The central government on Tuesday informed Rajya Sabha that no state in the country is absolutely free from the Iodine Deficiency Disorders (IDD) problem. While responding to a question by an MP Dr. Ashok Kumar Mittal, Dr. Mansukh Mandaviya, Union Minister of Health and Family Welfare said that to prevent and control Nutritional Iodine Deficiency Disorders (IDDs), most commonly Nutritional Goitre, the government is implementing National Iodine Deficiency Disorders Control Programme (NIDDCP) in the country.
“The goals under the programme are to bring the prevalence of IDD to below 5 percent in the country and to ensure 100 percent consumption of adequately iodated salt (15ppm) at the household level,” the Minister said while responding to the question on Tuesday.
In 1962, the government launched the National Goitre Control Programme (NGCP) which renamed to National Iodine Deficiency Disorders Control Programme (NIDDCP) in 1992 with a view of a wide spectrum of Iodine Deficiency Disorders like mental and physical retardation, deaf mutism, cretinism, stillbirths, abortions among others. In 2005, universal salt iodisation was made mandatory in the country. According to doctors and health experts, iodine is a crucial micronutrient that is required daily at 100-150 micrograms for normal human growth and development.
“Iodine is a trace element which is a halogen by chemical compound and it is a very important component of the thyroid hormones. So without it, the hormones cannot be formed and can lead to a deficiency of thyroid hormone, called hypothyroidism. So that is the reason iodine is very important and realizing this, the government has fortified salt with iodine,” Dr. Abhay Ahluwalia – Endocrinologist, Manipal Hospitals, Gurugram told Financial Express.com.
According to the latest National Family Health Survey (NFHS-5), Daman and Diu and Dadra and Nagar Haveli and Andhra Pradesh have emerged as outliers, having the lowest consumption of iodized salt in the country.
The Union Minister also revealed that as per National Family Health Survey – 5 (2019-21), the prevalence of Goitre and any other thyroid disorders, based on self-reports in the women (15-49 years) was found to be 3 percent which is the national average.
“However, in the States of Kerala, Jammu & Kashmir, Chandigarh, Telangana, Delhi, Laddakh, West Bengal, Andhra Pradesh, Andaman & Nicobar Islands, Tamil Nadu and Puducherry, the prevalence of Goitre and any other thyroid disorders in women in the age 15-49 years was found to be in the range of 4.1 percent to 8.7 percent,” the Minister responded in Rajya Sabha on Tuesday.
What do experts say?
According to Dr. Ahluwalia, if the thyroid gland doesn’t work properly it can lead to various complications that can affect the whole body. If the body produces too many thyroid hormones it can lead to hyperthyroidism and when the body produces less than normal hormones it can lead to hypothyroidism.
“So iodine deficiency can ultimately result in iodine deficiency disorders i.e. hyperthyroidism. Till 1986, till the time the Universal Iodization Act came, iodine deficiency used to be very common. However, since 1989, there is very little prevalence of iodine deficiency in India now because the salt has been fortified. Most of the population already iodine, except for a few which may be there because of the environment and planning reasons we’ve got,” he added.
According to Dr. Arun Mukka, Consultant Endocrinologist, Yashoda hospitals Hyderabad, Iodine is a key constituent of the thyroid hormones T3 and T4 and iodine deficiency can cause hypothyroidism in people of all age groups.
“Thyroid hormones are essential for the normal growth and development of children. Iodine deficiency is the most common preventable cause of mental deficiency in the world,” Dr. Mukka told Financial Express.com.
Prevalence of iodine deficiency in India
According to a study published in the Indian Journal of Medical Research, in India, the entire population is prone to IDD due to a deficiency of iodine in the soil of the subcontinent and consequently the food derived from it.
“The entire population if you don’t fortify iodine, there is a higher risk for iodine deficiency. The test is very simple. You will have Urine-ID Test and there are certain labels which indicate whether the iodine deficiency is there in the population. As a mass screening, you can do iodine, urine sample of iodine status for the population that tells you what is the equivalent of iodine status of the population,” Dr. Ahluwalia told Financial Express.com.
Meanwhile, Dr. Mukka revealed that mountainous regions of the world including the northern Indian subcontinent have been endemic for iodine deficiency. The leaching effect of the rain, flooding and agriculture lead to the soil erosion, causing iodine depletion of the soil which cannot be corrected naturally.
“Crops produced in the iodine deficient soil are also iodine deficient. Iodine deficient communities are less educable and less economically productive posing a social and economic burden to the society. There is reduced school performance in children and reduced productivity in adults,” he said.
Moreover, Dr. Ahluwalia also highlighted that the prevalence of Hypothyroidism in India can be roughly around 8-12 percent of the population.
“So basically, we are iodine depleting population and we don’t have it. So people should be using iodine-fortified salt. So replacing it by non-iodised salt is not good and thyroid disorders are quite prevalent. So routinely there should be an annual screening of the thyroid, which will pick up the area of thyroid disorder,” Dr. Ahluwalia said.
Dr. Mukka highlighted that iodine deficiency disorders are among the easiest and least expensive of all nutrional disorders to prevent.
“Universal salt iodisation of the human salt including the salt used in the food industry is a safe, effective and sustainable strategy to ensure sufficient intake of iodine by all individuals, and is now recognised as the most effective way to achieve virtual elimination of iodine deficiency,” he added.