From the Guidelines
The patient's iodine level should be monitored regularly by measuring thyroid hormone concentrations, and iodine should be provided with parenteral nutrition (PN) at a daily dose of 1-10 mg/kg in preterms and at least 1 mg/kg/day in infants and children. This is based on the strongest and most recent evidence from the Clinical Nutrition journal, which states that iodine is an essential component of thyroid hormones and should be provided with PN to maintain normal thyroid function 1.
Iodine Intake and Monitoring
The recommended daily intake of iodine varies depending on the individual's age, sex, and health status. For example, preterm infants may require higher doses of iodine, ranging from 10-55 mg/kg/d, due to their high iodine requirements and limited stores 1. In contrast, infants and children may require at least 1 mg/kg/day of iodine to maintain normal thyroid function.
Iodine Supplementation
Iodine supplementation may be necessary for individuals with iodine deficiency or insufficiency, particularly pregnant and lactating women. However, the evidence on iodine supplementation is inconclusive, and potential benefits and harms must be carefully considered 2. A recent Cochrane review found that iodine supplementation in pregnancy and lactation may have both positive and negative effects, including lower likelihood of insufficient iodine status and congenital abnormalities, as well as potential harm such as overactive thyroid function and nausea and vomiting during pregnancy.
Key Considerations
- Iodine is essential for proper thyroid function and should be provided with PN to maintain normal thyroid function.
- The recommended daily intake of iodine varies depending on the individual's age, sex, and health status.
- Iodine supplementation may be necessary for individuals with iodine deficiency or insufficiency, but potential benefits and harms must be carefully considered.
- Regular monitoring of thyroid hormone concentrations is necessary to assess iodine status and adjust supplementation as needed.
- Iodine excretion in 24-hour urine samples may be difficult to obtain, and normal thyroid function tests may be considered as surrogate markers for adequate iodine status 1.
From the Research
Iodine Levels
- The provided studies do not directly mention a patient's iodine level, but they discuss the importance of iodine intake and the consequences of iodine deficiency 3, 4, 5, 6.
- Iodine deficiency can lead to inadequate thyroid hormone production, causing various health issues such as goiter, hypothyroidism, and mental retardation 3, 4, 5, 6.
- The recommended daily iodine intake varies by age, sex, and physiological condition, with higher requirements for infants, children, and pregnant women 4, 5.
Assessment of Iodine Status
- Urinary iodine concentration is a validated biomarker for assessing population iodine status 6.
- Median urinary iodine concentration (UIC) can facilitate monitoring of population iodine status 6.
- Research is needed to develop biomarkers for assessing individual iodine status for routine patient care 6.
Iodine Supplementation
- Iodine supplementation is necessary to prevent iodine deficiency disorders, especially in endemic areas 5.
- Iodized salt is the cornerstone of iodine prophylaxis in endemic areas, and continuous monitoring of community iodine intake and its related clinical outcomes is essential 5.
- Detailed strategies to implement iodine intake (supplementation) could be considered for specific population groups when iodized salt alone is insufficient to provide adequate requirements 5.