The primary cause of iodine deficiency is insufficient dietary intake due to low levels of iodine in the soil and water. Regions far from the sea, where the soil is iodine-deficient, are particularly affected. Additionally, consumption of foods with goitrogens, substances that interfere with iodine uptake, can exacerbate the deficiency. Common goitrogens include certain vegetables like cabbage and cassava, as well as soy products.