Cost-benefit analysis supports CRN’s call to add iodine to prenatal supplements

By Elizabeth Crawford contact

- Last updated on GMT

Cost-benefit analysis supports adding iodine to prenatal supplements

Related tags: Iodine deficiency, Pregnancy, Dietary supplement

New research revealing the extent and cost of iodine deficiency among pregnant women underscores the importance of dietary manufacturers including at least 150 mcg of iodine in daily prenatal multivitamins as recommended by the Council for Responsible Nutrition. 

Pregnant women in the U.K. who take iodine supplements compared to those who do not can save the National Health Services about £200 in direct service costs and save the larger society £4,476 per child over their lifetime of earning and in public sector costs, according to a cost-benefit analysis published Aug. 9 in The Lancet Diabetes and Endocrinology​. 

The findings, which are based on clinical data from eight studies that compare the impact of iodine deficiency in pregnant women on their children’s IQ and income, are not restricted to only the U.K., according to the researchers from the University of Birmingham.

They explain that approximately 1.88 billion people live in 32 countries with iodine deficiency, which is the number one cause of preventable brain damage and mental retardation in children.

Even mild deficiency during pregnancy is associated with offspring with lower IQ, according to the research. Specifically, it found the offspring of women who took iodine supplements had a net gain of 1.22 IQ points compared to those whose mothers’ did not take the supplements. In more extreme cases of deficiency, children’s IQs have fall as much as 8.7 points, the authors note – pointing to a previous study of Chinese populations.

Based on this, the researchers recommend giving all pregnant women an iodine supplement.

This recommendation echoes that of several medical organizations, including the American Thyroid Association, the Endocrine Society and the American Academy of Pediatrics, as well as the Council for Responsible Nutrition. All of the groups are in the process of developing formal recommendations that pregnant and lactating women take a supplement with 150 mcg of iodine daily to support health brain development.

CRN asks manufacturers to step up to the plate

To help women consume sufficient iodine during pregnancy and while they breastfeed, CRN last January published recommended guidelines​ that all manufacturers of prenatal supplements include at least 150 mcg of iodine. 

Many CRN member companies already comply with the guidance, which does not become effective until Jan. 27, 2016, but research suggests the industry as a whole has a long way to go. Approximately 50% of prescription and nonprescription prenatal multivitamins do not contain iodine as an ingredient, and those that do might not contain the labeled amount, CRN scientists write in a recent article published in Natural Medicine Journal​. 

These factors partly explain why only 20% of pregnant women in the U.S. and 15% of lactating women in the U.S. take a dietary supplement with the recommended level of iodine, CRN says in the article in Natural Medicine Journal.

Lack of awareness of the importance of iodine during pregnancy and breastfeeding is another factor for the low percentage of women taking iodine supplements, said Barry Ritz, VP of scientific and regulatory affairs at Atrium Innovations, which makes prenatal supplements with 150 mcg of iodine.

He noted that CRN’s efforts to make industry more aware of the need to include at least 150 mcg of iodine in prenatal vitamins will empower manufacturers, in turn, to work with health care providers to educate women of iodine’s importance.

He also agreed that manufacturers could help educate women directly about iodine’s importance by making structure-function claims on prenatal supplements that explain iodine is essential for neurocognitive development.

Deficiency in the U.S. is rising

The urgency of CRN’s mission to help manufacturers increase the amount of iodine in supplements and the number of women who take them is underscored by the increasing rate of deficiency in the U.S.

In the article in the Natural Medicine Journal, CRN scientists explain iodine intake has decreased dramatically in the U.S. over the past several decades by as much as 50% since the 1970s. During this time, it adds, the percentage of women of childbearing age with iodine deficiency rose from 4% to 15% and now more than 35% of pregnant women have moderately deficient iodine levels, which places their children at risk.

The increase in iodine deficient women is partly due to consumer’s efforts to use less table salt, which is usually fortified with iodine, the rising popularity of “grass fed”​ cattle rather than cattle fed on iodine-containing mixed feed, the reduction of meat consumption in general, recommendations not to over-consume iodine-rich fish and an avoidance of dairy by an increasing portion of the population, said Michael Cleary, PhD, scientific and regulatory affairs, at SmartyPants Vitamins.

To help address the increasing problem of iodine deficiency, last May, SmartyPants Vitamins launched SmartyPants PreNatal, a gummy vitamin with iodine and folic acid, omega-3s and other vitamins, Cleary said.  

To help educate consumers about the role of iodine and other vitamins and nutrients in child development, the company is working to make support for the product claims publicly available as appropriate, Cleary said. He added, however, that this must be done carefully to observe copyright laws and, in cases where the research addresses disease conditions, not violate FDA prohibitions against promoting a supplement to diagnose, cure, mitigate, treat or prevent disease.

“It is precisely for that reason that we welcome fully examined position papers”​ like the iodine recommendation CRN published in the Natural Medicine Journal, he added. 

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