What prevents healthy heads

IODE SMART HEADS REACH IT. How to meet your iodine needs in a healthy way and prevent iodine deficiency diseases

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1 JOD! SMART HEADS USE IT How you can meet your iodine needs in a healthy way and prevent iodine deficiency diseases

2 In industrialized countries like Germany, a wide range of food is available today. Nevertheless, an undersupply of certain vitamins and minerals is not uncommon. An example of this is the trace element iodine, which is required by the thyroid gland to produce thyroid hormones. Whether we feel fit, babies are born healthy or schoolchildren can learn well, iodine is needed everywhere. Anyone can have an iodine deficiency. Studies show that people in this country with normal eating habits only consume about two thirds of the recommended amount of iodine. Even those who plan their diet to be extremely fresh and varied will find that their iodine intake is well below the recommendations. Our foods naturally contain too little iodine. Although, according to the World Health Organization (WHO), Germany is no longer a designated iodine deficiency area, significant parts of the population are not adequately supplied with iodine. Intensive education and the widespread use of iodized salt have significantly improved the iodine supply in recent years. However, a large part of the German population still has an insufficient supply of iodine. This brochure provides important information and clarifies open questions about the importance of iodine and the subject of iodine deficiency. It gives practical tips for your own diet and clears up some popular iodine myths. 2 HAPPY READING WISH YOU THE CHANGES IN THE JODMANGEL E.V.

3 WHY DO WE NEED IODINE Iodine is one of the essential trace elements that must be ingested with food. The iodine requirement changes in the course of life. Adolescents and adults need around 200 µg of the vital building block every day. Pregnant and breastfeeding women need more. RECOMMENDED IODINE SUPPLY PER DAY * Group of people Iodine (micrograms (µg) / day) Infants Children 1 9 years Children years 180 Adolescents years 200 Adults years 200 Adults over 50 years 180 Pregnant women 230 Breastfeeding women 260 * according to DA-CH reference values ​​for nutrient intake, 2013 The human body needs iodine primarily for the thyroid gland. The butterfly-shaped organ is located in the front of the neck below the larynx. Without them, the metabolism is as good as nothing. As a component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3), iodine controls energy metabolism, heart rhythm, blood pressure, growth and brain development, among other things. 3

4 If the body is not regularly supplied with iodine, this can lead to metabolic disorders, changes in organs and diseases. Constant tiredness, lack of drive or dry skin are the first signs of iodine deficiency. Then a so-called goiter can develop, an overgrowth of the thyroid gland caused by iodine deficiency. The production of hormones gets out of hand; not enough thyroid hormone thyroxine is released. FUNCTION OF THE THYROID HORMONES! n Control of energy consumption and basal metabolic rate n Growth and development of the child already in the womb n Regulation of body temperature n Strengthening of the immune system n Regulation of the cardiovascular system and blood pressure n Improvement of physical performance n Increased concentration and memory capacity n Improvement of the intelligence quotient ( IQ) especially in children n Mood-enhancing effect n Control of fertility in men and women n Important for intestinal activity and digestion 4

5 brain and nerves hair thyroid cardiovascular system bones gastrointestinal tract gonads connective tissue and skin IMPORTANT FOR THE WHOLE BODY! Body organs whose development and function are controlled by thyroid hormones. 5

6 WHAT HAPPENS IN CASE OF IODINE LOSS If the body does not receive enough iodine, the thyroid tries to compensate for the deficiency by causing the thyroid cells to multiply. The aim is to fish the small amounts of iodine out of the food particularly effectively. If the thyroid enlargement exceeds a certain level, the doctor calls it goiter or goiter. But this visible change is only the tip of the iceberg. Even if those affected still feel well, their iodine supply may already be inadequate. Some symptoms can indicate an iodine deficiency: poor concentration, lack of drive, constant tiredness, depressive moods as well as dry, flaky skin, indigestion and poor immune system. These rather minor complaints are to be taken seriously and, if possible, to be clarified with a doctor. The symptoms are particularly severe in children. Psychomotor development disorders, hearing defects, reduced intellectual performance and learning difficulties can be the result. An iodine deficiency can also lead to complications during pregnancy. Miscarriages are possible. The risk of deformities increases. Cerebral maturation can also be disrupted. 6th

7 If there is an enlarged thyroid or goiter due to iodine deficiency for a long time, the thyroid tissue changes. The doctor then speaks of knot formation. In so-called cold nodes, the cells have given up their function and no longer produce thyroid hormones. There is an underactive thyroid (medical: hypothyroidism). In rare cases, thyroid cancer occurs. Active and overactive thyroid cells collect in hot or autonomic nodes. Regardless of the actual need, these nodes produce hormones in an uncontrolled manner. An overactive thyroid gland (medical: hyperthyroidism) develops. Possible complaints are weight loss, nervousness, insomnia, fast and irregular heartbeat as well as diarrhea, thirst and decreased performance. But there are also genetic diseases that lead to thyroid dysfunction. In Hashimoto's thyroiditis, immune cells destroy the body's own thyroid tissue, resulting in hypofunction. In Graves' disease, an autoimmune reaction leads to an overactive thyroid. HOW DO THYROID DISEASES DEVELOP 7

