Iodine deficiency continues to linger in India, putting millions at risk

Despite widely available iodised salt, iodine deficiency continues to affect millions, silently contributing to fatigue and anomalies in metabolism and growth

 

For most of us, iodine is something we vaguely associate with table salt. But it does far more than season our meals: iodine in salt fuels metabolism, supports brain development, and helps maintain a steady heartbeat.

According to the Salt Commissioner Office, more than 200 million people in India remain at risk of iodine deficiency disorders (IDD), with over 70 million already suffering from goitre and other related conditions. Despite decades of salt iodisation programmes, iodine deficiency continues to persist across the country, silently contributing to serious health problems.

 

Why is iodine so important? 

Iodine is essential for the thyroid gland to make thyroid hormones, which control your body’s metabolism, growth, and many vital functions, says Dr Niranjan Singh, senior consultant for internal medicine, CK Birla Hospitals, Jaipur.

 

 

• Severe deficiency (below 10–20 micrograms per day): Leads to hypothyroidism, often accompanied by goitre (swelling of the thyroid gland).
• Pregnant women: Increases the risk of miscarriage, stillbirth, and serious problems in the foetus, including growth retardation and major neurodevelopmental deficits.
• Severe deficiency in pregnancy: Can result in cretinism, which is marked by intellectual disability, deaf-mutism, motor spasticity, stunted growth, delayed puberty, and other neurological and physical issues.
• Infants and children: Even less severe deficiency can reduce IQ and cause developmental delays.
• Mild to moderate deficiency in pregnancy: Linked to higher chances of children developing neuro-developmantal disorders.
• Deficiency in adults: Can cause goitre, fatigue, reduced mental sharpness, and lower work productivity due to hypothyroidism.
• Long-term deficiency: May raise the risk of follicular thyroid cancer.

 

“In some cases, an underactive or overactive thyroid (due to longstanding iodine imbalance) may contribute to heart rhythm problems, including palpitations,” says Dr Singh.

 

Recognising the warning signs 

One of the challenges with iodine deficiency is that its symptoms are often subtle in the beginning. Watch out for:

• Swelling in the front of the neck
• Unexplained fatigue and low energy
• Weight gain despite no major dietary changes
• Feeling unusually cold
• Dry skin and hair loss
• Trouble concentrating or memory lapses

If these appear, it’s important to get your thyroid checked, says Dr Singh. 

 

Who is most at risk?

Though iodised salt has reduced deficiency, certain groups remain at risk:

• People in hilly and tribal regions where soil and water are iodine-deficient
• Those with limited access to iodised salt (economically weaker sections)
• Pregnant and breastfeeding women (higher iodine requirements)
• Strictly vegan or natural-food diets without processed/ iodised salt
• Individuals relying on organic or rock salt that may not be fortified

 

How is iodine deficiency detected? 

• Urinary iodine concentration test – most reliable for population-level screening, as most of the excess iodine is passed in urine.
• Thyroid function tests (T3, T4, TSH levels) – to check if deficiency has already affected thyroid activity.

           Approx cost: ₹300 – ₹1000

 

Correcting the deficiency

Fortunately, iodine deficiency is both preventable and treatable.

• Dietary correction: Use adequately iodised salt. Include iodine-rich foods such as milk, curd, cheese, eggs, fish, and seaweed (if part of your diet).
• Medical treatment: In cases of significant deficiency or hypothyroidism, your doctor may prescribe iodine supplements or thyroid hormone replacement.

 

“Self-medicating with iodine drops or tablets is not recommended, as excess iodine can also harm the thyroid,” cautions Dr Singh. 

Nutritious iodine-rich options to prevent deficiency and thyroid disorders.

 

Need for routine checks 

“Routine iodine level checks are not necessary for everyone, but thyroid screening is very important, especially if you are pregnant, planning pregnancy, have unexplained fatigue, weight changes, neck swelling, or a family history of thyroid disorders,” says Dr Singh.

Early detection helps prevent long-term complications like heart disease, infertility, and developmental delays in children.

 

Safe correction requires balance: adequate iodised salt, vitamin C–rich diets, and targeted supplementation in high-risk groups, while avoiding excess that can tip into thyroid dysfunction, shares Sid Das, co-founder of eGenome.ai, a predictive health technologies firm. “By embedding personalised iodine strategies into routine health check-ups and prenatal care, India can finally close the gap between public health policy and individual protection, preventing the long-term complications of hidden iodine deficiency,” he says. 

   

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This report is for informational purposes only and is not a substitute for professional medical advice.