Dietary iodine is essential for thyroid hormone production. Although U.S. dietary iodine is generally adequate, some groups, especially women of childbearing age, are at risk for mild iodine deficiency. Children's average urinary iodine is higher than that of adults. U.S. dietary iodine sources have not been assessed recently. A survey of iodine content in 20 brands of bread, 18 brands of cows' milk, and eight infant formulae was performed between 2001 and 2002. Three bread varieties contained more than 300 microg iodine per slice. Iodine content in other brands was far lower (mean +/- sd, 10.1 +/- 13.2 microg iodine/slice). All cows' milk samples had at least 88 microg iodine/250 ml, ranging from 88-168 microg (116.0 +/- 22.1 microg/250 ml). Infant formulae values ranged from 16.2 to 56.8 microg iodine/5 oz (23.5 +/- 13.78 microg/5 oz). The public should be aware of the need for adequate dietary iodine intake and should be aware that ingredient lists do not reflect the iodine content of foods.

Perchlorate exposure was not significantly correlated with breast milk iodine concentrations. Perchlorate was detectable in infant formula but at lower levels than in breast milk. Forty-seven percent of women sampled may have been providing breast milk with insufficient iodine to meet infants' requirements.

Thalassemia major (beta-thalassemia) affects a significant segment of the population in certain areas of the world. Alterations in migration patterns have changed the geographic distribution of this disease and made it a worldwide health problem. Over the course of the past 2-3 decades hypertransfusion therapy has significantly increased the life expectancy, and improved the quality of life of these patients. At the same time there has been an increase in the frequency of complications of this therapy caused by iron overload. Endocrine gland abnormalities contributed little to the morbidity or mortality of beta-thalassemia in the past. As a result of hypertransfusion therapy and increased longevity, however, endocrinopathies have become more common and contribute significantly to morbidity in these patients. In this article we briefly review the current understanding of endocrine gland abnormalities, primarily caused by iron overload, in patients with thalassemia major.

A DEQUATE MATERNAL IODINE intake is essential for fetal neurodevelopment. Worldwide, iodine deficiency is the leading cause of preventable mental retardation (1). Since the iodization of salt and other foods in the 1920s, U.S. dietary iodine has generally been adequate. However the median adult U.S. dietary iodine intake decreased by 50% from the time of the first National Health and Nutrition Examination Survey (NHANES I, 1971-1974) to the time of NHANES III (1988-1994) (2). Women of childbearing age may be at increasing risk for moderate iodine deficiency. The U.S. Institute of Medicine's recommended dietary allowance (RDA) for pregnant women is 220 mg iodine daily (3); this corresponds approximately to a urinary iodine concentration of 15 mg/dL. The median urinary iodine value in pregnant women (n 5 208) from NHANES I was 32.7 mg/dL, with 1% of the women sampled having urinary iodine levels below 5 mg/dL. The median urinary iodine level among pregnant women from NHANES III (n 5 348) was 14.1 mg/dL, with 6.9% having urinary iodine levels below 5 mg/L. Dietary iodine is currently being surveyed in NHANES IV but results will not be reported until after the survey is completed.

Dietary iodine is essential for the production of thyroid hormones. Breast-fed infants are reliant on maternal iodine intake. The aim of this study was to evaluate iodine sufficiency in lactating women in Iran. The sample consisted of 100 lactating mothers referred to the Taleghani Hospital of Gorgan, Iran. Goiter was graded according to World Health Organization (WHO) classification. Spot urine and breast-milk samples were collected for the measurement of iodine concentrations. Urine iodine concentrations (UIC) less than 100 and breast-milk iodine concentrations (MIC) less than 50 microg/L were considered consistent with iodine deficiency. Forty-three percent of women had grade 1 and 2 goiters, respectively. The median UIC was 259 microg/L. UIC was less than 100 in 16%. Grade 1 and 2 goiters were each present in 8% of mothers with UIC less than 100 microg/L. The median MIC was 93.5 microg /L. MIC was less than 50 microg /L in 19%. Grade 1 and 2 goiters were present in 11% and 8%, respectively, of women with MIC <50 mg/L. MIC and UIC levels were significantly correlated (r = 0.44, p < 0.0001). Iodine deficiency and goiter were associated (p < 0.0001). UIC and MIC concentrations are sufficient in Gorgan, Iran. However, individual infants remain at risk for low iodine intake via breast milk.