Types of Cretinism

Introduction 

Cretinism is referred to brain damage and mental retardation which can’t be fixed. It can even cause stunted growth in infants and children due to a severe lack of iodine during pregnancy which is usually caused by thyroid hormone production. Cretinism is known to be the most severe/serious iodine deficiency in pregnant women. 

The main cause of the deficiency or lack of iodine could be due to the diet of the person, so it can be fixed by correcting the die and the deficiency before giving birth to the child. Types of cretinism that are present are 2. Usually, the medical definition of cretinism involves three features, which are as follows

1. It could be associated with endemic goiter and severe iodine deficiency. 
2. There might be some clinical symptoms which include some kind of mental deficiency or defects in hearing speech or stunted growth. 
3. When the iodine deficiency is corrected in the area there is no sign of cretinism to be observed. 

There are many disorders related to iodine deficiency, some of those disorders which start even before birth can jeopardize the mental health and the survival of the child. Iodine deficiency is now recognized as the most common preventable brain disease by WHO. 

What is neurological cretinism?

Do you know or want to know what is neurological cretinism? Neurological cretinism is the type of cretinism that is usually characterized by squint, mental retardation, and disorders related to stance of gaits. It is now agreed by scientists that neurological cretinism is usually caused by maternal hypothyroidism due to severe iodine deficiency.

Types of cretinism

1. Neurological Cretinism: Neurological cretinism is the type of cretinism that is usually characterized by squint, mental retardation, and disorders related to stance of gaits. It is now agreed by scientists that neurological cretinism is usually caused by maternal hypothyroidism due to severe iodine deficiency. 
2. Myxoedematous cretinism: Myxoedematous cretinism is also known as hypothyroid cretinism. Some of the characteristics of cretinism are mental retardation, dwarfism, and hypothyroidism with physical symptoms. Goiter is usually absent in this type of cretinism and the thyroid is often not palpable, referring to thyroid atrophy.

The most severe type of iodine deficiency is called endemic cretinism. Types of syndromes in this disorder are neurological and myxoedematous. The endemic cretinism neurological type was found in endemic cretinism which was investigated in 104 cretins from a predominantly myxoedematous endemic in western China and 35 cretins from central Java, Indonesia, a predominantly neurological endemia.  They found the almost same pattern in the neurological involvements in almost all the cretins from both typed of endemic which is neurological and myxoedematous. 

Causes of cretinism

Types of cretinism can have different causes. Some of the causes of cretinism are as follows:

1. Parental iodine deficiency can be caused by less or inadequate secretion of the thyroid hormone. 
2. If you are immune to the thyroid.
3. The interaction with the other trace elements like selenium is known to play a big role in developing cretinism.
4. The most common cause of cretinism is the minimal or no presence of iodine in the diet of pregnant women.

Symptoms of cretinism

The symptoms of cretinism are as follows 

1. A problem in gaining weight 
2. Suffering from constipation.
3. Swollen skin 
4. Abnormal growth of bones.
5. Voice becoming hoarse. 

Iodine requirements in pregnancy

Some research and studies related to iodine turnover and thyroidal radioiodine uptake, tell us that an average requirement of iodine in a non-pregnant woman is 91-96 ug/dl. The average requirement of iodine in a non-pregnant woman ≥14 years, is 95ug/dl. The requirement of iodine for non-pregnant women is 150 ug/dl proposed by WHO/UNICEF/ICCIDD. The average requirement of iodine for a pregnant woman increases. 

The reasons for the increase in the average requirement of iodine for a pregnant woman are as follows: 

1. There is an increase of 50% in maternal thyroxine production which helps to maintain maternal euthyroidism and to transfer the thyroid hormone directly to the fetus of the female who is about to give birth to a child.
2. The thyroid hormone needs to be transferred to the fetus for the production of fetal thyroid hormone. 
3. There is an increase in renal iodine clearance. 

Recently the WHO increased the rate of iodine intake from 200 to 250ug/dl. They even said that they will need more accurate data that ensure maternal and newborn euthyroidism. 

How to prevent cretinism 

Types of cretinism do not matter in this case as we know that cretinism is caused by severe deficiency of iodine in pregnant women, so we just need them to maintain a rate of adequate iodine intake in the diet as proposed by WHO/UNICEF/ICCIDD. The most common idea among all the countries of the world is universal salt iodization. The main drawback of universal salt iodization is the population; it is not practical for all of them to intake the given amounts of iodine as that can lead to a shortage of iodine for several pregnant women all over the earth.

For this reason, WHO/UNICEF/ICCIDD has proposed that the countries that have large populations must use more detailed data and categorize the data according to the area/town/district and city. For the ideal situation, pregnant women should be provided with an ample amount of iodine which is 150 ug/dl. The supply must not stop even after giving birth to a child as breastfeeding a child will take even more iodine intake than a pregnant woman. 

Conclusion

To sum it all up cretinism is referred to as brain damage and mental retardation which can’t be fixed. It can even cause stunted growth in infants and children due to a severe lack of iodine during pregnancy which is usually caused by thyroid hormone production. Cretinism is known to be the most severe/serious iodine deficiency in pregnant women. There are many disorders related to iodine deficiency, some of those disorders which start even before birth can jeopardize the mental health and the survival of the child.