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Cretinism, and check out Cretinism on Wikipedia, Youtube, Google News, Google Books, and Twitter on Digplanet.
Cretinism is a condition of severely stunted physical and mental growth due to untreated congenital deficiency of thyroid hormones (congenital hypothyroidism) usually due to maternal hypothyroidism.
Neurological impairment may be mild, with reduced muscle tone and coordination, or so severe that the person cannot stand or walk. 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. Sporadic and genetic cretinism results from abnormal development or function of the foetal thyroid gland.
Thyroxine must be dosed as tablets only, even to newborns, as the liquid oral suspensions and compounded forms cannot be depended on for reliable dosing. Iodine deficiency results in the impairments in varying degrees of physical and mental development.
Goiter is the most specific clinical marker of either the direct or indirect insufficient intake of iodine in the human body.
More mildly affected areas of Europe and North America in the 19th century were referred to as "goitre belts". The early 20th century saw the discovery of the relationships of sporadic cretinism with congenital hypothyroidism, and of endemic cretinism with hypothyroidism due to iodine deficiency. If untreated, it results in mild to severe impairment of both physical and mental growth and development. Cognitive impairment may also range from mild to so severe that the person is nonverbal and dependent on others for basic care.

This type of cretinism has been almost completely eliminated in developed countries by early diagnosis by newborn screening schemes followed by lifelong treatment with thyroxine (T4).
In the case of dosing infants, the T4 tablets are generally crushed and mixed with breast milk, formula milk or water.
There is evidence of goiter, and its medical treatment with iodine-rich algae and burnt sponges, in Chinese, Egyptian, and Roman ancient medical texts. The degree of iodine deficiency was milder and manifested primarily as thyroid enlargement rather than severe mental and physical impairment.
The term spread more widely in popular English as a markedly derogatory term for a person who behaves stupidly. A condition of severely stunted physical and mental growth due to the untreated congenital deficiency of thyroid hormones. In adults, Cretinism results in mental deterioration, swelling of the skin, loss of water and hair.[1] Bone maturation and puberty are severely delayed. If the medication is mixed with formulas containing iron or soya products, larger doses may be required, as these substances may alter the absorption of thyroid hormone from the gut.[2] Frequent monitoring (every 2a€“3 weeks during the first months of life) is recommended to ensure that infants with congenital hypothyroidism remain within the high end of normal range, or euthyroid.
It has affected many people worldwide and continues to be a major public health problem in many countries.
It is being combated in many countries by public health campaigns of iodine administration.
In 1848, the Italian King Carlo Alberto of Sardinia commissioned the first epidemiological study of goiter and cretinism in his Haute-Savoy territories, where hideous cases of goiters and cretinism frequently occurred in the population.
In Switzerland, for example, where soil does not contain a large amount of iodine, cases of cretinism were very abundant and even considered genetically caused.

Iodine is an essential trace element, necessary primarily for the synthesis of thyroid hormones.
In past centuries, the well reported social diseases prevalent among the poorer social classes and farmers, caused by dietary and agricultural monocultures, were: pellagra, rickets, beriberi, scurvy in long-term sailors, and the endemic goiter caused by I-deficiency.
As the variety of food sources dramatically increased in Europe and North America and the populations became less completely dependent on locally grown food, the prevalence of endemic goitre diminished.
Iodine deficiency is the most common preventable cause of brain damage worldwide.[4] Although iodine is found in many foods, it is not universally present in all soils in adequate amounts. However, this disease was less mentioned in medical books because it was erroneously considered to be an aesthetic rather than a clinical disorder.[7] Endemic cretinism was especially common in areas of southern Europe around the Alps and was described by ancient Roman writers, and often depicted by medieval artists. Most iodine, in iodide form, is in the oceans where the iodide ions oxidize to elemental iodine, which then enters the atmosphere and falls to earth as rain, introducing iodine to soils.
Earth deficient in iodine is most common inland and in mountainous areas and areas of frequent flooding, but can also occur in coastal regions owing to past glaciation, and leaching by snow, water and heavy rainfall, which removes iodine from the soil.[5] Plants and animals grown in iodine deficient soils are correspondingly deficient. The proportion of people affected varied markedly throughout southern Europe and even within very small areas it might be common in one valley and not another.
The number of severely affected persons was always a minority, and most persons were only affected to the extent of having a goitre and some degree of reduced cognition and growth.

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