Indian Journal of Endocrinology and Metabolism

: 2015  |  Volume : 19  |  Issue : 4  |  Page : 534--535

Reluctance in use of iodized salt for elimination of iodine deficiency

Shan Elahi1, Zulqurnain Syed1, Nazish Saleem2, Nayab Batool Rizvi2,  
1 Centre for Nuclear Medicine (CENUM), Mayo Hospital, Lahore, Pakistan
2 Department Biochemistry, Institute of Chemistry, University of the Punjab, New Campus, Lahore, Pakistan

Correspondence Address:
Dr. Shan Elahi
Principal Scientist, Centre for Nuclear Medicine (CENUM), Mayo Hospital, Lahore

How to cite this article:
Elahi S, Syed Z, Saleem N, Rizvi NB. Reluctance in use of iodized salt for elimination of iodine deficiency.Indian J Endocr Metab 2015;19:534-535

How to cite this URL:
Elahi S, Syed Z, Saleem N, Rizvi NB. Reluctance in use of iodized salt for elimination of iodine deficiency. Indian J Endocr Metab [serial online] 2015 [cited 2021 Sep 17 ];19:534-535
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Full Text


This refers to a recently published research article in your journal regarding the prevalence of thyroid disorders particularly goiter in the general population living in district Pak Pattan, Pakistan. [1] The authors have reported a high prevalence of palpable goiter, nodularity and hyperthyroidism in the study area, a pattern commonly observed in other iodine deficient areas of the world. [2] A novel observation of this study was the association of turmeric intake in diet with reduced risk of goiter development. Thus, authors concluded that instead of using iodized salt, increase turmeric consumption could help to reduce the goiter risk in the study population. We feel it would have been better if such education is imparted only to goitrous hyperthyroid patients rather than the general population because iodized salt intake might cause aggravation of hyperthyroidism in such patients. The reluctance of physicians on the use of iodized salt is surprising, but it is not for the first time in Pakistan. Already similar views had been expressed about the use of iodized salt in a well-known iodine deficient area of Pakistan. [3] We disagree with the suggestion of avoiding use iodized salt to eradicate goiter on the basis of evidence provided in literature. The authors might suggest it because of reported iodine-induced complications of thyroid dysfunction (increase in iodine-induced hyperthyroidism, hypothyroidism, thyroid autoimmunity etc.) in the background of iodized salt use. [4] No doubt, high levels of iodine intake have sometimes been associated with these side effects and have been reported in severe iodine deficient areas at the start of iodized salt prophylaxis. [2],[5] However, global experiences have shown that these complications are transient and subside with the passage of time. Moreover, they depend on the iodine content of iodized salt, underlying thyroid autonomy and genetic susceptibility of the population to the thyroid disorders. [5]

In fact, the real problem in the study area is severe iodine deficiency that is much more than mere goiter development. The readily available solution to this problem is to increase the iodination of salt and periodically monitoring of iodine content of salt. Optimal iodine intake is necessary for proper thyroid hormone production by the thyroid gland. The spectrum of iodine deficiency disorders is broad. The most vulnerable population groups to iodine deficiency are pregnant women and newborn children. The association of decreased thyroid hormone production during pregnancy with obstetrical complications and developmental brain damage to fetus is well-documented. [2],[6] The role of iodine deficiency in retardation of somatic growth, learning disability and lowering IQ of children has been proved in a number of studies. [2] In addition, avoiding the use of iodized salt to correct iodine deficiency is not in compliance with global experience and universal salt iodization program patronized by the Government of Pakistan.


1Jawa A, Jawad A, Riaz SH, Assir MK, Chaudhary AW, Zakria M, et al. Tumeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan (THYPAK) study. Indian J Endocrinol Metab 2015;19:347-50.
2Zimmermann MB. Iodine deficiency. Endocr Rev 2009;30:376-408.
3Khan A, Akhter S, Siddiqui MM, Nawab G, Khattak KN. Continuous use of iodized salt may cause thyrotoxicosis in plain areas of North West Frontier Province (NWFP) of Pakistan. J Med Sci 2003;3:423-8.
4Zimmermann MB. Iodine requirements and the risks and benefits of correcting iodine deficiency in populations. J Trace Elem Med Biol 2008;22:81-92.
5Utiger RD. Iodine nutrition - More is better. N Engl J Med 2006;354:2819-21.
6Elahi S, Nagra SA. Low maternal iodine intake and early pregnancy hypothyroxinemia: Possible repercussions for children. Indian J Endocrinol Metab 2014;18:526-30.