Community Nutrition

COMMUNITY NUTRITION 3 (1+2)

Lesson 11 : Iodine Deficiency Disorders

Classification of Goiter severity (WHO/UNICEF, 1994) with signs and symptoms

GOITER

GRADE 1

GRADE 2

Grading of IDD: Depending upon the urinary iodine excretion levels and prevalence of TGR in the community, the severity of endemicity of IDD is graded as follows.

Category	Urinary Iodine level mg/dl
Mild IDD	5.0 – 9.99
Moderate IDD	2.0 – 4.99
Severe IDD	≤ 2.0

1. Mild IDD: IDD is an endemic area, with median urinary iodine level 5.0-9.99 µg/dl.TGR 5.0 -19.9% is considered as mild. Mental and physical development will be normal.
2. b. Moderate IDD; In this category of endemics, the median urinary iodine excretion level is 2 - 4.99 μg/dl and TGR is 20.0-29.9%. In these communities, there may be impaired thyroid hormone levels, with the risk of hypothyroidism. However, there will not be overt cases of cretinism.
3. c. Severe IDD: Endemia with median urinary iodine level of 20μg/dl or less and TGR >30% are considered to be severe. The population will be at risk of marked hypothyroidism, mental retardation and overt cretinism.

Cretinism is the visible but small component of IDD, whereas the other components, through large are generally invisible.