Iodine deficiency 2025028 221738495 2008-06-25T21:38:21Z 122.57.251.229 /* Goitre */ {{Refimprove|article|date=March 2008}} {{Infobox_Disease | Name = Iodine deficiency | Image = | Caption = | DiseasesDB = 6933 | ICD10 = {{ICD10|E|00||e|00}} - {{ICD10|E|02||e|00}} | ICD9 = | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 1187 | MeshID = | }} [[Iodine]] is an essential [[trace element]]; the [[thyroid hormone]]s [[thyroxine]] and [[triiodotyronine]] contain iodine. In areas where there is little iodine in the diet&mdash;typically remote inland areas where no marine foods are eaten&mdash;'''iodine deficiency''' gives rise to [[goiter]] (so-called [[endemic goitre]]), as well as [[cretinism]], which results in developmental delays and other health problems. In some such areas, this is now combatted by the addition of small amounts of iodine to table salt in form of [[sodium iodide]], [[potassium iodide]], [[potassium iodate]]&mdash;this product is known as ''[[iodized salt]]''. Iodine compounds have also been added to other foodstuffs, such as flour, water and milk in areas of deficiency<ref>{{cite web|title=The Iodine Deficiency Disorders|url=http://www.thyroidmanager.org/Chapter20/20-frame.htm|work=Thyroid Disease Manager|author=François Delange, Basil Hetzel}}</ref>. [[Seaweed]] is also a well known source of iodine<ref>[http://seaweed.ucg.ie/Nutrition/iodine.html Iodine in Seaweed<!-- Bot generated title -->]</ref>. Thus iodine deficiency is more common in mountainous regions of the world where food is grown in soil poor in iodine. ==Goitre== {{main|Goitre}} Low amounts of thyroxine (T<sub>4</sub>, one of the two thyroid hormones) in the blood, due to lack of dietary iodine to make them, gives rise to high levels of thyroid stimulating hormone [[TSH]], which stimulates the thyroid gland to increase many biochemical processes; the cellular growth and proliferation can result in th characteristic swelling or hyperplasia of the thyroid gland, or goitre. The introduction of iodized salt since the early 1900s has eliminated this condition in many affluent countries, however there are a number of European countries, Australia, and New Zealand where iodine deficiency is a significant public health problem <ref name="pmid16175826">{{cite journal |author=Andersson M, Takkouche B, Egli I, Allen HE, de Benoist B |title=Current global iodine status and progress over the last decade towards the elimination of iodine deficiency |journal=Bull. World Health Organ. |volume=83 |issue=7 |pages=518–25 |year=2005 |pmid=16175826 |doi=}}</ref>. It is more common in poorer nations. Public health initiatives to lower the risk of cardiovascular disease have resulted in lower discretionary salt use at the table, and with a trend towards consuming more processed foods the non-iodized salt used in these foods also means that people are less-likely to obtain iodine from adding salt during cooking. Goitre is said to be endemic when the prevalence in a population is > 10%, and in most cases goitre can be treted with iodine supplementation. If goitre is untreated for around 5 years, however, iodine supplementation or thyroxine treatment may not reduce the size of the thyroid gland because the thyroid is permanently damaged. ==Cretinism== {{main|Cretinism}} Iodine deficiency is the leading cause of [[mental retardation]], producing typical reductions in [[IQ]] of 10 to 15 IQ points. It has been speculated that deficiency of iodine and other [[micronutrients]] may be a possible factor in observed differences in IQ between ethnic groups: see [[race and intelligence]] for a further discussion of this controversial issue. Cretinism is a condition associated with iodine deficiency and goitre, commonly characterised by mental deficiency, deaf-mutism, squint, disorders of stance and gait, stunted growth and [[hypothyroidism]]. ''[[Paracelsus]]'' was the first to point out the relation between goitrous parents and mentally retarded children.