Urinary Iodine, Perchlorate, and Thiocyanate Concentrations in U.S. Lactating Women

Lee, Sun Young; McCarthy, Alicia M.; Stohl, Hindi E.; Ibrahim, Sherrine; Jeong, Christina; Braverman, Lewis E.; Ma, Wendy; He, Xuemei; Mestman, Jorge H.; Schuller, Kristin E.; Jahreis, Katherine A.; Pearce, Elizabeth N.; Leung, Angela M.

doi:10.1089/thy.2017.0158

Cited by 12 publications

(6 citation statements)

References 36 publications

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“…We found similar median concentrations for maternal urinary thiocyanate and nitrate in this study and in our previously published work including non-lactating and non-pregnant women ( 15 ). Interestingly, the median maternal urinary thiocyanate concentrations (274 μg/L) in our study were relatively lower than the U.S. lactating women (514 μg/L) ( 27 ). We believe this discrepancy is not related to the number of active smokers in the study groups since only a few women actively smoked in both groups during lactation.…”

Section: Discussioncontrasting

confidence: 77%

“…We found that median urinary perchlorate concentration in Turkish lactating women (3.89 μg/L) was relatively higher than in the U.S. lactating women [3.0 μg/L ( 26 ), 3.1 μg/L ( 27 )]. This result is consistent with our previously published work, in which we evaluated urinary perchlorate concentrations in non-pregnant and non-lactating women and found that median urinary perchlorate concentration (6.4 μg/L) was more than twice as high as the median concentration found in U.S. women (2.9 μg/L) ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 83%

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Exposure to Perchlorate in Lactating Women and Its Associations With Newborn Thyroid Stimulating Hormone

et al. 2018

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Background: Perchlorate, thiocyanate, and nitrate can block iodide transport at the sodium iodide symporter (NIS) and this can subsequently lead to decreased thyroid hormone production and hypothyroidism. NIS inhibitor exposure has been shown to reduce iodide uptake and thyroid hormone levels; therefore we hypothesized that maternal NIS inhibitor exposure will influence both maternal and newborn thyroid function.Methods: Spot urine samples were collected from 185 lactating mothers and evaluated for perchlorate, thiocyanate, and nitrate concentrations. Blood and colostrum samples were collected from the same participants in the first 48 h after delivery. Thyroid hormones and thyroid-related antibodies (TSH, fT3, fT4, anti-TPO, anti-Tg) were analyzed in maternal blood and perchlorate was analyzed in colostrum. Also, spot blood samples were collected from newborns (n = 185) between 48 and 72 postpartum hours for TSH measurement. Correlation analysis was performed to assess the effect of NIS inhibitors on thyroid hormone levels of lactating mothers and their newborns in their first 48 postpartum hours.Results: The medians of maternal urinary perchlorate (4.00 μg/g creatinine), maternal urinary thiocyanate (403 μg/g creatinine), and maternal urinary nitrate (49,117 μg/g creatinine) were determined. Higher concentrations of all three urinary NIS inhibitors (μg/g creatinine) at their 75th percentile levels were significantly correlated with newborn TSH (r = 0.21, p < 0.001). Median colostrum perchlorate level concentration of all 185 participants was 2.30 μg/L. Colostrum perchlorate was not significantly correlated with newborn TSH (p > 0.05); however, there was a significant correlation between colostrum perchlorate level and maternal TSH (r = 0.21, p < 0.01). Similarly, there was a significant positive association between colostrum perchlorate and maternal urinary creatinine adjusted perchlorate (r = 0.32, p < 0.001).Conclusion: NIS inhibitors are ubiquitous in lactating women in Turkey and are associated with increased TSH levels in newborns, thus signifying for the first time that co-exposure to maternal NIS inhibitors can have a negative effect on the newborn thyroid function.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 83%