8 HOW THE DOCTOR RECOGNIZES THYROID DISEASES An enlargement of the thyroid gland can be felt and determined by an ultrasound examination (sonography) reliably and painlessly for the patient. With sonography, the doctor can also recognize structural changes such as lumps. A further imaging process (scintigraphy) can be used to make visible whether nodes recognized in the ultrasound image have ceased to function (cold nodes) or are working increasingly (hot nodes). A thyroid malfunction, i.e. over- or under-function, can be identified on the basis of a blood test. Doctors also use it to detect possible defense substances (antibodies) in the case of autoimmune diseases such as Hashimoto's thyroiditis or Graves' disease. 8th

9 HOW DOES THE TREATMENT WORK To treat an iodine deficiency goiter, your doctor will prescribe iodine tablets, thyroid hormones (thyroxine) or a combination of both. If there is an undersupply of the thyroid gland, he gives thyroxine. The prescribed dose is adjusted to the hormone levels in the blood. If there is no improvement despite therapy, an operation may be necessary, especially in older patients. So-called anti-thyroid drugs are prescribed for people who are overactive. These drugs curb the production of hormones until normal thyroid activity is achieved. If that is not enough, radioiodine therapy is used to destroy active thyroid tissue or to remove it surgically. 9

10 ADEQUATE IODINE SUPPLY WITH THE DIET, BUT LIKE Iodine, only occurs in very small amounts in domestic soils and bodies of water. Since it is water-soluble, it is washed out with rainwater or via rivers from the soil and rock layers towards the sea. Crop plants can grow and flourish without iodine, but hardly enrich themselves with iodine. Vegetables and fruits therefore only contribute around three percent to the iodine supply. IODINE CONTENT OF IMPORTANT FOODS Food iodine content in µg / 100g haddock, saithe herring, tuna cod, plaice milk and dairy products 10 * hen's egg 10 Source: Souci, Fach, Kraut 2011; * Roland Gärtner: Current iodine levels in cow's milk and breast milk in 2009 Animals, like us humans, are dependent on iodine. Therefore, the animal feed is fortified with iodine for the benefit of animal health. Daily milk and dairy products as well as occasionally meat and sausage products improve the iodine balance in this way. 10

11 Due to the iodine content of the seas, sea fish and other marine animals or plants such as mussels and algae are naturally rich in iodine. Sea fish should be on the menu once or twice a week. Nevertheless, a varied diet without iodized salt and products made with it only cover a maximum of half of the recommended daily intake. For the other half, the use of iodized salt in all foods and especially in finished products (whether bread, ready meals, sausage or cheese) plays a special role. Consumers can recognize foods that are healthier to the thyroid by the designation iodized table salt or iodized salt instead of table salt on the list of ingredients. For many years, nutritionists and doctors have advised only using iodized salt at home, following the motto: if salt, then iodized salt. RECOMMENDED ADULTS FOR ADULTS 200 µg IODINE PER DAY 100 µg IODINE NATURAL FOOD (E.G. SEA FISH, MILK, EGG) 100 µg IODINE IODINE SALT AND FOOD PRODUCTS MANUFACTURED WITH IT = 5 g SALT 11

12 IF SALT THEN IODINE SALT! Iodized salt looks just like normal table salt, tastes the same and can be used in exactly the same way. The iodine enrichment of table salt is a good way to improve the iodine supply of the population because it is ingested in similar amounts by all people. Iodized salt contains an average of 20 µg iodine per gram of salt. With just five grams of table salt per day, 100 µg iodine would be absorbed if food manufacturers and consumers only used iodized salt. Consumers are already quite health-conscious here, because 80 percent of private households already use iodized salt. But using iodized salt in your own kitchen alone is not enough to absorb the recommended amounts of iodine. This only works if all other meals, for example in the canteen, are prepared with it. 12th

13 IODINE RIGHT FOR EVERYONE! Whether baby, school child or adult Iodine is indispensable in every age. Iodized salt is inexpensive, protects safely and reliably against symptoms of deficiency and does not involve any risks. PREGNANCY AND BREAST-FEEDING Mothers-to-be need more iodine from the beginning of their pregnancy: on the one hand to increase the production of their own thyroid hormones and on the other for the growing baby. From the 12th week of pregnancy, the fetus's thyroid begins to produce hormones. The need for iodine is also high in the breastfeeding phase in order to provide for the infant. 13th

