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RUSCHLIKON, SWITZERLAND. Iodine deficiency disorders (IDD), notably goiter (enlarged thyroid gland)
and hypothyroidism (inadequate production of thyroid hormone) are endemic in many parts of the
developing world and are even re-emerging in Australia and New Zealand. Fortifying table salt with iodine is
the simplest and most effective way of controlling IDD and 109 of the 130 countries affected by IDD now
have legislation in place or in draft form mandating iodization of salt. Unfortunately, salt iodization often falls
by the wayside in poor or politically unstable countries and this can have devastating effects, particularly on
children.
Researchers at the Swiss Federal Institute of Technology report that discontinuing salt iodization results in
the return of goiter and hypothyroidism within a relatively short period of time. Their study involved 159
Moroccan school children 10 years of age. The children had a high incidence of goiter (72%) and
hypothyroidism (3%) and a low urinary iodine level (18 microgram/L) at the start of the study. Following one
year of using iodized salt the prevalence of goiter had dropped to 44% and that of hypothyroidism to 1%.
Urinary iodine excretion had increased to 180 microgram/L. Salt iodization was then discontinued due to
financial constraints experienced in the small village where the children lived. Fourteen months after
discontinuation the prevalence of goiter had risen to 75%, that of hypothyroidism to 10% while urinary iodine
excretion had regressed to 20 microgram/L. The researchers conclude that children in IDD-affected areas
are highly vulnerable to even short-term lapses in salt iodization programs. Clearly, ensuring the
sustainability of iodization programs is one of the great remaining challenges in the global fight to eliminate
IDD.
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