This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hollowell, J. G. Articles by Jackson, R. J. Search for Related Content PubMed PubMed Citation Articles by Hollowell, J. G. Articles by Jackson, R. J.

Iodine Nutrition in the United States. Trends and Public Health Implications: Iodine Excretion Data from National Health and Nutrition Examination Surveys I and III (1971–1974 and 1988–1994)

Centers for Disease Control (J.G.H., N.W.S., P.L.G.), National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Atlanta, Georgia 30341; National Center for Environmental Health, Division of Environmental Health Laboratory Science, Centers for Disease Control (W.H.H., E.W.G., D.T.M.), Atlanta, Georgia 30341; Emory University School of Public Health (D.W.F., G.F.M.), Atlanta, Georgia 30322; and Brigham and Women’s Hospital (L.E.B., S.P.), Boston, Massachusetts 02115

Address all correspondence and requests for reprints to: Joseph G. Hollowell, M.D., M.P.H., Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-28, Atlanta, Georgia 30341. E-mail address: jgh1{at}cdc.gov

Iodine deficiency in a population causes increased prevalence of goiter and, more importantly, may increase the risk for intellectual deficiency in that population. The National Health and Nutrition Examination Surveys [NHANES I (1971–1974) and (NHANES III (1988–1994)] measured urinary iodine (UI) concentrations. UI concentrations are an indicator of the adequacy of iodine intake for a population. The median UI concentrations in iodine-sufficient populations should be greater than 10 µg/dL, and no more than 20% of the population should have UI concentrations less than 5 µg/dL. Median UI concentrations from both NHANES I and NHANES III indicate adequate iodine intake for the overall U.S. population, but the median concentration decreased more than 50% between 1971–1974 (32.0 ± 0.6 µg/dL) and 1988–1994 (14.5 ± 0.3 µg/dL). Low UI concentrations (<5 µg/dL) were found in 11.7% of the 1988–1994 population, a 4.5-fold increase over the proportion in the 1971–1974 population. The percentage of people excreting low concentrations of iodine (UI, <5 µg/dL) increased in all age groups. In pregnant women, 6.7%, and in women of child-bearing age, 14.9% had UI concentrations below 5 µg/dL. The findings in 1988–1994, although not indicative of iodine deficiency in the overall U.S. population, define a trend that must be monitored.

This article has been cited by other articles:

				G. Stilwell, P. J. Reynolds, V. Parameswaran, L. Blizzard, T. M. Greenaway, and J. R. Burgess The Influence of Gestational Stage on Urinary Iodine Excretion in Pregnancy J. Clin. Endocrinol. Metab., May 1, 2008; 93(5): 1737 - 1742. [Abstract] [Full Text] [PDF]

				Subsection Reports J. Clin. Endocrinol. Metab., August 1, 2007; 92(8_suppl): s8 - s47. [Full Text] [PDF]

				M. Abalovich, N. Amino, L. A. Barbour, R. H. Cobin, L. J. De Groot, D. Glinoer, S. J. Mandel, and A. Stagnaro-Green Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., August 1, 2007; 92(8_suppl): s1 - s47. [Abstract] [Full Text] [PDF]

				E. N. Pearce, A. M. Leung, B. C. Blount, H. R. Bazrafshan, X. He, S. Pino, L. Valentin-Blasini, and L. E. Braverman Breast Milk Iodine and Perchlorate Concentrations in Lactating Boston-Area Women J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1673 - 1677. [Abstract] [Full Text] [PDF]

				J. E. Haddow, M. R. McClain, G. E. Palomaki, and J. G. Hollowell Urine Iodine Measurements, Creatinine Adjustment, and Thyroid Deficiency in an Adult United States Population J. Clin. Endocrinol. Metab., March 1, 2007; 92(3): 1019 - 1022. [Abstract] [Full Text] [PDF]

				E. N. Pearce, J. G. Hollowell Jr., G. Morreale de Escobar, F. Escobar del Rey, and R. D. Utiger Iodine Nutrition -- More Is Better N. Engl. J. Med., October 5, 2006; 355(14): 1500 - 1501. [Full Text] [PDF]