14 JOD FOR TWO IS THE DEVISE! In concrete terms, this means: 1. Balanced diet with sea fish once or twice a week and dairy products daily 2. Exclusive use of iodized salt 3. Preference for foods made with iodized salt such as bread, ready-made meals and sausages 4. Additionally daily µg iodine in tablet form (if taken of iodine-containing multivitamin tablets or dietary supplements accordingly less) iodine tablets are no longer reimbursed by the health insurance companies as a preventive measure. For this reason, it is appealed to pregnant and breastfeeding women to bear the comparatively low costs themselves in the interests of their own health and that of the child. With an adequate iodine supply, you can reduce the risk of developmental disorders, deformities and miscarriages. Iodine tablets are available from pharmacies without a prescription. If the baby gets from the 5th / 6th Month of porridge food, this is partially enriched with iodine. Here it is important to pay attention to the list of ingredients. Since salting is not recommended in the first year of life, half an iodine tablet (50 µg) should be given daily for self-made porridge without added iodine. 14th

15 CHILDREN AND YOUNG PEOPLE SUPPLEMENT OF IODINE In the second year of life, toddlers take part in family dinners more and more. Parents should pay attention to the addition of iodine to bread and sausage products and regularly give their child milk and dairy products. It is helpful to get children used to regular fish eating as early as possible and, if necessary, to add moderate salt with iodized salt. Particularly important for school children: the need for iodine increases with every growth spurt, especially during puberty. At the age of 13, young people need just as much iodine as adults. A good iodine supply prevents concentration and learning difficulties in school children and contributes to optimal performance development. Fast food popular with children is not a good source of iodine; instead, milk, sea fish and iodized salt should be on the menu. The pediatrician knows when teenagers should take iodine tablets in individual cases. 15th

16 IODINE SUPPLY FOR VEGETARIANS Vegetarians who forego meat, sausage, sea fish and marine animals must pay particular attention to their iodine supply. Vegans who also do not consume dairy products and eggs and thus eliminate other sources of iodine from the menu are particularly at risk. In addition to the exclusive use of iodized salt and products made with it, it is advisable to consult a doctor about taking iodine tablets. SPORTS PEOPLE AND IODINE 16 Active athletes get their metabolism going and have an increased need for thyroid hormones. In addition, they sweat and drink a lot, which leads to iodine losses. Therefore, athletes should pay particular attention to their diet, only use iodized salt and possibly take iodine tablets as a supplement.

17 IODINE SUPPLY IN SPECIAL SITUATIONS Smokers are often at risk of goiter formation. Cigarette smoke contains goitre-promoting (goiter-inherent) substances. These are substances that cause the thyroid to enlarge by hindering the production of thyroid hormones. A sufficient intake of iodine through food is therefore all the more important for smokers. Iodized salt is also suitable for people with restricted potassium intake, for example with kidney failure. Iodine is added to the salt as potassium iodate. However, the amount of potassium is less than a thousandth of the recommended intake and is therefore of no significance for kidney disease. People who have to limit their consumption of table salt for medical reasons such as high blood pressure can use so-called iodized salt substitutes instead of iodized salt. 17th

18 IODINE SUPPLY FOR THYROID DISEASES The amount of iodine supplied with food does not trigger an overactive thyroid. Iodized salt is a safe and necessary food that can also be used in diseases of the thyroid gland (autonomic adenomas, Graves' disease, autoimmune thyroiditis). However, in consultation with their doctor, those affected should avoid higher amounts of iodine, some of which contain medication or X-ray contrast media. Caution also applies to the regular consumption of algae and seaweed products such as sushi: some of them contain an extremely high amount of iodine. IS THERE AN OVER SUPPLY WITH IODINE There is no so-called iodine allergy. Iodine as an ion or salt cannot cause allergies because it is too small to be recognized by the body as a foreign substance. There are indeed intolerances to complex iodine compounds such as those found in x-ray contrast media containing iodine, disinfectants or a few drugs. The reaction here does not, however, trigger the iodine itself. 18th

19 Acne is neither triggered nor worsened with the usual dietary amounts of iodine. Iodine acne or chloracne are symptoms that occur when toxic doses of these substances are administered. These amounts are up to times higher than the dose used for iodine deficiency prophylaxis. WHY IS IODINE SALT WITH FLUORIDE AND FOLIC ACID The use of iodized salt with fluoride provides two preventive measures: against thyroid diseases caused by iodine deficiency and, with fluoride, also against dental caries. Fluoride in table salt has a local effect through direct contact with the tooth surface. It protects against tooth decay even while eating. Folic acid can reduce the incidence of neural tube defects in newborns. These defects include, for example, the cleft lip and palate (harelip). That is why women who want to get pregnant should think about using iodized salt with folic acid. 19th

20 Working Group Jodmangel e.v., 1st Chairman Prof. Dr. med. Roland Gärtner Medical Clinic Downtown, University of Munich Hospital Editing and address for further information: Arbeitskreis Jodmangel e.v. Organization office Leimenrode Frankfurt Tel .: Fax: Further information on the Internet: Photos: Arbeitskreis Jodmangel e.v., Fotolia (p. 9, 12, 13, 15, 16, 17), Getty Images (p. 19)