Best Practice & Research Clinical Endocrinology & Metabolism
Volume 24, Issue 1 , Pages 143-158 , February 2010

Iodine in Enteral and Parenteral Nutrition

  • Michael B. Zimmermann, MD

      Affiliations

    • Human Nutrition Laboratory, ETH Zürich, Switzerland
    • Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
    • Corresponding Author InformationCorresponding author. Laboratory for Human Nutrition, Swiss Federal Institute of Technology Zürich, Schmelzbergstrasse 7, LFV E19, CH-8092 Zürich, Switzerland. Tel.: +41 44 632 8657; fax: +41 44 632 1470.
    • ,
  • Catherine M. Crill, PharmD

      Affiliations

    • Departments of Clinical Pharmacy and Pediatrics, The University of Tennessee Health Science Center, Memphis, TN, USA
    • Le Bonheur Children's Medical Center, Memphis, TN, USA

References 

  1. Zimmermann MB, Jooste PL, Pandav CS. The iodine deficiency disorders. Lancet. 2008;372:1251–1262
  2. World Health Organization/International Council for the Control of the Iodine Deficiency Disorders/United Nations Children's Fund (WHO/ICCIDD/UNICEF) . Assessment of the Iodine Deficiency Disorders and Monitoring their Elimination. 3rd Ed.. Geneva: WHO; 2007;
  3. Pearce EN, Pino S, He X, et al. Sources of dietary iodine: bread, cows' milk, and infant formula in the Boston area. The Journal of Clinical Endocrinology and Metabolism. 2004;89:3421–3424
  4. Haldimann M, Alt A, Blanc A, et al. Iodine content of food groups. Journal of Food Composition and Analysis. 2005;18:461–471
  5. Institute of Medicine (IOM) . Academy of Sciences, USA. Dietary reference intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium and Zinc. Washington DC: National Academy Press; 2001;
  6. El-Ghawi UM, Al-Sadeq AA. Determination of iodine in Libyan food samples using epithermal instrumental neutron activation analysis. Biological Trace Element Research. 2006;111:31–40
  7. Thomson BM, Vannoort RW, Haslemore RM. Dietary exposure and trends of exposure to nutrient elements iodine, iron, selenium and sodium from the 2003-4 New Zealand Total Diet Survey. The British Journal of Nutrition. 2007 Oct 10;1–12[Epub]
  8. Phillips DI. Iodine, milk, and the elimination of endemic goitre in Britain: the story of an accidental public health triumph. Journal of Epidemiology and Community Health. 1997;51(4):391–393
  9. Nicola JP, Basquin C, Portulano C, Reyna-Neyra A, Paroder M, Carrasco N. The Na+/I- symporter mediates active iodide uptake in the intestine. American Journal of Physiology. Cell Physiology. 2009;296(4):C654–C662
  10. Rousset BA, Dunn JT. Thyroid hormone synthesis and secretion. Available at: http://www.thyroidmanager.org/Accessed November 18, 2007
  11. Eskandari S, Loo DD, Dai G, et al. Thyroid Na+/I- symporter. Mechanism, stoichiometry, and specificity. The Journal of Biological Chemistry. 1997;272:27230–27238
  12. Zimmermann MB. Methods to assess iron and iodine status. British Journal of Nutrition. 2008;99(S3):2–9
  13. Andersen S, Karmisholt J, Pedersen KM, et al. Reliability of studies of iodine intake and recommendations for number of samples in groups and in individuals. British Journal of Nutrition. 2008;99(4):813–818
  14. Knudsen N, Christiansen E, Brandt-Christensen M, et al. Age- and sex-adjusted iodine/creatinine ratio. A new standard in epidemiological surveys? Evaluation of three different estimates of iodine excretion based on casual urine samples and comparison to 24h values. European Journal of Clinical Nutrition. 2000;54:361–363
  15. Zimmermann MB, Hess SY, Molinari L, et al. New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: a World Health Organization/Nutrition for Health and Development Iodine Deficiency Study Group Report. European Journal of Clinical Nutrition. 2004;79:231–237
  16. Berghout A, Wiersinga WM, Smits NJ, et al. Determinants of thyroid volume as measured by ultrasonography in healthy adults in a non-iodine deficient area. Clinical Endocrinology. 1987;26(3):273–280
  17. Maravall FJ, Gómez-Arnáiz N, Gumá A, et al. Reference values of thyroid volume in a healthy, non-iodine-deficient Spanish population. Hormone and Metabolic Research. 2004;36(9):645–649
  18. Delange F. Neonatal screening for congenital hypothyroidism: Results and perspectives. Hormone Research. 1997;48:51–61
