Make Sure Iodine is in Your Prenatal

Although severe iodine deficiency was eliminated in the United States nearly a century ago after the introduction of iodized salt, iodine intake has declined in recent decades. “Public health efforts to limit salt intake to decrease cardiovascular risk, in conjunction with increasing use of kosher salt and sea salt (neither of which contain iodine),” may in part be to blame. Not adding salt to foods is a good thing, as sodium is considered the second leading dietary killer in the world (second only to not eating enough fruit), but if you do add table salt, make sure it’s iodized. “It is a myth (often also false advertising) that ‘natural’ sea salt contains significant amounts of iodine.”

Fruits and vegetables provide iodine, but the amounts can vary depending on where it’s grown and how much iodine is in the soil. Because iodine is particularly important for fetal brain development, there’s a recommendation that “all US women who are pregnant, lactating, or even planning a pregnancy should ingest dietary supplements containing 150 mcg of potassium iodide per day,” which I discuss in my video Iodine Supplements Before, During, and After Pregnancy.

Is there evidence they’re not getting enough? We’d like to see urine levels over 150 mcg/L in pregnant women, but in the United States, pregnant women only average about 125 mcg/L. For example, a recent survey in New York City showed only about half of pregnant women were making the cut.

Don’t most pregnant women take prenatal vitamins, though? Only about half of prenatal multivitamins contain any iodine at all, and so only about one in five pregnant women in the United States are following the recommendations of the American Thyroid Association to take a daily iodine supplement, specifically in the form of potassium iodide rather than seaweed, as the levels in seaweed are subject to natural variability. Though the iodine content was as much as 90 percent off in some of the potassium iodide prenatal supplements, the kelp supplements varied even wider, off by as much as 170 percent.

Now, the American Thyroid Association admits it doesn’t have evidence that the current borderline insufficiency levels are leading to undesirable outcomes and so its rationale that all pregnant women take iodine supplements is a bit tenuous. Until such data are available, though, it figures better safe than sorry.

A randomized, placebo-controlled, interventional trial would answer the question once and for all, but the existing evidence for iodine supplementation during pregnancy is so convincing that it would be considered unethical to randomize pregnant women to a placebo.

When it comes to sufficient iodine intake during pregnancy, I’d recommend: Just do it.


Women eating plant-based diets may find this video of special importance: Pregnant Vegans at Risk for Iodine Deficiency.

This isn’t to say sea vegetables aren’t good for you in their own right. See Which Seaweed Is Most Protective Against Breast Cancer?.

For more videos on having a healthy pregnancy, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Meat Can Cause Stress Hormone Levels to Rise and Testosterone levels to Drop

A critique of the scientific validity of the dietary advice in Men’s Health magazine discovered nuggets claiming meat can give men “a testosterone boost,” but we’ve known for a quarter century that a meal with that much fat can drop testosterone levels by nearly one-third within hours. In fact, a significant drop of both free and bound testosterone in the bloodstream occurs within just one hour of it going in one’s mouth, whereas a low-fat meal of mostly carbs has no such effect. Based on in vitro studies on the effects of fat on testicle cells in a petri dish, researchers suspect fat in the blood may actually suppress testosterone production in real time. If you feed people lots of eggs and meat, including fish and poultry, and then switch them to a diet with bread, fruit, vegetables, and sugar—but about the same amount of fat—all their testosterone levels go up. Even more importantly, however, all their levels of cortisol, a stress hormone produced by our adrenal glands, go down.

Having low stress hormone levels is good, because high cortisol levels may “strongly predict cardiovascular death” in men and women both with and without pre-existing cardiovascular disease. In fact, this may help explain “death from a broken heart,” the heightened heart attack and stroke risk in the immediate weeks following the loss of a spouse. Higher cortisol levels days, months, or even years after losing someone you love may increase cardiac risk and reduce immune function. And, the rise in stress hormone levels from the loss of a spouse, a bump of about 50 points, is less than the bump you get by eating high-meat diet.

Cortisol may also help explain why those who are depressed tend to put on abdominal fat. The reason obesity around the middle is associated with elevated cortisol secretion may be that abdominal fat kind of sucks it up, so the accumulation of fat around our internal organs may be an adaptation by which our body deals with excess stress.

These spikes in stress hormone levels every time we eat a lot of meat may not just affect our health, but that of our children, which I discuss in my video Maternal Diet May Affect Stress Responses in Children. “Substantial evidence now suggests that maternal diets of high protein density have adverse effects on the fetus.” For example, back in the 1960s, an experiment was performed on pregnant women in Motherwell, Scotland, in which they were told to eat a high-meat diet in hopes of preventing preeclampsia, a disease of pregnancy. It didn’t work. In fact, the lowest preeclampsia rates I’ve ever seen were among women eating strictly plant-based diets—only 1 case out of 775 pregnancies. Preeclampsia normally strikes about 5 percent of pregnancies, so there should have been dozens of cases, suggesting a plant-based diet could alleviate most, if not all, of the signs and symptoms of this potentially serious condition. So what did happen when pregnant women went from eating about one daily portion of meat to about two portions a day? Mothers who ate more meat and fewer vegetables during pregnancy gave birth to children who grew up to have higher blood pressures.

