How Can I Ensure That I'm Getting Enough Iodine Through My Diet?

Posted on Mon, 14 Jul 2014

Question: Hello and how are you? How can I ensure that I'm getting enough iodine through my diet?

Thanks

Answered by Dr. Shehzad Topiwala (1 hour later)

Brief Answer:
Iodine

Detailed Answer:
I am doing well thank you. I hope things are well with you too.

You have asked an important question. The best way to assess if you are getting adequate amounts of iodine through your diet is to check it's levels in urine.

Measurements of urinary iodine concentration in randomly collected urine samples have proven to be as useful as the conventional 24 hour urine test. (In the 24 hour urine test, measurements of urinary creatinine and iodine and calculation of the iodine:creatinine ratio are performed). The results from random samples also correlate well with 24-hour urine collections. So nowadays a convenient urine sample can be tested for iodine status instead of the cumbersome 24 hour urine collection.
As a result, iodine nutrition is often defined by the urinary iodine concentration in randomly collected urine samples. Mild iodine deficiency is defined as a median urinary iodine concentration of 50 to 99 mcg/L, moderate deficiency as 20 to 49 mcg/L, and severe deficiency as <20 mcg/L

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 hour later)

Where can I get this test done? I asked my family doctor to check my iodine levels but he said that he can't since our labs here don't check for iodine. I should let you know that I live in Toronto Canada.

Answered by Dr. Shehzad Topiwala (4 hours later)

Brief Answer:
Follow up

Detailed Answer:
Yes I noted your residence address.

I am somewhat familiar with the Canadian healthcare system. This is not an exotic test but it is not entirely common either.

Commercial laboratories will offer the test. I dont know if national chains like those in USA exist in Canada (such as Quest or Labcorp). Even if they do, you will need a prescription from a doctor to run this test.

It is a standard test that should be offered to you if you would like to know your iodine status. However, Canadian healthcare protocols probably place the onus on the doctor to determine if the test is necessary or not.
In many ways that is also fair because with implementation of the universal salt iodization program, iodine deficiency has become uncommon in most parts of the world where such programs exist, unless of course one totally abstains from salt.

As such, indirect assessments such as a blood test for thyroid function such as TSH gives a fair idea about iodine sufficiency

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (18 hours later)

my GP checked my thyroid about a month ago during my checkup and it's still within the normal range but I do have an enlarged goitre and three years ago I suffered from subacute thyroiditis for four months. i asked my GP to check my iodine levels last week and he said that he can't since our labs don't check for iodine. do you think I should get it checked?

Answered by Dr. Shehzad Topiwala (3 hours later)

Brief Answer:
Follow up

Detailed Answer:
If you consume salt then it is extremely unlikely to get iodine deficiency and hence there is no need to check.

The thyroid enlargement warrants an ultrasound test to see if there are nodules. Ultrasound is the best way to characterize them and decide the next course of action such as periodic monitoring versus biopsy versus surgery

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (7 minutes later)

well I do consume salt but I just noticed that it's not iodized salt. I try to consume himalayan pink crystal salt only and it's not iodized but I've heard that it's the best salt and I just noticed that the other table salt that we have at home isn't iodized either. I've had a few ultrasound scans of my thyroid during the past eight years that I've had this goitre and the result is that it's a benign and no biopsy was ever requested by my doctor since there is no fluid in it.

Answered by Dr. Shehzad Topiwala (3 hours later)

Brief Answer:
SECOND FOLLOW UP

Detailed Answer:
Ask your doctor or contact your government/state health department to confirm if Canada follows the universal salt iodization program. It is extremely likely they do, as do most developed countries globally.

And if you are not consuming that anyway, then it is relevant to check your urine iodine levels. I cannot help you have that test ordered in your country. You will have to work with your doctor and the health system

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (16 hours later)

We have table salt at home but we probably add salt to our food every five our six months and when we do it's an small amount.

Answered by Dr. Shehzad Topiwala (13 hours later)

Brief Answer:
Third follow up

Detailed Answer:
Yes, salt must be consumed in normal amounts daily. What constitutes adequate intake for you is best determined by seeing a dietitian

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (34 hours later)

do you think that if I tell my family doctor that we don't add salt to our food he would check my iodine? so far he has been saying that he can't since our labs don't check for iodine. my mom does most of the cooking at our home and she doesn't like to add sal to our food though she knows that this puts us at risk for iodine deficiency!

Answered by Dr. Shehzad Topiwala (3 hours later)

Brief Answer:
Fourth follow up

Detailed Answer:
Yes, admitting to virtually no salt intake may convince him to test for urinary iodine. Your healthcare provider must realize that (s)he is liable if a diagnosis is missed

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar