Transcript The Story of Iodine Deficiency Disorders in India

IODINE
DEFFICIENCY
DISORDERS
SREERAJ.V.T
JR.HEALTH INSPECTOR
PHC UDAYAGIRI
Iodine deficiency disorders:
A public health problem
Worldwide distribution
What is iodine
&
what is iodine
deficiency?
What is iodine?
 Nutrient needed in a
minute quantity daily.
Recommended daily intake:
150 μg (Micronutrient)
 Total quantity present in body
is (15-20 mg)
mostly in thyroid gland
What is iodine?
 Iodine: Essential component of
thyroid hormones,
which are needed for:
- Optimal mental & physical development
- Regulation of body metabolism
(Generation & utilization of body energy)
Iodine : Daily requirements
Age Group
Iodine Requirement
(µg/day)
0 – 11 months
50
12 – 59 months
90
6 – 12 years
120
> 12 years
150
Pregnant & Lactating
Women
200
[WHO, UNICEF, ICCIDD: Recommended iodine levels in salt and guidelines for
monitoring their adequacy and effectiveness. WHO/NUT/96.13. Geneva. 1996 ]
Sources of iodine
 Food is the main source of iodine
 Meat, fish & dairy products
 Vegetables, cereals
 High amounts in sea fish & seaweeds
Sea salt is a poor source of iodine
Iodine deficiency – Disease of
the soil
Gradual leaching of iodine from soil due to:
Floods
Melting of Glaciers
Rivers changing course
Iodine deficiency :
A disease of the soil
SOIL EROSION
:
Low Availability
of iodine
Effect on animals
Effect on people
WATER, SOIL
:
:
:
Environmental iodine
deficiency
PLANTS
Iodine poor feeds &
fodders, goitrogens
LIVESTOCK
Clinical & Reproductive
disorders,
Decreased productivity
HUMANS
Health &
Socio - economic
impact
What are the
consequences of
iodine deficiency?
Effects on humans:
Fetus
Mortality
 Spontaneous abortions & stillbirths
 Increased perinatal mortality
Disability




Birth defects
Defects of speech & hearing
Psychomotor defects
Cretinism
Effects on humans:
Neonate
Mortality
 Increased neonatal mortality
Morbidity
 Neonatal Goiter
 Neonatal Hypothyroidism
(Decreased production of thyroid hormones at
birth)
Effects on humans:
Children & adolescents
 Goiter
 Hypothyroidism
 Retarded physical development
 Impaired mental function (13 IQ points)
Effects on humans: Adults
 Goiter & its complications
 Hypothyroidism
 Impaired mental function
 Iodine induced
hyperthyroidism (IIH)
Effects on livestock
 Goiter
 Hypothyroidism
 Reproductive disorders
 Decreased productivity
(Milk, meat, wool, eggs)
Goiter in animal
 Lower work output
Importance of iodine in
brain development  50,000 brain cells
produced/second
in developing
fetal brain
 100 billion brain cells in
adult
 One million billion
connections between
these brain cells:
Determine IQ
100 billion brain
cells in adult
human
Comparable to the
number of stars in the
sky
Brain Cell Growth
Iodine Deficiency Iodine Sufficiency
Iodine Deficiency is the single most
common cause of preventable mental
retardation
Brain cell branching
• Diminished brain cell branching due to iodine deficiency
• Diminished branching  Less connections  Lower IQ
Importance of iodine in
brain development
90 % of human brain development occurs between
3rd month of pregnancy & 3rd year of life
(Critical period)
Deficiency of iodine during this critical period of development results in
permanent brain damage
 This brain damage can primarily be prevented by correcting iodine
deficiency before & during pregnancy
 This makes it vital
that all expectant
& lactating mothers
get their
daily requirement
of iodine
 Iodine deficiency is
single most common
cause of mental
handicap worldwide
 It is totally
preventable
Spectrum of IDD
Goiter
Cretinism
Spontaneous Abortions,
Stillbirths,
Birth Defects
Defects of Speech & Hearing,
Squint,
Psychomotor defects
Loss of 13 IQ points,
Leading Cause of Mental handicap
Thyroid Hormones
triiodothyronine (T3)
thyroxine (T4)
Thyroid-stimulating hormone
(TSH or thyrotropin)
Hypothyroidism is
a state in which
the thyroid gland
does not make
enough thyroid
hormone.
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Cold intolerance, increased sensitivity to cold
Constipation
Weight gain and water retention
Bradycardia (low heart rate – fewer than sixty beats per
minute)
Fatigue
Decreased sweating
Muscle cramps and joint pain
Dry, itchy skin
Thin, brittle fingernails
Rapid thoughts
Depression
Poor muscle tone (muscle hypotonia)
Female infertility; any kind of problems with menstrual
cycles
Hyperprolactinemia and galactorrhea
Elevated serum cholesterol
Goiter has been known since the
days of Lord Buddha and before
Earliest evidence of goiter: 3000 BC
Goiter
Goiter is a swelling of the thyroid gland
is painless
not a cause of death
has been perceived as a
cosmetic problem only
Cretinism
Iceberg of IDD
1% - 10%
Cretinism
5% - 30%
Some brain damage
30% - 70%
Loss of energy due to hypothyroidism
High risk groups:
 - Pregnant & lactating
women
 - Pre-school children
Our primary concern
 Every population should
&
 Every mother & child must
Get their daily supply of iodine
Iodine consumption on daily
basis for all times to come
 Daily requirement of iodine per person
is 150 µg – fits on the tip of hair !
 Lifetime requirement for 70 years is 5 gms – one
teaspoonful !
 However, this daily requirement
has to be met daily, for all times to come
 “Daily consumption of adequately
iodized salt is a healthy habit”
Vehicle for iodine : Salt
 One food item consumed every day,
by everybody in fixed quantities
 Rich or poor, urban or rural area,
man or woman, child or adult
 Average daily consumption in India
per person is 10 gm
 Iodization of salt is a simple process
 Cost of salt iodization is :
10 paise/person/year
What is Iodated Salt?
 Iodated salt is common salt containing
minute quantities of an iodine compound
 Iodated salt looks, tastes and smells exactly
like ordinary salt.
 The Govt. of India has issued notification
banning the salt of non iodized salt for
direct human consumption with effect from
17th May, 2006.
Iodized salt – The panacea
for iodine deficiency
Salt production and iodization
(Supply)
Promotion of Iodized Salt Consumption
(Demand)
Universal Salt Iodization
 In 1983, Government of India took
policy decision to iodize all salt meant for human
consumption
– Universal Salt Iodization (USI)
 Private sector was permitted and encouraged to
produce iodized salt
 “Elimination of goiter” was included in Prime
Minister’s 20-point National Development
Program
India & China
Iodized salt coverage <80%
Iodized salt coverage >80%
The Dandi March
Daily consumption of adequately
iodized salt is a healthy habit
Thank You!
For
Towards
Sustainable
Elimination of IDD