IODINE
Goiter has been known since the days of Lord
Buddha and before
Earliest evidence of goiter: 3000 BC
Framework
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History
Sources of iodine
Mechanism
Daily requirements
Spectrum of IDD
Assessment of iodine
National Iodine deficiency disorders control
program
HISTORY
• In 1811 Bernard Curtois discovered
iodine.
• During that time Napoleon’s army
needed larger quantity of the
gunpowder.
• The basic component of the gunpowder
was niter, which production requires
bigger amount of wooden ashes.
• Since the war lasted for a long time, and
woods eligible for logging, burning and
making gunpowder were disappearing
fast, so seaweeds were burned.
• Making niter, Curtois accidentally added
too much of sulfuric acid, and purple
cloud of condensated gas has shown on
the radiator, forming glistening crystals.
BERNARD CURTOIS
• Curtois realized that he
has created something
new and started to
examine that.
• Governmental resources
were overloaded by
Napoleon’s wars, so there
was no money for further
experiments.
• Finally Humphry Davy on
December 10th in 1813
named this element
IODINE after Greek word
“purple color ”.
HUMPHRY DAVY
What is iodine?
• Iodine is an essential micronutrient supporting some of the
most vital functions of the human body.
• Iodine is a nutrient needed in a minute quantity daily.
Recommended daily intake: 150 μg
• Total quantity present in body is (15-20 mg)
mostly in thyroid gland
Mechanism of formation of thyroid harmones
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
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Vegetables grown on iodine-rich soils.
Seafood
Dairy products
Eggs
Cereal grains
Legumes
Green leaves(spinach)
Water
Loss of iodine
Iodine deficiency is endemic in the
mountainous areas with poor soil content such
as the sub-Himalayan regions. This is due to
iodine being washed from the soil.
GOITROGENS
The spectrum of IDD
Assessment of iodine nutrition
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Thyroid size by palpation and/or by ultrasonography,
Urinary Iodine (UI) excretion
Neonatal serum TSH screening for hypothyroidism
Serum thyroglobulin concentation.
National iodine deficiency disorders
control program
• Following the successful trial of iodised salt in
Kangra valley, Himachal Pradesh in 1962, India
has launched 100% centrally sponsored the
National Goitre Control Programme.
• In 1992, the National Goitre Control
Programme (NGCP) was renamed as National
Iodine Deficiency Disorder Control
Programme(NIDDCP).
Objectives
1.Surveys to assess the magnitude of the Iodine Deficiency
Disorders.
2.Supply of Iodated salt in place of common salt.
3.Resurvey after every 5 Years to assess the extent of Iodine
Deficiency Disorders and the impact of iodated salt.
4.Laboratory monitoring of iodated salt in urinary iodine
excretion.
5.Health education.
Strategies:
The recommended strategy for IDD control is based on
correcting the deficiency by increasing iodine intake
through supplementation or food fortification.
Iodine supplementation
The first iodine supplements
were in the form of an oral
solution of iodine such as
Lugol, which was given daily.
After the Second World War,
considerable progress was made
in reducing IDD with iodized oil –
initially using the intramuscular
form and in the 1990s, using the
oral form
• The oral form of iodized oil has several advantages
over the intramuscular form:
 it does not require special storage conditions or
trained health personnel for the injection
 it can be given once a year.
• Compared to iodized salt, however, it is more
expensive and coverage can be limited since it
requires direct contact with each person.
• With the introduction of iodized salt on a large
scale, iodized oil is now only recommended for
populations living in severely endemic areas with no
access to iodized salt.
Food fortification with iodine
• The World Health Assembly adopted universal salt iodization
(USI) as the method of choice to eliminate IDD.
• In 2002, at the Special Session on Children of the United
Nations (UN) General Assembly, the goal to eliminate IDD by
the year 2005 was set.
• USI was chosen as the best strategy based on the following
facts:
 Salt is one of the few commodities consumed by everyone
 Salt consumption is fairly stable throughout the year
 Salt production is usually in the hands of few producers
 USI is easy to implement & available at a reasonable cost
 The addition of iodine to salt does not affect its colour, taste
or odour
 The quality of iodized salt can be monitored at the
production, retail and household levels
 Salt iodization programmes are easy to implement.
• In order to meet the iodine requirements of a
population it is recommended to add 20 to 40 parts
per million (ppm) of iodine to salt (assuming an
average salt intake of 10 g per capita/day) .
• There are two forms of iodine fortificants,
Potassium iodate
Potassium iodide.
• Pottasium iodate is more stable under extreme
climatic conditions it is preferred to iodide, especially
in hot and humid climates .
• North America and some European countries use
potassium iodide while most tropical countries use
potassium iodate.
Criteria for monitoring process towards sustainable IDD elimination
References
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WHO, UNICEF, ICCIDD. Assessment of iodine deficiency disorders and monitoring their
elimination. Geneva, World Health Organization, 2001 (WHO/NHD/01.1).
• Walter F, Boron . "SYNTHESIS OF THYROID HORMONES" in: Medical Physiology: A
Cellular And Molecular Approach. Elsevier/Saunders.2003.48 :1300. Available
from ISBN 1-4160-2328-3
• http://www.nihfw.org/NDC/DocumentationServices/NationalHealthProgramme/NATIO
NALIODINEDEFICIENCYDISORDERS.html
• Government of Maharashtra, public health department. Directorate of health services
http://www.mahaarogya.gov.in/projectandschemes/default.htm
• Iodine status worldwide .WHO Global Databaseon Iodine Deficiency.2004
• Andersson M et al .Global Iodine Status and Trends over the Past Decade .2011.
Thank you