Iodine's Role in Thyroid Health

Why it's essential and how much you need

Iodine is an element that's required for the thyroid gland to produce thyroid hormones. Since the body does not produce iodine on its own, it needs to come from dietary sources—and striking the right balance is key. Inadequate levels or overconsumption of iodine can lead to or worsen thyroid disease, as well as cause other significant health concerns.

The Importance of Iodine

When you consume iodine, it is quickly absorbed and entered into your bloodstream. Your thyroid, which has tiny cells that capture the circulating iodine, takes in and oxidizes it so it can begin to be used to create triiodothyronine (T3) and thyroxine (T4)—thyroid hormones that make their way throughout the body to regulate metabolism and ensure healthy functioning of the heart, brain, and other organs. While the major portion of iodine is concentrated in the thyroid gland, the nonhormonal iodine is found in a variety of body tissues including the mammary glands, the eyes, the gastric mucosa, the cervix, and the salivary glands. 

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Levels of T3 and T4—as well as thyroid stimulating hormone (TSH), which is influenced by the two—that are out of normal ranges can lead to issues such as hypothyroidism and hyperthyroidism, and the complications related to having an underactive or overactive thyroid.

This can occur for a number of reasons, including taking in too little or too much iodine.

How Much Iodine You Need

According to the Food and Nutrition Board of the National Academies (formerly the National Academy of Science), the recommended dietary allowance (RDA) for iodine in the United States ranges anywhere from 90 mcg per day for toddlers to 150 mcg for teens and adults.

Considering that one cup of plain low-fat yogurt contains about 75 mcg, 3 ounces of fish sticks contain about 54 mcg, a cup of cooked pasta contains about 27 mcg, and a quarter teaspoon of iodized salt contains about 71 mcg, that's generally an easy amount for most people to consume.

Pregnant and Breastfeeding Women

The American Thyroid Association recommends that all pregnant and breastfeeding women in the United States and Canada take a prenatal vitamin containing 150 mcg of iodine a day as part of an overall recommended intake of 220 mcg/day and 290 mg/day, respectively. Excess iodine, however, can be particularly dangerous in these women.

Iodine Sources

Most Americans have no trouble meeting the recommended intake of iodine because of the iodization of salt in the United States and incorporation of iodine-rich foods such as the following:

  • Cod (3 ounces): 99 mcg
  • Plain low-fat yogurt (1 cup): 75 mcg
  • Reduced fat milk (1 cup): 56 mcg
  • White enriched bread (2 slices): 45 mcg
  • Shrimp (3 ounces): 35 mcg
  • Enriched macaroni (1 cup): 27 mcg
  • Egg (1 large): 24 mcg
  • Canned tuna in oil (3 ounces): 17 mcg
  • Dried prunes (5 prunes): 13 mcg
  • Cheddar cheese (1 ounce): 12 mcg
  • Raisin bran cereal, (1 cup): 11 mcg
  • Apple juice (1 cup): 7 mcg
  • Frozen green peas (1/2 cup): 3 mcg
  • Banana (1 medium): 3 mcg
ways to hit your daily iodine
Illustration by Cindy Chung, Verywell

Supplements (e.g. potassium iodide, sodium iodide, kelp) and iodine-containing herbs, such as bladderwrack, are other sources that can be considered.

Iodine Deficiency

Since iodine is needed to make thyroid hormone, diminished levels can lead to hypothyroidism (low thyroid function). Iodine deficiency is also linked to the development of goiter (thyroid enlargement).

The impact of too little iodine reaches further. Children born to mothers with severe iodine deficiency can suffer from stunted growth, severe and irreversible intellectual disabilities, and problems with movement, speech, and hearing.

Even mild iodine deficiency during pregnancy can lead to subtle intellectual deficits, although many children improve with iodine supplementation. Mild iodine deficiency can also cause miscarriage.

Fibrocystic breast disease, a benign condition characterized by lumpy, painful breasts mostly in women of reproductive age, is also associated with iodine deficiency.

