By Dr Akanksha Parikh
On this World Iodine Deficiency Day let us revisit the role iodine plays in a child’s well-being. Iodine is an essential micronutrient, needed by the thyroid gland of our body to produce thyroid hormones. These hormones play a pivotal role in a child’s overall growth and mental development, as well as the smooth functioning of the various organs of the body such as heart, brain and muscles.
Low content of iodine in the Indian population is mainly due to deficiency of iodine in the soil and therefore the food derived from it. Iodine deficiency disease is the largest cause of preventable brain damage and often associated with serious medical consequences such as stillbirth, infantile death, as well as permanent neurological damage in a child. It also leads to a condition called hypothyroidism or reduced functioning of the thyroid gland.
The recommended daily requirement of iodine intake is age-dependent that varies between 250 micrograms per day in a pregnant or lactating woman, to 90 micrograms per day in a child up to five years of age. In 1997, acknowledging the importance of iodisation, the Indian government had banned the sales of non-iodised salt. Today, iodised salt is the highest source of iodine in the diet. Each gram of iodised salt provides 15 micrograms of iodine. According to the latest National Iodine and Salt Intake survey, almost 25 per cent of Indians, especially from rural households still consume inadequately iodised salt. One should look for the ‘smiling sun’ logo which signifies governmental certification of iodisation, on a salt packet before buying and consuming table salt.
A newborn depends on its mother’s milk to provide an adequate supply of iodine. Thus, iodine deficiency in the lactating mother can affect the baby, putting it at risk for hypothyroidism. Signs of hypothyroidism in the newborn include poor feeding, jaundice, excessive sleepiness and constipation. However, these signs may often be missed, leading to a delay in diagnosis and initiation of treatment. Failing to treat within the first few weeks of life can result in irreversible intellectual disability in the child. To prevent this, every newborn should undergo a screening blood test for hypothyroidism between the 3rd to 5th day after birth. It also helps to recognise and treat hypothyroidism early in infants ensuring normal brain growth.
Iodine deficiency can also cause hypothyroidism in older children resulting in poor growth, constipation, lethargy, poor school performance and goitre. Additionally, puberty and reproductive functions in adolescents as well as adults can be affected.
The treatment of hypothyroidism is simple and involves daily medication and long-term follow up with specialists in the field of hormonal imbalances in children or paediatric endocrinologists. Most children require long-term treatment which if taken correctly enables them to grow to their genetic potential and live a normal life.
With the global attention focussed on battling the ongoing COVID-19 pandemic, let us not forget that iodine deficiency is also a serious public health problem that needs to be addressed. A diet rich in seafood, dairy products and vegetables like onions and sweet potatoes provides supplemental sources of iodine. Further, simple measures such as the use of iodised salt can help prevent iodine deficiency and hypothyroidism in women, infants and children and the resultant intellectual disability.
(The writer is Consultant Paediatric Endocrinology, Kokilaben Dhirubhai Ambani Hospital)
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