Exposure to Perchlorate in Lactating Women and Its Associations With Newborn Thyroid Stimulating Hormone

et al. 2018

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“…It is a common contaminant of foods and drinking water, and lactating women may be exposed through diet ( 289 ). Data in lactating women report a positive association between urinary concentrations of perchlorate and iodine ( 290 ), whereas the fractional excretion in breast milk is higher for perchlorate than for iodine ( 245 , 268 ). Although human data provide limited support for an inhibiting effect of perchlorate on BMIC, the studies are small and inconclusive ( 245 , 279 , 291-293 ).…”

Section: Iodine In Human Milkmentioning

confidence: 99%

“…Thiocyanate exposure is a strong risk factor for goiter ( 298 , 299 ), but likely secondary to iodine deficiency and at high thiocyanate intakes and inadequate protein nutrition ( 300 ). Urinary thiocyanate concentration positively correlates with UIC in lactating women ( 290 ), but a study conducted in cassava-eating mothers observed no correlation with thiocyanate concentration in maternal serum and breast milk ( 301 ). Thiocyanate excretion in human milk appears to be limited, indicated by low fractional excretion ( 268 , 300 ).…”

Section: Iodine In Human Milkmentioning

confidence: 99%

The Role of Iodine for Thyroid Function in Lactating Women and Infants

Andersson

2021

Endocrine Reviews

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Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.

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“…Chronic consumption of ClO 4 − in adults has been estimated as high as 0.07 to 0.34 µg/Kg of body weight per day in Europe [70], and 0.2 to 0.4 µg/Kg of body weight per day in the USA [74]. Despite ClO 4 − consumption being generally below the level of recommended reference dose in adults [75], it may become critical, especially in some categories, such as children, high sensitive patients, cigarette smokers, iodine deficient people, and pregnant and breast feeding women as well [76][77][78]. Indeed, the inhibition of I uptake and any potential downstream effects induced by ClO 4 − are strictly dependent on the exposure to other environmental NIS inhibitors, such as thiocyanates and nitrates, and iodine intake itself [79].…”

Section: Chronic Esposure To Perchlorate Compounds By Food and Drinkimentioning

confidence: 99%

Interference on Iodine Uptake and Human Thyroid Function by Perchlorate-Contaminated Water and Food

et al. 2020

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Background: Perchlorate-induced natrium-iodide symporter (NIS) interference is a well-recognized thyroid disrupting mechanism. It is unclear, however, whether a chronic low-dose exposure to perchlorate delivered by food and drinks may cause thyroid dysfunction in the long term. Thus, the aim of this review was to overview and summarize literature results in order to clarify this issue. Methods: Authors searched PubMed/MEDLINE, Scopus, Web of Science, institutional websites and Google until April 2020 for relevant information about the fundamental mechanism of the thyroid NIS interference induced by orally consumed perchlorate compounds and its clinical consequences. Results: Food and drinking water should be considered relevant sources of perchlorate. Despite some controversies, cross-sectional studies demonstrated that perchlorate exposure affects thyroid hormone synthesis in infants, adolescents and adults, particularly in the case of underlying thyroid diseases and iodine insufficiency. An exaggerated exposure to perchlorate during pregnancy leads to a worse neurocognitive and behavioral development outcome in infants, regardless of maternal thyroid hormone levels. Discussion and conclusion: The effects of a chronic low-dose perchlorate exposure on thyroid homeostasis remain still unclear, leading to concerns especially for highly sensitive patients. Specific studies are needed to clarify this issue, aiming to better define strategies of detection and prevention.

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Urinary Iodine, Perchlorate, and Thiocyanate Concentrations in U.S. Lactating Women

Cited by 12 publications

References 36 publications

Exposure to Perchlorate in Lactating Women and Its Associations With Newborn Thyroid Stimulating Hormone

Exposure to Perchlorate in Lactating Women and Its Associations With Newborn Thyroid Stimulating Hormone

The Role of Iodine for Thyroid Function in Lactating Women and Infants

Interference on Iodine Uptake and Human Thyroid Function by Perchlorate-Contaminated Water and Food

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