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Old 09-15-2018, 05:00 AM   #121
R.B.
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

I was recently in Valais, a very beautiful alpine area of Switzerland, (sadly just for a couple of days), and in a random conversation it was suggested that women in the area were worried by what appeared to them to be a greater number of breast cancer cases in the area than might be expected. They were puzzling as to possible factors that impacted them that could potentially be implicated including localized water supplies. I recalled from general reading the Alpine Switzerland was an area at risk of low iodine intake and goiter. Historically Valais was a region known for being at high risk of goiter, and so like other iodine deficiency risk areas historically exhibited the impacts of severe iodine deficiency including cretinism. Supplementation of salt and wider food intake and distribution has alleviated the risk of severe iodine insufficiency, but arguably the risks of mild insufficiency remain relevant.

Iodine insufficiency, as identified in this thread, is arguably a risk factor for occurrence and progression of breast cancer.


“The regular monitoring of urinary iodine excretion of Swiss population groups revealed a decrease in the iodine supply in children and pregnant women between 2004 and 2009 [9].” (See below for reference *)

Iodine intake has been a long-term concern in some European countries including Switzerland, and steps have been taken by Governments to reduce iodine insufficiency, but despite this there are indications (e.g. above) that levels in children and women are again falling in recent years. Large numbers of people are insufficient in many other countries as well, including the UK where there is no national iodisation program.

A report Iodine supply in Switzerland: Current Status and Recommendations, was prepared in 2012 for the Federal Commission for Nutrition https://www.google.com/url?sa=t&rct=...5flcQ0Sxir53sk


Those who eat no dairy, marine fish, or bread (where made with iodised salt), and avoid salt (so reduce iodised salt intake) and or use other salts e.g. sea salt, are at particular risk of insufficiency. Those who use organic dairy products (as against non-organic) are at greater risk or low iodine/iodide.

To add to the complications it appears iodine and iodide are not metabolized in exactly the same way. As discussed previously, only iodine was shown to potentially ameliorate mastagla, and interestingly the breast has specific iodine import mechanisms. I do not think it is known exactly in what forms and proportions iodide/iodine is found in dairy products. Clearly iodised salt and products made with iodised salt, only contains iodide. Clearly much research is still needed so these issues and their implications, including for national supplementation strategies, are better understood.


Reasons for falling intakes:

• The main dietary sources of iodine are
  • Dairy (organic milk has lower amounts)
  • Fish (marine - fresh water fish contain little iodine)
  • Iodised salt
  • Flour if fortified or iodised salt added
  • Eggs (depending on diet of hens)
• Areas of Switzerland are know to be at higher risk of goitre due to lower soil so food levels due to greater water flows through soils. Risks are likely higher in mountain areas.
• Local dairies are still common, and iodine status in the cattle will depend pasture content, on feed used, and if the milk is organic (so different feed type).
• Alpine pastures / soils are logically at greater risk of containing low iodine.
• Globally greater numbers avoid dairy foods
• Fish intake is likely lower in inland areas.
• Salt intake is falling due to health concerns
• Specialty salts such sea salt are generally not iodised
• Iodine can sublime out of iodised salt in storage
• It is not clear if flour is fortified and if so how widespread the usage of it is, and or to what extent iodized salt is always used in the small local bakeries which still exist and are widely supported.


In addition effects of insufficiency would be compounded where milk was included in the diet but itself contained goitrogenic products derived form plants in feeds or pastures (see below in upcoming following post)


Relevance of dairy products inducing the difference in iodine content between organic and non-organic milk

Dairy products as essential sources of iodine in the Swiss population
https://www.ethz.ch/content/dam/ethz...eet%20MIOD.pdf

"Iodine deficiency is estimated by the WHO to be the leading cause of preventable mental retardation worldwide. National surveys have shown sufficient iodine intake in school aged children and pregnant women in Switzerland but other groups, such as weaning infants and women of reproductive age, have low intakes. Along with iodized salt, milk and dairy products are supplying more than half of the iodine intakes in Switzerland."

