Iodine Deficiency in Latvia: Current Status and Need for National Recommendations

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In the absence of a mandatory salt iodisation programme, two nationwide cross-sectional cluster surveys revealed persisting iodine deficiency among Latvian schoolchildren during the spring season and a noteworthy iodine deficiency in pregnant women in Latvia; these deficiencies warrant intervention. The consequences of mild-to-moderate iodine deficiency during pregnancy and lactation can adversely affect foetal brain development. Data from a Latvian population survey revealed the consumption of approximately 100 μg of iodine per day through foods and iodised salt. Therefore, strategies to increase the consumption of iodine-containing products should be implemented, particularly for children. In addition, to meet the increased iodine requirement during pregnancy, pregnant women should take daily supplements containing 150 μg iodine from the earliest time possible. All women of childbearing age should be advised to increase their dietary iodine intake by using iodised table salt and iodine-rich products: seafood, milk and milk products. For women with pre-existing thyroid pathologies, the medical decision should be considered on a case-by-case basis. Urinary iodine concentration monitoring among schoolchildren and pregnant women and neonatal thyrotropin registry analysis every five years would be an appropriate strategy for maintaining iodine intake within the interval that prevents iodine deficiency disorders.

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  • Anonymous (2007). ACOG Committee Opinion No. 381. Subclinical hypothyroidism in pregnancy. Obstetr. Gynecol.110 959–960.

  • Anonymous (2008). Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers. Third edition. World Health Organization UNICEF ICCIDD. Available from: (accessed 15 May 2016).

  • Anonymous (2014). Sodium intake for adults and children. WHO. Available from: (accessed 18 April 2016).

  • Abalovich M. Amino N. Barbour L. A. Cobin R. H. De Groot L. J. Glinoer D. Mandel S. J. Stagnaro-Green A. (2007). Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J. Clin. Endocrin. Metab.92 S1–S47.

  • Als C. Haldimann M. Bürgi E. Donati F. Gerber H. Zimmerli B. (2003). Swiss pilot study of individual seasonal fluctuations of urinary iodine concentration over two years: Is age-dependency linked to the major source of dietary iodine? Eur. J. Clin. Nutr. 57 636–646.

  • Arrizabalaga J. J. Larrańaga N. Espada M. Amiano P. Bidaurrazaga J. Latorre K. Gorostiza E. (2012). Changes in iodine nutrition status in schoolchildren from the Basque Country. Endocrinología y Nutrición59 474–84.

  • Ausó E. Lavado-Autric R. Cuevas E. Escobar Del Rey F. Morreale De Escobar G. Berbel P. (2004). A moderate and transient deficiency of maternal thyroid function at the beginning of fetal neocorticogenesis alters neuronal migration. Endocrinology145 4037–4047.

  • Barin J. G. Talor M. V. Sharma R. B. Rose N. R. Burek C. L. (2005). Iodination of murine thyroglobulin enhances autoimmune reactivity in the NOD.H2 mouse. Clin. Exper. Immunol.142 (2) 251–259.

  • Bath S. C. Steer C. D. Golding J. Emmett P. Rayman M. P. (2013). Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: Results from the Avon Longitudinal Study of Parents and Children (ALSPAC). Lancet27 (382) 331–337.

  • Becker D. V. Braverman L. E. Delange F. Dunn J. T. Franklyn J. A. Hollowell J. G. Lamm S. H. Mitchell M. L. Pearce E. Robbins J. Rovet J. F. (2006). Iodine supplementation for pregnancy and lactation-United States and Canada: Recommendations of the American Thyroid Association. Thyroid16 949–951.

  • de Benoist B. McLean E. Anderson M. (2009). Iodine deficiency: The extent of the problem. In: Preedy V. R. Burrow G. N. Watson R. R. (eds.). Comprehensive Handbook of Iodine. Academic Press Elsevier London pp. 461–467.

  • Berbel P. Guadańo-Ferraz A. Angulo A. Ramón Cerezo J. (1994). Role of thyroid hormones in the maturation of interhemispheric connections in rats. Behav. Brain Res. 64 9–14.

  • Berbel P. J. Escobar del Rey F. Morreale de Escobar G. Ruiz-Marcos A. (1985). Effect of hypothyroidism on the size of spines of pyramidal neurons of the cerebral cortex. Brain Res. 337 217–223.

  • Bernal J. Nunez J. (1995). Thyroid hormones and brain development. Eur. J. Endocrinol.133 390–398.

  • Bougma K. Aboud F. E. Harding K. B. Marquis G. S. (2013). Iodine and mental development of children 5 years old and under: Asystematic review and meta-analysis. Nutrients5 1384–1416.

  • Brent G. A. (2007). Editorial: Diagnosing thyroid dysfunction in pregnant women: Is case finding enough? J. Clin. Endocrinol. Metab.92 39–41.

  • Bürgi H. (2010). Iodine excess. Best Practice Res. Clin. Endocrinol. Metab.24 (1) 107–115.

