Questions on Iodine Deficiency Disorders:
It is now known the one out of every five people in India lives in identified iodine-deficient areas and is at a risk of being affected by Iodine Deficiency disorders. These disorders, all caused by a lack of iodine in the diet, can range from goiter, mental retardation and physical sub normality to cretinism. The majority of these disorders are permanent and incurable. However, each one of them us completely preventable. Iodated salt, consumed daily, offers complete protection against all iodine deficiency disorders, at an annual cost per person that is less than the price of a cup of tea.

To enable everyone to include iodine in their daily diet, a number of salt iodations plants have been set up and in the near future iodated salt will be available in every town and village of India.

Here we have some common questions about iodine deficiency.

1. What is Iodated (Iodised) Salt?
Iodated or iodised salt is used to prevent iodine deficiency. It is common salt containing minute quantities of an iodine compound. Iodated salt looks, tastes and smells exactly like ordinary salt and it should be used in the same way.

2. What is iodine?
Iodine is a natural element which is essential to human life. It is an essential nutrient. Some of the vital functions of the human body depend upon a steady supply of iodine.

3. Why is iodine so important?
Iodine is essential for the normal growth, development and functioning of both the brain and body. A lack of iodine can give rise to a goiter and make a person dull, listless and easily tired. Such a person is less active than a normal individual.

But more importantly, without enough iodine, a new bornís brain and body can become permanently retarded and stunted. Iodine is vitally needed during early childhood, puberty and pregnancy. A woman who is deficient in iodine is likely to produce an abnormal child. If left untreated, the childís mental and physical condition worsens a he grows older.

4. How much Iodine does a person normally need?
The average daily requirement of an adult is 150 micrograms a day, an amount so small that it could fit on to a pinhead (1,000,000 micrograms Ė 1 gm). An average lifetimeís requirement of an individual would add upto less than a teaspoonful. However, it is important that the body gets this Iodine regularly every day. This is why it must form part of every personís daily diet.

5. From where do we normally get Iodine?
Iodine is present in its natural state in the soil and in water. So our normal requirement comes from crops grown on iodine-rich soil. But when the soil of any area lacks iodine, the crops too are deficient in this essential nutrient. Consequently, those people who live on iodine-deficient land and eat its crops regularly, do not get their daily requirement of this essential element.

6. What happens if a person does not get enough Iodine?
Goiter is only one of the many consequences of iodine deficiency. A number of physical and mental abnormalities, some serious, some mild, result from iodine deficiency. 

7. What exactly is a Goiter?
A goiter is a swelling of the neck caused by an enlarged thyroid gland. When the body does not get enough iodine, the thyroid increases in size. Not all goiters are visible. Many of them, particularly in the early stages can be detected only by an experienced doctor. It is only when goitre grows quite large that it can be seen and recognised by everyone. A person with a goiter may also have other hidden iodine deficiency disorders.

8. What are Iodine Deficiency Disorders (IDD)?
Iodine Deficiency Disorders (IDD) form a spectrum of abnormalities which include goiter, mental retardation, deaf mutism, squint, difficulties in standing or walking normally and stunting of the limbs. Iodine-deficient women frequently suffer abortions and still births. Their children may be born deformed, mentally deficient or even cretins. All these problem are caused by a simple lack of iodine and goiter is the least tragic of them.

9. Why does a child become a Cretin?
A baby growing in the motherís womb needs a steady supply of iodine for the normal growth and development of its brain and body. Only the motherís body can provide this essential iodine. But if the mother is iodine-deficient, the child too is deprived of this much-needed nutrient. If the womanís deficiency is serve, the childís brain and body are seriously and permanently stunted and he becomes a cretin, unable to walk, talk or think normally. If the motherís deficiency is minor, the child will still be affected, even though he may look normal. The damage to his brain usually shows up years later in poor school performance and an inability to perform normal, everyday tasks. Millions in our country suffer from this form of iodine deficiency and it affects the social and economic progress of whole regions.

10. Where does IDD occur in India?
The areas of severest iodine deficiency lie in the great sub-Himalayan belt that extends from Jammu and Kashmir, all along North India, to the North East, covering an area of 2500 square kms. But IDD has also been reported from Maharashtra, Gujarat, Madhya Pradesh, Andhra Pradesh, Orissa, Karnataka, Kerala, Tamilnadu, Goa, Rajasthan, West Bengal and Delhi. In fact, no state in India is free from IDD and new pockets of iodine deficiency are being discovered every day.

