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Iodine Deficiency Disorder
- 2. Iodine - essentialtrace element. In the body - minute amount (normally 20-30 mg) . 80% (15 milligrams in adult) of the iodine -in the thyroid gland for the synthesis of several thyroid hormones.
- 3. The remainder -distributed throughout other tissues, like mammary, salivary, gastric glands and in the kidneys. Within the circulation iodine occurs as free iodine ion or as protein-bound iodine. Excretion - in urine and small amount in feces.
- 4. SOURCES OF IDD 40%cereals 37% milk & milk products 2% vegetables 10% pulses 11% flesh foods 16% water
- 5. FOODS REGION µg/100g GOITROUS NON- GOITROUS BAJRA26 42 SOYA BEAN 4 49 GROUNDNUT 14 47
- 6. FUNCTIONS INCREASE BRAIN CELL PROLIFERATION CONVERTS CAROTENE TO VITAMIN-A SYNTHESIS PROTEIN& ABSORB CARBOHYDRATE SYNTHESIS T3 & T4 REGULATES GROWTH & DEVELOPMENTAL HORMONES STIMULATE METABOLIC RATE BY 30% NORMAL DEVELOPMENT OF BRAIN ESSENTIAL FOR REPRODUCTION
- 7. Dietary iodide Small intestine Blood 1/3 rd iodine- thyroid gland Remainin g- kidney Prevents accumula tion Residues of tyrosine+ oxidized iodide Iodine levelfalls Hypothal amus- TRF - Plasma TRF- pituitary gland & stimulate TSH TSH- thyroid gland Stimulate enzyme producti on Release tyrosine residues from protein Residues to T3 & T4 into plasma Regulate energy releasing Overall metabolic rate
- 8. CATEGORY µg/100g INFANTS 90 CHILDREN(1-5+) 90 SCHOOL GOING (6-11+) 120 ADOLESCENTS > 12 150 ADULTS 150 PREGNANCY 200 LACTATION 200 (SOURCE: ICMR- Recommended Dietary Allowances of iodine- 2010)
- 9. * Excess intake-harmful, causing inhibition of thyroid hormone ‘s synthesis. * Generally- neonatal chemical hypothyroidism in women receiving higher doses of iodine in pregnancy as iodized oil ingestion * Low intake- brain cell damage, still births, goiter, cretinism, impaired mental function, retarded physical growth, hypothyroidism, psychomotor defects.
- 10. FOODS METHODS OFCOOKING NUTRIENT LOST (%) Iodine containing foods frying 20 Iodine containing foods grilling 23 Iodine containing foods Boiling 58 Cereals boiling 30-60 vegetables frying 25-52 Iodine containing foods steaming 30 fish Frying or grilling 20
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- 12. Popularly knownas IDD WHO- Recognized it as the preventable cause of brain damage in the world. major global public health problem 1.5 billion population- risk of IDD out of which, 200 million in India Developed countries- virtually eliminated by prophylaxis programmes.
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- 18. Substances thatinterfere with iodine metabolism at various stages of thyroid hormone homeostasis. Inhibition of any of these hormones- disturbs hormonal balance & leads to iodine deficiency. Depending on the level of interference, it is categorized as follows:
- 20. Rare congenital defects-in hormone synthesis & secretion & peripheral resistance to thyroid hormones & also result in goiter
- 21. Goiter Loss of 13IQ points, Leading Cause of Mental handicap Cretinism Spontaneous Abortions, Stillbirths, Birth Defects Defects of Speech & Hearing, Squint, Psychomotor defects
- 22. IDD Problem Pyramid 1%-10% 5%- 30% 30% - 70% Goitre & Cretinism Some brain damage Less active population due to decreased thyroid function (hypothyroidism) • It's worldwide major public health problem. Globally 1.5 billion- risk of Iodine deficiency disorders. • The pyramid shows the visible effects of Iodine Deficiency Disorders (IDD) Goitre and Cretinism account only for 1--10% of these, • Whereas 90% of the effects remain hidden.
- 26. GRADE SIGNS &SYMPTOMS GRADE 0 Not palpable or visible goitre. GRADE 1 Palpable but not visible goitre. GRADE 2 Visible, Swelling of neck & enlargement of goitre.
- 29. NEUROLOGICAL CRETINISM • Mentalretardation, deaf mutism, squint, spastic displegia, spastic rigidity- forms gait & brisk reflexes. • Affects cochlea & brain development. • Low iodine intake- pregnancy: physically or mentally retarded children.
- 30. Iodine Deficiency IodineSufficiency “Iodine Deficiency is the single most common cause of preventable mental retardation”
- 31. MYXEDEMATOUS CRETINISM •Coarse &dry skin, swollen tongue, deep hoarse voice, apathy, skeletal growth retardation, deaf- mutism . • predominant- Goitrogens containing foods like tapioca, sorghum, finger millets, sweet potato, soya beans, almonds, groundnuts etc., are used in excess.
- 32. IDD – TheHourglass Historic View Current View Iodine Deficiency = Goitre = Visible Swelling No Pain = Not a cause of Mortality = Cosmetic problem Cretinism rare Mental & Physical growth Loss of Energy-hypothyroidism Learning Disability, Poor Motivation Child Development and Child Survival
- 33. PREVALENCE OF GOITRE PREVALENCE OF CRETINISM URINARYIODINE EXCRETION MEASUREMENT OF THYROID FUNCTION PREVALENCE OF NEONATAL HYPOTHYROIDISM