Low iodine intake in children can have a negative impact

Two months ago, I saw a 36-year-old patient who was referred from Lindi for further management of her condition. Her complaints included front neck swelling. The neck swelling started as a small mass on the right side of the neck that progressively increased in size, it was associated with protrusion of the eyes and heat intolerance, she also reported history of weight loss and lower limb swelling.

A lot of tests were done, which later revealed that the patient had ‘goitre’, with symptoms of what doctors described as ‘thyrotoxicosis’.

The woman told to me that she became nonplussed after hearing that even her high blood pressure was due to the that swelling.

“I didn’t know that this swelling could bring on all of these troubles,” she added as her face was slowly being flooded with tears since she thought that her cruel illness insinuated the twilight point of her life on earth.

Many Tanzanians have incidentally been diagnosed with such swelling especially in their childhood. People are not aware that such swelling might point to something more serious, thus I advise my esteemed readers do not take any palpable or noticeable neck swelling for granted.

What is the swelling?

Goitre is an enlarged thyroid gland, this gives a lump at the front of your neck, it produces hormones called thyroid hormones, you either have overactive (hyperthyroidism) or underactive (hypothyroidism)thyroid gland, and that means you make too much or too little thyroid hormone respectively. The case of the woman from Lindi was making too much thyroid hormone.

When you go the hospital, doctors will try to look for the cause of the problem, although goitre can be painless but when it’s enlarged it may cause symptoms like difficulty in breathing, swallowing and sensation of choking.

What exactly causes goitre?

The causes may be due to Iodine deficiency as expounded hereunder, others include thyroid cancer and autoimmune diseases of the thyroid gland.

The most common type of goitre is endemic goitre, which is due to iodine deficiency. Iodine is an essential nutrient that is required for production of thyroid hormone.

The so called endemic goitre is said to be more common in female than in male, it occurs most commonly in inland and mountainous regions where the natural iodine content of water and soil is very low, thus it can easily be prevented by the use of salt or food to which iodine has been added.

It may regress with increasing iodine intake especially in young people, however the likelihood of regression diminishes with age, thus surgery may be required if the swelling causes further complications like difficulty in breathing or swallowing.

In one of the study published in PubMed done by Assey in 2009 that received the limelight among some endocrinologists, titled , “Tanzania national survey on Iodine deficiency, impact after 12 years of salt Iodine”, it was revealed that there was a significant improvement in iodine nutrition in Tanzania 12 years after initiation of salt iodination program in Tanzania.

In addition, my second biggest concern apart from the case of the woman narrated above is about children who become victims of iodine deficiency, you must know this, that the maturation of brain desperately requires thyroid hormone in the perinatal period.

In many low income countries, children are at greater risk of iodine deficiency disorders, including brain damage as expounded above.Thus, I think it’s imperative that policy makers in Africa must endorse that screening for neonatal/newborn hyperthyroidism should be mandatory with a view to cutting down the number of mentally retarded children.