Prevalence of iodine deficiency among multinodular goiter patients: a South Indian study

Abstract

Background: Mass iodization of table salt was introduced by the Government of India to treat as well as prevent iodine deficiency problems including goitres. However, even after so many years of introduction of iodized salt, the number of patients reporting with multi nodular goiter to the hospitals in Kerala seems to be high. The coastal districts of Trivandrum and Kollam report especially high prevalence of goitres and subsequently thyroidectomies. The aim of this study was to find the prevalence of iodine deficiency among patients with multi nodular goiter in South Kerala.Methods: This was a cross sectional study of 300 patients admitted with multinodular goitre in the general surgical wards of Government Medical College Trivandrum, Kerala, India. From June 2013 to June 2014, these patients were evaluated clinically and with the investigatory facilities available at this institution. Their urine spot iodine excretion levels were measured at the laboratory of state iodine deficiency control cell, Trivandrum, Kerala, India.Results: Out of the 300 cases, 6 patients were found to have mild iodine deficiency. Mean iodine level was normal at 170 microgram per decilitre. The prevalence of iodine deficiency in multinodular goiter cases studied was found to be 2%.Conclusions: The high prevalence of multinodular goiter cases in Kerala cannot be sited per se as due to iodine deficiency as only 2% of the total number of cases studied had low urine iodine levels. This raises a question whether the salt iodization programme needs to be re-analyzed and possibly re-structured for the state of Kerala.