Iodine in Swiss milk depending on production (conventional versus organic) and on processing (raw versus UHT) and the contribution of milk to the human iodine supply*

Journal of Trace Elements in Medicine and Biology Volume 46, March 2018, Pages 138-143
https://www.sciencedirect.com/scienc...46672X17305308

“A total of 110 samples of conventional and organic ultra-heat treated (UHT) whole milk were collected in the period between 1 May 2013 and 30 April 2014 from two large-scale companies, processing milk from two regions in Switzerland. The iodine concentration in organic milk (average 71 ± 25 μg/l) was significantly lower than in conventional milk (average 111 ± 26 μg/l) and varied between suppliers. Milk iodine concentration varied according to the month of collection in organic and conventionally produced milk, with lowest values between August and October (organic milk 42 μg/l; conventional milk 75 μg/l) and highest values in January (organic milk 99 μg/l; conventional milk 145 μg/l). Heat treatment did not influence iodine concentration. Since milk and dairy products are significant source of food-related iodine intake in Switzerland, consumers who prefer organic milk and dairy products are likely to have an inferior iodine status.”

“Iodine is an essential element for thyroid hormone production. A too low dietary iodine offer may create a thyroid hormone deficit with deficiency symptoms including cretinism, brain damage, irreversible mental retardation, deaf-mutism, and goitre. Iodine deficiency, with its various mental and physical consequences is part of the history of most European countries, especially in alpine regions of Austria, France, Italy, and Switzerland [1]. These regions are characterized by iodine deficient soils, where iodine has been washed away by glaciation [2].”

“The regular monitoring of urinary iodine excretion of Swiss population groups revealed a decrease in the iodine supply in children and pregnant women between 2004 and 2009 [9].”

https://www.ncbi.nlm.nih.gov/pubmed/29508687
The main determinants of iodine in cows' milk in Switzerland are farm type, season and teat dipping.
Br J Nutr. 2018 Mar;119(5):559-569. doi: 10.1017/S0007114517003798.


Levels of iodine in dairy products are as a generality higher in the UK than Switzerland and other European countries but the issues are the same. (despite this iodine insufficiency in the UK is widespread)(The UK has no national salt fortification strategy - see earlier posts)


Iodine concentration of organic and conventional milk: Implications for iodine intake.
July 2011The British journal of nutrition 107(7):935-40 https://www.researchgate.net/publica..._iodine_intake

Organic milk was 42·1 % lower in iodine content than conventional milk (median iodine concentration 144·5 v. 249·5 ng/g; P < 0·001). There was no difference in the iodine concentration of either conventional or organic milk by area of purchase. However, a difference was seen in iodine concentration of organic milk by region of origin (P < 0·001). The lower iodine concentration of organic milk has public-health implications, particularly in view of emerging evidence of iodine deficiency in UK population sub-groups, including pregnant women. Individuals who choose organic milk should be aware that their iodine intake may be compromised and should ensure adequate iodine intake from alternative sources.”


(For 'nerds' - interesting data from the 1920s on cancer and goiter rates with a focus on Switzerland in a paper called Cancer and Goiter possibly suggesting some associations - cancer prevalence trends have clearly changed - https://www.jstor.org/stable/2331713...o_tab_contents - just posted as of general interest and old data can be hard to find)

Last edited by R.B.; 10-04-2018 at 04:28 PM..
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Old 09-15-2018, 05:19 AM   #122
R.B.
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

Wisdom and hard won lessons of our fore-bearers

It is important not to lose sight of historic hard won wisdom. Where diseases are not now commonly seen, we loose sight of their impact, the fundamental importance of the steps that were taken to reduce them, and the positive consequences of preventative health strategies for individuals families and at national level.

This abstract is a reminder of the fundamental relevance of the need for iodine everywhere but particularity in low iodine areas including in Switzerland.


Evaluating the Efficiency of Iodization Programs

Amar K. Chandra, in Comprehensive Handbook of Iodine, 2009
Impact of iodized salt in Switzerland (1920–1934)

https://www.sciencedirect.com/topics...cine/cretinism

The prevalence of goiter and cretinism was high throughout Switzerland because it is in the elevated region of the European Alps. In 1923, the Canton of Berne with a population of about 700000 had to hospitalize 700 cretins who were incapable of self-care. However, following the introduction of iodized salt, the prevalence of goiter fell sharply. Later, deaf and dumb institutions were closed and diverted to other institutions. A great decline in goiter was also seen among schoolchildren in the Canton of Valais, where the problem was very severe (Table 79.2).

