Goiter Prevalence Below Five Percent

Prevalence of goiter has been reduced to a large extent thanks to salt iodization programs over three decades.

Almost a quarter century ago, nearly 80% of the Iranian population suffered from goiter while its prevalence is less than 5% today, IRNA reported.

A goiter is a swelling of the neck or larynx resulting from enlargement of the thyroid gland. Worldwide, over 90% cases of goiter are caused by iodine deficiency, a lack of the trace element iodine, an essential nutrient in the diet. The best prevention method is adding small amounts of iodine to table salt, a product known as iodized salt.

Iodine deficiency resulting in goiter occurred in 187 million people globally as of 2010 (2.7% of the population). It resulted in 2,700 deaths in 2013 up from 2,100 deaths in 1990.

“Iran is the only country in the Middle East that regularly monitors the population’s iodine levels and sustainably controlled Iodine Deficiency Disorders (IDD),” said Hussein Delshad, head of the micronutrients research team at Shahid Beheshti University’s research center for endocrine and metabolism sciences.

Since 2000, the World Health Organization (WHO) has recognized Iran as the only country in the region where IDD has been eliminated.

Prior to 1989, when the national salt iodization program was initiated, IDD were largely prevalent in Iran. Despite the comprehensive IDD control program, less than 50% of households in rural areas consumed iodized salt till 1994.

Legislation under the universal iodization program was passed in 1992. This important step was accompanied by a far-reaching education and social mobilization campaigns that persuaded the general public about the merits of iodized salt and the health hazards related to IDD.

Iodine deficiency disorders are the most important preventable cause of impaired development of the brain and subsequent mental retardation in the world.

The average daily level of iodine intake is 100 mg for children, 150 mg for adult men and women and 200-250 mg for pregnant and breastfeeding women.

Iodine is essential for building a healthy brain, skeleton and metabolism. During the first 14-16 weeks of pregnancy, a fetus is entirely dependent on the mother for its supply of thyroid hormone. If she is deficient in iodine and thyroid hormone both during pregnancy and during pre-conception, the baby risks mental impairment. Severe iodine deficiency can lead to the extreme disability known as cretinism.

“Following studies on pregnant women in Iran, adequate amounts of iodofolic tablets (containing iodine and folic acid) were imported by a drug company,” said Delshad. A domestic production line has also been launched.

The average level of urinary iodine in students is among the indices of iodine consumption adequacy in a population. The Health Ministry monitors student’s urinary iodine levels periodically. Based on the latest survey, cases with urinary iodine below 100 micrograms were not found in any of the provinces.