Iodine deficiency is the most common worldwide cause of goiter

Dear Ask The Doctor: I am 26 and after 2 years of hair loss, fatigue, weight gain I went to the Doc and tested with a TSH of 7.6 and was diagnosed with hypothyroidism. I have been on various thyroid hormones (Armour Thyroid, Synthroid, Levothyroxine) for 1.5 years now. Nothing makes me feel better, even though my numbers are all now perfect. My thyroid antibodies are within normal range. There is absolutely nothing else wrong with me healthwise. I am wondering if it is possible that I have a iodine deficiency? My problems first started after living in Nepal for 1 year. I do not eat seafood, rarely eat dairy and only consume sea salt (not iodized salt). My endochronologist refuses to test my iodine levels saying that it is virtually impossible for the condition to exist in the US...... I understand that autoimmune problems are the common cause of hypothyroidism; but before I am ready to commit to switching off my thyroid at age 26 and taking meds for the rest of my life, isn't this an option worth thinking about?

Dear Katy: Theoretically it is possible that you are iodine deficient, which has resulted in the development of a goiter and subsequent hypothyroidism. Worldwide, the soil in large geographic areas is deficient in iodine. This occurs primarily in mountainous regions such as the Himalayas, the European Alps, and the Andes, where iodine has been washed away by glaciation and flooding. Iodine deficiency also occurs in lowland regions far from the oceans, such as central Africa and Eastern Europe. If you only consumed local produce while living in Nepal you were at risk of iodine deficiency. In the United States, iodine has been voluntarily supplemented in table salt (70 mcg/g). Other major sources of dietary iodine in the US are egg yolks, milk, and milk products because of iodine supplementation in chicken feed, the treatment of milk cows and cattle with supplemental dietary iodine to prevent hoof rot and increase fertility, and the use of iodophor cleaners by the dairy industry. Enlargement of the thyroid gland begins in response to low iodine intake and iodine deficiency is the most common cause of goiter in the world. If you suspect your current dietary intake of iodine-rich foods is low, I would advise substitution of iodized salt in both cooking and at the table and to increase your intake of milk, egg yolks, and saltwater fish.