Iodine deficiency diseases in Switzerland one hundred years after Theodor Kocher's survey: a historical review with some new goitre prevalence data.
Bürgi H1, Supersaxo Z, Selz B.
Author information
Abstract

In certain regions of Switzerland, before prophylaxis, 0.5% of the inhabitants were cretins, almost 100% of schoolchildren had large goitres and up to 30% of young men were unfit for military service owing to a large goitre. Iodization of salt was introduced in 1922 at 3.75 mg I per kg and the iodine content was doubled twice, in 1962 and 1980, to the present 15 mg I per kg.


An 1850s viewpoint on the impact of severe iodine deficiency - whilst of its time, and unacceptable in a modern world, is a powerful reminder of the severe potential consequences of major iodine deficiency related conditions, the subtext carrying a sense of fear incomprehension outrage and indignation that human lives and futures could be changed so much for want of small amounts of a simple nutrient. Is it possible the language was intended to shock to bring attention to the issue?


Iodine Deficiency in the Alps, 1800s

Source: The National Magazine, Vol XI, 1857

"Recollections of Switzerland"


http://iodinehistory.blogspot.com/20...lps-1800s.html

"To the mournfulness of nature may be added that which is inspired at the sight of the inhabitants. What are these deformed dwarfs with a doltish look, a stupid form, abortive efforts at humanity, that creep rather than walk, that make inarticulate sounds in their throats in place of words, whose laugh is a grimace, and whose smile freezes you, that stop you as mendicants, and whose contact with you causes an involuntary horror, as if you were seized by a phantom in the nightmare. Yet they appear inoffensive, and whatever may be the hideous complication that in them attains to perfect ugliness, an ugliness so monstrous that it would disgrace a beast, yet I know not whether it is their early degradation or a kindly decay that extinguishes upon their features even the appearance of malice and all of the passions. What are these objects of fear or of derision? They are idiots! (cretins.)"

"the fathers of these poor idiots were a simple people and pious Christians, who came to find pasturage for their herds in these secluded valleys, who passed their lives in prayer, and through lack of bread lived upon milk; who, through lack of wine, cooled their thirst with the clear water of the rivulets. But this water, against which no instinct could guard them, tends to produce that most terrible of all maladies, the goiter, which becomes hereditary and acquires the fullest development; and under the influence of the same regime continued, the intellectual faculties are changed, and idiocy appears. What venomous principle diffused in these running waters has led to such rapid and profound disorders in the physical organization, and consequently in the mind? None at all.

The presence of a little magnesia or the absence of a little iodine suffices to produce this effect. And this frightful degeneracy of the human species from the same causes manifests itself throughout mountainous countries, in the Pyrenees and in the Alps, in the Hartz and in the Jura, in the valleys of Thibet, in the Ural chain, in the Andes, and the Cordilleras."

"The canton of Valais, in Switzerland, is one of those countries where there is a predilection to the goiter and idiocy. The latter, in its excess, is happily the exception, but the goiter, more or less developed, is general among the women, and it is almost as much of a deformity as the neck of a swan would be in carrying the head of a Valaisian woman."


A more recent perspective from 1990


Iodine deficiency diseases in Switzerland one hundred years after Theodor Kocher's survey: A historical review with some new goitre prevalence data
Hans Burgi,Zeno Supersaxo and Beat Selz - Medizinische Klinik, Bürgerspital, Solothurn, Switzerland

"In the years 1886 to 1891, 8 to 11% of 19-yearold men were unfit for service owing to a goitre causing symptoms, smaller goitres not being a reason for exemption (3) (Fig. 1). Bircher, in an exhaustive monograph, compiled tables and maps of goitre prevalence at recruitment from 1875 to 1880 for every single town and village in Switzerland, together with the prevalence of deaf-mutism
and cretinism in selected areas (6). He concluded that a. Goitre prevalence varied enormously from one village to another,"

https://eje.bioscientifica.com/view/..._123_6_002.xml

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Old 09-15-2018, 01:27 PM   #123
R.B.
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

Some useful information about iodine in the food chain.


