoholism (-ve) Mental disease (-ve)

http://www.wilderdom.com/personality/L4-1IntelligenceNatureVsNurture.html
Iodine Australia
What effect does ID have on IQ?
 Minus 13.5 points
(ref) http://members.aol.com/svennord/ed/normal.htm arbitrary average of 100 and standard deviation of 15.
Iodine Australia
What effect does ID have on IQ?
 Minus 5 points doubles developmental delay
Iodine Australia
What effect does ID have on IQ?
 Minus 13.5 points!!!!
 3 times increase in mild developmental delay
IQ <85
 7 times increase in severe developmental
delay IQ <70
 bright (IQ>115) and gifted children (IQ>130)
plummet from (bright) 16% to 2.3%, and the
gifted from 2.3% to 0.13% = 1/18th i.e almost
totally absent.

Note that the definitions may vary for delay and giftedness but the statistics are accurate for the IQ number.
Iodine Australia
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A general diminution in intelligence in iodine-deficient communities such that iodine
deficiency is considered to be the commonest cause of preventable intellectual
disability worldwide.
Further, there is now very good evidence that a small decrease in serum free
thyroxine level during pregnancy, either because of iodine deficiency or thyroid
disease, is an important risk factor for impaired psychomotor development in infants.
The recent demonstration of intellectual impairment in the children of American
women who had mild hypothyroidism in pregnancy highlights the need for better
detection and treatment of hypothyroidism in early pregnancy, irrespective of its
cause.
Recent Italian work demonstrates increase in ADHD in children born in an area with
reduced iodine intake
Iodine Australia
WHO daily intake: optimal
iodine nutrition
Adults
150 µg/day
Pregnancy and
Lactation
200 µg/day
Children (6-12
years)
120 µg/day
Infants (0-5
years)
90 µg/day
http://www.nutritionaustralia.org/Food_Facts/FAQ/what_is_iodine_faq.asp
Iodine Australia
 Iodine deficiency in Australia is a severe
public health problem (Ref 1,2,3,4).
Iodine intake continues to fall. WHO is in the
process off increasing the reference intakes
for iodine, so the level of deficiency from
current published estimates is a significant
underestimate.
Iodine Australia
ID in Australia 1
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Iodine deficiency and goitre in schoolchildren in Melbourne, 2001 Ciara M McDonnell,
Mark Harris and Margaret R Zacharin
76% (439/577) of students had abnormal urinary iodine values, with 27%
(156/577) having values consistent with moderate–severe deficiency. The
median urinary iodine excretion for the total group was 70μg/L, with values
for school years 5–12 ranging from 62 μg/L (Year 12) to 76 μg/L (Year 9).
The median urinary iodine value in girls was lower than that in boys (64μg/L
v 82 μg/L), and girls had significantly lower urinary iodine values overall (P <
0.002). There was no association between goitre grade and moderate–severe
(< 50 μg/L; P = 0.39) or mild (50–99 μg/L; P = 0.07) urinary iodine
deficiency.
http://www.mja.com.au/public/issues/178_04_170203/mcd10274_fm.html
Iodine Australia
ID in Australia 2

Iodine deficiency in urban primary school children: a cross-sectional analysis Kamala
Guttikonda, Cheryl A Travers, Peter R Lewis and Steven Boyages MJA 2003; 179 (7):
346-34 http://www.mja.com.au/public/issues/179_07_061003/gut10121_fm.html
Iodine Australia
ID in Australia 3
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Iodine deficiency in ambulatory participants at a Sydney teaching hospital: is Australia
truly iodine replete? Jenny E Gunton, Graham Hams, Marcelle Fiegert and Aidan
McElduf MJA 1999; 171: 467-470
http://www.mja.com.au/public/issues/171_9_011199/gunton/gunton.html
Results: Moderate to severe iodine deficiency was found in 16 pregnant women
(19.8%), five postpartum women (19.2%), 46 patients with diabetes (34.1%) and five
volunteers (26.3%). Mild iodine deficiency was found in an additional 24 pregnant
women (29.6%), nine postpartum women (34.6%), 51 patients with diabetes (37.8%)
and 9 normal volunteers (47.4%). Median urinary iodine concentration was 104 µg/L in
pregnant women, 79 µg/L in postpartum women, 65 µg/L in patients with diabetes
mellitus and 64 µg/L in volunteers.
Iodine Australia
ID in Australia 4
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Where has all our iodine gone? The possible re-emergence of iodine deficiency in
Australia needs to be investigated in national surveys Creswell J Eastman AM
(Editorial)MJA 1999; 171: 455-456
http://www.mja.com.au/public/issues/171_9_011199/eastman/eastman.html
It was predicted by a speaker at the Nutrition Society of Australia Annual Scientific
Meeting in Brisbane 2004 that he expected to see cretinism emerge again in Australian
neonates if the problem of iodine intake is not addressed.
Iodine Australia
WHO daily intake: optimal
iodine nutrition
Adults
150 µg/day
Pregnancy and
Lactation
200 µg/day
Children (6-12
years)
120 µg/day
Infants (0-5
years)
90 µg/day
Iodine Australia
WHO daily intake: optimal
iodine nutrition
Adults
150 µg/day
Pregnancy and
Lactation
200 µg/day
Children (6-12
years)
120 µg/day
Infants (0-5
years)
90 µg/day
Iodine Australia
Iodine Deficiency Australian Style?
 The irony: Australians receive international
accolades for helping 3rd world countries beat
iodine deficiency!
Iodine Australia
Iodine Deficiency Australian Style?
Iodine Australia
Myths about nutrient
supplements
 Myth 1. Vitamins just give you expensive
urine
 Fact 1. All drugs etc give you expensive urine,
it it what they do before they enter the urine
that matters. Many vitamins have measurable
physiological effects. A good explanation for
this is that the Western diet has on 1/7 to 1/3
of the vitamins and minerals of huntergatherer diets.
Iodine Australia
Myths about nutrient
supplements
 Myth 2. Australia's food supply is so
good that nobody needs supplements.
 Fact 2. The physiological effects of
vitamin supplements are so clearly
demonstrated that, by law many foods
must be supplemented with vitamins.
Eg B1 and B3 in rice and flour, folic acid
supplements etc.
Iodine Australia
Iodine Supplements
 Adults. Centrum
Iodine Australia
Iodine Supplements
 Blackmore's Pregnancy
and Breastfeeding
Formula
Sun-Herald
5-12-04
Iodine Australia
Iodine Supplements
 4 to 12 years. Blackmore’s Kids
Multivitamin and Minerals Chewable
Iodine Australia
Iodine Supplements
 Under 4 years. Consider iodine
solution.
 NB Most infant formulae are mildly
deficient in iodine
Iodine Australia
Eastman’s 7 point strategy

1. ANZ education strategy
2. Encourage intake of cows milk (still a good source despite lack
of standardisation)[and lack of commitment from Dairy Australia
in my opinion]
3. Only iodised salt should be used for cooking and seasoning
except for people with nodular goitres or overactive thyroid
disease).
4. Increase seafood consumption where possible.
5. Supplement iodine before & during pregnancy and during
lactation.
6. Encourage mothers to choose infant formula with higher level
of iodine. NB some criticisms of FSANZ's current standard 2.9.1 of
1.2 ug iodine/ 100 kJ as too low. (Ben- calculation 4000 kJ= 48
ug iodine cf RDI= 90 ug/day. Whoops! ).
7. Develop a national policy
(Heinz newsletter)
Iodine Australia