Pregnant Vegans at Risk for Iodine Deficiency

Pregnant Vegans at Risk for Iodine Deficiency
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Disinfectants used to sanitize cow udders may provide a source of iodine for dairy consumers, but can also increase the concentration of pus in milk from cows with staph infection mastitis.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The mineral iodine is important for thyroid function, but critical during pregnancy for fetal neurologic development. Even a mild deficiency can impair cognitive ability.

The derogatory word cretin was originally a medical term describing those with stunted physical and mental development due to an untreated congenital iodine deficiency. It remains one of the most common preventable causes of brain damage worldwide, because of iodine-deficient soil, which is why most table salt is iodized.

“Iodine can also be found in dairy products due to iodine supplementation of cattle feed,” and because it may leach into the milk from the use of iodine-containing disinfectants to wash the udders, dip the teats, and clean the milk tanks out with. Dipping the teats in iodine disinfectant can decrease the bacteria concentration, but in cows with staph mastitis can actually increase the pus content in milk by as much as 60%. Regardless: “The iodine content of dairy products contributed by sanitizing products is usually not regulated and is a nondeliberate source of iodine.” But it is a source of iodine nonetheless.

These considerations therefore “raise concerns about the iodine status of pregnant women and women of reproductive age who are not consuming dairy products.” So, last year they concluded: “Iodine levels among U.S. women should be monitored, particularly among subgroups at risk.” Good idea, so this year they did it: “Iodine Status and Thyroid Function of Boston-Area Vegetarians and Vegans.” How did they do?

One way to measure iodine status is with a urine test. The World Health Organization recommends we should average 100 micrograms in our daily urine, unless we’re pregnant—in which case, we’d really like to see it up around 150. This is where vegetarians came out; not bad; conclusion: “U.S. vegetarians are iodine sufficient.”

What about vegans? 78.5. That’s not good. “U.S. vegans may [therefore] be at risk for low iodine intake.” Therefore: “Vegan women of child-bearing age should supplement with 150 micrograms of iodine daily.”

The best new resource for those planning a plant-based pregnancy is probably Vegan for Life by Norris and Messina, out July 2011.

Please consider volunteering to help out on the site.

Images thanks to Tyabji [GFDL or CC-BY-SA-3.0] via Wikimedia CommonsPhotos by Lina via flickr, and Cafe Press

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The mineral iodine is important for thyroid function, but critical during pregnancy for fetal neurologic development. Even a mild deficiency can impair cognitive ability.

The derogatory word cretin was originally a medical term describing those with stunted physical and mental development due to an untreated congenital iodine deficiency. It remains one of the most common preventable causes of brain damage worldwide, because of iodine-deficient soil, which is why most table salt is iodized.

“Iodine can also be found in dairy products due to iodine supplementation of cattle feed,” and because it may leach into the milk from the use of iodine-containing disinfectants to wash the udders, dip the teats, and clean the milk tanks out with. Dipping the teats in iodine disinfectant can decrease the bacteria concentration, but in cows with staph mastitis can actually increase the pus content in milk by as much as 60%. Regardless: “The iodine content of dairy products contributed by sanitizing products is usually not regulated and is a nondeliberate source of iodine.” But it is a source of iodine nonetheless.

These considerations therefore “raise concerns about the iodine status of pregnant women and women of reproductive age who are not consuming dairy products.” So, last year they concluded: “Iodine levels among U.S. women should be monitored, particularly among subgroups at risk.” Good idea, so this year they did it: “Iodine Status and Thyroid Function of Boston-Area Vegetarians and Vegans.” How did they do?

One way to measure iodine status is with a urine test. The World Health Organization recommends we should average 100 micrograms in our daily urine, unless we’re pregnant—in which case, we’d really like to see it up around 150. This is where vegetarians came out; not bad; conclusion: “U.S. vegetarians are iodine sufficient.”

What about vegans? 78.5. That’s not good. “U.S. vegans may [therefore] be at risk for low iodine intake.” Therefore: “Vegan women of child-bearing age should supplement with 150 micrograms of iodine daily.”

The best new resource for those planning a plant-based pregnancy is probably Vegan for Life by Norris and Messina, out July 2011.

Please consider volunteering to help out on the site.

Images thanks to Tyabji [GFDL or CC-BY-SA-3.0] via Wikimedia CommonsPhotos by Lina via flickr, and Cafe Press

Doctor's Note

Check out these videos for more info on iodine in the diet:
Can Gargling Prevent The Common Cold?
Which Seaweed is Most Protective Against Breast Cancer?