  19. Zimmermann MB, Aeberli I, Torresani T, et al. Increasing the iodine concentration in the Swiss iodized salt program markedly improved iodine status in pregnant women and children: a 5-y prospective national study. The American Journal of Clinical Nutrition. 2005;82:388–392
  20. Spencer CA, Wang CC. Thyroglobulin measurement - techniques, clinical benefits, and pitfalls. Endocrinology and Metabolism Clinics of North America. 1995;24:841
  21. Knudsen N, Bülow I, Jørgensen T, et al. Serum Tg–a sensitive marker of thyroid abnormalities and iodine deficiency in epidemiological studies. The Journal of Clinical Endocrinology and Metabolism. 2001;86(8):3599–3603
  22. Benmiloud M, Chaouki ML, Gutekunst R, et al. Oral iodized oil for correcting iodine deficiency: optimal dosing and outcome indicator selection. The Journal of Clinical Endocrinology and Metabolism. 1994;79:20–24
  23. Missler U, Gutekunst R, Wood WG. Thyroglobulin is a more sensitive indicator of iodine deficiency than thyrotropin - development and evaluation of dry blood spot assays for thyrotropin and thyroglobulin in iodine-deficient geographical areas. European Journal of Clinical Chemistry and Clinical Biochemistry. 1994;32:137–143
  24. Zimmermann MB, Moretti D, Chaouki N, et al. Development of a dried whole-blood spot thyroglobulin assay and its evaluation as an indicator of thyroid status in goitrous children receiving iodized salt. The American Journal of Clinical Nutrition. 2003;77:1453–1458
  25. Zimmermann MB, de Benoist B, Corigliano S, et al. Assessment of iodine status using dried blood spot thyroglobulin: development of reference material and establishment of an international reference range in iodine-sufficient children. The Journal of Clinical Endocrinology and Metabolism. 2006;91(12):4881–4887
  26. Koenig RJ. Modeling the nonthyroidal illness syndrome. Current Opinion in Endocrinology, Diabetes, and Obesity. 2008;15(5):466–469
  27. Sack J. Thyroid function in pregnancy- maternal-fetal relationship in health and disease. Pediatric Endocrinology Reviews. 2003;1(Suppl 2):170–176
  28. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Role of thyroid hormone during early brain development. European Journal of Endocrinology. 2004;151(Suppl. 3):U25–U37
  29. Pop VJ, Kuijpens JL, van Baar AL, et al. Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clinical Endocrinology. 1999;50:149–155
  30. Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. The New England Journal of Medicine. 1999;341:549–555
  31. Zimmermann MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. The American Journal of Clinical Nutrition. 2009;89(2):668S–672S
  32. Bleichrodt N, Garcia I, Rubio C, et al. Developmental disorders associated with severe iodine deficiency. In:  Hetzel B,  Dunn J,  Stanbury J editor. The prevention and control of iodine deficiency disorders. Amsterdam: Elsevier; 1987;p. 65–84
  33. Qian M, Wang D, Watkins WE. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pacific Journal of Clinical Nutrition. 2005;14:32–42
  34. Zimmermann MB, Connolly K, Bozo M, et al. Iodine supplementation improves cognition in iodine-deficient schoolchildren in Albania: a randomized, controlled, double-blind study. The American Journal of Clinical Nutrition. 2006;83:108–114
  35. Zimmermann MB, Jooste PL, Mabapa NS, et al. Treatment of iodine deficiency in school-age children increases insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations and improves somatic growth. The Journal of Clinical Endocrinology and Metabolism. 2007;92(2):437–442
  36. Delange F, Dalhem A, Bourdoux P, Lagess R, Glinoer D, Fisher DA, et al. Increased risk of primary hypothyroidism in preterm infants. The Journal of Pediatrics. 1984;105:462–469
  37. Etling N. Concentration of thyroglobulin, iodine contents of thyroglobulin and iodoaminoacids in human neonates thyroid glands. Acta Paediatrica Scandinavica. 1977;66:97–102
  38. van de Hove MF, Beckers C, Devlieger H, de Zegher F, De Nayer PH. Hormone synthesis and storage in the thyroid of human preterm and term newborns: effect of thyroxine treatment. Biochimie. 1999;81:563–570
  39. Gushurst CA, Mueller JA, Green JA, Sedor F. Breast milk iodide: reassessment in the 1980s. Pediatrics. 1984;73:354–357
