İyot
Özet
İyot, diyetteki besin öğeleri ile veya iyot içeren takviyeler yoluyla elde edilen temel mikro besin maddesidir. Tiroid hormonlarının üretimi için gerekli olan iyot, büyüme, gelişme, metabolizma ve beyin fonksiyonları gibi birçok hayati süreçte rol oynar. İyot eksikliği ağır nörolojik bozukluk (nörolojik kretenizm), cücelik, psikomotor gerilik, ölü doğum, guatr, hipotiroidi, endemik nörobilişimsel bozukluk ve fiziksel gelişimde gecikmeye neden olabilir. Kırmızı et, balık, tavuk, ekmek ve süt ürünleri iyi iyot kaynakları olup başlıca bitkisel kaynak deniz yosunudur. Ülkemizde ve dünyada yeterli iyot alımını sağlamak için en sık kullanılan yöntem ev tuzuna iyot eklenmesidir. İyotlu tuzun alternatifleri iyotlu yağ, lugol solüsyonu, iyotlu su, iyot tabletleri ve iyot damlalarıdır. Çocukluk yaş grubunda iyot için önerilen günlük alım miktarları 90-150 mcg/gündür. İyot eksikliğinin önlenmesi için dengeli beslenilme, iyotlu tuz kullanımı teşvik edilmeli, iyot eksikliği taramaları yapılmalı ve riskli gruplarda iyot takviyesi yapılmalıdır.
Iodine is an essential micronutrient obtained through dietary intake or through iodine-containing supplements. Iodine, which is necessary for the production of thyroid hormones, plays a role in many vital processes such as growth, development, metabolism and brain functions. Iodine deficiency can cause severe neurological disorder (neurological cretinism), dwarfism, psychomotor retardation, stillbirth, goiter, hypothyroidism, endemic neurocognitive disorder and delay in physical development. Red meat, fish, chicken, bread and dairy products are good sources of iodine, and the main plant source is seaweed. The most commonly used method to ensure adequate iodine intake in our country and around the world is adding iodine to household salt. Alternatives to iodized salt are iodized oil, lugol's solution, iodized water, iodine tablets and iodine drops. The recommended daily intake for iodine in the childhood age group is 90-150 mcg/day. To prevent iodine deficiency, a balanced diet, the use of iodized salt should be encouraged, iodine deficiency screening should be performed and iodine supplements should be given in risk groups.
Referanslar
Swain PA. 2005. Bernard Courtois (1777-1838) famed for discovering iodine (1811), and his life in Paris from 1798. Bull. Hist. Chem. 30, 103-111.
Coindet JF. Découverte d’un nouveau remède contre le goître. Ann Chim Phys. 1820;15(2): 49-59.
Chatin A. Recherches sur l’iode des eaux douces; de la présence de ce corps dans les plantes at les animaux terrestes. C R Acad Sci Paris. 1851;31:280-3.
Gropper SS, Smith JL. Advanced nutrition and human metabolism. Wadworth Cengege Learning. Sixth Edition. (2013), ISBN-13: 978-113310.
WHO. Vitamin and mineral requirements in human nutrition. 2005.
Alpers DH, Taylor BE, Bier DM, et al. Minerals. Manual of Nutritional Therapeutics. 5th ed. Philadelphia: Wolters Kluwer Health; 2015. p.656.
Bayram F, Beyazyıldız A, Gökçe C, et al. The prevalence of iodine deficiency, serum thyroglobulin, anti-thyroglobulin and thyroid peroxidase antibody levels in the urban areas of Kayseri, Central Anatolia. Exp Clin Endocrinol Diabetes 2009;117:64-8.
WHO, UNICEF & ICCIDD. Assessment of Iodine Deficiency Disorders and Monitoring their Elimination: A Guide for Programme Managers. Geneva: World Health Organization, 2007.
Aslan N, Kurku H, Pirgon Ö. Urine Iodine Excretion and Iodine Deficiency Status in School Age Children at Isparta Province. J Clin Anal Med 2015; 6(suppl 5): 612-6.
