Iodine status in a Sherpa community in a village of the Khumbu region of Nepal

Abstract

Objective: To assess the iodine status of Sherpa residents living in Kunde village, Khumbu region, Nepal. Design: Prevalence of goitre was determined by palpation. Urinary iodine concentrations (UIC) were determined in casual morning samples, and thyroidstimulating hormone (TSH) in finger-prick blood samples on filter paper. Dietary and demographic data were obtained via questionnaire, and selected foods analysed for iodine. Setting: Khumbu region is an area of low soil iodine in Nepal, where the prevalence of goitre was greater than 90 % in the 1960s prior to iodine intervention. Subjects: Two hundred and fifteen of 219 permanent residents of Kunde were studied. Results: Overall prevalence of goitre was 31 % (Grade 1 goitre, 27?0 %; Grade 2, 4?2 %). When adjusted to a world population, goitre prevalence was 27 % (95 % CI 23, 32 %); Grade 2 goitre prevalence was 2?8 % (95 % CI 1?0, 4?6 %). Median UIC was 97 mg/l, but only 75 mg/l in women of childbearing age. Thirty per cent had UIC , 50 mg/l and 52 % had UIC , 100 mg/l, while 31 % of children aged ,14 years had UIC . 300 mg/l. Ten per cent of participants had TSH concentrations .5 mU/ml. Conclusions: The prevalence of severe iodine deficiency has decreased since the 1960s, but mild iodine deficiency persists, particularly in women of childbearing age. The consumption of high-iodine uncooked instant noodles and flavour sachets by school-aged children contributed to their low prevalence of goitre and excessive UIC values. This finding may obscure a more severe iodine deficiency in the population, while increasing the risk of iodine-induced hyperthyroidism in children. Ongoing monitoring is essential.

Investigation of iodine deficient state and iodine supplementation in patients with severe motor and intellectual disabilities on long-term total enteral nutrition

“…On the other hand, five subjects (14.7%) among them were diagnosed as having HID. The incidence of HID is surprisingly low in view of the extremely low iodine intake but may actually be in line with other data from population studies [9][10][11][12][13][14] or may reflect difficulty in recognizing hypothyroid state in these patients or may be due to thyroid adaptive processes [15][16][17][18]. Possibly SMID patients, the targets of this study, might be at risk of developing disorders with a poor response of TSH that renders their hypothyroidism difficult to diagnose.…”

“…Several investigators concluded that significant remission of thyroid function was brought about after IS, especially in iodine status [11][12][13][14]20]. In our study, however, statistically significant alteration of thyroid function was not detected even after the entire period of long-term IS, although short-term IS caused clear remission of thyroid dysfunction and significant UIC elevation in 5 HID cases.…”

Work-health needs of high-altitude mountain guides (Sherpas) in Nepal – a pilot study

“…[7][8][9][10] A number of studies also deal with the general health of high-altitude climbing Sherpas in Nepal. [11][12][13][14][15][16][17][18][19][20][21][22][23] These studies deal with various health topics, from epidemiology of hepatitis viruses [16] to iodine status in the Sherpa community. [20] However, no research was found that surveyed Sherpas' perceptions of their health in relation to *Corresponding author.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22][23] These studies deal with various health topics, from epidemiology of hepatitis viruses [16] to iodine status in the Sherpa community. [20] However, no research was found that surveyed Sherpas' perceptions of their health in relation to *Corresponding author. Email: ewan.macdonald@glasgow.ac.uk their work.…”

Treatment of Hypothyroidism due to Iodine Deficiency Using Daily Powdered Kelp in Patients Receiving Long-term Total Enteral Nutrition

“…Iodine deficiency (ID) may cause hypothyroidism which results in severe developmental delay in infants and stillbirth in pregnant women (1). In iodine deficient areas, which are distributed in fifty-four countries of the world, iodine supplementation programs using iodized salt have been implemented (2,3,4,5). …”