Iodine Supplementation in Childhood: Preventing Thyroid Disorders in the Era of Precision Medicine

Iodine deficiency disorders (IDDs) are a group of conditions that have been identified as one of the most preventable but persisting important causes of irreversible neuro-cognitive impairment among paediatric populations across the world (Bertinato, 2021; Feei & Brough, 2025; Zimmermann & Andersson, 2021). Existing universal supplementation programmes are showing to be inadequate as they do not accommodate the new regional deficiencies and the concomitant risk of iodine excess (Kalarani & Veerabathiran, 2022; Seetharaman et al., 2024). This paper proposes a paradigm shift in paediatric endocrinology to precision medicine, in which the iodine interventions are tailored to each child. Wearable biosensors, which continuously monitor physiological and biochemical parameters, complex mobile-health applications which can track dietary intake in real-time, support adherence, and education, as well as comprehensive telehealth platforms which allow remote care (Fernández-Luque et al., 2021; Foster et al., 2022; Kim et al., 2023; Magsayo & Khatami, 2025; Majeed‐Ariss et al., 2015; Mercuri et al., 2021; Rashid, 2024; Zhou et al., 2024). Integration of advanced biomarkers and multi-omics data (genomics, proteomics, metabolomics and microbiomics) - integrated with AI/ML algorithms - will help to dynamically predict risk, implement early intervention strategies and design protocols for the supplementation of these individuals (Bidlingmaier et al., 2022; Dhanka et al., 2025; Giorgini et al., 2023; Lu et al., 2025; Mehta et al., 2025). By combining technology with personalised care, this strategy promises to optimise iodine nutrition, protect neurodevelopment and enhance the long term health outcomes of all children (Delange, 2007; Milanesi & Brent, 2016; Untoro et al., 2007).