Spitzweg, C., Harrington, KJ., Pinke, LA, et al. Clinical review 132: The sodium iodide symporter and its potential role in cancer therapy. J. Clin. Endocr. Metab. 2001. 86, 3327-3335.
Serrano-Nascimento C, Salgueiro RB, Vitzel KF, et al. Iodine excess exposure during pregnancy and lactation impairs maternal thyroid function in rats. Endocr Connect. 2017;6(7):510-21.
Food and Nutrition Board of the Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academies Press, Washington DC, 2000. https://www.nap.edu/catalog/10026/dietary-reference-intakes-for-vitamin-a-vitamin-k-arsenic-boron-chromium-copper-iodine-iron-manganese-molybdenum-nickel-silicon-vanadium-and-zinc (Accessed on May 21, 2024).
Newsome S, Hickmen PE. 2010. Chapter 49: Thyroid. Clinical Chemistry. Kaplan A.L., Pesce J.A. Fifth eds. Elsevier, pp: 948-960.
Barrett KE, Barman SM, Boitano S, et al. 2010. Ganong’s Review of Medical Physiology. The McGraw-Hill Education (Asia), Singapore. pp. 301-314.
Grotzke M. Bishop, ML., Fody, EP, et al. Chapter 22: The Thyroid Gland. Clinical Chemistry.. Sixth eds. Lippincott Williams&Wilkins, 2010. pp: 490-495.
Lavado-Autric R, Auso E, Garcia-Velasco JV, et al. Early maternal hypothyroxinemia alters histogenesis and cerebral cortex cytoarchitecture of the progeny. J Clin Invest 2003; 111: 1073-1082.
Lewander WJ, Lacouture PG, Silva JE, et al. Acute thyroxine ingestion in pediatric patients. Pediatrics 1989; 84:262.
De Benoist B, Andersson M, Takkouche B, et al (2003). Prevalence of iodine deficiency worldwide. The Lancet, 362(9398), 1859-1860.
Zimmermann MB, Wegmüller R, Zeder C, et al. The effects of vitamin A deficiency and vitamin A supplementation on thyroid function in goitrous children. J Clin Endocrinol Metab 2004; 89:5441.
Melse-Boonstra A, & Jaiswal N. (2010). Iodine deficiency in pregnancy, infancy and childhood and its consequences for brain development. Best practice & research Clinical endocrinology & metabolism, 24(1), 29-38.
Aghini-Lombardi F, Vitti P, Antonangeli L, et al. The size of the community rather than its geographical location better defines the risk of iodine deficiency: results of an extensive survey in Southern Italy. J Endocrinol Invest 2013; 36:282.
Gallego ML, Loango N, Londoño AL, et al. Urinary iodine excretion levels in schoolchildren from Quindío, 2006-2007. Rev Salud Publica (Bogota) 2009;11:952-60.
Gür E, Ercan O, Can G, et al. Prevalence and risk factors of iodine deficiency among schoolchildren. J Trop Pediatr 2003;49(3):168– 71.
Barutçugil MB. Bakırköy bölgesi bir ilköğretim okulu öğrencilerinde idrar iyot atılımı ve guatr prevelansı. T.C. Sağlık Bakanlığı Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi; 2005.
Çelik T, Savaş N, Kurtoğlu S, et al. Iodine, copper, zinc, selenium and molybdenum levels in children aged between 6 and 12 years in the rural area with iodine deficiency and in the city center without iodine deficiency in Hatay. Türk Ped Arş 2014; 49: 111-116.
Erdoğan MF, Ağbaht K, Altunsu T, et al. Current iodine status in Turkey. J Endocrinol Invest 2009;32(7):617-22.
Cox JT, Carney VH. Nutrition for reproductive health and lactation. In: Mahan LK, EscottStump S, Raymond JL, eds. Krause’s Food and the Nutrition Care Process. 14th ed. St. Louis: Elsevier; 2016. p.260.
Eastman CJ, Zimmermann MB. The Iodine Deficiency Disorders. [Updated 2018 Feb 6]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet].
Pennington JAT, Young BE. Total diet study nutritional elements, 1982-1989. J. Am. Diet. Assoc. 1991, 179-83.
