IODINE DEFICIENCY DISORDERS (ANC-1)



Iodine is essential for synthesis of thyroxin hormone. Iodine can be obtained by consumption of food items that naturally contains iodine and water. Iodine Deficiency Disorders (IDD) arises out of inadequate dietary consumption of this trace element.Generally iodine deficiency is common in all over the world. In India cases of IDD was found in certain pockets of population in the Himalayan and Sub-Himalayan regions starting from Jammu and Kashmir in the northern part of the country to Nagaland in the Eastern end of the country. Recently alarming cases have been reported from other parts of the country as well. In the recent past, IDD have been reported from southern part of Vindhas from Maharashtra, Andhra Pradesh and Karnataka. In North India, Delhi has reported high number of IDD cases.

Iodine Deficiency include a wide range of disabling conditions that adversely affect the health of the person. There is so specific age group that is more prone to IDD, the ill effects of iodine deficiency can be observed in a unborn child to the adult population.

Causes:

Iodine enables the normal functioning of the endocrine gland, commonly knows as the thyroid gland. It is present in the base of the throat. The thyroid gland secretes a hormone called Thyroxin which plays vital role in the growth and development of humans mentally as well as physically. Iodine aides in the formation of thyroxin hormone in the thyroid gland; in absence or shortage of iodine, the thyroid glands become enlarged in order to produce thyroxin to fulfill body requirement.

Being a trace element, the requirement of iodine is very small; an adult requires only 150 μg of iodine for normal functioning of thyroid gland. Iodine requirement can be fulfilled through food and water; but areas which experience heavy rainfall and low temperatures are mostly deficient in iodine. Rains wash away iodine present in the soil. Crops grown in such regions are deficient in iodine as compared to the crops grown in areas where the soil is rich iodine.

Another reason for iodine deficiency is substances called goitrogens. These substances are present in vegetables like cabbage and radish. These gaitrogens restrict the utilization of iodine in the body. Excess consumption of these vegetables leads to iodine deficiency in the body.

Clinical Features:

Today, IDD is a global problem; it is associated with a wide range of conditions that affect the health of the human beings from their foetal stage to the stage of adulthood. Most recognizable and known form of Iodine deficiency is Goitre and Cretinism. Some of the manifestations of the iodine deficiency disorders are:

  • Goitre
  • Hypothyroidism
  • Cretinism
  • Subnormal Intelligence
  • Mental deficiency
  • Hearing problem
  • Squint in eyes
  • Spasticity
  • Muscle weakness
  • Spontaneous abortions and
  • Miscarriages
Goitre:

Goitre is a condition in which the thyroid gland enlarges in the event of iodine deficiency so that they can take in whatever little iodine is present in the body. The enlargement of this gland leads to visible swelling in the neck region. One can grade the severity of goiter on the basis of the size of swelling in the neck region. In some cases the swelling is so negligible that one needs to make the patient completely stretch the neck to observe the swelling; whereas in some cases neck becomes so protruding that one can even notice it from a distance. Goitre is more common in girls than in boys and maximum cases are seen in the adolescent girls. Generally it is noticed that patients with large goitre experience symptoms of choking, have difficulty in the breathing and swallowing.

Cretinism:

It is the most dreaded and severe form of iodine deficiency. Cretinism is the IDD which adversely affects the infants and young children. As we know that an iodine deficient mother transfers the deficiency to the fetus and the child born may suffer from hypothyroidism. Hypothyroidism during the critical period of development of the fetus may lead to permanent mental retardation. This mean deficiency of iodine can cause irreversible brain damage to the child even before its birth. This deficiency affects the mental development of the fetus. If this deficiency continues for longer time after the birth, a child may suffer from number of serious problems like mental retardation, stunned growth, lack of speech clarity, hearing defects, nerve and muscle disorders and in extreme cases paralysis. 

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