11. Can the daily consumption of Iodated Salt cure Goitre, Cretinism and other Iodine Deficiency Disorders?
Cretinism is permanent and incurable. Like many other iodine deficiency disorders, with the exception of certain types of goiter, it cannot be cured but it can be easily prevented before it occurs. The regular consumption of iodated salt provides protection to present and future generations against the tragic consequences of iodine deficiency disorders.

12. Are there is special food that I can eat which are rich in Iodine?
Except for certain types of seaweed, there are no foods that are inherently rich in iodine. All food derives its iodine from the soil on which it grows. If the soil is poor in iodine all the food grown on it will be low in iodine. Therefore in areas of iodine deficiency, the only way to ensure a steady intake of essential iodine is by adding it to the diet in the form of iodated salt.

13. Why is Iodine added to salt? Canít it be taken separately, like medicines?
An important fact about iodine is that although it is needed in tiny amounts, it is needed regularly, every day. While it could be taken every day like medicine or a vitamin tablet, this would involve taking a tablet every day for the rest of your life. Salt, however, is something that we all use every day. All of us roughly the same amount of salt 10 to 15 grams a day, and if it is iodated, we automatically get the right amount of iodine.

14. But if I live in an area that is not Iodine-deficient, wonít the extra Iodine in the salt harm me?
No, it will not. All of us need only a certain amount of iodine to function normally. If this iodine is already available to the body, it will simply reject any additional quantities and excrete it unused through the urine. On the other hand, if you are deficient in iodine, your thyroid gland will use as much iodine as it needs and reject the rest. This makes iodated salt safe for everyone.

Remember iodine is an essential nutrient Ė not a medicine 

15. Can Iodated Salt be used by pregnant women, very young children or someone who is ill? Is it like ordinary salt?
Yes. Every person young, old, sick or healthy needs iodine every day. Pregnant women and young children need it even more than others, so it is not only safe but also necessary for them to use iodated salt every day.

16. How can I tell if salt contains Iodine?
Sale of non-iodated salt has been banned in UP., Bihar, Himachal Pradesh, J & K, Punjab, Haryana, Chandigarh, Delhi, Sikkim, Assam, Arunachal Pradesh, Mizoram, Meghalaya, Manipur, Nagaland, Tripura, part of West Bengal, Part of Maharashtra, Part of Gujarat, Dadra and Nagar Haveli and part of Madhya Pradesh. A low cost testing kit is available which allows you to test for the iodine content of the salt on the spot.

17. Is it possible to used Iodated Salt for livestock?
Yes. Iodated Salt improves the health and productivity of animals and reduces the number of still births and miscarriages. Also, cattle who are fed iodated salt produce milk that is rich in Iodine.

18. Can Iodated Salt be stored like normal salt?
Storing iodated salt involves a few precautions. The iodine in the salt can be destroyed by prolonged exposure to direct sunlight and moisture. Therefore, store the salt in an airtight container made of plastic, wood, glass or clay, with a well-fitting lid. Make sure you consume iodated salt as early as possible.

19. What should I do if I cannot find Iodated Salt in my local market?
The Government of India has decided to make iodated salt available in a phased manner all over the country by 1992. If your local market does not stock this salt, write to the nearest Salt Commissionerís Office, the address of which is given on the last page of this booklet. Manufacturers are starting to use the Iodine Namak logo on bags and packets of salt. When you by salt look for this logo. Insist on iodised salt.

20. How long will I have to keep using iodated salt?
If you live in an iodine-deficient environment, there is no likelihood of the deficiency being corrected at the source, namely, in the soil. On the contrary, the increase degradation of our environment is making the problem wore. Large scale deforestation, among other things, has led to increase flooding and erosion of the top soil, which carries away the precious iodine. With the environmental deficiency growing, worse day by day, iodine supplementation will have to become part of our everyday lives. Most Europe and America have been iodating salt continuously since the 1920ís for this is the only safe, long term answer to a problem that threatens the physical and mental well-being of millions of unsuspecting people. Using Iodated salt every day is the only way to protect yourself and your children from the tragic and completely preventable effects of iodine deficiency. It is a small investment towards helping your children to get the best chance to grow up with sound minds in healthy bodies.
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