Zimmermann MB. Iodine deficiency. Endocr Rev 2009; 30: 376- 408.
UNICEF. Iodine deficiency, current status and progress. Available at: https://data.unicef.org/topic/nutrition/iodine-deficiency/ (Accessed on April 21, 2024).
Gibson RS, King JC, Lowe N. A Review of Dietary Zinc Recommendations. Food Nutr Bull 2016; 37:443.
Van den Briel T, West CE, Bleichrodt N, et al. Improved iodine status is associated with improved mental performance of schoolchildren in Benin. Am J Clin Nutr 2000; 72:1179.
DeLong GR, Leslie PW, Wang SH, et al. Effect on infant mortality of iodination of irrigation water in a severely iodine-deficient area of China. Lancet 1997; 350:771.
Kopp P, Kimura ET, Aeschimann S, et al. Polyclonal and monoclonal thyroid nodules coexist within human multinodular goiters. J Clin Endocrinol Metab 1994; 79:134.
Barrea L, Gallo M, Ruggeri RM, et al. Nutritional status and follicular-derived thyroid cancer: An update. Crit Rev Food Sci Nutr 2021; 61:25.
Soriguer F, Millón MC, Muñoz R, et al. The auditory threshold in a school-age population is related to iodine intake and thyroid function. Thyroid 2000; 10:991.
Qian M, Wang D, Watkins WE,, et al. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pac J Clin Nutr. 2005;14(1):32-42.
Hetzel BS. Iodine and neuropsychological development. J Nutr 2000; 130: 493-495.
Bath SC, Steer CD, Golding J, et al. Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: results from the Avon Longitudinal Study of Parents and Children (ALSPAC). Lancet 2013; 382:331.
Hynes KL, Otahal P, Hay I, et al. Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort. J Clin Endocrinol Metab 2013; 98:1954.
Braverman LE. Iodine and the thyroid: 33 years of study. Thyroid 1994; 4:351.
Markou K, Georgopoulos N, Kyriazopoulou V, et al. Iodine-Induced hypothyroidism. Thyroid 2001; 11:501.
Laurberg P, Cerqueira C, Ovesen L, et al. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab 2010; 24:13.
Zimmermann MB, Andersson M. (2011). Prevalence of İodine Deficiency in Europe in 2010. Ann Endocrinol. 72: 164-6.
Zimmermann MB, Molinari L, Spehl M, et al. Updated provisional WHO/ICCIDD reference values for sonographic thyroid volume in iodine-replete school-age children. IDD Newsletter 2001; 17:12.
Subcommittee on the Tenth Edition of the Recommended Dietary Allowances. Recommended Dietary Allowances,10th Edition. Available at: https://www.nap.edu/catalog/1349/recomended-dietary-allowances-10th-edition (Accessed on April 21,2024).
Phillips F. Vegetarian nutrition. Nutr Bull 2005;30(2):132-67
Haidimann M, Alt A, Blanc A etal. Iodine content of food groups, J Food Comp Anal.2005:18 (6):461-71.
Nerhus I, Markhus MW, Nilsen Bm, Øyen J, Maage A, Ødegård ER, et al. Iodine content of six fish species, Norwegian dairy products and hen’s egg. Food Nutr Res. 2018;62(24):1291.
Van Der Reijden Ol, Zimmermann Mb, Galetti V. Iodine in dairy milk: Sources, concentrations and importance to human health. Best Practice & Research Clinical Endocrinology & Metabolism. 2017;31(4):385-95.
Rasmussen LB, Larsen EH, Ovesen L. Iodine content in drinking water and other beverages in Denmark. Eur J Nutr. 2000;54(1):57-60.
Roseland JM, Phillips KM, Patterson KY, et al. Large variability of iodine content in retail cow’s milk in the US. Nutrients. 2020;12(5):1246.
Soriguer F, Gutierrez-Repiso C, Gonzalez-Romero S, et al. Iodine concentration in cow’s milk and its relation with urinary iodine concentrations in the population. Clin Nutr. 2011;30(1):44-8.
Nazeri P, Norouzian MA, Mirmiran P, et al. Heating process in pasteurization and not in sterilization decreases the iodine concentration of milk. Int J Endocrinol Metab. 2015;13(4):e27995.