  40. Rogahn J, Ryan S, Wells J, et al. Randomised trial of iodine intake and thyroid status in preterm infants. Archives of Disease in Childhood. Fetal and Neonatal Edition. 2000;83:F86–F90
  41. Tsang RC, Lucas A, Uauy R, et al. Nutritional needs of the preterm infant. Scientific basis and practical guidelines. NewYork: Caduceus Medical Publishers; 1993;288–289
  42. Delange F, Bourdoux p, Chanoine JP, et al. Physiology of iodine nutrition during pregnancy, lactation, and early postnatal life. In:  Berger H editors. Nestle nutrition workshop series. Vitamins and minerals in pregnancy and lactation. 16:New York: Vevey/Raven Press; 1988;p. 205–214
  43. Ares S, Escobar-Morreale HF, Quero J, et al. Neonatal hypothyroxinemia: effects of iodine intake and premature birth. The Journal of Clinical Endocrinology and Metabolism. 1997;82:1704–1712
  44. Ibrahim M, Morreale de Escobar GM, Visser TJ, et al. Iodine deficiency associated with parenteral nutrition in extreme preterm infants. Archives of Disease in Childhood. Fetal and Neonatal Edition. 2003;88:F56–F57
  45. Ingenbleek Y, Malvaux P. Iodine balance studies in protein-calorie malnutrition. Archives of Disease in Childhood. 1974;49:305–309
  46. Malvaux P, Beckers C, De Visscher M. Iodine balance studies in nongoitrous children and in adolescents on low iodine intake. The Journal of Clinical Endocrinology and Metabolism. 1969;29:79–84
  47. Caldwell KL, Miller GA, Wang RY, Jain RB, Jones RL. Iodine status of the U.S. population, National Health and Nutrition Examination Survey 2003–2004. Thyroid. 2008;18:1207–1214
  48. Leung AM, Pearce EN, Hamilton T, He X, Pino S, Merewood A, et al. Colostrum iodine and perchlorate concentrations in Boston-area women: a cross-sectional study. Clinical Endocrinology. 2009;70:326–330
  49. Semba RD, Delange F. Iodine in human milk: perspectives for infant health. Nutrtion Reviews. 2001;59:269–278
  50. Etling N, Padovani E, Fouque F, Tato L. First-month variations in total iodine content of human breast milks. Early Human Development. 1986;13:81–85
  51. Ares S, Quero J, Duran S, et al. Iodine content of infant formulas and iodine intake of premature babies: high risk of iodine deficiency. Archives of Disease in Childhood. Fetal and Neonatal Edition. 1994;71:F184–F191
  52. Seibold-Weiger K, Wollmann H, Rendl J, et al. Iodine concentration in the breast milk of mothers of premature infants. Zeitschrift Für Geburtshilfe und Neonatologie. 1999;203:81–85
  53. Pearce EN, Leung AM, Blount BC, Bazrafshan HR, He X, Pino S, et al. Breast milk iodine and perchlorate concentrations in lactating Boston-area women. The Journal of Clinical Endocrinology and Metabolism. 2007;92:1673–1677
  54. Hopkins B. Enteral nutrition products. In:  Zaloga GP editors. Nutrition in Critical Care. St Louis, USA: Mosby; 1994;p. 439–468
  55. Greene HL, Hambidge KM, Schanler R, et al. Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition. The American Journal of Clinical Nutrition. 1988;48:1324–1342
  56. Koletzko B, Goulet O, Hunt J, et al. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR). Journal of Pediatric Gastroenterology and Nutrition. 2005;41(Suppl. 2):S1–87
  57. Smerdely P, Lim A, Boyages SC, et al. Topical iodine containing antiseptics and neonatal hypothyroidism in very-low-birthweight infants. Lancet. 1989;2:661–664
  58. Hardy G, Menendez AM, Manzanares W. Trace element supplementation in parenteral nutrition: Pharmacy, posology, and monitoring guidance. Nutrition. 2009;Epub May 30
  59. Moukarzel AA, Buchman AL, Salas JS, et al. Iodine supplementation in children receiving long-term parenteral nutrition. The Journal of Pediatrics. 1992;121(2):252–254
  60. Atkinson M, Worthley LI. Nutrition in the critically ill patient: part II. Parenteral nutrition. Critical Care and Resuscitation. 2003;5(2):121–136
  61. Koretz RL, Lipman TO, Klein S, et al. AGA technical review on parenteral nutrition. Gastroenterology. 2001;121(4):970–1001
  62. Gough DC, Laing I, Astley P. Thyroid function on short-term total parenteral nutrition without iodine supplements. JPEN. Journal of Parenteral and Enteral Nutrition. 1982;6(5):439–440
  63. Leung FY. Trace elements in parenteral micronutrition. Clinical Biochemistry. 1995;28(6):561–566
  64. Navarro AM, Suen VMM, Souza IM, et al. Patients with severe bowel malabsorption do not have changes in iodine status. Nutrition. 2005;21:895–900
