Goitre cases still persist as non-iodised salt sold in many districts

BENGALURU: With at least 85 per cent of salt samples from various districts of the state found to have iodine levels less than the stipulated limit, Karnataka continues to report iodine deficiency disorders like goitre. This, despite the launch of the National Iodine Deficiency Disorders Control Programme in 1988-89, almost 30 years ago, in Karnataka. In 2017, from January to November, 145 cases were reported.

This indicates that various districts in Karnataka still continue to sell non-iodised salt.

Chamarajnagar reported the highest with 63 cases followed by Udupi (43) and Belagavi 28. Other endemic districts are Dakshina Kannada (9) and Uttara Kannada (2), Ballari, Kodagu, Chikkamagalur, Bengaluru Urban, Bengaluru Rural and Shivamogga.

Iodine deficiency causes cretinism, deaf mutism, dumbness, physical and mental retardation. Laboratory monitoring of salt samples for iodine content and urine samples for urine iodine excretion is being done in the state though.

Dr Priyanka Rohatgi, a nutritionist at Apollo Hospital, Bannerghatta Road, said, “There is marketing for non-iodised salt on national channels, this should be disallowed. Food or diet per se will not give you sufficient amount of iodine. The quality of soil has deteriorated a lot, so the amount of iodine that enriches vegetables has also reduced a lot.”

Iodine is highly sensitive to oxidation. “If we fortify 30 parts per million, by the time it reaches the customers in a packaged form, 50 per cent of it will be oxidised. There is a loss of a lot of iodine due to oxidation. It is important that at the household level iodine is present in at least 15 parts per million,” she said.

A health department official said, “Our Accredited Social Health Activists (ASHA) workers and Auxiliary Nurse Midwives (ANMs) test salt samples with a kit. Wherever there is nil or mild iodine content, urine samples of the residents are sent to the only urine iodine testing lab in the state. If it is less than 20 micrograms per decilitre, it is a severe deficiency,” she said.

“An inflammation in the neck due to the thyroid gland inflammation is considered goitre. But some inflammations may be benign tumours or cancers. After urine iodine excretion test and testing the household salt, a fine needle aspiration biopsy can confirm if it is Goitre or not,” the official said.
“Bakeries may not be using iodised salt. Salt per se does not have iodine, it needs to be fortified with it. At the production level, at least 30 parts per million should be fortified. At the consumer level, at least half of it will be left with iodine,” she said.