Endemic goitre Endemic goitre Endemic goiter is a type of goitre that is associated with dietary iodine deficiency. Some inland areas where soil and water lacks in iodine compounds and consumption of marine foods is low are known for higher incidence of goitre. In such areas goitre is said to be "endemic". This type of goiter is easily preventable. In most developed countries regulations have been put into force by health policy institutions requiring salt, flour or water to be fortified with iodine. Treatment of endemic goiter is medical with iodine and thyroxine preparations. Surgery is only necessary in cases where complicated
Vitamin B12 deficiency vitamin B. Elevated methylmalonic acid levels may also indicate a deficiency. A type of anemia known as megaloblastic anemia is often but not always present. Treatment consists of using vitamin B by mouth or by injection; initially in high daily doses, followed by less frequent lower doses as the condition improves. If a reversible cause is found, that cause should be addressed if possible. If no reversible cause is found - or when found it cannot be eliminated - lifelong vitamin B supplementation is usually recommended. Vitamin B deficiency is preventable with supplements containing the vitamin: this is recommended in