Iodine

Most of I in the diet comes from sea

High concentrations in sea water and sea food
Plants grown close to sea are high in I
I content in inland plants and water depends on I
level of soil
I comes to food from contaminants and
additives. Therefore, dairy products may contain
Sterilizing agents and colourings contain I
Fortified salt contain I
I in sea salt is lost due to sun drying

I in the body
Essential component of thy hormones
Thy hormones regulate BMR, growth &
development and promote protein
synthesis
RDA for I in men and women 150g /day
Needs are increased during preg and lact
Deficiency reduces production of thy
hormones and then metabolic rate slows
causing fatigue and weight gain

Importance
Body contains 15-50mg I, (70-80% in thyroid
gland)
Functions as an integral part of thyroid hormones (T 4
& T3)
Thyroid hormones are required for :
- normal growth & development of
tissues and,
- maturation of the whole body
- maintaining the metabolic rate through energy
production and oxygen consumption of cells

IDD
Goiter is the most visible sign of IDD
In pregnancy ID leads to mental and
physical defects in the baby ranging from
mild to cretinism.
ID preg mothers suffer from still births and
abortions
In severely ID mothers the effects on baby
are irreversible

 ID in adults make persons dull, listless and

easy tired, less active and apathy
Their productivity is reduced and mental
function impaired
There can be reproductive failure

In inadequacy of thyroid
hormone
Hypothyroidism where basal metabolic
rate is reduced, and general activities of
the individual is decreased, normal growth
& devt impaired
When T4 falls secretion of TSH from the
pituitary is increased. This enhances
thyroid activities and out-put of T4 into
circulation

Spectrum of abnormalities

Goiter
Delayed milestones
Lowered educational performance (low IQ)
Speech and hearing defects
Retarded physical development
Mental retardation
Squint
Stunting of limbs in children and
adolescents

Contd

Skin changes
Enlargement of tongue
Hoarsening of voice
Slowness of movements
Rising lipid content of plasma
Cardiac insufficiency
Fluid retention

 Metabolism is closely linked to thyroid

function
Absorbed in the form of iodide and taken up
immediately by the thyroid gland
Converted to I in the gland and bound to
tyrosine residues to form T4 and T3
Thyroid gland needs about 60g iodide/day
for adequate supply of T4
Excess I is excreted in urine (small
amounts in sweat & faeces also)

Absorption of I
Organic form is rapidly degraded in the gut
to iodide.
Almost completely absorbed in the
stomach and upper small bowel.
80% thyroxin absorbed remainder lost in
feces
Iodide used in fortification is readily
absorbed
Iodate is reduced to iodide for absorption

Transport of I
Absorbed iodide appears in the blood in
free and dializable form (not bound to any
protein)
Rapidly picked up by the thyroid and
kidney
Concentration in blood depends on supply
and clearance rate

Storage

Only storage site is thyroid gland

Stored as hormone or hormone precursors
10-20mg of I in abundant supply
< 200g in chronic I deficiency

Turnover of thyroid hormone is slow

Half life of
thyroxin (T 4) 7 days

triidothyronine (T3)
1.5-3 days

Recommended Dietary Intake

WHO/UNICEF/ICCIDD (2001)
Up to 59months
6-12y
120
>12y and adults
Preg and lactating

90 g/day

150
200

Inhibition by goitrogens
Cyanogenic glycosides in cassava, maize,
bamboo shoots, sweet potatoes, lima beans
and millet
Release cyanide which forms thiocyanate,
this competes with I uptake by the gland
Goitrins in cabbage, rape and mustard
also converted to thiocyanate, blocks the
uptake and inhibits coupling process to
produce T4 (increase supply to overcome)

Management of ID
Depends on:
- the severity of IDD
- the accessibility of target population
- the resources available
Food based approaches
Use of natural foods

 Use of iodized salt to provide

120-140g/day of iodine
Concentration in salt be: 20-40mg of I /kg
of salt
20% losses at manufacturing, storage
and transport
20% losses during cooking
Average salt intake is 5-10g/person/day
Potassium iodate or iodide used

 Iodination of drinking water- in China

Fortification of infant formulas concentration of
200g/l in pre-term formula and /or 100g/l
in starting formula
Fortification of foods for farm animals
Use of iodized oil administered IM or orally in
the form of slowly resorbable iodized oil.
Effectiveness can be enhanced by use of
monounsaturated oil (rapeseed or peanut oil).
Deworming is needed as intestinal parasites suck
oil.
Use of 10% KI solution - 30mg/month or 8mg
every 2 weeks

Selenium

 Food is the major source,

Depends on soil conditions
Garlic, mushrooms, broccoli, fish, organ
meats
RDI (WHO) is 40g/day

 Importance in human was reported in

1979
Protects against cancers and CVD
Maintains healthy immune system
Constituent in several selenoproteins that
are needed for thyroid metabolism,
immune function, reproductive function

Function
In immune function role to play in the
defense system (related to its antioxidant
function)
In cancer acts as an anti-carcinogenic
agent
In CVD -

Metabolism
Main dietary form is selenoamino acids
Metabolism depends on the chemical form
Absorbed mainly from duodenum, high
absorption about 80%.
Selenomethionine is better absorbed than
selenite
Absorption is unaffected by Se status
Se status is influenced by dietary intake
Excretion through urine, unabsorbed
through feces

Assessment of status
Mainly by blood selenium levels (serum
Se short term status and erythrocyte Se
long term status)
Urinary Se is also used

Fluoride

 Acts to reduce dental caries

inhibits bacterial enzymes that produce
acid in plaques of teeth, erosion of dental
enamel by acid is prevented
Sources drinking water, tea infusions
RDI is 0.5-1.0mg/day for children and 34mg/day for adults. Water supply should
contain 0.7-1.0 ppm of fluoride

Copper

 100mg Cu in the body

Plasma Cu level is 15mol/L and up to
90% of this is associated with
caeruloplasmin
Cu has diverse functions erythropoiesis,
connective tissue synthesis, oxidative
phosphorylation, thermogenesis
Transported as caeruloplasmin