Enhanced iodine concentrating capacity by the mammary gland in iodine deficient lactating women of an endemic goiter region in Sicily

Vermiglio, Francesco; Presti, Vincenzo Pio Lo; Finocchiaro, M; Battiato, S; Grasso, Lucia; Ardita, F V; Mancuso, Alfredo; Trimarchi, Francesco

doi:10.1007/bf03348681

Cited by 35 publications

(15 citation statements)

References 13 publications

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“…This deterioration during the post-natal period may be due to breastfeeding, which may increase the demand for extra iodine intake placed by the sequestration of some of the maternal iodine pool to the breast milk (Delange et al, 1988). Data concerning breast milk iodine content are seemingly scanty (Vermiglio et al, 1992). Published reports indicate that the iodine content of human breast milk, at least in Europe, varies individually from 7.0 to 9.0 mgadl (Catala 1993).…”

Section: Discussionmentioning

confidence: 99%

Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women

Eltom

Eltom²,

Elnagar³

et al. 2000

Eur J Clin Nutr

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Objective To elucidate the persistence, or otherwise, of the pregnancy-related changes in the iodine metabolism and thyroid function in a population residing in an area of mild iodine de®ciency in the Sudan. Design: A longitudinal prospective cohort study involving pregnant women who were recruited during their third trimester of pregnancy and were followed up for up to nine months after delivery. Setting: The study was conducted among Sudanese women residing in the Omdurman area in Khartoum, an area with a total goitre rate of 17.5%. Subjects: Forty-seven pregnant women were recruited during their third trimester of pregnancy. Their mean age and weight were 29 AE 4.6 y and 62.4 AE 8.7 kg, respectively. Age matched healthy non-pregnant women living in the same area (n 40) served as a control group. Methods: Serum levels of thyrotropin (TSH), thyroxine (T4), triiodothyronine (T3), thyroglobulin (Tg) and the urinary iodine concentration (UIC) were determined during the third trimester (®rst occasion), and subsequently at three months (second occasion), six months (third occasion) and nine months after delivery (fourth occasion). Control subjects provided corresponding samples on one occasion. Main outcomes measures: UIC, TSH, Tg, FT4 and T3. Results: During the third trimester of pregnancy the median UIC and the free T4 (FT4) were lower than in the control group (P`0.0001, P`0.0001, respectively), while the median Tg was higher than in the controls (P`0.03). Three months post-partum maximum thyroidal stimulation was evident, with elevated serum levels of TSH and Tg (P`0.0001, P`0.03) and reduced UIC and serum T3 and FT4 (P`0.0004, P`0.0005, P`0.0001), compared with the control group. Nine months post-partum the thyroid function was restored to the pre-pregnancy state, and the median values of TSH, Tg, T3, FT4 and UIC did not differ signi®cantly from those in the control group. Conclusions: Our study suggests that the reversibility of the pregnancy-induced changes in the iodine status and thyroid function to the pre-pregnancy levels may depend on the iodine status of the mother during and after pregnancy. The thyroidal stress during the ®rst three months of the post-partum period, which is partially due to the iodine loss in the breast milk, justi®es further detailed studies to assess the iodine content of the breast milk and the role of breast milk as a vehicle for iodine supply of infants in situations of iodine de®ciency.

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Section: Discussionmentioning

confidence: 99%

Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women

Eltom

Eltom²,

Elnagar³

et al. 2000

Eur J Clin Nutr

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“…This may help explain why, in areas where there is an ID, BMIC is often greater than expected based on the UI concentration of lactating mothers 55,56 . The BMIC is strongly influenced by the mothers' iodine intake 58 .…”

Section: Iodine Intakes During Lactation and Urinary Iodine And Breasmentioning

confidence: 93%

The impact of iodised salt or iodine supplements on iodine status during pregnancy, lactation and infancy

Zimmermann

2007

Public Health Nutr.

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Objectives: Monitoring of iodine status during pregnancy, lactation and infancy is difficult as there are no established reference criteria for urinary iodine concentration (UI) for these groups; so it is uncertain whether iodized salt programs meet the needs of these life stages. Design and Subjects: The method used in this paper was: 1) to estimate the median UI concentration that reflects adequate iodine intake during these life stages; and 2) to use these estimates in a review of the literature to assess whether salt iodisation can control iodine deficiency in pregnant and lactating women, and their infants. Results: For pregnancy, recommended mean daily iodine intakes of 220-250 mg were estimated to correspond to a median UI concentration of about 150 mg l 21 , and larger surveys from the iodine sufficient countries have reported a median UI in pregnant women $ 140 mg l 21 . Iodine supplementation in pregnant women who are mild-tomoderately iodine deficient is beneficial, but there is no clear affect on maternal or newborn thyroid hormone levels. In countries where the iodine intake is sufficient, most mothers have median breast milk iodine concentration (BMIC) greater than the concentration (100-120 mg l 21 ) required to meet an infant's needs. The median UI concentration during infancy that indicates optimal iodine nutrition is estimated to be $ 100 mg l 21 . In iodine-sufficient countries, the median UI concentration in infants ranges from 90-170 mg l 21 , suggesting adequate iodine intake in infancy. Conclusions: These findings suggest pregnant and lactating women and their infants in countries with successful sustained iodised salt programs have adequate iodine status.

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“…Because the mammary gland is able to concentrate iodine, iodine supply to the newborn via the breast milk may be maintained even in the face of maternal iodine deficiency (94,95). This may help explain why, in areas of iodine deficiency, BMICs are often greater than expected based on the UI of the lactating mother (95)(96)(97).…”

Section: G Assessing Status During Lactationmentioning

confidence: 96%

Iodine Deficiency

2009

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Iodine deficiency has multiple adverse effects in humans, termed iodine deficiency disorders, due to inadequate thyroid hormone production. Globally, it is estimated that 2 billion individuals have an insufficient iodine intake, and South Asia and sub-Saharan Africa are particularly affected. However, about 50% of Europe remains mildly iodine deficient, and iodine intakes in other industrialized countries, including the United States and Australia, have fallen in recent years. Iodine deficiency during pregnancy and infancy may impair growth and neurodevelopment of the offspring and increase infant mortality. Deficiency during childhood reduces somatic growth and cognitive and motor function. Assessment methods include urinary iodine concentration, goiter, newborn TSH, and blood thyroglobulin. But assessment of iodine status in pregnancy is difficult, and it remains unclear whether iodine intakes are sufficient in this group, leading to calls for iodine supplementation during pregnancy in several industrialized countries. In most countries, the best strategy to control iodine deficiency in populations is carefully monitored universal salt iodization, one of the most cost-effective ways to contribute to economic and social development. Achieving optimal iodine intakes from iodized salt (in the range of 150-250 microg/d for adults) may minimize the amount of thyroid dysfunction in populations. Ensuring adequate iodine status during parenteral nutrition has become important, particularly in preterm infants, as the use of povidone-iodine disinfectants has declined. Introduction of iodized salt to regions of chronic iodine deficiency may transiently increase the incidence of thyroid disorders, but overall, the relatively small risks of iodine excess are far outweighed by the substantial risks of iodine deficiency.

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Enhanced iodine concentrating capacity by the mammary gland in iodine deficient lactating women of an endemic goiter region in Sicily

Cited by 35 publications

References 13 publications

Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women

Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women

The impact of iodised salt or iodine supplements on iodine status during pregnancy, lactation and infancy

Iodine Deficiency

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