Iodine in animal nutrition and Iodine transfer from feed into food of animal origin

G. Flachowsky
Institute of Animal Nutrition, Federal Agricultural Research Centre (FAL),
Braunschweig, Germany

Lohmann Information

Vol. 42 (2), Oct. 2007, Page 47

http://www.lohmann-information.com/c..._artikel11.pdf


Also with particular reference to Switzerland

Iodine content of food groups
M. Haldimann*, A. Alt, A. Blanc, K. Blondeau
Swiss Federal Office of Public Health, Division of Food Science, 3003 Bern, Switzerland

http://www.ign.org/cm_data/2005_Hald...roups_JFCA.pdf
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Old 09-15-2018, 02:22 PM   #124
R.B.
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

Iodine insufficiency is a global problem, and is more complicated than iodine/ iodide intake alone.

Some may have adequate intake but uptake may be inhibited, thyroid function impaired, excretion increased, or digestion reduced by external factors.

The subject of impairment of uptake and function by various inhibiting factors in vegetable foods is discussed earlier in the thread.

Uptake and function inhibition may also be caused indirectly where they are uptaken by animals, and then eaten by humans as in dairy products. The amount of research in this area is limited but historic papers suggest it can in certain circumstances be a real issue.

I raise it here as it is a factor that might have historically contributed to the specific regionality of goiter in Switzerland. Are gotregenic plant present in significant amounts in some Alpine pastures - I have no idea, but it is an interesting question.


THE EPIDEMIOLOOY OF ENDEMIC GOITRE IN THE EASTERN PACIFIC REGION*

http://iris.wpro.who.int/bitstream/h...re_1966_en.pdf


"Practically the whole of Tasmania is goitrous. In 1949 Clements examined 8000 schoolchildren and found visible goitres in approximately 6% of boys and 20%. of girls in the age-group 12-14 years. Iodine therapy did not control goitres in some areas. Clements and Wishart later suspected a goitrogenic substance in cow's milk which interfered with the synthesis of thyroxine and so the subjects drinking that milk were not amenable to .the standard iodine preventive measures. The goitrogenic substance was consumed by cows feeding on pastures containing a certain variety of Brassica; the children were being given increased quantities of milk under a free milk scheme. later, a goitrogenic iso-thiocyanate was isolated from these plants and the milk of the cows eating them (Bachelard and Triltojus, 1960)."

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Old 09-15-2018, 03:06 PM   #125
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

Roles for bacteria?

Interestingly roles for bacteria in iodine insufficiency, working directly, by impacting gut function, and by binding iodine in water, have been proposed. These if indeed relevant (and why not in principle) would likely only be significant where other factors meant iodine uptake/metabolism was marginal. Cuuld such factors help account for wide variation in the same regions, as historically in Switzerland.

CONGENITAL GOITRE IN SHEEP IN SOUTHERN TASMANIA
Michael Statham, B. Agr. Sc. (Hons.), Tas.

https://eprints.utas.edu.au/21682/1/...974_thesis.pdf

"It has been suggested that bacteria may induce goitre if they are present in large enough numbers, as Macchia, Bates and Pastan (1967) have isolated a thyroid stimulating factor from Clostridium perfringens. This compound, which was thought to be a protein with a molecular weight of about 30,000, acted in a manner similar to Thyroid Stimulating Hormone when incubated with thyroid slices, and when injected into chickens it depleted the thyroid of radioiodine.

Other bacteria which commonly inhabit the human intestinal tract (particularly Paracolobacterium) have been shown to exhibit myrosinase activity which converts progoitrin into the goitrogenic agent goitrin (Oginsky, Stein and Greer 1965).

An unusual theory has been proposed by Beres (1969) who concluded that goitre in Hungary was associated with wet areas and high levels of magnesium, calcium and potassium ions. He proposed that the goitre of these areas was caused by algae, particularly Microcystis, which removed iodine from water and secreted antithyroid compounds including thiourea, thiouracil, methyl mercaptan and cyanides."


