congenital iodine deficiency syndrome congenital iodine deficiency syndrome congenital iodine deficiency syndrome is a medical condition present at birth marked by impaired physical and mental development, due to insufficient thyroid hormone (hypothyroidism) often caused by insufficient dietary iodine during pregnancy. it is one cause of underactive thyroid function at birth, called congenital hypothyroidism, historically referred to as cretinism (obsolete). if untreated, it results in impairment of both physical and mental development. symptoms may include goiter, poor length growth in infants, reduced adult stature, thickened skin, hair loss, enlarged tongue, a protruding abdomen; delayed bone maturation and puberty in children; and mental deterioration, neurological impairment, impeded ovulation, and infertility in adults. congenital iodine deficiency syndromeother namesendemic cretinisma man with congenital iodine deficiency syndromespecialtyendocrinologysymptomsgoiter, mental impairment, poor growth, infertility, hair loss in developed countries, thyroid function testing of newborns has assured that in those affected, treatment with the thyroid hormone thyroxine is begun promptly. this screening and treatment have virtually eliminated the consequences of the disease. signs and symptoms iodine deficiency causes gradual enlargement of the thyroid gland, referred to as a goiter. poor length growth is apparent as early as the first year of life. adult stature without treatment ranges from 100 to 160 cm (3 ft 3 in to 5 ft 3 in), depending on severity, sex, and other genetic factors. other signs include thickened skin, hair loss, enlarged tongue, and a protruding abdomen. in children, bone maturation and puberty are severely delayed. in adults, ovulation is impeded and infertility is common. mental deterioration is common. neurological impairment may be mild, with reduced muscle tone and coordination, or so severe that the person cannot stand or walk. cognitive impairment may also range from mild to so severe that the person is nonverbal and dependent on others for basic care. thought and reflexes are slower. cause disability-adjusted life years (daly) lost from iodine deficiency in 2012 in proportion to a million people 52–163 181–217 221–221 222–310 320–505 512–610 626–626 653–976 984–1,242 1,251–3,159 around the world, the most common cause of congenital iodine deficiency syndrome (endemic cretinism) is dietary iodine deficiency. iodine is an essential trace element, necessary for the synthesis of thyroid hormones. iodine deficiency is the most common preventable cause of neonatal and childhood brain damage worldwide. although iodine is found in many foods, it is not universally present in all soils in adequate amounts. most iodine, in iodide form, is in the oceans, where the iodide ions are reduced to elemental iodine, which then enters the atmosphere and falls to earth in rain, introducing iodine to soils. soil deficient in iodine is most common inland, in mountainous areas, and in areas of frequent flooding. it can also occur in coastal regions, where iodine might have been removed from the soil by glaciation, as well as leaching by snow, water and heavy rainfall. plants and animals grown in iodine-deficient soils are correspondingly deficient. populations living in those areas without outside food sources are most at risk of iodine deficiency diseases. diagnosis differential diagnosis dwarfism may also be caused by malnutrition or other hormonal deficiencies, such as insufficient growth hormone secretion, hypopituitarism, decreased secretion of growth hormone-releasing hormone, deficient growth hormone receptor activity and downstream causes, such as insulin-like growth factor 1 (igf-1) deficiency. prevention