				L. E. Braverman, E. N. Pearce, X. He, S. Pino, M. Seeley, B. Beck, B. Magnani, B. C. Blount, and A. Firek Effects of Six Months of Daily Low-Dose Perchlorate Exposure on Thyroid Function in Healthy Volunteers J. Clin. Endocrinol. Metab., July 1, 2006; 91(7): 2721 - 2724. [Abstract] [Full Text] [PDF]

				R. D. Utiger Iodine nutrition--more is better. N. Engl. J. Med., June 29, 2006; 354(26): 2819 - 2821. [Full Text] [PDF]

				American Academy of Pediatrics, S. R. Rose, and the Section on Endocrinology and Committee on, American Thyroid Association, R. S. Brown, and the Public Health Committee, and Lawson Wilkins Pediatric Endocrine Society Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics, June 1, 2006; 117(6): 2290 - 2303. [Abstract] [Full Text] [PDF]

				T. Remer, N. Fonteyn, U. Alexy, and S. Berkemeyer Longitudinal examination of 24-h urinary iodine excretion in schoolchildren as a sensitive, hydration status-independent research tool for studying iodine status Am. J. Clinical Nutrition, March 1, 2006; 83(3): 639 - 646. [Abstract] [Full Text] [PDF]

				S. A. H. Cann Hypothesis: dietary iodine intake in the etiology of cardiovascular disease. J. Am. Coll. Nutr., February 1, 2006; 25(1): 1 - 11. [Abstract] [Full Text] [PDF]

				E. H. Hoogendoorn, A. R. Hermus, F. de Vegt, H. A. Ross, A. L.M. Verbeek, L. A.L.M. Kiemeney, D. W. Swinkels, F. C.G.J. Sweep, and M. den Heijer Thyroid Function and Prevalence of Anti-Thyroperoxidase Antibodies in a Population with Borderline Sufficient Iodine Intake: Influences of Age and Sex Clin. Chem., January 1, 2006; 52(1): 104 - 111. [Abstract] [Full Text] [PDF]

				J. A. Walker, E. H. Illions, J. F. Huddleston, and R. C. Smallridge Racial Comparisons of Thyroid Function and Autoimmunity During Pregnancy and the Postpartum Period Obstet. Gynecol., December 1, 2005; 106(6): 1365 - 1371. [Abstract] [Full Text] [PDF]

				M. B Zimmermann, I. Aeberli, T. Torresani, and H. Burgi 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 Am. J. Clinical Nutrition, August 1, 2005; 82(2): 388 - 392. [Abstract] [Full Text] [PDF]

				E. L. Mazzaferri Empirically Treating High Serum Thyroglobulin Levels J. Nucl. Med., July 1, 2005; 46(7): 1079 - 1088. [Full Text] [PDF]

				R. D. Utiger The Multiplicity of Thyroid Nodules and Carcinomas N. Engl. J. Med., June 9, 2005; 352(23): 2376 - 2378. [Full Text] [PDF]

				L. H Allen Multiple micronutrients in pregnancy and lactation: an overview Am. J. Clinical Nutrition, May 1, 2005; 81(5): 1206S - 1212S. [Abstract] [Full Text] [PDF]

				J H Lazarus and L D K E Premawardhana BEST PRACTICE NO 184 Screening for thyroid disease in pregnancy J. Clin. Pathol., May 1, 2005; 58(5): 449 - 452. [Abstract] [Full Text] [PDF]

				M. B Zimmermann, Y. Ito, S. Y Hess, K. Fujieda, and L. Molinari High thyroid volume in children with excess dietary iodine intakes Am. J. Clinical Nutrition, April 1, 2005; 81(4): 840 - 844. [Abstract] [Full Text] [PDF]

				R. M. Belin, B. C. Astor, N. R. Powe, and P. W. Ladenson Smoke Exposure Is Associated with a Lower Prevalence of Serum Thyroid Autoantibodies and Thyrotropin Concentration Elevation and a Higher Prevalence of Mild Thyrotropin Concentration Suppression in the Third National Health and Nutrition Examination Survey (NHANES III) J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 6077 - 6086. [Abstract] [Full Text] [PDF]

