By Andrew M. Seaman
NEW YORK (Reuters Health) - Pregnant women should take an iodide-containing supplement to protect the brain development of their babies, according to the leading U.S. group of pediatricians.
Iodine, which the body can get from iodide, is needed to make the thyroid hormones that are required for children’s brain development before and after birth.
“Women who are childbearing age need to pay attention to this topic as well, because about half of the pregnancies in the U.S. are unplanned,” Dr. Jerome Paulson said. “Women in the early part of the pregnancy may not realize they’re pregnant.”
Paulson is the chairperson of the American Academy of Pediatrics Council on Environmental Health, which authored the policy statement. He is also a pediatrician at Children's National Medical Center in Washington, D.C.
The recommendations were published in the journal Pediatrics on Monday.
People typically get the iodine they need from table salt, which in the U.S. is fortified with iodide. Eating processed foods exposes Americans to salt that is not iodized, however.
The Council writes that past research has suggested about one-third of pregnant women in the U.S. are marginally iodine deficient. Also, only about 15 percent of women take a supplement containing an adequate amount of iodide.
The American Thyroid Association and the National Academy of Sciences suggest pregnant and breastfeeding women get 290 micrograms of iodide per day.
Women may need to take a supplement with 150 micrograms of iodide to reach that recommended level, but most prenatal and lactation vitamins contain less, according to the Council.
“Breastfeeding mothers should take a supplement that includes at least 150 micrograms of iodide and use iodized table salt,” the Council writes.
Additionally, the Council says women may need to be tested for iodine deficiency if they are vegan or don’t eat fish.
“Obviously iodine is critical to the fetal and child brain,” Dr. Loralei Thornburg said. “Therefore having a diet that’s rich in iodine is critical.”
Thornburg was not involved in making the new recommendation. She is a high-risk pregnancy expert at the University of Rochester Medical Center in New York.
“Although many women are largely iodine deficient, most women do get iodine in the (form) of food,” she told Reuters Health. “This isn’t something women should freak out about just yet.”
Thornburg said the ideal amount of iodide supplementation depends on how much of the compound women already get from their diets.
The Council says a pregnant or lactating woman’s combined iodide intake should be between 290 and 1100 micrograms per day. Specifically, it should be in the form of potassium iodide.
“This is something that’s fairly routine,” Paulson said. “I think what we’re saying is people need to pay attention to the details of what they’re doing, but not radically change their behavior.”
The authors also suggest pregnant or lactating women avoid nitrate, found in contaminated well water, and thiocyanate, which is usually found in cigarette smoke and certain vegetables like broccoli, cauliflower and cabbage. The two chemicals can disrupt the ability of iodine to be processed into hormones. However, women rarely eat enough of the vegetables for thiocyanate levels from those sources to be concerning, they note.
Finally, the Council recommends that the U.S. Environmental Protection Agency proceed with appropriate regulation of perchlorate in waterways. Perchlorate, which is a chemical used in rocket fuels and explosives, can disrupt the body’s use of iodine to make thyroid hormones.
“I think people can have some control over their exposure to tobacco smoke, but they may not even be aware of the perchlorate or other chemicals in the water,” Paulson said.
The Council also writes that there is some inconsistency between the iodide on the label of supplements and their actual content. The U.S. Food and Drug Administration should “do what is necessary to allow consumers to identify and use iodide supplements with confidence” if the industry’s actions are insufficient, it adds.
SOURCE: http://bit.ly/uFc4g2 Pediatrics, online May 26, 2014.