Symbolic image representing iodine and thyroid health in America

Iodine: Are You Getting Enough? The Resurgence of Deficiency in America

"A closer look at why iodine deficiency is making a comeback and what you can do to ensure you're meeting your daily needs."


Iodine is an essential mineral crucial for the synthesis of thyroid hormones, which regulate metabolism, growth, and development. Inadequate iodine intake can lead to a range of adverse health consequences known as iodine deficiency disorders (IDDs). These disorders can manifest as goiter (enlargement of the thyroid gland) and hypothyroidism (underactive thyroid) at any stage of life.

Pregnant women are particularly vulnerable to the effects of iodine deficiency, as it increases the risk of obstetric complications. Furthermore, even mild iodine deficiency in mothers can negatively impact fetal neurodevelopment, potentially leading to decreased cognitive function and lower intelligence quotients (IQ) in children.

A recent case report highlighted the re-emergence of iodine deficiency in the United States, a country once considered iodine sufficient. This resurgence raises concerns about the adequacy of iodine intake among certain populations and underscores the importance of understanding the factors contributing to this trend.

The Return of Iodine Deficiency

Symbolic image representing iodine and thyroid health in America

A century ago, iodine deficiency was widespread in the U.S., particularly in the Great Lakes region, earning it the moniker "the goiter belt." The introduction of iodized salt in the 1920s effectively eliminated this public health problem, and since the 1940s, the U.S. has been considered iodine sufficient. However, over the past few decades, dietary iodine intakes in the U.S. have declined by 50% since the 1970s, leading to the re-emergence of mild iodine deficiency in certain population groups.

Several factors have contributed to this decline. Unlike many other countries, the U.S. does not mandate salt iodization. As a result, many consumers opt for non-iodized salt, including kosher and sea salt. Additionally, overall salt consumption has decreased due to concerns about cardiovascular health. A significant portion of salt intake comes from commercially processed foods, which almost universally contain non-iodized salt.
Here are some contributing factors:
  • Decreased use of iodized salt in processed foods.
  • Lower overall salt consumption due to health concerns.
  • Increased popularity of specialty salts (sea salt, kosher salt) that are often not iodized.
  • Dietary shifts away from dairy.
Currently, the primary source of dietary iodine in the U.S. is dairy products. Iodine is added to cow's milk through supplementation of cattle feed and the use of iodophor cleansers in the dairy industry. This reliance on dairy makes vegans, individuals with lactose intolerance or dairy sensitivities, and those with limited dairy intake particularly vulnerable to iodine deficiency. The women described in the case report mentioned earlier all reported low dairy intake, underscoring this connection.

Protecting Yourself and Your Family

The re-emergence of iodine deficiency in the U.S. is a reminder of the importance of this essential nutrient. By understanding the risk factors and taking proactive steps to ensure adequate intake, you can protect your thyroid health and overall well-being. If you have concerns about your iodine levels, consult with your healthcare provider for personalized advice and guidance.

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