				S. J. Mandel A 64-Year-Old Woman With a Thyroid Nodule JAMA, December 1, 2004; 292(21): 2632 - 2642. [Full Text] [PDF]

				M S Kibirige, S Hutchison, C J Owen, and H T Delves Prevalence of maternal dietary iodine insufficiency in the north east of England: implications for the fetus Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2004; 89(5): F436 - F439. [Abstract] [Full Text] [PDF]

				E. N. Pearce, S. Pino, X. He, H. R. Bazrafshan, S. L. Lee, and L. E. Braverman Sources of Dietary Iodine: Bread, Cows' Milk, and Infant Formula in the Boston Area J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3421 - 3424. [Abstract] [Full Text] [PDF]

				K. L. Caldwell, C. B. Maxwell, A. Makhmudov, S. Pino, L. E. Braverman, R. L. Jones, and J. G. Hollowell Use of Inductively Coupled Plasma Mass Spectrometry to Measure Urinary Iodine in NHANES 2000: Comparison with Previous Method Clin. Chem., June 1, 2003; 49(6): 1019 - 1021. [Full Text] [PDF]

				E. M. Allen, W.-C. Hsueh, M. M. Sabra, T. I. Pollin, P. W. Ladenson, K. D. Silver, B. D. Mitchell, and A. R. Shuldiner A Genome-Wide Scan for Autoimmune Thyroiditis in the Old Order Amish: Replication of Genetic Linkage on Chromosome 5q11.2-q14.3 J. Clin. Endocrinol. Metab., March 1, 2003; 88(3): 1292 - 1296. [Abstract] [Full Text] [PDF]

				K. Guttikonda, J. R. Burgess, K. Hynes, S. Boyages, K. Byth, and V. Parameswaran Recurrent Iodine Deficiency in Tasmania, Australia: A Salutary Lesson in Sustainable Iodine Prophylaxis and Its Monitoring J. Clin. Endocrinol. Metab., June 1, 2002; 87(6): 2809 - 2815. [Abstract] [Full Text] [PDF]

				J. T. Dunn Guarding our Nation's Thyroid Health J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 486 - 488. [Full Text] [PDF]

				J. G. Hollowell, N. W. Staehling, W. D. Flanders, W. H. Hannon, E. W. Gunter, C. A. Spencer, and L. E. Braverman Serum TSH, T4, and Thyroid Antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 489 - 499. [Abstract] [Full Text] [PDF]

				S. A. H. Cann, J. P. van Netten, C. van Netten, F. H. Messerli, and R. E. Schmieder Iodized Salt and Hypertension Arch Intern Med, January 14, 2002; 162(1): 104 - 105. [Full Text] [PDF]

				R. C. Smallridge and P. W. Ladenson Hypothyroidism in Pregnancy: Consequences to Neonatal Health J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2349 - 2353. [Full Text] [PDF]

				G. Morreale de Escobar, M. Jesús Obregón, and F. Escobar del Rey Is Neuropsychological Development Related to Maternal Hypothyroidism or to Maternal Hypothyroxinemia? J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 3975 - 3987. [Abstract] [Full Text]

				C. Herzmann, J. K. Torrens, G. M. de Escobar, F. E. del Rey, M. Fukushi, K. Honma, K. Fujita, J. G. Hollowell, P. L. Garbe, D. T. Miller, et al. Maternal Thyroid Deficiency during Pregnancy and Subsequent Neuropsychological Development of the Child N. Engl. J. Med., December 23, 1999; 341(26): 2015 - 2017. [Full Text]

				Z. A. Gomo, T. J Allain, J. A Matenga, B. Ndemere, A. Wilson, and P. Urdal Urinary iodine concentrations and thyroid function in adult Zimbabweans during a period of transition in iodine status Am. J. Clinical Nutrition, November 1, 1999; 70(5): 888 - 891. [Abstract] [Full Text] [PDF]

				R. D. Utiger Maternal Hypothyroidism and Fetal Development N. Engl. J. Med., August 19, 1999; 341(8): 601 - 602. [Full Text]

				J. T. Dunn What's Happening to Our Iodine? J. Clin. Endocrinol. Metab., October 1, 1998; 83(10): 3398 - 3400. [Full Text]