  65. Allemand D, Gruters A, Beyer P, Weber B. Iodine in contrast agents and skin antiseptics is the major cause for hypothyroidism in premature infants during intensive care. Hormone Research. 1987;28:42–49
  66. Mimoz O, Villeminey S, Ragot S, Dahyot-Fizelier C, Laksiri L, Petitpas F, et al. Chlorhexidine-based antiseptic solution vs alcohol-based povidone-iodine for central venous catheter care. Archives of Internal Medicine. 2007;167(19):2066–2072
  67. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Disease Society of America. Clinical infectious diseases. 2009;49:1–45
  68. O'Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR. Recommendations and Reports. 2002;51:1–29
  69. Upadhyayula S, Kambalapalli M, Harrison CJ. Safety of anti-infective agents for skin preparation in premature infants. Archives of Disease in Childhood. 2007;92:646–647
  70. Cicalese MP, Bruzzese E, Guarino A, Spanguolo MI. Requesting iodine supplementation in children on parenteral nutrition. Clinical Nutrition. 2009;28:256–259
  71. Crill C, Norman J, Hak E, Christensen M, Helms R. Iodine deficiency and hypothyroidism in an infant receiving parenteral nutrition. Nutrition in Clinical Practice. 2009;24(1):137–138
  72. Grant JP. Handbook of Total Parenteral Nutrition. Philadelphia: W.B. Saunders Company; 1992;280
  73. Reuss ML, Leviton A, Paneth N, et al. Thyroxine values from newborn screening of 919 infants born before 29 weeks' gestation. American Journal of Public Health. 1997;87:1693–1697
  74. Lucas A, Morley R, Fewtrell MS. Low triiodothyronine concentration in preterm infants and subsequent intelligence quotient (IQ) at 8 year follow up. BMJ. 1996;312:1132–1133
  75. Reuss ML, Paneth N, Pinto-Martin JA, et al. The relation of transient hypothyroxinemia in preterm infants to neurologic development at two years of age. The New England Journal of Medicine. 1996;334:821–827
  76. Ibrahim M, Sinn J, McGuire W. Iodine supplementation for the prevention of mortality and adverse neurodevelopmental outcomes in preterm infants. Cochrane Database of Systematic Review. 2006;2:CD005253
  77. van Wassenaer AG, Kok JH, de Vijlder JJ, et al. Effects of thyroxine supplementation on neurologic development in infants born at less than 30 weeks' gestation. The New England Journal of Medicine. 1997;42:87–92
  78. Osborn DA, Hunt RW. Prophylactic postnatal thyroid hormones for prevention of morbidity and mortality in preterm infants. Cochrane Database Systematic Review. 2007;24:CD005948
  79. Dasgupta PK, Liu Y, Dyke JV. Iodine nutrition: iodine content of iodized salt in the United States. Environmental Science & Technology. 2008;42:1315–1323
  80. Zimmermann MB. The influence of iron status on iodine utilization and thyroid function. Annual Review of Nutrition. 2006;26:367–389
  81. Zimmermann MB. Interactions of vitamin A and iodine deficiencies: effects on the pituitary-thyroid axis. International Journal for Vitamin and Nutrition Research. 2007;77:236–240
  82. Burk RF, Levander OA. Selenium. In:  Shils ME,  Shike M,  Ross AC, et al. editor. Modern Nutrition in Health and Disease. 10th ed. Philadelphia, PA: Lipincott, Williams, & Wilkins; 2006;
  83. Chow CC, Phillips DI, Lazarus JH, et al. Effect of low dose iodide supplementation on thyroid function in potentially susceptible subjects: Are dietary iodide levels in Britain acceptable?. Clinical Endocrinology. 1991;34:413–416
  84. Zimmermann MB, Ito Y, Hess SY, et al. High thyroid volume in children with excess dietary iodine intakes. American Journal of Clinical Nutrition. 2005;81:840–844
  85. Material Safety Data Sheet . Iodopen. http://www.apppharma.com/ProductDetail.aspx?Id=63&name= Iodopen_Sodium_Iodide_Injection
  86. Available at: http://www.merck.com/mmpe/sec01/ch005/ch005e.html
  87. European Commission HaCPD-GSCoF . Opinion of the Scientific Committee on Food on the tolerable upper level of intake of iodine. Brussels: European Commission; 2002;
  88. Zimmermann MB. Iodine deficiency. Endocrine Reviews. 2009;30(4):376–408

PII: S1521-690X(09)00110-9

doi: 10.1016/j.beem.2009.09.003

Best Practice & Research Clinical Endocrinology & Metabolism
Volume 24, Issue 1 , Pages 143-158 , February 2010

Article Tools

* Image Usage & Resolution