Iodine - Selenium - Cretinism

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Iodine - Selenium - Cretinism

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Special Resources

Iodine - Selenium

A Selection of Internet Sites

[*] Outstanding
[P] For Professionals

International Council for the Control of Iodine Deficiency Disorders (ICCIDD)
A nonprofit nongrovernment organization … Expert international body on Iodine …

[*][P] Iodine Deficiency and Fetal Brain Damage
Editorial … The New England Journal of Medicine -- December 29, 1994 -- Vol. 331, No. 26 … Iodine deficiency is by far the most common preventable cause of mental deficits in the world. The most severe effect of iodine deficiency is endemic cretinism, which is characterized by the combination of mental deficiency, deaf-mutism, and motor rigidity or, less commonly, by severe hypothyroidism … Endemic cretinism is still found in southern and eastern Europe and is common in Asia, Africa, and Latin America, where the prevalence may reach 10 percent in some communities … In 1990, the World Health Organization estimated that 20 million people in the world had varying degrees of preventable brain damage …

[*][P] B. Endemic cretinism
Recognized for many centuries in the Alpine villages of Europe. A survey carried out at Nepoleon's order (1810) in what is now the Swiss canton of Valais, revealed 4,000 cretins among 70,000 inhabitants … At the 1870 census in Switzerland 24.5 per 10,000 inhabitants were deaf mute … Neurological Cretinism … Three characteristic features of neurological endemic cretinism in its fully developed form are extremely severe mental deficiency together with squint, deaf mutism and motor spasticity with disorders of the arms and legs of a characteristic nature … Mental deficiency is characterized by a marked impairment of the capacity for abstract thought … Deafness is the striking feature. This may be complete in as many as 50% cretins … The motor disorder shows a characteristic proximal rigidity of both lower and upper extremities and the trunk … A larger proportion of the population (estimated to be 3-5 times as great) suffers from some degree of mental retardation and coordination defect … Myxedematous Cretinism … The typical myxedematous cretin (Fig.20-7)(Fig. 20-10) has a less severe degree of mental retardation than the neurological cretin … Present since early life, as in non-recognized sporadic congenital hypothyroidism: severe growth retardation, incomplete maturation of the features including the naso-orbital configuration, atrophy of the mandibles, puffy features, myxedematous, thickened and dry skin and rare hair, eyelashes and eyebrows and much delayed sexual maturation … Goiter is unusually absent and the thyroid is often not palpable, suggesting thyroid atrophy … Myxedematous cretinism used to be particularly common in Zaire … Selenium deficiency. Severe selenium deficiency has been reported in Zaire in populations where myxedematous cretinism is endemic. Selenium is present in Glutathione Peroxidase (Gpx) that detoxifies H₂O₂ produced in excess in thyroid cells hyperstimulated by TSH because of iodine deficiency … During the past five to ten years, major progress has been made in our understanding of endemic cretinism, mostly based on new epidemiological studies and on experimental aspects of thyroid homeostasis during the perinatal period in conditions of iodine deficiency, largely due to the outstanding group of Morreale de Escobar et al ...

[*][P] Kashin-Beck Disease -- Expanding the Spectrum of Iodine-Deficiency Disorders
The New England Journal of Medicine -- October 15, 1998 -- Vol. 339, No. 16 … Selenium, as selenocysteine, is an integral component of two important enzymes -- glutathione peroxidase and iodothyronine deiodinase -- that are present in may tissues, including the thyroid gland … Selenium and iodine are thus linked biochemically because both are involved in thyroid hormone production. Selenium and iodine are also linked geographically, most notably in Asia. Severe deficiency of both iodine and selenium occurs in a region extending from northeastern China and adjacent regions of Siberia and Korea to southwestern China, including Tibet … Three disorders have been associated with it: Keshan disease, Kashin-Beck disease, and (when it occurs in combination with iodine deficiency) hypothyroid cretinism. Keshan disease is a cardiomyopathy affecting mostly young and middle-aged women. It is characterized by multifocal myocardial necrosis and fibrosis and leads to cardiogenic shock and congestive heart failure. The name derives from Keshan County in northeastern China … The second disorder associated with selenium deficiency is Kashin-Beck disease, named for two investigators who studied affected patients in Siberia in the 19th century. It is an osteoarthropathy of the hands and fingers, elbows, knees, and ankles in children and adolescents. It is characterized by necrosis of growth-plate and epiphyseal chondrocytes and proliferation of surrounding chondrocytes, and it leads to a hypertrophic osteoarthropathy and, in some subjects, to short stature.

