Iodine is essential for the synthesis of thyroid hormones. Its deficiency has an adverse impact on thyroid function and leads in particular in early developmental stages to serious irreparable disorders. Our country has been for times immemorial in an area of inadequate iodine supplies, in the past even endemic cretenism was encountered in our country. Other sequelae of iodopenia are goitre, hypothyroidism, impaired somatic and mental development, reduced fertility, increased neonatal and infant mortality and a generally reduced physical and mental quality of the population. Supplementation of table salt with iodine led to a marked improvement of the position, however, recently an increase of goitre was again recorded. This is why pilot studies of iodine supplies and the thyroid state are under way in the Czech Republic. Random population samples from six regions were examined, a total of some 3300 subjects aged 6-65 years. It was revealed that the iodine supplies (evaluated from the iodinuria) is liminal and that 10% of the children and 20% of the adults (more girls and women than boys and men) suffer from severe iodine deficiency (iodinuria 50 micrograms/l in the morning urine). The sonographically assessed volume of the thyroid gland in our country is greater than in areas with adequate iodine supplies. The mean values of thyroid hormones, TSH and the Achilles tendon reflex are within the normal range. Solution of iodine deficiency is one of the fundamental parts of the programme of the UN, WHO and UNICEF. In our country we must, with this objective in mind, improve the iodization of table salt, increase the iodine content of salt and ensure an adequate intake of iodine in pregnant and lactating women by supplementation with iodine tables. An increase of the iodine intake of infants is also essential, in bottlefed infants supplementation of formulas is necessary. The problem cannot be solved without ensuring the use of iodized table salt in the food industry and without ensuring an overall iodine supply from multiple sources. This complex problem calls for an interdisciplinary approach. Only in this way it will be possible to fulfil the pretentious task of elimination of iodine deficiency diseases in children and adolescents by the year 2000.

Endokrinologický ústav Praha

Iodine Intake and Iodine Status in the Czech Republic - Past, Present, Future