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      Turmeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan

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          Abstract

          Sir, This is in response to the letter to the editor by Elahi et al., titled “Reluctance in use of iodized salt for elimination of iodine deficiency” to our original article titled “Turmeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan.”[1] The comments by Elahi et al., that we have suggested the use of turmeric “instead” of iodized salt are misleading and far from the truth.[2] For the sake of clarity, I would like to paraphrase the relevant discussion part of our original article: “Owing to the limitation of resources, we did not assess iodide sufficiency, thiocyanate exposure and autoimmunity in this study. The underlying assumption is that there is significant iodine deficiency among the subjects screened. However, we need objective data in the populace, including children and pregnant women. It would be interesting to see the urinary iodide thiocyanate excretion and autoimmunity state in subjects in future studies. Our study findings have important real life implications. Advising people to avoid goitrogen containing food is impractical. However, if we can educate them to incorporate turmeric, spices and green chilies in their cooking recipes, we can reduce the risk of goiter development. In addition, use of iodized salt in their daily diet cannot be overemphasized.” Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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          Reluctance in use of iodized salt for elimination of iodine deficiency

          Sir, This refers to a recently published research article in your journal regarding the prevalence of thyroid disorders particularly goiter in the general population living in district Pak Pattan, Pakistan.[1] The authors have reported a high prevalence of palpable goiter, nodularity and hyperthyroidism in the study area, a pattern commonly observed in other iodine deficient areas of the world.[2] A novel observation of this study was the association of turmeric intake in diet with reduced risk of goiter development. Thus, authors concluded that instead of using iodized salt, increase turmeric consumption could help to reduce the goiter risk in the study population. We feel it would have been better if such education is imparted only to goitrous hyperthyroid patients rather than the general population because iodized salt intake might cause aggravation of hyperthyroidism in such patients. The reluctance of physicians on the use of iodized salt is surprising, but it is not for the first time in Pakistan. Already similar views had been expressed about the use of iodized salt in a well-known iodine deficient area of Pakistan.[3] We disagree with the suggestion of avoiding use iodized salt to eradicate goiter on the basis of evidence provided in literature. The authors might suggest it because of reported iodine-induced complications of thyroid dysfunction (increase in iodine-induced hyperthyroidism, hypothyroidism, thyroid autoimmunity etc.) in the background of iodized salt use.[4] No doubt, high levels of iodine intake have sometimes been associated with these side effects and have been reported in severe iodine deficient areas at the start of iodized salt prophylaxis.[2 5] However, global experiences have shown that these complications are transient and subside with the passage of time. Moreover, they depend on the iodine content of iodized salt, underlying thyroid autonomy and genetic susceptibility of the population to the thyroid disorders.[5] In fact, the real problem in the study area is severe iodine deficiency that is much more than mere goiter development. The readily available solution to this problem is to increase the iodination of salt and periodically monitoring of iodine content of salt. Optimal iodine intake is necessary for proper thyroid hormone production by the thyroid gland. The spectrum of iodine deficiency disorders is broad. The most vulnerable population groups to iodine deficiency are pregnant women and newborn children. The association of decreased thyroid hormone production during pregnancy with obstetrical complications and developmental brain damage to fetus is well-documented.[2 6] The role of iodine deficiency in retardation of somatic growth, learning disability and lowering IQ of children has been proved in a number of studies.[2] In addition, avoiding the use of iodized salt to correct iodine deficiency is not in compliance with global experience and universal salt iodization program patronized by the Government of Pakistan.
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            Tumeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan (THYPAK) study

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              Author and article information

              Journal
              Indian J Endocrinol Metab
              Indian J Endocrinol Metab
              IJEM
              Indian Journal of Endocrinology and Metabolism
              Medknow Publications & Media Pvt Ltd (India )
              2230-8210
              2230-9500
              Jan-Feb 2016
              : 20
              : 1
              : 147
              Affiliations
              [1] Department of Endocrinology, SZABMU, PIMS, Islamabad, Pakistan
              Author notes
              Corresponding Author: Dr. Ali Jawa, Department of Endocrinology, SZABMU, PIMS, Islamabad, Pakistan. E-mail: alijawa@ 123456gmail.com
              Article
              IJEM-20-147
              10.4103/2230-8210.172246
              4743378
              26904486
              9f7aefaf-7b02-44ed-8d26-3fd0ddfbe7a5
              Copyright: © Indian Journal of Endocrinology and Metabolism

              This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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              Letter to the Editor

              Endocrinology & Diabetes
              Endocrinology & Diabetes

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