Endemic Goiter and Cretinism in Latin America, by Country

Economic Consequences of Endemic Goiter
Latin American Thyroid Society … The most severe consequence of endemic goiter is endemic cretinism. There are two forms of this disorder: hypothyroid and neurologic. Severe mental deficiency occurs in both forms, are related to maternal iodine deficiency during pregnancy and to endemic goiter. The causal relationship of central neurologic damage to gestational iodine deficiency has been proven in the sheep model of Hetzel and his colleague's (4). Abundant data relate the incidence of endemic goiter in a population to the severity of the iodine deficiency, as reflected in urinary iodine excretion (5,6) … Hypothyroidism in children reduces growth and physical development (PQ), thus impairing physical performance and the ability to do manual labor … Thyroid carcinoma probably occurs more frequently in populations with endemic goiter ...

Iodine Deficiency Disorder
IDD Problem Statement … Iodine deficiency is the single most common cause of preventable mental retardation and brain damage in the world … Children with IDD can grow up stunted, apathetic, mentally retarded and incapable of normal movement, speech or hearing. IDD in pregnant women cause miscarriage, stillbirth and mentally retarded children. 1.6 billion people are at risk, IDD affects 50 million children, 100,000 cretins are born every year. 1% - 10% Cretinism … 5% - 30% Some Brain Damage … 30% - 70% Loss of Energy due to Hypothyroidism … Solutions … A teaspoon of iodine is all a person requires in a lifetime … Iodized Salt … Costs only US $0.04 per person annually ...

The Micronutrient Initiative
L'initiative pour les micronutriments … Eliminating micronutrient malnutrition can significantly improve the health and socio-economic wellbeing of billions of people ...

Potassium Iodide (KI) Working Group of the Radiation Emergency Preparedness Advisory Committee (REPAC)
By Peter Cane … September 13, 1999 … Governments throughout the developed world recognize that the major health lesson learned from Chernobyl is the extreme sensitivity of children's thyroid glands to radioiodines: thus the upsurge of childhood thyroid cancer in Belarus, Russia, and Ukraine. In Poland, by contrast, health authorities gave out 18 million doses of KI, and protected virtually all of the nation's 10.5 million children … Poland has been spared a similar increase in thyroid cancer … American tend to assume that public health protection for their children is second to none. In the case of KI, this is not the case. Twice in 20 years the NRC has made commitments to the American people on KI, only to renege on them afterwards. As a result, we are still in a pre-Three Mile Island state of preparedness on KI … I laid out the 20-year history of the NRC's mishandling of the issue; it may be found on the NRC's rulemaking website, ruleforum@llnl.gov ...

Potassium Iodide (KI) Radiation Protection
What is Potassium Iodide (KI)? … How does Potassium Iodide (KI) pill provide radiation protection? … What about Potassium Iodate (KIO3)? … June 23, 1966, the New England Journal of Medicine. Vol. 274 on Page 1442 states: The thyroid gland is especially vulnerable to atomic injury since radioactive isotopes of iodine are a major component of fallout … Increase in cancer caused by Chernobyl … Was detected in Belarus, Russia, and Ukraine. Notably, this increase, seen in areas more than 150 miles (300 km) from the site, continues to this day and primarily affects children who were 0-14 years old at the time of the accident…the vase majority of the thyroid cancers were diagnosed among those living more than 50 km (31 miles) from the site ... A salt of the elements potassium and iodine, taken orally even in very small quantities 1/2 hour to 1 day before radioactive iodines are swallowed or inhaled, prevents about 99% of the damage to the thyroid gland that otherwise would result … The Chernobyl accident demonstrated that thyroid cancer can indeed be a major result of a large reactor accident. Moreover, although the Food and Drug Administration declared KI "safe and effective" as long ago as 1978, the drug had never been deployed on a large scale until Chernobyl. The experience of Polish health authorities during the accident has provided confirmation that large scale deployment of KI is safe … The revised policy also reflects wide scale change in international practice following the Chernobyl disaster, specifically 1989 World Health Organization recommendations (updated in 1995) and 1996 and 1997 International Atomic Energy Agency standards and guidance, which have led to use of KI as a supplementary protective measure in much of Europe, as well as in Canada and Japan … Potassium Iodate (KIO3), offered in an 85 mg tablet (200 tablets to a bottle) is the "cousin" of Potassium Iodide (KI) … Its U.S. manufacturer, Medical Corps, claims it is/has a) extended shelf life b) no bitter taste c) cheaper per dose … It is more stable … Is non-hygroscopic ...

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21/January/2002 dc

Special ResourcesIodine - Selenium

Special Resources

Iodine - Selenium