IODINE DEFICIENCY PRESENTERS

M.RAJALAKSHMY
MODERATOR V.RAJESH
DR.THAMIZHMATHI.J M.RAJSHREE
B.REETHIKA
 IODINE:
It is an essential micronutrient.

FUNCTIONS:
Required for synthesis of Thyroid hormones
Minute amount for normal growth and development and well
being of all humans.

ADULT HUMAN BODY CONTAINS :50mg of IODINE

BLOOD LEVEL :8-12micrograms/dl
SOURCES :

COD LIVER
SEA FISH SEA SALT
OIL
OTHER FOODS:

MILK MEAT

VEGETAB
CEREALS
LES
GOITROGENS:

“Goitrogens” , are chemical substances leading to the

development of Goitre.
They interfere with iodine utilization by thyroid gland.
They may occur in food and water.
BRASSICA GROUPS OF VEGETABLES (CABBAGE AND
CAULIFLOWER) may contain goitrogens.
Most important among the dietary goitrogens are probably
CYANOGLYCOSIDES and THIOCYANATES.
DEFICIENCY:
Most obvious consequence of Iodine deficiency is goitre but recent
studies have indicated that there is much wide spectrum
disorder ,some of them so severe as to be disabling . They include:
Hypothyroidism
Retarded physical development and impaired mental function
Increased rate of spontaneous abortion and stillbirth
Neurological cretinism includes deaf mutism
Myxoedema cretinism, including dwarfism and severe mental
retardation.
 IODINE DEFICIENCY
DISORDER :
It is an another nutritional problem in India . Previously Iodine
deficiency was equated with goitre.
In recent years ,it has become increasing clear that iodine
deficiency commencing with the intrauterine life and extending
through childhood to adult life with serious health and social
implications .
Social impact of iodine deficiency arise not so much from goitre as
from the effect on the central nervous system.
SPECTRUM OF IODINE DEFICIENCY
DISORDER IN APPROPRIATE ORDER OF
INCREASING
DISORDER
SEVERITY: LEVEL OF SEVERITY

GOITRE -GRADE1
-GRADE 2
-GRADE3
-MODERATE

HYPOTHYROIDISM VARYING COMNBINATIONS OF CLINICAL SIGN

(DEPENDING ON AGE OF ONSET ,DURATION
AND SEVERITY

SUBNORMAL INTELLIGENCE ,MENTAL VARAIBLE SEVERITY

DEFICIENCY
DELAYED MOTOR MILESTONES ,HEARING
DEFECTS ,SPEECH DEFECTS
STRABISMUS (SQUINT) UNILATERAL
NYSTAGMUS BILATERAL
SPASTICITY MUSCLE WEAKNESS IN LEGS.
(EXTRAPYRAMIDAL)NEUROMUSCULAR ARMS, TRUNK ,SPASTIC
WEAKNESS DIPLEGIA ,SPASTIC QUADRIPLEGIA
ENDEMIC CRETINISM HYPOTHYROIDISM
CREITNISM,NEUROLOGICAL
CRETINISM
INTRAUTERINE DEATH (SPONTANEOUS
ENDEMIC
CRETINISM
REQIUREMENT:
Daily requirement of Iodine for
ADULTS:150micrograms
Recommendations of WHO for pregnancy:250mcg per day
RDA FOR INDIAN-2020
AGE GROUP CATEGORY OF BODY Wt (kg) IODINE
WORK
µg/day
MEN MODERATE 65 150
WOMEN PREGNANT 55+10 250
WOMEN
INFANTS 6-12 MONTHS 5.8 130
CHILDREN 4-6 YEARS 18.3 120
BOYS 10-12 YEARS 34.9 150
GIRLS 10-12 YEARS 36.4 150
BOYS 13-15 YEARS 50.5 150
GIRLS 13-15 YEARS 49.6 150
BOYS 16-18 YEARS 64.4 150
GIRLS 16-18 YEARS 55.7 150
EPIDEMIOLOGICAL ASSESSMENT OF
IODINE DEFICIENCY
This is necessary before initiating an iodization programme ,and for
surveillance of goitre control programmes,
Following indicators are useful in this regard
1. Prevalance of goitre
2. Prevalance of cretinism
3. Urinary iodine excretion
4. Measurement of thyroid function by determination of serum
levels of thyroxine(T4) and pituitary thyrotropic hormones
(TSH);and
5. Prevalance of neonatal hypothyroidism
Objectives of the goitre control programme is to (increase iodine
intake ,indices of urinary excretion are particulary recommended
for use in surveillance).
NEONATAL HYPOTHYROIDISM has been found to be sensitive
indicator of environmental iodine deficiency .
Serum T4 level is a more sensitive indicator of thyroid insufficiency
than T3
THE PROBLEM :
Whereas goitre has ceased to be a major problem in many
developed countries (although not eradicated)it continues to be a
serious health problem in many third World countries .
For example iodine deficiency is a heath problem of considerable
magnitude in INDIA and neighbouring countries of
BANGLADESH,BHUTAN MYANMAR,INDONESIA, NEPAL,SRI
LANKA and THAILAND.
More people are affected and levels of severity are higher in South-
east Asia than anywhere else in the world .
It has always been thought in India that goitre and cretinism were
only found to a significant extent in “HIMALAYA GOITRE BELT”
which is the world biggest goitre belt .
It stretches from Kashmir to the Naga Hills in the East ,extending
about 2400km and affecting the Northern states of Jammu and
Kashmir , Himachal Pradesh ,Punjab , Haryana ,Delhi, Uttar
Pradesh ,Nagaland ,Mizoram ,Meghalaya , Tripura and Manipur.