Risk Factors

Research suggests that 35% to 45% of the world's population is iodine deficient. At a global scale, roughly 2 billion people are classified as having iron deficiency, of which around 50 million have clinical symptoms.

To address this global concern, 124 countries have instituted legislation for mandatory salt iodization as of 2022, resulting in 88% of the world's population having access to iodized salt on grocery store shelves.

Even so, 21 countries have insufficient iodine in their diets, according to research from the Iodine Global Network. These not only include developing countries like Madagascar, Mali, Cambodia, Haiti, Lebanon, and Tajikistan, but also developed countries like Norway, Israel, Finland, and Germany.

The risk of iodine deficiency in the United States has long been considered small due to the implementation of salt iodization starting back in the 1920s. However, recent research suggests that mild-to-moderate iodine deficiency is, in fact, common in the U.S. and appears to be increasing.

According to data from the ongoing National Health and Nutrition Examination Survey (NHANES), no less than 38% of the U.S. population had a urine iodine concentration (UIC) of under 100 in 2012, meaning that they met the definition of being iodine deficient.

There are certain risk factors that may account for such deficiencies, not only in the United States but other developed and developing countries:

  • Pregnancy
  • A low- or no-salt diet
  • An iodine-poor diet high in goitrogenic foods such as soy, cassava, and cruciferous vegetables (such as cabbage, broccoli, and cauliflower), which can impact your body's ability to utilize iodine

Changing dietary habits have fueled increasing rates of iodine deficiency in the United States. The overall reduced use of table salt has been led by health concerns about sodium and high blood pressure.

At the same time, there has been an increased demand among consumers for sea salt, which is naturally low in iodine. As a result, only 53% of table salt sold in the United States is iodized.

Preventive Supplementation When You Have Thyroid Disease

Some healthcare providers are almost knee-jerk in their insistence that anyone with a thyroid problem requires iodine supplementation; alternative healthcare providers may recommend iodine-containing herbs, like kelp or seaweed.

This can be particularly risky, in part because iodine supplements can interact with several types of drugs, including anti-thyroid drugs used to treat hyperthyroidism. Taking high doses of iodine with anti-thyroid medications can have an additive effect and could cause hypothyroidism.

If iodine deficiency isn't the cause of hypothyroidism, then iodine supplements won't be helpful.

You'll want to be very careful about upping your iodine intake unless you and your healthcare provider have some very strong evidence that you're deficient. This is especially true if you're pregnant or planning to become pregnant.

Excess Iodine

Given the strong link between iodine and thyroid health, it's reassuring to learn that iodine deficiency is rare in the United States and other developed countries where iodized salt is used. Indeed, as an International Journal of Molecular Sciences study reported in 2014, iodine excess is currently a more frequent occurrence in these places. This, though, is not without concern.

For some people with abnormal thyroid glands, excessive iodine can trigger or worsen hypothyroidism. While initially, you may have more energy, high doses can cause an "iodine crash" that leaves you feeling exhausted and achy within a few days.

That's because high iodine intake can initiate and exacerbate infiltration of the thyroid by lymphocytes, the white blood cells that accumulate due to chronic injury or irritation.

In addition, large amounts of iodine block the thyroid's ability to make thyroid hormones. A 2014 study in the journal Endocrinology and Metabolism found that more-than-adequate or excessive iodine levels are unsafe and may lead to hypothyroidism and autoimmune thyroiditis (Hashimoto's thyroiditis, chronic lymphocytic thyroiditis), especially for people with recurring thyroid disease.

Women who take too much supplemental iodine during pregnancy may give birth to babies with congenital hypothyroidism, a thyroid deficiency that, if left untreated, can lead to mental, growth, and heart problems, according to a 2012 study published in The Journal of Pediatrics.

While iodine poisoning is rare, the overconsumption of iodine can be just as problematic as consuming too little.

Are You Getting Enough or Too Much?

