The thyroid is the ruler and regulator of our bodies’ hormones. This important gland can be easily disrupted by stress, poor diet choices and even hereditary conditions. But what makes the thyroid healthy and happy? Iodine.

Most of us are aware of common symptoms which accompany thyroid disorders (in extreme cases, goiters) but, for many, the awareness stops there. If you find the endocrine system puzzling or don’t know what it takes to have healthy hormones, you’re not alone.

• In 7th Century China (the “Tang” Dyansty, to be exact) pills and powders of raw thyroid glands were used to treat goiters – a common, possibly crippling, defect that is the result of a malfunctioning thyroid.

• In Ancient Rome, travelers to the Alpine regions of southern Europe came back with stories of what would be referred to, and seen in the 18th century, as “cretinism.” A potentially devastating developmental condition brought on by thyroid issues both during childhood and while in the womb.

• In the 19th century, in the Miesbach and Salzburg regions of Bavaria, a traditional type of Germanic clothing called the “Tracht,” included a choker, dubbed “Kropfband” which was used to hide either goiters themselves, or the scars of goiter surgery, due to their sheer frequency.

• In the early 20th century, the United States had such a serious issue with hypothyroidism, and the concurrent goiters and developmental defects, that the region surrounding the Great Lakes, extending to into the northern midwest and intermountain regions became known as the “Goiter Belt.”

• In 2014, the synthetic thyroid drug “Synthroid,” was the #1 most prescribed drug in America – beating both: “Crestor” (#2) the most popular statin for cholesterol, and “Nexium” (#3) a proton pump inhibitor used to help people continue to eat nachos without fear.

These, and any number of additional examples, point to one of the most pervasive medical conditions found in human history: iodine deficiency. An issue so serious that, to this day, it still affects roughly one-third of the human population, making it the leading preventable cause of intellectual and developmental disabilities in the world. According to a 2008 study, in Germany alone (by no means an underdeveloped nation), iodine deficiency causes one BILLION dollars a year in health care costs.

Why and how does this happen? In order to understand to understand iodine deficiency, we need to understand what iodine is. Iodine is an essential micronutrient. Translation: it’s very tiny and if you don’t have enough of it, bad things happen. Why? It’s the ocean’s fault. You see, we are all creatures of the sea – or, more importantly, the creatures that came before us were. Life on earth was born in the ancient seas, and it spent a LOT of time there before moving on. As a result, at some level we are still dependent on the same basic things on which we were founded, and the sea was, and still is, the best place on earth to find iodine.

Iodine is the most essential nutrient for the health of your thyroid gland, and your thyroid gland is the “master gland” of your endocrine system, which produces and regulates all the hormones in your body. We get iodine from seafood, from any number of crops grown in coastal regions, meat and dairy from animals raised on iodine-rich soil, asparagus, garlic, pineapple, coconuts, leafy greens, and blackstrap molasses, among other things.

What happens when you don’t get enough iodine? It’s called “hypothyroidism” and, depending on just how much iodine you do or don’t get, results may vary.

For your average adult in a modern, affluent country, symptoms can include: lowered metabolism, lower energy, cognition issues (“not thinking so good”), weight gain, depression, hormone issues – basically, the body just doesn’t function quite as well with low amounts of iodine in it.

In more extreme cases of iodine deficiency, the most well-known symptom is goiter: a swelling of the thyroid gland, located on the front of the neck, potentially to dramatic proportions. Major physical deformities and neurological issues can result from insufficient iodine levels during prenatal and developmental years – the antiquated, but still-used medical term “Cretinism” refers to those who exhibit this condition. Symptoms can include: dwarfism, swelling or thickened skin, bulging eyes, hair loss, infertility, and mental deterioration ranging from slower thoughts and reflexes to almost total impairment. Recorded throughout history – particularly in isolated, inland regions – this type of iodine deficiency is still a major concern in areas ranging from South America, to inland China, Australia and New Zealand, Central Asia, and even still in certain parts of Europe.

But, here in the U.S., and most other parts of the developed world, this is seen as a relic of a bygone era, if anyone is even aware of it at all. Why is this not a great enough concern which you and I hear about on a regular basis? Perhaps our best way to understand all of this is through the history of something so common you’ve probably had some today, and one of the largest single public health initiatives in modern history: this is the story of iodized salt.

Iodine exists in unrefined sea salt – and all salt is sea salt (salt comes from salt water, or places where salt water once was) – but there only are incremental amounts of that iodine available at best. You’d have to consume literally toxic quantities of it to get anywhere near enough. Your common commercial salt crystals are refined for ease of use, and that eliminates the iodine all but entirely. So, whatever kind of salt you’re using, if there’s any significant amount of iodine in it, it’s there for one reason and one reason alone – someone put it there.

As an element, iodine was officially discovered in 1811. By 1820 iodine intake was found to be directly connected to goiter size and, by the end of the century, iodine treatments were found to have a positive impact on overall hypothyroidism.  This issue, however, was far greater than something that could be treated on a case by case basis. Something needed to be done to get iodine to the population at large: the answer was salt.

Salt is one of the most universally consumed commodities on earth. Salt production has a history that dates back 8,000 YEARS. Wars have been fought for salt. Whole economies have been based on salt. Religions have used salt as a symbol of their consecration with God. Also, salt tastes great. Conveniently, its an incredibly good structure to bond an iodine to. Past all that, it doesn’t spoil. Everything about salt makes it virtually the perfect vehicle to deliver iodine to the population at large. Before the end of the 19th century, this was already a proposed and accepted idea. Still, science and society took a little time to get there.