For details on exactly how much iodine we need, and practical tips on the best way to get iodine (without the pus), check out: Avoiding Iodine Deficiency.

For even more context, check out my associated blog posts: Do Eden Beans Have Too Much Iodine?How much pus is there in milk?; and Head Shrinking from Grilling Meat.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

33 responses to “Pregnant Vegans at Risk for Iodine Deficiency

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  1. Dr Greger I have a friend who drinks low fat soy milk at home but skim milk cappuccinos when out because she is worried that the full fat soy milk they have at cafes has too much fat (she is watching her weight).
    What can I tell her?

  2. Dr. Greger, I’m a pregnant vegan taking a prenatal vitamin that supplies 150 mcg of iodine. Am I still at risk for deficiency? Thank you!

    1. Hi Don, I hope all is well with you and your family, more than nine months later! I eat kelp occassionally but only recently learned it has enormous quantities of iodine. From the numbers I’ve seen 100g dried kelp can have about 60 000 mcg of iodine (not quite a fatal dose, but way over the recommended upper limit). I’ve chopped my dried kelp into hundreds of stamp sized strips for a daily tab. I also soak the kelp a bit before using to remove the occassional ‘crunch’. I assume that lowers the salt content but probably not the iodine.

  3. Dear Dr. Greger,
    I am 4 weeks pregnant and i’m vegan. I have watched your videos and I am concerned about iodine and vitamin B12. I eat a healthy varied diet of fruits, vegetables, nuts, beans and other legumes.
    Should I start taking vitamin B12 and iodine supplements? What do you suggest?
    Thank you

    1. Congratulations on your pregnancy! According to the above video, it sounds like all of us vegans should be supplementing our diets with 150mcg of iodine daily.

      Dr. Greger has lots of videos espousing the importance of supplementing a vegan diet with B12, especially when pregnant (http://nutritionfacts.org/video/did-a-vegan-diet-kill-this-baby/). This video (http://nutritionfacts.org/2011/08/25/vegan-b12-deficiency-putting-it-into-perspective/) can give you some more context, and for the B12 Dr. Greger recommends, see this video: http://nutritionfacts.org/video/cheapest-source-of-vitamin-b12/

      He says to take one 2500 microgram sublingual, chewable, or liquid supplement of cyanocobalamin once a week.

      Hope that helps! :)

  4. Dear Doctor Greger, do you have any data on whether alcohol free beer is safe during pregnancy? The data in internet is quite contradictory. Many thanks in advance.

  5. What about cranberries, seaweed or baked potatoes, aren’t those good sources of iodine? I will probably start eating cranberries everyday again like I used to.

  6. I’m currently vegan and 10 weeks pregnant. A vegan nutritionist told me about iodine supplementation. When i mentioned it to my endocrinologist (i have hashimoto’s thyroiditis) , he said that her information was completely false and the supplements wouod kill off my thyroid even more. (The nutritionnist coaimed the opposite, that my dose requirement of synthroid wouod go down).
    Who’s right? I don’t want to harm my baby or my thyroid!! How likely will i have caused cretinism in my baby since i listened to the endocrinologist so far? :(
    Thank you

  7. I am a whole food vegan. 39 years old. just got pregnant. You recommend that pregnant vegans take an iodine supplement. I cannot find a pregnancy safe iodine supplement in Cape Town, South Africa. Is there a brand that you can recommend? Or must I just take the ones I can find over here even though it says on the packaging pregnant women should not take it.

    1. Hi Margie: Unfortunately, I don’t have an answer for you regarding a supplement brand. However, I would not recommend taking a supplement that reads “do not take during pregnancy” on the label. Can you talk with your medical provider to see if they have a recommendation? They should be able to monitor your iodine status through a simple urine test – there’s a chance you may not need to supplement if these numbers look OK.

  8. Hi there,

    Thanks so much for all this information. I am 7-8 weeks pregnant. Based on all the videos I believe I must take vitamin B12, 150mg iodine and DHA. I am really struggling to find a vitamin B12 and iodine – where the bottle does not say ‘Do not take when pregnant or breastfeeding’. Perhaps I should take a pregnancy supplement as I cannot find all these items required. Do you recommend a pregnancy supplement? When I am not pregnant I obviously avoid supplements – trying to be a healthy vegan.

    Thanks so much. All the best,
    Michelle

  9. Oops can you please remove my full name in the earlier post; I did not expect it to appear in the post!! thanks so much.

