Hypothyroidism WARNING: The 13 symptoms of a rare iodine deficiency

Iodine is a trace element that is naturally present in some foods, is added to some types of salt, and is available as a dietary supplement. Although iodine deficiency is considered an uncommon thing, recent research suggests it’s more common than you’d think – especially among pregnant women. For example, a 2016 study in the Southwest of England on 308 women in late pregnancy found that 73 percent had suboptimal iodine levels. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out the 13 symptoms of iodine deficiency.

Iodine is an essential trace element that is required throughout life to make the hormone thyroxine.

Without thyroxine, your body can’t regulate its daily physiological and metabolic functions.

Dr Lee warned: “Iodine deficiency has serious consequences, especially in pregnancy for the developing fetal brain.

“Pregnant women are more likely to be iodine-deficient, but they actually need 50 percent more iodine than non-pregnant women.

“In fact, a low intake of iodine in pregnancy has been linked to significantly lower intelligence scores and reduced reading ability in the offspring.

“It is also linked to pregnancy loss, preeclampsia, low birth weight, and in severe cases it can cause cretinism and stillbirth.

“Ideally, iodine levels should be in the normal range before conception.”

Those most at risk of iodine deficiency are people who don’t eat fish or seafood or avoid cow’s milk (some plant milk is fortified with iodine, but most are not).

It’s important to take note of the iodine content of the milk you are drinking and make sure you are not at risk of iodine deficiency.

Vegetarians and vegans are at risk of iodine deficiency and are advised to take an iodine supplement.

As mentioned, pregnant women are also at risk as their iodine requirements increase in pregnancy.

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Most iodine is found in fish and seafood, and in seaweed, so up your intake of these foods.

Dr Lee added: “Cow’s milk is also a good source, as it is enriched with iodine, resulting from the addition of iodine to animal feed.

“Poultry, eggs, bread, nuts, fruit, and vegetables contain small amounts of iodine.

“In the UK, iodine is not routinely added to salt, as it is in many European countries, as too much salt is harmful to blood pressure.”

Iodine deficiency results in an underactive thyroid gland, with low levels of thyroxine, also known as hypothyroidism.

Dr Lee said: “The symptoms and signs can come on very insidiously meaning it can be a long time before it is diagnosed or sometimes low thyroxine levels are discovered incidentally from a blood test.”

At other times, your doctor may be alerted that you could be hypothyroid because of various signs including the following 13 symptoms:

Weight gain

When thyroxine levels are low, your metabolic rate slows, and this is associated with weight gain.

Dr Lee pointed out that massive weight gain is unusual and it is usually only around five to 10 pounds.

Feeling weak

Because your body is releasing energy less efficiently, you feel weak and tired.

Tiredness and fatigue

The tiredness associated with hypothyroidism is not the usual tiredness you experience after a bad night’s sleep.

Dr Lee said: “It’s a deep sense of fatigue that makes you feel exhausted and can interfere with your ability to function normally.”

Dry skin and nails

Hypothyroidism results in under activity of the sweat glands.

As a result, your skin becomes dry and flaky and you can also get dry, brittle nails, with vertical white ridges, Dr Lee noted.

Hair loss

Hypothyroidism slows the rate of hair growth, plus disrupts the hair cycle.

There may be generalised thinning of the hair and loss of eyebrows.

Feeling cold

When the levels of thyroxine are low, this slows the metabolic rate and can lower your core temperature.

This means sufferers feel cold a lot of the time, even on a warm day.

A slow pulse

Low levels of thyroxine result in the heart beating more slowly.

Dr Lee said: “As it is also linked to raised cholesterol levels, there is an increase in arterial stiffness, and sometimes raised diastolic (lower reading) blood pressure.”


When thyroxine levels are low, this also slows gut motility, meaning intestinal contents take longer to pass through the gut, and leading to constipation.

Heavy periods

Hypothyroidism inhibits ovulation, leading to disordered menstrual cycles and heavy periods.

Dr Lee added: “It is also associated with raised prolactin levels which also inhibit ovulation.”

Pregnancy loss

An underactive thyroid is a recognised cause of various complications of pregnancy – notable, anaemia, miscarriage, stillbirth, preeclampsia, and low birth weight.

Dr Lee said: “This is because if there is not enough thyroxine, the body’s metabolic processes cannot work properly.”

A hoarse voice

When thyroxine levels are low, fluid can build up around the vocal cords, giving rise to a hoarse voice.

Raised cholesterol

When your thyroid is underactive it does not break down cholesterol in the gut so efficiently, and this can lead to a raised level of LDL bad cholesterol.

This is a risk factor for cardiovascular disease.

Swelling in the neck

People with iodine deficiency characteristically have a swelling in the neck called a goitre.

Dr Lee explained: “This is because the thyroid gland is working overtime, trying to cope with too little iodine.

“A goitre can be associated with a cough, shortness of breath and/or a hoarse voice.

“There are other causes of goitres, for example, a goitre can also be present if the thyroid is overactive (hyperthyroidism).”

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