{{Fact|date=March 2008}} As a result of restricted diet, isolation, intermarriage, etc., as well as low iodine content in their food, children often had peculiar stunted bodies and retarded mental faculties, a condition later known to be associated with thyroid deficiency. [[Diderot]] in his 1754 ''[[Encyclopédie]]'' described these patiens as "crétins". In French, the term "crétin des Alpes" also became current, since the condition was observed in remote [[valleys of the Alps]] in particular. The word ''cretin'' appeared in English in 1779. ==Local impact== Certain areas of the world, due to natural deficiency and governmental inaction, are severely affected by iodine deficiency, which affects approximately two billion people worldwide. It is particularly common in the [[Netherlands]], [[Pacific Ocean|Western Pacific]], [[South-East Asia]] and [[Africa]]. [[India]] is the most outstanding, with 500 million suffering from deficiency, 54 million from goitre, and two million from [[cretinism]].{{fact|date=May 2008}} Among other nations affected by iodine deficiency, [[Peoples Republic of China|China]] and [[Kazakhstan]] have begun taking action, while [[Russia]] has not. Successful campaigns for the adoption of the use of iodized salt require education and regulation of salt producers and sellers and a [[communication campaign]] directed at the public, the salt trade, politicians and policy makers. The cost of adding iodine to salt is negligible. <ref>[http://www.nytimes.com/2006/12/16/health/16iodine.html "In Raising the World’s I.Q., the Secret's in the Salt"], article by Donald G. McNeil, Jr., December 16, 2006, ''[[New York Times]]''</ref> Iodine deficiency has largely been confined to the developing world for several generations, but reductions in salt consumption and changes in dairy processing practices eliminating the use of iodine-based disinfectants have led to increasing prevalence of the condition in Australia and New Zealand in recent years. A proposal to mandate the use of iodized salt in most commercial breadmaking is expected to be adopted in 2009 <ref>[http://www.news.com.au/heraldsun/story/0,21985,23583571-662,00.html "Iodine plan no help for mums-to-be"], article appearing in April 23, 2008, from [[Herald-Sun]]</ref> <ref>[http://www.times.co.nz/cms/news/2008/04/art100019834.php"Nutritionist supports switch to iodised bread], article by Rebecca Gardiner, April 3, 2008, ''Howick and Pakuranga Times''</ref>. ==See also== *[[Basil Hetzel]] *[[Lugol's iodine]] ==References== <references/> ==External links== * [http://www.iccidd.org/index.php International Council for the Control of Iodine Deficiency Disorders] * [http://www.vrp.com/articles.aspx?page=LIST&ProdID=1781&qid=&zTYPE=2 Iodine: The Universal Nutrient Article] * [http://iodine4health.com/overviews/summaries/iodinesource.htm IodineSource] * [http://iodine4health.com/ortho/ortho.htm Orthoiodosupplementation] * [http://iodine4health.com/body/body.htm Iodine and the Body] * [http://iodine4health.com/special/special.htm Iodine - Special Topics] * [http://www.unu.edu/unupress/food/8F173e/8F173E0n.htm Can Africa meet the goal of eliminating iodine-deficiency disorders by the year 2000?] * [http://www.iodinenetwork.net Network for Sustained Elimination of Iodine Deficiency] * [http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6VNM-4MK1DDB-2-1&_cdi=6182&_user=10&_orig=browse&_coverDate=01%2F31%2F2007&_sk=999619998&view=c&wchp=dGLbVtb-zSkzS&md5=ac324e3ff800f9aa5c8c1d1c1f1acc2a&ie=/sdarticle.pdf] Goiter and Other Iodine Deficiency Disorders: A Systematic Review of Epidemiological Studies to Deconstruct the Complex Web Archives of Medical Research, Volume 38, Issue 1, January 2007, Pages 1-14. Atul Kotwal, Ritu Priya and Imrana Qadeer. {{Endocrine pathology}} [[Category:Iodine|Deficiency]] [[Category:Malnutrition]] [[ja:ヨード欠乏症]] [[ru:Эндемический зоб]] [[sv:Jodbrist]] [[zh:碘缺乏病]]