  • Casey B. M. (2006). Subclinical hypothyroidism and pregnancy. Obstetr. Gynecol. Surv. 61 415–420.

  • Cuevas E. Ausó E. Telefont M. Morreale De Escobar G. Sotelo C. Berbel P. (2005). Transient maternal hypothyroxinemia at onset of corticogenesis alters tangential migration of medial ganglionic eminence-derived neurons. Eur. J. Neurosci. 22 541–551.

  • Delange F. (2002). Iodine deficiency in Europe and its consequences: An update. Eur. J. Nucl. Med. Mol. Imag.29 404–416.

  • Dosiou C. Barnes J. Schwartz A. Negro R. Crapo L. Stagnaro-Green A. (2012). Cost-effectiveness of universal and risk-based screening for autoimmune thyroid disease in pregnant women. J. Clin. Endocrin. Metab.97 (5) 1536–1546.

  • Dosiou C. Sanders G. D. Araki S. S. Crapo L. M. (2008). Screening pregnant women for autoimmune thyroid disease: A cost-effectiveness analysis. Eur. J. Endocrinol.158 841–851.

  • Glinoer D. (1998). The systematic screening and management of hypothyroidism and hyperthyroidism during pregnancy. Trends Endocrinol. Metab.9 403–411.

  • Glinoer D. Soto M. F. Bourdoux P. Lejeune B. Delange F. Lemone M. Kinthaert J. Robijn C. Grun J. P. de Nayer P. (1991). Pregnancy in patients with mild thyroid abnormalities: Maternal and neonatal repercussions. J. Clin. Endocrinol. Metab.73 421–427.

  • Gowachirapant S. Winichagoon P. Wyss L. Tong B. Baumgartner J. Melse-Boonstra A. Zimmermann M. B. (2009). Urinary iodine concentrations indicate iodine deficiency in pregnant Thai women but iodine sufficiency in their school-aged children. J. Nutr.139 1169–1172.

  • Grīnberga D. Pudule I. Velika B. Gavare I. Villeruša A. (2015). Health Behaviour Among Latvian Adult Population 2014. The Centre for Disease Prevention and Control Latvia. 124 pp.

  • Guan H. Li C. Li Y. Fan C. Teng Y. Shan Z. Teng W. (2005). High iodine intake is a risk factor of post-partum thyroiditis: Result of a survey from Shenyang China. J. Endocrinol. Investig.28 876–881.

  • Gyurjyan R. H. Lugovska R. Vevere P. van der Haar F. (2006). Newborn thyrotropin screening confirms iodine deficiency in Latvia. Eur. J. Clin. Nutr. 60 688–690.

  • Hollowell J. G. Staehling N. W. Flanders W. D. Hannon W. H. Gunter E. W. Spencer C. A. Braverman L. E. (2002). Serum TSH T(4) and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J. Clin. Endocrinol. Metab. 87 489–499.

  • Horacek J. Spitalnikova S. Dlabalova B. Malirova E. Vizda J. Svilias I. Cepkova J. Mc Grath C. Maly J. (2010). Universal screening detects two-times more thyroid disorders in early pregnancy than targeted high-risk case finding. Eur. J. Endocrinol.163 645–650.

  • Huang W. Peng C. Huang H. Zhang J. Liu. J. Mao L. Luo R. Xiao Y. (2013). Control of iodine-deficiency disorders following universal salt iodization in Shenzhen China 1997–2011. Food Nutr. Bull. 34 (3) 331–337.

  • Jones G. Schneider W.J. (2006). Intelligence human capital and economic growth: A Bayesian Averaging of Classical Estimates (BACE) approach. J. Econ. Growth 11 71–93.

  • Kahaly G. J. Dienes H. P. Beyer J. Hommel G. (1998). Iodide induces thyroid autoimmunity in patients with endemic goitre: A randomised double-blind placebo-controlled trial. Eur. J. Endocrinol.139 (3) 290–297.

  • Konrade I. Dambrova M. Makrecka M. Neimane L. Strele I. Liepinsh E. Lejnieks A. Vevere P. Gruntmanis U. Pīrāgs V. Dambrova M. (2012). Seasonal iodine deficiency in Latvian school children. Thyroid22 1088–1089.

  • Konrade I. Kalere I. Strele I. Makrecka-Kuka M. Jekabsone A. Tetere E. Veisa V. Gavars D. Rezeberga D. Pīrāgs V. Lejnieks A. Dambrova M. (2015). Iodine deficiency during pregnancy: A national cross-sectional survey in Latvia. Public Health Nutr. 18 (16) 2990–2997.

  • Konrade I. Neimane L. Makrecka M. Strēle I. Liepinsh E. Lejnieks A. Vevere P. Gruntmanis U. Pīrāgs V. Dambrova M. (2014). A cross-sectional survey of urinary iodine status in Latvia. Medicina 50 (2) 124–129.

