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emic goitre and iodine deficiency
Endemic goitre and iodine deficiency
– G oit r e is a n e n la r ge m e n t of t h e t h yr oid gla n d . E n d e m ic goit r e oc c u r s in
iod in e -
d e fic ie nt a r e a s . G oitr e c a n a ls o be c a u s e d or a ggr a v a te d by the r e gu la r
c ons u m p tion
of goitr oge ns s u c h a s m a nioc , c a bba ge , tu r nip s , m ille t e tc .
– G oit r e is a n a d a p t iv e p r oc e s s : iod in e is e s s e n t ia l for t h e p r od u c t ion of
t h yr oid
hor m one s ; iod ine d e fic ie nc y im p a ir s thyr oid hor m one s ynthe s is ; to c om p e ns a te ,
the
thyr oid gla nd inc r e a s e s in v olu m e . T hyr oid fu nc tion u s u a lly r e m a ins nor m a l.
– A s w e ll a s th e d e v e lop m e n t of goit r e , iod in e d e fic ie n c y in p r e gn a n t w om e n
ha s
s e r iou s c on s e q u e n c e s for t h e c h ild ( foe t a l a n d p e r in a ta l m or ta lit y,
p h ys ic a l a n d
m e nta l r e ta r d a tion, c r e tinis m ). T he s e r is ks m u s t be p r e v e nte d by p r ov id ing
iod in e
s u p p le m e nta tion in iod ine -d e fic ie nt a r e a s .
Clinical features
– T he W H O p r op os e s a s im p lifie d c la s s ific a tion ba s e d on the s ignific a nc e of
goitr e :
G r ou p 0 : nor m a l thyr oid , no p a lp a ble or v is ible goitr e
G r ou p 1 : e nla r ge d thyr oid , p a lp a ble bu t not v is ible w he n the ne c k is in the
nor m a l
p os ition
G r ou p 2 : thyr oid c le a r ly v is ible w he n the ne c k is in the nor m a l p os ition
– P os s ible m e c ha nic a l c om p lic a tions (r a r e ): c om p r e s s ion, d e v ia tion of the
tr a c he a or of
the oe s op ha gu s .
Prevention and treatment O r a l iod is e d oil
P op u la tion a s a s ingle ye a r ly d os e
T h e obje c t iv e of p r e v e n tion i(s2 t0o0r emdguc ca ep stuhlee )c on s e q u e n c e s of iod in e
d e fic ie n c y in
n e on a te s a nd c h ild r e n . Su p p lying iod is e d s a lt t hr ou gh na t ion a l p r ogr a m m e s
is th e
r e c om m e nd e d m e thod of p r e v e ntion.
F or p r e v e ntion in p op u la tions liv ing in iod ine d e fic ie nt a r e a s w he r e iod is e d s a lt
is not
a v a ila ble a nd for c u r a tiv e tr e a 2tmc ea nptsouf lpeas tie nts w ith goitr e4: 8u0s me gio(d1ismedl)oil,
a c c or d ing to
na tiona l p r otoc ols . F or infor m a tion (a c c or d ing to the W H O ):
C hild r e n u nd e r 1 ye a r 1 c a p s u le IM iod is e d oil,
2 c a p s u le s e v e r y 2 ye a r s
C hild r e n fr om 1 to 5 ye a r s 3 c a p s u le s u s ing a gla s s s yr inge
(4 8 0 m g/ m l a m p ou le )
C hild r e n fr om 6 to 1 5 ye a r s
2 4 0 m g (0 .5 m l)
P r e gna nt or la c ta ting w om e n
or w om e n of c hild be a r ing a ge 4 8 0 m g (1 m l)
4 8 0 m g (1 m l)
Endemic goitre and iodine deficiency
– G oit r e is a n e n la r ge m e n t of t h e t h yr oid gla n d . E n d e m ic goit r e oc c u r s in
iod in e -
d e fic ie nt a r e a s . G oitr e c a n a ls o be c a u s e d or a ggr a v a te d by the r e gu la r
c ons u m p tion
of goitr oge ns s u c h a s m a nioc , c a bba ge , tu r nip s , m ille t e tc .
– G oit r e is a n a d a p t iv e p r oc e s s : iod in e is e s s e n t ia l for t h e p r od u c t ion of
t h yr oid
hor m one s ; iod ine d e fic ie nc y im p a ir s thyr oid hor m one s ynthe s is ; to c om p e ns a te ,
the
thyr oid gla nd inc r e a s e s in v olu m e . T hyr oid fu nc tion u s u a lly r e m a ins nor m a l.
– A s w e ll a s th e d e v e lop m e n t of goit r e , iod in e d e fic ie n c y in p r e gn a n t w om e n
ha s
s e r iou s c on s e q u e n c e s for t h e c h ild ( foe t a l a n d p e r in a ta l m or ta lit y,
p h ys ic a l a n d
m e nta l r e ta r d a tion, c r e tinis m ). T he s e r is ks m u s t be p r e v e nte d by p r ov id ing
iod in e
s u p p le m e nta tion in iod ine -d e fic ie nt a r e a s .
Clinical features
– T he W H O p r op os e s a s im p lifie d c la s s ific a tion ba s e d on the s ignific a nc e of
goitr e :
G r ou p 0 : nor m a l thyr oid , no p a lp a ble or v is ible goitr e
G r ou p 1 : e nla r ge d thyr oid , p a lp a ble bu t not v is ible w he n the ne c k is in the
nor m a l
p os ition
G r ou p 2 : thyr oid c le a r ly v is ible w he n the ne c k is in the nor m a l p os ition
– P os s ible m e c ha nic a l c om p lic a tions (r a r e ): c om p r e s s ion, d e v ia tion of the
tr a c he a or of
the oe s op ha gu s .
Prevention and treatment O r a l iod is e d oil
P op u la tion a s a s ingle ye a r ly d os e
T h e obje c t iv e of p r e v e n tion i(s2 t0o0r emdguc ca ep stuhlee )c on s e q u e n c e s of iod in e
d e fic ie n c y in
n e on a te s a nd c h ild r e n . Su p p lying iod is e d s a lt t hr ou gh na t ion a l p r ogr a m m e s
is th e
r e c om m e nd e d m e thod of p r e v e ntion.
F or p r e v e ntion in p op u la tions liv ing in iod ine d e fic ie nt a r e a s w he r e iod is e d s a lt
is not
a v a ila ble a nd for c u r a tiv e tr e a 2tmc ea nptsouf lpeas tie nts w ith goitr e4: 8u0s me gio(d1ismedl)oil,
a c c or d ing to
na tiona l p r otoc ols . F or infor m a tion (a c c or d ing to the W H O ):
C hild r e n u nd e r 1 ye a r 1 c a p s u le IM iod is e d oil,
2 c a p s u le s e v e r y 2 ye a r s
C hild r e n fr om 1 to 5 ye a r s 3 c a p s u le s u s ing a gla s s s yr inge
(4 8 0 m g/ m l a m p ou le )
C hild r e n fr om 6 to 1 5 ye a r s
2 4 0 m g (0 .5 m l)
P r e gna nt or la c ta ting w om e n
or w om e n of c hild be a r ing a ge 4 8 0 m g (1 m l)
4 8 0 m g (1 m l)
