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Fluorosis and Iodine Deficiency Disorders in India

This review focuses on fluorosis and iodine deficiency disorders, two serious, highly prevalent metabolic disorders that are under-reported. These are caused by the two elements of the halogen family, fluorine and iodine. The former in excess and the latter in deficiency are the cause for concern. Excess fluoride (F) consumption through untreated groundwater was the main reason for fluorosis and defluoridation of water was the focus to provide safe water with F < 1.0 mg/l. On the other hand, iodine deficiency in diet was due to agricultural crops grown in iodine-deficient soil, and iodization of cooking salt was identified as the way forward to attain iodine sufficiency (i.e. 15 ppm in iodized salt). The two diseases are addressed through structured national programmes, but the implementation unfortunately is in a compartmentalized manner. The major issue is that both F excess and iodine deficiency caused goitre. Besides, other disorders identical in clinical manifestations, also occur. This review discusses the issues to address the diseases with better understanding that has emerged from the scientific information available for correct diagnosis and management of patients in an integrated manner.