Fast forward a few years to 1924 – Dr. David Murray Cowie, the first professor of Pediatrics at the University of Michigan, had been consumed with the issue of goiters in the Great Lakes regions. At the time, the Great Lakes, as previously mentioned, were a part of what was referred to as  the “Goiter Belt.”  This extended from the midwest, through the Great Lakes region, and into the Pacific Northwest. People in this region ate little or no seafood and both the local soil and water had relatively low amounts of dissolved iodine, resulting in little exposure from locally grown foods or water. (Major attention had drawn to the issue several years earlier when a significant number of men in that part of the country were disqualified from the WWI draft due to goiters.) Noting the success of a small-scale Swiss program to iodize salt in 1922, he started a campaign to bring iodized salt to Michigan. All he had to do was convince a lot of people that he was right.

Public opinion at the time actually supported Cowie: the 1920’s were a major time for research in the areas of food and nutrition. This was the period during which that the seeds of the modern “health-food” movement (and, by extension, places like your friendly, neighborhood, Mama Jean’s) were being sown. However, convincing the greater manufacturing community of this was going to be difficult. Appealing to the salt manufacturers directly wasn’t going to work. Convincing a giant industry to make a major addition to its standard (and profitable) practices takes a voice with a little more heft, specifically the government – but this was obviously going to be a piece of work itself.

It took seven months of papers and deliberations but, finally, the Executive Council of Michigan State Medical Society gave Cowie the authority to endorse and implement the production of iodized salt in the state. Michigan salt producers agreed to begin producing iodized table salt with labels reading “contains .01 per cent sodium iodide.” On May 1, 1924, iodized salt by Diamond Crystal Salt, Mulkey Salt, Inland Delray Salt, Michigan Salt Works, and Ruggles and Rademaker debuted on Michigan grocers’ shelves. The initial program was deemed such a success that, by that fall, the Morton Salt Company of Chicago began distributing iodized salt nationwide. And so began one of the largest and simplest public health initiatives in the world.

It literally worked brilliantly. In areas where iodine deficiency had previously been an issue, not only did goiters decrease in frequency and overall health improve, but the average IQ in those regions jumped 15 points in the succeeding generations. As governments around the world prevailed on their own salt industries to adopt these practices, previously chronic levels of hypothyroidism and the resultant symptoms all but disappeared in a number of major populations.

The best part: it’s all incredibly cheap. The amount of potassium iodide necessary to iodize one ton of salt costs about $1.15 (as of 2006). That’s right, the cost of iodizing enough salt to solve the thyroid problems of 500,000 people a day can be done for the low, low cost of the change in your couch. According to public health experts, iodisation of salt may be the world’s simplest and most cost-effective measure available to improve health, costing approximately 5 CENTS per person per year, on average.

As it stands, however, hypothyroidism still affects roughly 30% of the world’s population, and not just in developing countries. In developed nations which have never widely adopted the practice of iodizing salt (Russia), in vast swaths of arid land in the interiors of large continents (inland Chaina and Australia), in regionally isolated areas amidst otherwise healthy populations (especially in poorer, mountainous regions of Europe and the US) hypothyroidism is still prevalent. In some places, it is even the result of unfortunate urban legends and misconceptions which have taken hold (in Pakistan, many believe salt iodization is part a secret, western plot to lower the birth-rate in muslims – seriously – and as a result, only 17% of the population uses iodized salt). In the case of India, a cultural conflict involving the local production of salt dating back to the colonial era has led to inordinately high rates of of neurological and physiological deformities amongst the salt producers themselves (check out this fascinating article “India’s Salt Wars” here: http://www.salon.com/2001/08/20/salt/)

In more recent times, hypothyroidism has experienced a creeping resurgence in places like Britain and the U.S. as well. This unfortunate resurgence is caused by everything from changing dietary habits, shifts to artisanal salts, unfortunate misconceptions regarding iodized salt (everything from simply “if it’s processed, it’s bad for you” to a myth that iodized salt causes AIDS – seriously), and even changes during the last 30 years in the dairy and bread-making industries, where iodine was once commonly used as a part of the manufacturing process. Low-level hypothyroidism has again become a serious issue, but it doesn’t have to be.

So, what does all this mean to you, the MaMa Jean’s shopper? First and foremost, it means that you need iodine, period. Not a lot, just a basic amount in a day. The RDA is 150mcg – that’s not much – but many feel that up to and including several milligrams a day may be necessary. You should always make the effort to get iodine in through your diet, particularly with quality seafood, but it doesn’t mean you absolutely have to use iodized salt. If for one reason or another, iodine isn’t as available to you as you need it to be (and, really, that’s what this article is all about) there’s another solution: iodine supplements.

Iodine supplementation and thyroid support are a huge part of the supplement industry for all the reasons listed above. Benefits for even a healthy individual include: increased energy, increased cognition (“thinking much better”), lower pain levels, improved mood, better hormone levels (including improved testosterone and estrogen levels) and, of course, weight loss. You can find a wide range of products to that end readily available in just about any health food store, certainly at Mama Jean’s. Here, we have a broad selection of supplements available to help nutrify and restore your thyroid, and any number of people who will be happy to help you find the right one. Come by and check them out sometime – don’t be a cretin.