Flachowsky G, Franke K, Meyer U, et al. Influencing factors on iodine content of cow milk. Eur J Nutr. 2014;53(2):351-65.
Leung AM, Lamar A, He X, et al. İodine status and thyroid function of Boston area vegetarians and vegans. J Clin Endocrinol Metab 2011;96(8): 1303-7.
Yiğit A, Samur, G. Is a Vegetarian Diet Safe to Follow During Childhood? Süleyman Demirel University Journal of Health Sciences 2022; (3): 540-550.
Burch HB. Drug Effects on the Thyroid. N Engl J Med 2019; 381:749.
Kennedy RL, Griffiths H, Gray TA. Amiodarone and the thyroid. Clin Chem. 1989; 35: 1882-1887.
Haugen BR. Drugs that suppress TSH or cause central hypothyroidism. Best Pract Res Clin Endocrinol Metab. 2009; 23: 793-800.
Weng HX, Yan AL, Hong CL, et al. Uptake of different species of iodine by water spinach and its effect to growth. Biol Trace Elem Res 2008; 124:184.
Tonacchera M, Dimida A, De Servi M, et al. Iodine fortification of vegetables improves human iodine nutrition: in vivo evidence for a new model of iodine prophylaxis. J Clin Endocrinol Metab 2013; 98:E694.
Kinoshita H, Yasuda M,Furumoto Y,et al.Severe duodenal hemorrage induced by Lugol’s aolution administered for thyroid crisis treatment. Intern Med 2010; 49:759.
Park JM, Seok Lee I, Young Kang J, et al. Acute esophageal and gastric injury: complication of Lugol’s solution. Scand J Gastroenterol 2007;42:135.
Heidemann P, Stubbe P. Serum 3, 5, 3’-triidothyronine, thyroxine and thyrotropin in hypothyroid infants with congenital goiter and response to iodine. JCEM 1978; 47:189-92.
Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid 2017; 27:315.
Berbel P, Mestre JL, Santamaría A, et al. Delayed neurobehavioral development in children born to pregnant women with mild hypothyroxinemia during the first month of gestation: the importance of early iodine supplementation. Thyroid 2009; 19:511.
Benmiloud M, Chaouki ML, Gutekunst R, et al. Oral iodized oil for correcting iodine deficiency: optimal dosing and outcome indicator selection. J Clin Endocrinol Metab 1994; 79:20.
Lamberg BA, Haikonen M, Mäkelä M, et al. Further decrease in thyroidal uptake and disappearance of endemic goitre in children after 30 years of iodine prophylaxis in the east of Finland. Acta Endocrinol (Copenh) 1981; 98:205.
Global fortification data exchange (GFDx), 2021. (Available at: http://www. fortificationdata.org). Accessed on 18 Feb 2024.
UNICEF. United Nations Children’s Fund, Division of data, analysis, planning and monitoring. UNICEF Global Databases on Iodized salt, New York, 2019. Accessed on 11 February 2024.
TNSA 2008 https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/TNSA-2008_tr.pdf
Surks MI. Iodine-induced thyroid dysfunction.www.uptodate.com. Sep 2023:Uptodate®.
Martins MC, Lima N, Knobel M, et al. Natural course of iodine-induced thyrotoxicosis (Jodbasedow) in endemic goiter area: a 5 year follow-up. J Endocrinol Invest 1989; 12:239.
Roti E, Uberti ED. Iodine excess and hyperthyroidism. Thyroid 2001; 11:493.
Stanbury JB, Ermans AE, Bourdoux P, et al. Iodine-induced hyperthyroidism: occurrence and epidemiology. Thyroid 1998; 8:83.
Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid 2016; 26:1343.
Burman KD, Wartofsky L. Iodine effects on the thyroid gland: biochemical and clinical aspects. Rev Endocr Metab Disord 2000; 1:19.
Lee SY, Rhee CM, Leung AM, et al. A review: Radiographic iodinated contrast media-induced thyroid dysfunction. J Clin Endocrinol Metab 2015; 100:376.