While iodine can be detected in urine, relying on such a test is not helpful, since 90 percent of the iodine you ingest is quickly expelled. Rather, healthcare providers use thyroid tests to determine if your iodine intake is concerning or not.

In addition, iodine deficiency is typically suspected based on the development of goiter, hypothyroidism, or congenital hypothyroidism (low thyroid function at birth).

Be sure that any adjustments you make to your iodine intake, whether you have a circumstance that seems to call for them or not, are cleared by your healthcare provider first.

Frequently Asked Questions

  • What is iodine used for?

    Iodine is important for the production of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). The body does not make iodine, so it needs to come from dietary sources. Fortunately, it is not hard to get enough iodine in your diet thanks to the iodization of table salt. 

  • What foods contain iodine?

    Iodine is found in animal protein, sea vegetables, iodized table salt, and fortified foods. Common sources are seaweed, tuna fish, oysters, shrimp, dairy products, eggs, chicken, and beef liver. 

  • Can iodine make hypothyroidism worse?

    Yes, taking iodine supplements can worsen hypothyroidism. High doses of iodine interfere with the production of thyroid hormones. This can exacerbate problems for people with an already under-active thyroid. Iodine may provide temporary relief of symptoms, but this is followed by a crash that causes fatigue and body aches. 

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ahad F, Ganie SA. Iodine, Iodine metabolism and Iodine deficiency disorders revisited. Indian J Endocrinol Metab. 2010;14(1):13-17.

  2. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Understanding thyroid tests.

  3. National Institutes of Health (NIH). (2001) Chapter 1: Dietary Reference Intake for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Nutrient Recommendations: Dietary Reference Intakes (DRI). Bethesda, Maryland: NIH.

  4. Yarrington C, Pearce EN. Iodine and pregnancy. J Thyroid Res. 2011;2011:934104. doi:10.4061/2011/934104

  5. Office of Dietary Supplements: National Institutes of Health. Iodine: Fact Sheet for Health Professionals. Bethesda, Maryland.

  6. Hatch-McChesney A, Lieberman HR. Iodine and iodine deficiency: a comprehensive review of a re-emerging issue. Nutrients. 2022 Sep;14(17):3474. doi:10.3390/nu14173474

  7. Biban BG, Lichiardopol C. Iodine deficiency, still a global problem? Curr Health Sci J. 2017 Apr-Jun;43(2):103–111. doi:10.12865/CHSJ.43.02.01

  8. Zimmerman MB, Andersson M. Global endocrinology: global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020. Eur J Endocrinol. 2021 Jul 1;185(1):R13–R21. doi:10.1530/EJE-21-0171

  9. Ezemaduka Okoli CB, Woldu HG, Peterson CA. Low urinary iodine concentration is associated with increased risk for elevated plasma glucose in females: an analysis of NHANES 2011-12. Nutrients. 2021;13:4523. doi:10.3390/nu13124523

  10. Maalouf J, Barron J, Gunn JP, Yuan K, Perrine CG, Cogswell ME. Iodized salt sales in the United States. Nutrients. 2015;7:1691–1695. doi:10.3390/nu7031691

  11. Luo Y, Kawashima A, Ishido Y, et al. Iodine excess as an environmental risk factor for autoimmune thyroid disease. Int J Mol Sci. 2014;15(7):12895-912. doi:10.3390/ijms150712895

  12. Sun X, Shan Z, Teng W. Effects of increased iodine intake on thyroid disorders. Endocrinol Metab (Seoul). 2014;29(3):240-7. doi:10.3803/EnM.2014.29.3.240

  13. Connelly KJ, Boston BA, Pearce EN, et al. Congenital hypothyroidism caused by excess prenatal maternal iodine ingestion. J Pediatr. 2012;161(4):760-2. doi:10.1016/j.jpeds.2012.05.057

  14. American Thyroid Association. Iodine deficiency.

Additional Reading

By Mary Shomon
Mary Shomon is a writer and hormonal health and thyroid advocate. She is the author of "The Thyroid Diet Revolution."