In recent years renewed surveys outside the conventional Goitre belt

have identified endemic foci of iodine deficiency and the associated IDD
in parts of Madhya Pradesh, Gujarat , Maharashtra, Andhra
Pradesh , Kerala, Karnataka and Tamil Nadu.

More and more news areas are being identified . Even areas near the sea
coast like Bharuch district in Gujarat and Ernakulam districts in Kerala are
found Goitre -affected.

In short no state in India can be said to be entirely free from

Goitre.
The magnitude if the problem in India is far greater than what had been
estimated in 1960s, it was estimated that about 9 million persons were
affected by Goitre . Results of sample survey conducted in 325 districts
covering all the states/Ut s have revealed that 263 districts are endemic
where the prevalance of IDD is more than 71million persons are suffering
from Goitre and other iodine deficiency disorders in the country.
 IODINE DEFICIENCY DISORDERS
PROGRAMME:
India commenced a goitre control programme in 1962,based on iodized
salt .
At the end of three decades , the prevalence of the disease still remained
high.
As a result , a major national programme – “The IDD Control
Programme’’ was initiated in which national wide ,rather than area-
specific use of iodized salt is being promoted .
It was decided as a national policy of fortify all the edible salt in a
phase manner by end of 8th plan .
The essential components of a national IDD programme are use of
iodized salt in place of common salt ,
Monitoring and
 Surveillance ,
Manpower training and
OBJECTIVES OF THE
PROGRAMME ARE:
1. Surveys to asses the magnitude of the Iodine deficiency
Disorders in districts.
2. Supply of Iodized salt in place of common salt .
3. Resurveys to assess the magnitude of the Iodine deficiency
disorders and the impact of iodized salt after every 5 years in
districts.
4. Laboratory monitoring of iodized salt and urinary iodine
excretion .
5. Health education and publicity .
SIGNIFICANT
ACHIEVEMENTS:
Consequent upon liberalization of iodized salt production ,salt commissioner
has issued licenses to 824 salt manufactures out of which 777 units have
commenced productions .
These units have annual production capacity of 222 lakh metric tones of
iodized salt.
Production supply of iodized salt from April 2015 to August 2015 was 26.44
lakh tonnes and 25.12 lakh tonnes.
Notification banning the sale of non iodized salt for different human
consumption in the entire country is already issued under “Food Safety &
Standards Act 2006 and Regulations 2011” .
For effective implementations of national iodine deficiency disorders control
programme 34 states/UTs have established Iodine deficiency disorders
control cells in their state health directorate.
HAZARDS OF IODIZATIONS :
A mild increase in THYROTOXICOSIS has now been described
following iodized salt programmes .
An increase in the lymphocytic thyroiditis (Hashimoto’s
disease )has also been claimed.
The risk of iodism or iodized goitre however seems to be very
small.
SUMMARY:
BLOOD LEVEL:8-12mcg/dl
ADULT HUMAN BODY CONTAINS:50mg of Iodine
GOITROGENS: Brassica group of vegetables, Cyanoglycosides,
thiocyanates.
PREVENTION OF IODINE DEFICIENCY :By “The IDD Control
Programme’’.
 No state in India can be said to be entirely free from goitre.
IODIZATION: Mild increase in THYROTOXICOSIS.
THANK YOU