Pollution

https://www.ncbi.nlm.nih.gov/pmc/art...07356-0001.pdf

Sir Robert McCarrison, an important early researcher into goiter, who acted as Doctor to the Hunza and other tribes in the Gilgit area noted that fecal pollution of water, and wider related pollution increased the occurrence of goiter. For example once a new clean water supply was made to a school the symptoms of goiter disappeared. McCarrison noted the Hunza were free of goiter but adjacent groups with lower standards of of ensuring access to clean water suffered from it.

Quality of water supplies, freedom or presence of high levels of nitrates, fecal and bacteriological contaminants, would arguably also have effected predisposition to goiter, so may also have been factors historically, before centrally provided treated water, helping explain the historic difference in rates of goiter occurrence in the same goiter prone geographic regions.


Iodine is an important co-factor in immune function, and possible usage of it in these pathways may reduce the wider availability of it.

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Old 09-16-2018, 03:06 AM   #126
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

IS THERE A ROLE FOR IODINE IN
BREAST DISEASES?
Sebastiano Venturi, Servizio di Igiene, ASL n.1, Regione Marche; Pennabilli (Pesaro), Italy

Published in "THE BREAST" , Vol.10, Number 5, 2001, p 379-382,

Abstracts of this have been previously referred; this is a link to a PDF of the paper.

https://scholar.google.com/scholar?h...DISEASES&btnG=

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Old 10-08-2019, 03:05 PM   #127
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327366/

Abstract - full free paper at link - one important factor of several I suspect


"Changes in Dietary Iodine Explains Increasing Incidence of Breast Cancer with Distant Involvement in Young Women"

"In conclusion, dietary iodine insufficiency represents a plausible explanation for the increasing incidence of breast cancer in young women with distant metastasis. In view of the established reduction in iodine levels in US women of childbearing age since the mid 70s, this group would be most vulnerable to increased breast cancer risk. The increased sensitivity of breast tissue to estradiol induced proliferative changes in the setting of dietary iodine insufficiency, provides a plausible mechanistic explanation for the increasing incidence of breast cancer with distant involvement in this age group. Based on the importance of iodine in thyroid and breast health, fetal brain development, as well as deficits in nutritional trends among younger women, iodine testing and management may be considered as a potentially important aspect for clinical practice."

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Old 10-08-2019, 03:11 PM   #128
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Re: Iodine deficiency ! - falling intakes - goitregens - competition bromine and fluo

As usual more research required!


https://journals.lww.com/oncology-ti...Cancer.13.aspx

"How Molecular Iodine Attacks Breast Cancer"
Oncology Times: December 25, 2016 - Volume 38 - Issue 24 - p 34
doi: 10.1097/01.COT.0000511599.52147.f1

Abstract

"Researchers have elucidated the mechanism of action for molecular iodine to determine how it helps protect women from fibrocystic breast condition (FBC) and confirm how it attacks breast cancer.

"Numerous studies have previously suggested iodine supplementation can promote breast health, but none had determined precisely how it worked with FBC cells. Investigators sought to identify the specific MOA that made molecular iodine effective."

"The breast cancer study focused on two common breast cancer subtypes using well-established breast cancer cell lines, MCF7 (a luminal A subtype) and MDA-MB231 (a triple-negative subtype). Cells were treated with molecular iodine at various concentrations to measure proliferation and cell death. This was subsequently followed by gene expression analysis of key important molecular markers, which are primarily responsible for cell growth and apoptosis. Primary human mammary epithelial cells derived from a healthy female donor were used as an internal control."

"Data from these studies indicated that molecular iodine has potent inhibitory effects on cell growth in both breast cancer and FBC (fibrocystic breast condition) The data also showed a dramatic increase in cell death in breast cancer cell lines used in the study and in cells derived from fibrocystic breast tissue."

"“Although several studies have, through the years, shown that molecular iodine can promote breast health and protect women from fibrocystic breast condition and potentially cancer, no one has ever identified molecular iodine's mechanism of action in fibrocystic breast condition,” said Usha Nagavarapu, PhD, study director and principal investigator of the project. “The pre-clinical investigations confirm the MOA and give the medical community reason to revisit the earlier research for clues on how best to use molecular iodine to treat and protect women.”"
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