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PUBLIC HEALTH DEPARTMENT , UNNES -2020

IODINE DEFICIENCY DISORDERS

“Preventing Disease, Prolonging Life,

and Improving Quality of Life”
- IDD-
LUKMAN FAUZI
 IODINE

Required to produce thyroid hormones that

control cell metabolism, neuromuscular tissue
growth and development, especially the fetal-
perinatal brain
Present in minute amounts (15-20 mg) in
the body
> 90% of iodine stored in the thyroid
 IODINE

Iodine were leached from the surface soil by

glaciating, erosion, rain, snow (mainly in
volcanic and mountain area) and were
carried by wind rivers and floods into the
sea.
 HORMONES

Endocrine: produced & circulated to distant

sites of action – vs -
Paracrine: act on neighboring cells
Autocrine: act on the same cells that produce
HORMONES
 HORMONES

Iodine needed for thyroid hormones :

- Thyroxine (T4)
- Triiodothyronine (T3)
Thyroid hormones regulate numerous
functions: eg
- Biochemical reactions (eg, protein synthesis,
enzyme activities)
- Influence early organ development (eg, brain
through 2-3 yrs of age
FUNCTION OF THYROID HORMONES

By influencing gene transcription, thyroid

hormones regulate oxygen and energy
utilization, evident through :
Cellular metabolism (oxygen & energy
utilization, ATP production)
Basal metabolic rate
Protein synthesis
Thermogenesis
 IDD

IDD is syndrome merge as result of

continuously low iodine content in human
body during a period of time.
Human body requires some amount of
iodine to produce thyroxin hormone which is
needed for normal growth and
development since the stage of newborn,
infant, children, adolescent, and until adult.
 IDD MECHANISM

1. Deficiency of iodine, then it will inhibit thyroxine

hormone formation by the thyroid gland
2. As a result there is no hormone that inhibits
TSH formation by the anterior hyphophysis
3. This allows the hypophysis to secrete
excessive amounts of TSH.
4. TSH then causes thyroid cells to secrete large
amounts of triglycerides into the follicle.
5. Glands grow larger and larger.
 IDD IMPACT

General Impacts:
1. LOW of CHILD INTELLECTUAL
2. ECONOMIC DEVELOPMENT : mental well
being affected decreased productivity
3. SOCIAL DEVELOPMENT : Social growth :
swelling --> under estimate; dysfunction
toward pregnant women
 IDD IMPACT

Specific Impact:
1. Capabilities of mental and psychomotor
2. Perinatal mortality
3. Fetal development disorder
4. Neonatal hypothyroidism
5. Clinical and biochemical hypothyroidism on
normal community
6. Iodine on breastfeed mother <
7. Calcification of basal ganglion
8. Brain damage (+)
9. Delayed of physical development of child in
community.
PLAY CAUSE OF HYPOTHYROIDISM

Iodine deficiency
Thyroiditis (inflammation) – autoimmune
(Hashimoto's Disease)
Surgical causes
Habit of consuming special food which can not
absorb the iodine
NON-CRETHINE DISORDER IN IODIUM-
DEFICIENCY AREA

KRETIIN

DEORK
GGOONIT

Psychomotor retardation

Motor deficit
Adult + childhood intellectual disruption

“ICEBERG PHENOMENON”
 INDONESIA'S IDD PROFILE

87 MILLIONS LIVING IN ENDEMIC RISK AREA

20 MILLIONS
HAD GOITERS

9 THOUSANDS
NEWBORN CRETINS / YEAR

200 THOUSANDS
SUFFRED OF CRETINS

IQ POINT LOST : 140 MILLIONS

→ Total Goitre Rate (TGR)
 TGR

TGR : number with goitres of grades 1 and 2

divided by total examined
It is recommended that a total goitre rate or
TGR of 5% or more in schoolchildren 6 to 12
years of age be used to signal the presence
of a public health problem.

WHO (2004)
REFERENCES
“Preventing Disease, Prolonging Life,
and Improving Quality of Life”
LUKMAN FAUZI
 ASSIGNMENT

• Prepare a Policy Brief/ Paper for Stakeholders regarding Danger of IDD,

Predisposing Factors, Enabling, and Reinforcing of IDD, as well as technical
recommendations.

• Please choose your own stakeholders, for example, sub-districts, districts,

offices, and so on

• Design as good as possible.

• Individual assignments

• Due date: See Elena