E-DRUG: Iodized salt (cont'd)

E-drug: Iodized salt (cont'd)
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We sent the inquiry about iodized salt to Peter Greaves, former Senior
Advisor on Micronutrients at UNICEF. We thought his reply might be of
interest to several people on the E-drug network. Peter's responses to
the five questions are 'sandwiched' below.

Philippa Saunders

We have heard a lot about iodized salt and the advantages/benefits of
using the iodized salt. I am more concerned about the following:

1. What is the minimum daily requirement (MDR), if any, of the iodine?

** WHO's current recommendations for daily iodine intakes are 150
   micrograms for adults and children over 12, and 200 micrograms for
   pregnant and lactating women.
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2. Does everybody need to use the iodized salts? I believe people who

are deficient in the MDR need it little more badly than anybody else.

** While everybody needs sufficient iodine, there is no NEED for
   everyone to use iodised salt. However, more and more countries are
   adopting the strategy of Universal Salt Iodisation, recommended by
   WHO, UNICEF and ICCIDD. This is a matter of practical convenience,
   to ensure that everyone gets enough - especially important for
   women of childbearing age since the developing brain in the foetus
   and first months of life is critically dependent (through the thyroid
   hormones) on iodine, and deficiency can lead to irreversible mental
   retardation. The amount of iodine to be added to salt depends on a
   number of factors, but commonly is between 20 and 40 milligrams of
   iodine (preferably as potassium iodate) per kg of salt (ie 20-40
   parts per million).
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3. What happens if you take this in excess of the need?

** Iodine is excreted in the urine. There is a close relation between
   iodine intake and iodine excretion.
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4. Is there any thing like the "iodine poisoning"? If so, what are the

signs and symptoms?

** When severely iodine deficient populations increase their iodine
   intake some (usually older) people may show increased activity of
   the thyroid gland, manifested as sweating, weight loss, increased
   appetite, changes in heart rhythm, nervousness, weakness etc. This
   is usually transient. On a population basis the benefits of
   correcting iodine deficiency through universal salt iodisation vastly
   outweigh the risks of iodine-induced hyperthyroidism.
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5. Does it, in any way, have any effect in the birth control? There is

a feeling by some of the users (no scientific data) that it delays the
conception. The experience covers the duration when it was being used
and after its withdrawal.

** I have never heard of any effect on conception.
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Peter suggests that anyone interested should contact the following
authorities directly:

A. The International Council for the Control of Iodine Deficiency
   Disorders (ICCIDD). Executive Director: Dr Francois Delange,
   Brussels. Fax: 32 2 675 1898, e-mail: fdelange@ulb.ac.be

B. The Micronutrient Initiative. Executive Director: Mr Venkatash
   Mannar, Ottawa. Fax: 1 613 236 9579.
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Best wishes,

Philippa Saunders & Gill Stoker
Essential Drugs Project
77 Lee Road, Blackheath, London SE3 9EN
UK
tel/fax: 44 (0)181 318 1419
e-mail: edp@gn.apc.org
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