  10. Hello again,

    I am trying to gain a full picture of what I should take during my pregnancy. It can be rather confusing but I am so appreciative of this web site. Thanks Dr! I believe this is the list:
    – 2500mcg of vitamin B12 (I have found one that simply says:Always consult your GP before taking Nutritional Supplements especially if you are taking medication.) it does not say it is for pregnancies but then it does not say you need to speak to your GP if you are pregnant. I will go with this one for now.
    – 200mg of DHA per day. I have found: Together Omega-3 DHA Rich Algae Oil Softgels; this contains 352 mg Omega 3, then 207 mg of DHA. Is that okay, it is slightly over?
    – 150mcg Tablets for Pregnancy Health | Iodine Supplements – Oxford Vitality.

    I have a few more questions: I assume I also need to take folic acid? I cannot see any videos on that here. I have been taking 400 mcg of folic acid per day.

    Then for the vitamin B12 the bottle often says you can take 1 of the 1000 mg a day; however I found this article by chance that says too much vit B12 and folic acid may be harmful for the baby.
    https://www.livescience.com/54711-autism-risk-linked-to-high-folate-levels.html
    Thus it may be dangerous listening to what is said on the bottles for Vitamin B12 – esp when pregnant. I will listen to Dr Greiger and ensure I only take the 2500 mg per week.

    In my zest for a good pregnancy I am nervous that I may ‘overdose’ on supplements. I sometimes eat the Engevita Yeast Flakes; these contain 4 mcg of Folic Acid per 100g: I suppose it is not much but perhaps I should avoid that if I am already taking Folic Acid?
    Then If I take the 150mg of Iodine, should I stay away from normal kitchen salt?

    I also take a mix of miled flaxseed, almond, brazil nuts, walnuts and co-enzyme Q10. Sound okay?

    I appreciate your feedback. Thanks so much.

    1. Thank you for your question! Unfortunately, it’s not safe for us to provide detailed, individual medical advice over the internet as we do not know your full medical history, lab values, etc. It would be a good idea to discuss this supplement list with your OB provider in order to get the best guidance and prenatal care. In the meantime, our friends at PCRM have some general recommendations for plant-based eating for pregnancy. You can find that info here. Wishing you a very happy and healthy pregnancy! Best of luck!

  11. Great video !

    Thank you very much.

    I would like to ask two questions:
    1. Does the urine test be only way to measure iodine status?
    Or we can also measure it with some kind of blood test ?

    2. I am vegan from 2015, and as I saw in the video vegans have insufficient levels of iodine.
    Except iodized salt and supplements, what other foods are rich in iodine ?

    Thanks in advance for your time

    Best Regards

    1. Hi Jhon. Many thanks for your question and comments!

      Apparently, there’re other methods to check your iodine status. As this study says, “these indicators are complementary, in that urinary iodine is a sensitive indicator of recent iodine intake (days) …)

      For your second question, you can check this other videos by Dr. Greger to find out about other iodine sources:

      Avoiding Iodine Deficiency
      All Videos for Iodine

      More info related to iodine: http://www.fao.org/docrep/004/y2809e/y2809e0i.htm#bm18.4

      Hope this is from help!

  12. Do you have a concise list of the recommended supplements in pregnancy as well as recommended brands? Attempting to be WFPB, but let’s be real sometimes ice cream gets me. Trying to avoid over supplementation as I believe foods truly are the best source and there is so much information we don’t know about restricting down to one molecule. I’m not pg, but hoping it’s in the works soon.

  13. Hi AliciaR – Thanks for your question! I would recommend meeting with an OB provider to further discuss pregnancy recommendations based on your own individual needs and medical background. In general:

    -It is recommended that a daily supplement containing at least 400 mcg of folic acid is imperative to reduce the risk of neural tube defects.
    -Consuming increased iron intake during pregnancy is also needed (ex: leafy greens, beans) and absorption can be increased by pairing these foods with vitamin C rich foods (ex. orange, strawberries). A prenatal multivitamin containing iron may be recommended by your physician.
    -If you are currently not already taking a vitamin B12 supplement, this is also imperative and Dr. Greger recommends a supplement containing 2500 mcg of cyanocobalamin once/week.
    -There are several other nutrients to keep in mind with pregnancy and here is a link for you to check it out in more detail: https://www.pcrm.org/health/diets/vegdiets/vegetarian-diets-for-pregnancy.

    Best of luck with your pregnancy and I hope this provides some insight!

    Janelle RD, CD
    Health Support Volunteer

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