  • Markou K. Georgopoulos N. Kyriazopoulou V. Vagenakis A. G. (2001). Iodine-Induced hypothyroidism. Thyroid 11 (5) 501–510.

  • Moleti M. Di Bella B. Giorgianni G. Mancuso A. De Vivo A. Alibrandi A. Trimarchi F. Vermiglio F. (2011). Maternal thyroid function in different conditions of iodine nutrition in pregnant women exposed to mild-moderate iodine deficiency: An observational study. Clin. Endocrinol. (Oxford) 74 762–768.

  • Moreno-Reyes R. Carpentier Y. A. MacOurs P. Gulbis B. Corvilain B. Glinoer D. Goldman S. (2011). Seasons but not ethnicity influence urinary iodine concentrations in Belgian adults. Eur. J. Nutr.50 285–290.

  • Morreale De Escobar G. Obregon M. J. Escobar Del Rey F. (2000). Clinical perspective: Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia? J. Clin. Endocrinol. Metab.85 3975–3987.

  • Muller A. F. Drexhage H. A. Berghout A. (2001). Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: Recent insights and consequences for antenatal and postnatal care. Endocrine Rev. 22 605–630.

  • Negro R. Schwartz A. Gismondi R. Tinelli A. Mangieri T. Stagnaro-Green A. (2010). Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. J. Clin. Endocrinol. Metab.95 1699–1707.

  • Oppenheimer J. H. Schwartz H. L. Mariash C. N. Kinlaw W. B. Wong N. C. Freake H. C. (1987). Advances in our understanding of thyroid hormone action at the cellular level. Endocrine Rev. 8 288–308.

  • Pearce E. N. Andersson M. Zimmermann M. B. (2013). Global iodine nutrition: Where do we stand in 2013? Thyroid 23 523–528.

  • Pedersen I. B. Laurberg P. Knudsen N. Jørgensen T. Perrild H. Ovesen L. Rasmussen L. B. (2007). An increased incidence of overt hypothyroidism after iodine fortification of salt in Denmark: A prospective population study. J. Clin. Endocrinol. Metab.92 (8) 3122–3127.

  • Pessah-Pollack R. Eschler D. C. Pozharny Z. Davies T. (2014). Apparent insufficiency of iodine supplementation in pregnancy. J. Women’s Health (Larchmt) 23 51–56.

  • Pop V. J. Kuijpens J. L. van Baar A. L. Verkerk G. van Son M. M. de Vijlder J. J. Vulsma T. Wiersinga W. M. Drexhage H. A. Vader H. L. (1999). Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clin. Endocrinol. (Oxford) 50 149–155.

  • Rohner F. Zimmermann M. Jooste P. Pandav C. Caldwell K. Raghavan R. Raiten D. J. (2014). Biomarkers of nutrition for development: Iodine review. J. Nutr. 144 1322S–1342S.

  • Selga G. Sauka M. Gerasimov G. (2000). Status of iodine deficiency in Latvia Reconsidered: Results of nationwide survey of 587 schoolchildren in the year 2000. IDD Newsletter16 54.

  • Speeckaert M. M. Speeckaert R. Wierckx K. Delanghe J. R. Kaufman J. M. (2011). Value and pitfalls in iodine fortification and supplementation in the 21st century. Brit. J. Nutr. 106 (7) 964–973.

  • Stagnaro-Green A. Chen X. Bodgen J. D. Davies T. F. Scholl T. O. (2005). The thyroid and pregnancy: A novel risk factor for very preterm delivery. Thyroid 15 351–357.

  • Stagnaro-Green A. Glinoer D. (2004). Thyroid autoimmunity and the risk of miscarriage. Best Practice Res. Clin. Endocrin. Metab.18 167–181.

  • Thung S. F. Funai E. F. Grobman W. A. (2009). The cost-effectiveness of universal screening in pregnancy for subclinical hypothyroidism. Amer. J. Obstetr. Gynecol. 200 (267) e1–e7.

  • Vaidya B. Anthony S. Bilous M. Shields B. Drury J. Hutchison S. Bilous R. (2007). Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding? J. Clin. Endocrinol. Metab.92 203–207.

  • Vanderpump M. P. Tunbridge W. M. French J. M. Appleton D. Bates D. Clark F. Grimley Evans J. Hasan D. M. Rodgers H. Tunbridge F. Yaing E. T. (1995). The incidence of thyroid disorders in the community: A twenty-year follow-up of the Whickham Survey. Clin. Endocrinol. (Oxford) 43 55–68.

  • Zimmermann M. B. Moretti D. Chaouki N. Torresani T. (2003). Introduction of iodized salt to severely iodine-deficient children does not provoke thyroid autoimmunity: A one-year prospective trial in northern Morocco. Thyroid 13 (2) 199–203.

  • Zoeller R. T. Rovet J. (2004). Timing of thyroid hormone action in the developing brain: Clinical observations and experimental findings. J. Neuroendocrinol. 16 809–818.

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