“One explanation proposed for the adverse effects of high-meat/fish consumption is that this may increase maternal cortisol concentrations, which, in turn, affect the developing fetus,” resetting his or her stress hormone thermostat to a higher level. But, we don’t know until we put it to the test. And indeed, researchers found higher blood cortisol levels “in both the sons and daughters of women who had reported higher meat/fish” consumption, about a 5 percent increase for every meat serving per day. Such diets may present a metabolic stress to the mother and kind of reprogram the adrenal axis of their children, leading to lifelong hypercortisolemia, elevated levels of stress hormones in the blood. This may help explain why every daily portion of meat during late pregnancy may lead to a 1 percent greater fat mass in their children by the time they reach adolescence. So, this could increase the risk of their children becoming obese later in life and thus has “important implications for public health and in terms of prevention of obesity.”

What if they’re already born? We may be able to bring down children’s stress hormone levels with similar dietary changes, but this is just baseline stress hormone levels. Do children of mothers who eat more meat during pregnancy also have exaggerated responses to life stressors? Researchers put them through a stressful challenge—public speaking and mental arithmetic—and then measured their cortisol responses. If their mom ate less than two servings of meat/fish a day while she was carrying them, they got little shots of stress hormones from their adrenal glands. Those whose moms ate more really got stressed out, and those whose moms ate the most—17 or more servings a week, which is more than 2 servings each day—appeared to be really quaking in their boots. In a way, you are what your mother ate.


Want more craziness from Men’s Health magazine? Check out my video Changing a Man’s Diet After a Prostate Cancer Diagnosis.

Here are some other popular videos about eating healthfully during pregnancy:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Estrogenic Growth Promoters in Meat

In 1979, an epidemic of breast enlargement was noted in Italian children. Poultry or veal was suspected, given that estrogens “may be fed to farm animals to accelerate their weight gain.” “After this episode, the European Union banned the application/use of anabolic growth promoters in agriculture,” as well as the importation of American meat from animals injected with drugs like Zeranol, sold as “Ralgro Magnum.”

Zeranol, one of the most potent known endocrine disrupters, is 100,000 times more estrogenic than the plastics chemical, BPA, for example, and is the subject of my video Zeranol Use in Meat and Breast Cancer. “Zeranol constitutes a special case among potential endocrine disrupters, because Zeranol, in contrast to all other oestrogenic ‘endocrine disrupting’ chemicals, is present in human food because it is deliberately used in the production of consumer products. Furthermore, Zeranol is designed to be a potent, fairly persistent, [estrogen] whereas the [estrogenic] properties of the chemicals that are considered potential endocrine disrupters is accidental.”

If you drip blood from a cow implanted with the drug onto human breast cancer cells in a petri dish, you can double the cancer growth rate. We don’t drink blood, though, but preliminary data showed that muscle extracts—that is, meat extracts—also stimulated breast cancer cell proliferation.

Furthermore, Zeranol may cause the transformation of normal breast cells into cancer cells in the first place. Zeranol-containing blood from implanted cattle “was capable of transforming the human normal breast epithelial cell line” into breast cancer cells within 21 days.

“[O]bese individuals may be at greater risk of developing zeranol-induced breast cancer,” since they already have high levels of leptin, which is a hormone produced by fat cells that can itself promote breast cancer growth. And, Zeranol exposure can greatly enhance this growth-promoting action. “This result also suggests that Z[eranol] may be more harmful to obese breast cancer patients than to normal weight breast cancer patients in terms of breast cancer development.”

“In conclusion, because the synthetic and the natural hormones, used as anabolic growth promoters in meat production, are by far the most potent hormones found in human food,” we should really be testing people, especially children, before and after eating this meat. It amazes me this hasn’t been done, and, until it has, we have no idea what kind of threat they may pose, though the fact that Zeranol is as potent as estradiol (the primary sex steroid in women) and DES should concern us. DES is another synthetic estrogen that was marketed to pregnant women until 1971 when it was shown to cause vaginal cancers in the daughters. But few know it was also used in meat.

“In the absence of effective federal regulation, the meat industry uses hundreds of animal feed additives…with little or no concern about the carcinogenic and other toxic effects of dietary residues of these additives. Illustratively, after decades of misleading assurances of the safety of diethylstilbestrol (DES) and its use as a growth-promoting animal-feed additive, the United States finally banned its use in 1979 some 40 years after it was first shown to be carcinogenic. The meat industry then promptly switched to other [potentially] carcinogenic additives,” such as Zeranol.

When girls started dying from vaginal cancer, DES-treated meat was banned in Europe. However, “misleading assurances…including the deliberate suppression of residue data, managed to delay a U.S. ban on DES” in the meat supply for eight years.

Today, “[v]irtually the entire U.S. population consumes, without any warning, labeling, or information, unknown and unpredictable amounts of hormonal residues in meat products over a lifetime.” If all hormonal and other carcinogenic feed additives aren’t banned immediately, the least we should have is “explicit labeling requirements of use and of [hormone] residue levels in all meat products, including milk and eggs.”


Isn’t the DES story amazing? I had no idea it was used in meat production. Check out Illegal Drugs in Chicken Feathers for more on Big Pharma on Big Farms.

The most dangerous additive used in the meat industry is antibiotics, though. See, for example:

For more on what may be bad for the breast, check out:

And, for what may be protective, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: