16 ms·

The curse of the goitre in Switzerland

610 points by _ihaque 3y ago

Faaak 3y ago
A really pleasant to read story. It's funny because I live in Switzerland and some of my friends debate the "ioded salt", and prefer to consume "natural salt" without the additives. Funny how history can repeat itself. I'm always impressed with all these doctors that would question the approach, try new protocols, and end up by finding a cure
- k__ 3y ago
  How come that the disease wasn't widespread earlier?
  - marcinzm 3y ago
    Why do you say it wasn't present earlier?
    - k__ 3y ago
      The article made that impression on me.
  - zweifuss 3y ago
    This might interest you: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169859/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169859/ "The interests of people in the thyroid gland have always been immense because of the widespread prevalence of its diseases. Therefore the earliest references to the gland date back to 1st century AD. The Chinese, Egyptian, Indian, Greek and Byzantine medicines are especially rich in their knowledge on the subject."
  - tekla 3y ago
    I am always flabbergasted when people question incredibly effective public health initiatives. https://en.wikipedia.org/wiki/Goitre#History https://en.wikipedia.org/wiki/Goitre#History https://en.wikipedia.org/wiki/Iodized_salt#In_public_health_initiatives https://en.wikipedia.org/wiki/Iodized_salt#In_public_health_... > Worldwide, iodine deficiency affects two billion people and is the leading preventable cause of intellectual and developmental disabilities.[1][2] According to public health experts, iodisation of salt may be the world's simplest and most cost-effective measure available to improve health, only costing US$0.05 per person per year
    - evanjrowley 3y ago
      It may not be a question of the initiative itself, rather, what conditions in Switzerland at the time led to an uptick in iodine deficiencies.
      - suchire 3y ago
        Maybe they should just RTFA
      - masklinn 3y ago
        There was no uptick, CIDS was endemic to the alps as far back as roman times. Its consequences literally slipped into linguistic vernaculars (e.g. french as the insult "crétin des alpes", lit. "cretin from the alps", and "cretin" was the original term for CIDS-induced mental impairment).
    - raverbashing 3y ago
      Tiktok mind and some angry people can't comprehend how hard it was to actually get to the cause and solution to a lot of diseases
    - k__ 3y ago
      Can I get some benefits of doubt please? :D I don't question the initiative. The article just read like it was some strange illness that affected Switzers around a certain time.
      - hef19898 3y ago
        The article mentions comments from the 19th century about the same subject. I think, that Switzerland, and especially those remote mountain regions, stayed more isolated than similar regions in France or Austria well into the early 20th century, making the issue stand out more in comparison.
        rurban 3y ago
        French alps had the very same problem. Austria I don't know. Many Austrian had the reverse problem with too much iodin and basedov eyes.
  - bee_rider 3y ago
    I think it was. We just don’t think about it because we’ve defeated it completely by putting iodine in the most popular spice, and also people in the past were afflicted by all sorts of horrible illnesses. It doesn’t stand out from the noise of the past being generally a mess.
    - k__ 3y ago
      Ah, okay. The article just read like there were some unusual strange things going on around 1900 in Switzerland.
      - jeffrallen 3y ago
        Swiss geology (retreat of the glaciers 10000 years ago) meant that the normal local products that would give a population iodine (milk and eggs) were themselves iodine-poor. A few parts of Switzerland which were not glaciated (i.e. Jura) did not have iodine deficient populations. Other places in the world had different geology and this different levels of natural iodine.
      - VintageCool 3y ago
        The article referenced mentions of goitre in Switzerland from Victor Hugo in 1839, Mark Twain in 1880, a medical survey in 1883, and Roman authors like Vitrivius and Pliny the Elder. It also mentioned that the iodine idea had been going around for a hundred years before the activities of the heroes of our story. Iodine had not been seen as a successful cure before because excess iodine causes a horrible condition. The key difference here was that Hunziker proposed regular use in minute quantities, and then Bayard tested the hypothesis with careful measurements and convincing evidence.
      - the_mitsuhiko 3y ago
        Goethe wrote in 1779 about his travels to Switzerland: “Die scheußlichen Kröpfe haben mich ganz und gar üblen Humors gemacht (“The horrible goiters have given me a very bad sense of humour”). Definitely plenty of earlier historic evidence.
  - gpvos 3y ago
    What makes you think it wasn't? The article doesn't claim so.
  - nyokodo 3y ago
    > How come that the disease wasn't widespread earlier? The article makes reference to the Madonna on the Albrecht Dürer’s Dresden Altarpiece having an obvious goiter. That was produced in the late 15th to early 16th century. That’s evidence from the article that the problem was so common then that it was depicted in sacred art.
  - kergonath 3y ago
    It was. Cretinism was one of the manifestations of iodine deficiency. The trope of crétin des Alpes (lit. cretin from the Alps) existed for a reason. The manifestation was goitres and stunted development, with people who seemingly stopped growing up around 14. Pretty much the story’s subject. It was a public health problem before iodised salt. https://en.m.wikipedia.org/wiki/Congenital_iodine_deficiency_syndrome https://en.m.wikipedia.org/wiki/Congenital_iodine_deficiency...
  - deleted 3y ago
    [deleted]
  - srott 3y ago
    In Slovakia, another landlocked country with lack of natural iodine from rainfall or diet, dementia became part of the culture. 30% (!!!) of population suffered from dementia. Iodizing salt raised IQ by 10 point every 10~ years but the damage is irreparable…
    - k__ 3y ago
      In Slovakia dementia is on place 2 of the most common death causes. In Slovenia it's on place 19. Crazy. Oh, and here in Germany it's on place 6?! Wouldn't have guessed!
  - ufo 3y ago
    It was widespread but has always been particularly worse in inland mountainous regions. To this day, efforts remain to eliminate iodine deficiency worldwide. Maps with goiter prevalence can be found on the WHO's website: https://www.who.int/teams/nutrition-and-food-safety/databases/vitamin-and-mineral-nutrition-information-system/search-for-maps https://www.who.int/teams/nutrition-and-food-safety/database...
- mytailorisrich 3y ago
  With the complex supply chains and processed/ready-made food we have nowadays I am wondering how much iodine makes its way into the diet of the Swiss today even without ioded table salt. I suspect that one of the issues was that most/all food used to be sourced locally, especially eggs and milk, which are good sources of iodine, with seafood probably mostly absent from the Swiss diet. Edit: apparently nowadays, and taking animal feed into account, Switzerland imports about 50% of its food.
  - bombcar 3y ago
    Most processed food uses uniodized salt iirc, which is actually becoming a problem in parts of the USA where populations eat nothing but processed food.
    - mytailorisrich 3y ago
      My understanding is that in general there no need for supplements with a normal, balanced diet, especially with eggs, dairy products, grains, and others if iodine is naturally present in the environment. So if Switzerland imports a lot of those, raw, or in prepared/processed food, or even the animal feed for its hens and cows the Swiss today probably already get much more iodine in their diet than 100 years ago.
      - dr_kiszonka 3y ago
        I was curious about your point about normal diet and have just looked it up. According to tables 1 and 2 in this article [0], it may be hard for some people to get enough (RDA) iodine from normal, not fortified foods. 0. https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/ https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/
      - oivey 3y ago
        People have been struggling to get enough iodine for a hundred+ years. That’s why it’s added to salt. This isn’t a 21st century problem.
- lostlogin 3y ago
  What are the arguments used against iodised salt? Where would they get their iodine?
  - emmet 3y ago
    they're afraid it'll give them 5G or whatever shite they make up on the spot
  - meepmorp 3y ago
    Some people dislike the flavor of iodized salt. But what would you expect from future cretins?
    - ch4s3 3y ago
      There's literally no way anyone can taste the difference between iodized and non iodized table salt blind to the source. There's just so little there, it seems the Swiss standard is something like 25 mg/kg. There's probably more plastic in the salt than iodine at this point.
      - tonfa 3y ago
        > There's probably more plastic in the salt than iodine at this point. Probably not in swiss salt tho (it's usually mountain salt, not sea salt).
        ch4s3 3y ago
        I thought it was clear that I meant that in jest. My point was that the amount of iodine is imperceptibly small.
        masklinn 3y ago
        People almost certainly confuse iodine with anticaking agents.
        tonfa 3y ago
- analog31 3y ago
  They probably get plenty of iodine from packaged food since it doesn't all come from the same region any more.
  - wahern 3y ago
    The salt used in processed and prepared foods usually isn't iodized, contributing to declining iodine intake given the increasing consumption of these foods.
    - tomjakubowski 3y ago
      industrially farmed cattle are often fed iodized salt, which can make their dairy products a good source of iodine. depends on the farm's practices though https://pubmed.ncbi.nlm.nih.gov/29221567/ https://pubmed.ncbi.nlm.nih.gov/29221567/
    - ufo 3y ago
      Depends on the country. That's the case in the USA but I'm not sure if it applies in Europe.
    - analog31 3y ago
      Good point. I'd hope that there are other sources of iodine than salt in regions that have higher iodine content -- after all, salt was just the vehicle chosen for the supplement. But I can also see what you say about prepared foods.
  - chasil 3y ago
    One interesting use of iodine supplementation is during nuclear accidents, where it is given to flood the thyroid and prevent unstable iodine isotopes from being taken up. "Iodine-131 (usually as iodide) is a component of nuclear fallout, and is particularly dangerous owing to the thyroid gland's propensity to concentrate ingested iodine and retain it for periods longer than this isotope's radiological half-life of eight days. For this reason, people at risk of exposure to environmental radioactive iodine (iodine-131) in fallout may be instructed to take non-radioactive potassium iodide tablets... Ingestion of [a] large dose of non-radioactive iodine minimises the uptake of radioactive iodine by the thyroid gland." https://en.wikipedia.org/wiki/Iodine#Other_formulations https://en.wikipedia.org/wiki/Iodine#Other_formulations
- WirelessGigabit 3y ago
  I (while not living in Switzerland) am one of those people. I don't want to eat salt with iodine. I don't like the taste. Too metallic, like in baking powder with aluminum.
  - nielsole 3y ago
    The article mentions iodine is apparently not changing the taste of salt in blind tasting. Do you have information to the contrary?
    - jmnicolas 3y ago
      Table salt has not only iodine added but anti-caking agents too so it might be what OP is tasting.
    - WirelessGigabit 3y ago
      I don't. Personally I can taste the metallic taste. But then again, so can I after using baking powder. Maybe I'm more sensitive to it?
      - wholinator2 3y ago
        You should conduct a blind test! (If you haven't already). Conducting blind tests on my perceptual preferences has been incredibly eye opening. It's especially illuminating for cooking with spices. Trying to identify spices by taste is something i never though to do but really helped me elevate my cooking from, "i guess we'll try this", to intentionally placing and making informed decisions. I bet the same thing could be done with regular salt and iodized salt. Maybe a couple tests, straight, in water, baked in a cookie, put on an hors d'ouvres (who really knows how to spell that) or something. Could be fun!
        babarock 3y ago
        It's spelled _Hors d'œuvre_ in French, using the weird ligature of o and e[1]. According to the Wikipedia article: > A number of words written with œ were borrowed from French and from Latin into English, where the œ is now rarely written. Modern American English spelling usually substitutes e, so diarrhœa has become diarrhea, although there are some exceptions, such as _phoenix_. In modern British English, the spellings generally keep the o but remove the ligature (e.g. diarrhoea). In the case of _Hors d'oeuvre_, it seems like the english wikipedia keeps the _o_. [2] [1]: https://en.wikipedia.org/wiki/%C5%92 https://en.wikipedia.org/wiki/%C5%92 [2]: https://en.wikipedia.org/wiki/Hors_d%27oeuvre https://en.wikipedia.org/wiki/Hors_d%27oeuvre
- teew 3y ago
  If you read German, the posted book review seems to me to be a trimmed-down version of this article (also written by the author) from 2022: https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die-schweiz-vom-kropf-erloesten-581754522295 https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die...
NelsonMinar 3y ago
Lovely article. It reminds me of the relationship of scurvy and Vitamin C. Despite scurvy being largely understood around 1750 the knowledge was forgotten or replaced with wrong theories as late as 1911. https://idlewords.com/2010/03/scott_and_scurvy.htm https://idlewords.com/2010/03/scott_and_scurvy.htm
- routerl 3y ago
  Lovely. Thanks for posting that. With all our popular narratives about the inevitability of scientific progress, it's always refreshing (from a historical point of view) and important (from a personal, ethical perspective) to remember that there's no guarantee that chronologically later developments will necessarily be improvements on earlier conclusions. It brings to mind our current replication crises in science.
  - vladms 3y ago
    Depends what you mean by "development", as the article does not describe developments on treating scurvy, but rather somehow random actions based on wrong assumptions (ex: limes are the same as lemons; acidity is all that matters). And even if in this case the initial solution was correct, it was still observing a correlation, as they had no clue why lemons do the job. My conclusion based on the article is that just experimenting is not enough, you also need to develop and test a complex understanding of the system. We probably don't cherish enough as a society, that some of us (as in: trained researchers, etc.) have a mindset that expects both replication and understanding, even if being humans we don't always reach this ideal.
- chihuahua 3y ago
  The article you're linking to is one of my favorite pieces of writing ever.
  - NelsonMinar 3y ago
    Maciej has a real gift for writing. His three part travelogue of visiting Yemen has been on my mind a lot recently. He published the first installment just a few months before the civil war started. https://idlewords.com/2015/05/ta_izz.htm https://idlewords.com/2015/05/ta_izz.htm
bill38 3y ago
Goitre and cretinism was present in French Alps too.
- eep_social 3y ago
  > In the last ice age, a permanent ice sheet formed over the Alps. Up to one kilometre thick, its tremendous weight ground against the terrain. It thawed and refroze in stages, and with every thaw, meltwater washed out the rubble. Over the course of 100,000 years, this ice sheet tore the top 250 metres of rock and soil from the surface of the Swiss Central Plateau. At its peak, about 24,000 years ago, it extended across all the northern cantons. It did not reach the Jura or Ticino. In 1964, Dr Franz Merke, a Basel surgeon, showed that the extent of the ice sheet ‘corresponded precisely’ with the prevalence of goitre: Switzerland had been stripped of its iodine.
- skrebbel 3y ago
  Nothing in the article suggests it magically stopped at the border.
- GuB-42 3y ago
  Hence the insult "crétin des Alpes". For many, the meaning has been lost, and it became a generic term to designate an idiot. Despite having heard and even used the expression many times, I think the popular character "Captain Haddock" and his expletives from the "Tintin" comics made it popular. Yet, I only came to the true meaning very recently.
catgary 3y ago
That was a fascinating read - there’s even a great villain in Eugene Bircher (not to get into politics, but he definitely seems to have trailblazer the “right wing populist attacks successful public health measures” strategy).
- karmakurtisaani 3y ago
  Not to be confused with Max Bircher-Benner, the inventor of Birchermuesli.
- rdevsrex 3y ago
  It's so sad how many people's heath is affected by assholes trying to protect their ego.
- Shacklz 3y ago
  I always find it fascinating that we don't "anti-celebrate" such obvious failures in history more. I remember reading the original article of the author (linked in another comment in here) in German and I haven't ever heard of Bircher before. Peddling nonsense against better knowledge that causes this amount of suffering deserves ridicule in posterity. We shouldn't just celebrate those who do great things for humanity, but also "anti-celebrate" those who do great harm.
  - throwaway8877 3y ago
    National shaming day.
    - hef19898 3y ago
      I am affraid some people would take this and turn it into a day of celibration...
  - lostlogin 3y ago
    If be more in favour of anti-celebrating the bad idea than of pillorying the individual. Though there is the odd individual who needs more criticism.
attachedhead 3y ago
This seems to be a slightly shortened version of an earlier article by the same author. The swiss weekly magazine "Das Magazin" published a german translation of this longer version in 2019 [1]. It is an absolutely fascinating read. Since the article from OP is relatively short on images, the following are links to more images from the german article, with captions translated into english. Warning: images contain depictions of the medical condition discussed in the article. YMMV, but i don't consider them 'gross' or NSFW. Image 1: https://cdn.unitycms.io/images/EzdPT4pM4HAAzsQiwi_L2d.jpg https://cdn.unitycms.io/images/EzdPT4pM4HAAzsQiwi_L2d.jpg Caption: Woman with goitre in Frienisberg, 1921. Image 2: https://cdn.unitycms.io/images/5PhByWEba4W8L0W1EnHXiE.jpg https://cdn.unitycms.io/images/5PhByWEba4W8L0W1EnHXiE.jpg Caption: Woman with cretinism, 1928. (Today the word has a derogatory connotation, but primarily describes an illness of great cruelty). Image 3: https://cdn.unitycms.io/images/Bu0SX8WY4gK8jMZgebpyss.jpg https://cdn.unitycms.io/images/Bu0SX8WY4gK8jMZgebpyss.jpg Caption: Six women with cretinism, ca. 1920. Image 4: https://cdn.unitycms.io/images/8qBQEgsuqq-BMdsEAPN63U.jpg https://cdn.unitycms.io/images/8qBQEgsuqq-BMdsEAPN63U.jpg Caption: Found the solution to Switzerland's original curse: Heinrich Hunziker from Adliswil ZH, drawn by Marianne Zumbrunn in 1977. Image 5: https://cdn.unitycms.io/images/7tdlChuPq-3AIeFiSvh5U1.jpg https://cdn.unitycms.io/images/7tdlChuPq-3AIeFiSvh5U1.jpg Caption: Experiments with the snow shovel: the Valais country doctor Otto Bayard, 1937. Image 6: https://cdn.unitycms.io/images/5JGFFaXN48BA4xOsHXf0Zu.jpg https://cdn.unitycms.io/images/5JGFFaXN48BA4xOsHXf0Zu.jpg Caption: Sun-tanned outdoorsman: the Herisau general practitioner and later chief physician Hans Eggenberger, undated. [1] https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die-schweiz-vom-kropf-erloesten-581754522295 https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die... or https://archive.is/rHzSV https://archive.is/rHzSV edit: formatting, removed german caption texts
- zwirbl 3y ago
  For German speakers there's also this 'Geschichten aus der Geschichte' Podcast episode on the matter which does a fairly good job telling the story IMO. https://www.geschichte.fm/archiv/gag368/ https://www.geschichte.fm/archiv/gag368/
  - arlcode 3y ago
bee_rider 3y ago
I think, outside Europe, this afflicted lots of places away from the coast, right? Like the middle part of the US. I’ve always wondered if the iodine in the air is part of the allure of the seaside. Coastal areas of course have produced a huge number of successful countries. Most of that must be the trade and logistics advantages. I wonder if getting the iodine right out of the air was another hidden major advantage though.
- ajuc 3y ago
  There are health resorts here in Poland where the whole reason is for them to exist in these particular places is because air there has a lot of iodine and other minerals from sea salt. I've been to one in Kołobrzeg as a child because of my asthma. There are also inland health resorts where they build huge salt evaporation walls so that people don't have to drive all the way to the sea to breath sea air- for example in Ciechocinek. And it's not modern technology - they have been built in early 19th century already. https://en.wikipedia.org/wiki/Ciechocinek_graduation_towers https://en.wikipedia.org/wiki/Ciechocinek_graduation_towers https://pl.wikipedia.org/wiki/Ciechocinek#/media/Plik:Teznie2007.JPG https://pl.wikipedia.org/wiki/Ciechocinek#/media/Plik:Teznie...
  - jongjong 3y ago
    Sounds similar to many parts of eastern Europe and Russia. People go to health retreats to drink water from specific natural springs that are high in minerals.
    - ajuc 3y ago
      Yeah we have that too, but this is about evaporating it to make the air healthy to breathe. Different benefits compared to drinking. Here's more about the mechanism: https://en.wikipedia.org/wiki/Graduation_tower https://en.wikipedia.org/wiki/Graduation_tower Apparently the first such towers were built in 1600s.
- contingencies 3y ago
  Yes. It was also common in mountainous areas of western China and Tibet.
simtel20 3y ago
This brought back memories of being told that my grandfather had invested in a factory to make iodized salt in china - probably in the Shanghai area, pre-ww2. I do not believe it was a good business for him, but that is how these things go sometimes. My mother didn't have the visual or historical resources to really show me, as a child, what goiters were. I never really got it until reading this article. But I've always made sure to have some iodized salt as I cook just to make sure we don't end up deficient, understanding that there was some easily avoided consequences at basically no cost.
hsuduebc2 3y ago
Very nice story. Love this stories of scientific progress. Thank you. And after reading it whole I must say. Fuck you Bircher.
pkdpic 3y ago
Great read, but I'm wondering why this began in the 1920's? Or was it always an issue for human beings living in Switzerland?
- samus 3y ago
  The condition has been described since Roman times, but not only in Switzerland. The problem also exists in other regions in the Alps and other mountain chains across the world.
  - masswerk 3y ago
    Speaking of the Alps and related regions, this was also considered a condition typical for Styrians (inhabitants of the country of Styria) in Austria.
  - masklinn 3y ago
    > The problem also exists in other regions in the Alps and other mountain chains across the world. As well as in the lowlands, far enough away from the sea to not have easy access to produces or sea salt through trade. It used to be common in the english midlands and the US midwest (as well as the appalachia and rockies).
- dougmwne 3y ago
  The Victor Hugo quote in the article was from 1839. Biologically speaking, this must have always been an issue. The iodine had washed away from the area long before human settlement. Before modern medicine, it would have been difficult to collect the data and even establish the pattern. People did not travel much in pre-modern times and many of these mountain villages would receive highly educated visitors very infrequently. They may have been barely aware that their situation was anything other than normal. The world was beset with maladies and this was just one medical mystery among all the others. In 1875, life expectancy in Switzerland was just 38, so life must have been harsher than any modern person can imagine.
  - margalabargala 3y ago
phkahler 3y ago
I am increasingly convinced that the "thyroid hormones" T1, T2, T3, and T4 are simply a place to store iodine. When iodine is needed somewhere in the body it can be taken from T4, converting it to T3. But it's not the case that "T3 is the active form" as you'll read in the literature, it's that the removed iodine is the active or useful thing. Changing the ratio of T3/T4 does cause a change in TSH (thyroid stimulating hormone) but that's IMHO simply a signal that the iodine is getting used, so please send us more. There are other tissues in the body that need iodine, as evidenced by the sodium-iodine symporter present on those cells, so to set the recommended daily iodine intake based solely on what the thyroid can use is IMHO a huge mistake. Some things with interesting iodine research: skin cancer, breast cancer, type 2 diabetes, asthma, polycystic ovaries, fibrocystic breast disease, other cancers. But yeah, it cures goiter...
- samus 3y ago
  ... and congenital deafness, low length growth, neurological impairment, and other symptoms known as Congenital iodine deficiency syndrome.
- lostlogin 3y ago
  > Some things with interesting iodine research: skin cancer, breast cancer, type 2 diabetes, asthma, polycystic ovaries, fibrocystic breast disease, other cancers. But yeah, it cures goiter... When I search for breast cancer and iodine, I find links that suggest iodine may help prevent that disease - and Japan’s low rate of the condition is potentially related to high consumption of iodine. Are you saying that all those conditions are due to excess iodine?
  - vulcan01 3y ago
    Based on their third paragraph, I assume they mean that people are not eating enough iodine.
    - lostlogin 3y ago
      I interpreted that as the opposite - just because the iodine is getting used, it doesn’t mean it should have more. I certainly find more on positive effects of iodine so I think I’ve misunderstood OP.
jazzkingrt 3y ago
I'm Swiss. My grandfather has stories of family members afflicted with Goitre. What a great read!
jackcosgrove 3y ago
The use of the term cretin for those with stunted growth due to iodine deficiency was not a pejorative. Cretin is a different spelling of Chretien, French for Christian. It was short for "poor Christian", a term for those suffering misfortune.
- deleted 3y ago
  [deleted]
- philwelch 3y ago
  This whole time I thought it was an ethnic slur against the people of Crete.
tim333 3y ago
Paywall free https://archive.ph/3wrzh https://archive.ph/3wrzh > in 1921, in the city of Bern, 94 per cent of schoolchildren had some swelling of the neck and almost 70 per cent had a goitre. Gosh - it's surprising that years after discovering relativity and the like they were still figuring that out. (Einstein lived in Bern from 1903 to 1905 and developed his Theory of Relativity there).
unnamed76ri 3y ago
I wonder if this was at least a factor in Switzerland remaining neutral in both world wars. If a significant portion of your military age men are unfit for military duty due to goiters, that would certainly affect your ability to conduct a war.
- ng12 3y ago
  Switzerland had a very active and well trained military during both World Wars. In fact Swiss neutrality is at least partly rooted in the historical role of Swiss mercenaries -- it was a lot easier to sell your mercenaries if you weren't involved in the war.
- tonfa 3y ago
  > I wonder if this was at least a factor in Switzerland remaining neutral in both world wars probably has more to do with 1515 (Marignano) and 1815 (Congress of Vienna, which secured Switzerland as an independent state, while enforcing neutrality).
- deleted 3y ago
  [deleted]
btbuildem 3y ago
What an interesting read! Fascinating to see how the theory was conceived, tested, and put into practice -- and all that in the backdrop of other approaches, even with the spectre of iodine as a poison!
boobsbr 3y ago
Happened in the French Alps as well. Captain Haddock, from Tin Tin used to call people 'crétin des Alpes'.
rmason 3y ago
My father told me that goitre's were quite common when he was growing up as a boy in Detroit in the 1920's. In my generation it was totally unknown. Yet I remember people affected by polio as a boy quite well. But I bet that millennials have no personal experience with it at all. Each generation moves forward and I can only hope there is a day when no one has any first hand experience with either cancer or Alzheimer's.
- masklinn 3y ago
  > But I bet that millennials have no personal experience with it at all. Mass vaccination started in the late 50s and especially early 60s (with Sabin’s oral vaccine). Millennials start in 1981, so they would / could well have known affected adults.
  - ponector 3y ago
    Considering current antivax movement, it is not unusual for people to get sick with polio, even some got paralyzed. It is hard to understand for me how people can intentionally increase risks of deadly diseases for their children.
    - arlcode 3y ago
      Complacency and political/financial benefits for some of the people paddling that shit, a world where public policy is only a team sport and everybody's opinion on expert topics is equally "valuable". I really hope we find a way out of this before to long. In the end (polio) vaccines work and praying/magic doesn't, so I'm positive we will be able to learn the same lessons our ancestors did.
    - bequanna 3y ago
      Antivax movement? Are you assuming everyone who was not interested in the COVID vaccine just plain doesn’t believe in vaccines?
      - ponector 3y ago
dghughes 3y ago
I had to start taking synthroid since about 5 years in my mid 40s. In my mid 20s I was into Tae Kwon Do and while sparring a guy taller and much heavier punch my in my neck. I have to wonder if he damaged my thyroid.
- ufo 3y ago
  I'd assume that the null-hypothesis is that it's unrelated. The most common cause of hypo is Hashimoto's thyroiditis, an autoimmune condition. More likely to appear the older you get.
more_corn 3y ago
Iodine deficiency for everyone not willing to wade through the story.
speeder 3y ago
This article made me a little sad. The article is about how people with a fear of iodine overdose resisted the idea of adding it to salt on first place. I spent my childhood in Brazil, a country where there are a good amount of natural iodine. Yet the government decided to ignore the risks, seemly well known for more than a century, and jack up the iodine in the salt to levels beyond what any international standard recommend or tested. And now I hypothyroidism caused by iodine overdose.
- d0gsg0w00f 3y ago
  To be fair, there was known evidence at the time that large iodine doses were harmful. Very little research had been done for small doses. There was cause for scrutiny.
tweetle_beetle 3y ago
For anyone interested in this area, I would highly recommend following the work of Iodine Global Network (and donating if possible). They work with politicians and industry in a very targetted way to increase the use of iodised salt in food production where it is most needed in the world. They don't directly fund any of the activities, but create the relationships, conditions and understanding for it to happen - meaning they are an extremely effective charity, creating population scale change with very modest funding. They also do lots of work to try to map the global picture of iodine intake from the very varied data available. Some of the results might surprise you - https://ign.org/scorecard/ https://ign.org/scorecard/
timClicks 3y ago
It's fascinating how determined people are with their positions, even in the face of overwhelming evidence that their position causes harm. We see similar arguments today against folate fortification of bread and fluoridation of water.
- teslabox 3y ago
  Flour is fortified with folic acid because it is more stable. People who are poor methylators can’t transform folic acid into folate, ergo they are harmed by folic acid fortification.
AlbertCory 3y ago
I'll always be grateful to the doctor who just noticed my throat being very slightly enlarged, even though I wasn't complaining. I had my TSH tested and found that I needed the synthetic thyroid hormone. It's cheap and you just take it once a day. Iodine deficiency is ONE cause of goiter, but not the only one. https://www.healthline.com/health/hypothryroidism/hashimotos-vs-hypothyroidism#hashimotos-disease https://www.healthline.com/health/hypothryroidism/hashimotos...
agnosticmantis 3y ago
Reminds me of John Snow's discovery and demonstration of the cause of cholera, which I learned about in the context of casual inference in this excellent paper by statistician David Freedman: https://psychology.okstate.edu/faculty/jgrice/psyc5314/Freedman_1991A.pdf https://psychology.okstate.edu/faculty/jgrice/psyc5314/Freed... Actual science looks nothing like the shoddy paper churning that we see in much of econ and social science using questionable and assumption-heavy casual inference methods.
fuzztester 3y ago
In India iodized salt is common these days, in such table salts as Tata Salt. Salt started being iodized only around 15 or so years back, IIRC.
- rldjbpin 3y ago
  the regular table salt has been iodized for a long time, as pointed out by another comment. although the rock salts of the world don't seem to be iodized iirc.
- Scoundreller 3y ago
  Israel notably iodizes very little of its salt and it’s hard to find. Combined with desalinated water consumption, their iodine deficiency rates are through the roof. https://www.haaretz.com/science-and-health/2017-03-27/ty-article/study-israelis-have-among-worlds-worst-iodine-deficiency/0000017f-e116-d9aa-afff-f95e8c5c0000 https://www.haaretz.com/science-and-health/2017-03-27/ty-art... https://ijhpr.biomedcentral.com/articles/10.1186/s13584-020-00367-4 https://ijhpr.biomedcentral.com/articles/10.1186/s13584-020-...
  - fuzztester 3y ago
    That's interesting, and surprising for such a technologically advanced country.
- truban 3y ago
  "India was one of the first countries in the world to have initiated a salt iodisation programme 1962." https://www.livemint.com/news/india/why-should-india-revisit-its-food-iodine-programme-after-pandemic-11625469128805.html https://www.livemint.com/news/india/why-should-india-revisit...
  - fuzztester 3y ago
    Oh wow, I didn't know it went that for back. But I am fairly sure I only noticed it in shops around 15 years ago as I said. Okay, maybe 20 or a bit more.
AiaAidan 3y ago
https://archive.ph/3wrzh https://archive.ph/3wrzh
Solortho 3y ago
I take Lugol's iodine almost everyday (with Selenium). It dramatically upgraded my life. The first week could be wild (fever is expected) but people should know how this cheap supplement can help them.
- ufo 3y ago
  Lugol's iodine is usually not recommended because a single drop has dozens of times the daily recommended dose of iodine. That can cause bad side effects (as discussed in the article)
  - Solortho 3y ago
    Not dozens but thousands!
  - infertainment 3y ago
    Yes, a minority of people (less than 2%) have Hashimoto's Thyroditis, some without knowing about it, and a large dose of iodine could cause damage to their thyroid, I think through some sort of auto-immune process. The selenium helps prevent that. It's a shame because the remaining 98% could get a lot of benefit and (setting aside the above) iodine is supposed to be the least toxic pure element. In the past Lugol's iodine was used as an antiseptic to put on cuts so I guess a fair amount got absorbed that way.
emmelaich 3y ago
As a kid we always used iodised salt. Now, people seem to buy rock salt and variations with no indication of additives. Does anyone have an idea of how much potassium iodide they might have, if any?
bored2sleep 3y ago
[flagged]
trackofalljades 3y ago
There's an amazing episode of Revisionist History about this. https://www.pushkin.fm/podcasts/revisionist-history/way-to-go-ohio https://www.pushkin.fm/podcasts/revisionist-history/way-to-g...
PlunderBunny 3y ago
New Zealand soil is naturally low in iodine, so by law iodine is added to certain foods (e.g. salt, bread): https://www.mpi.govt.nz/food-safety-home/nutrients-added-food/iodine-added-food/ https://www.mpi.govt.nz/food-safety-home/nutrients-added-foo...
jhoho 3y ago
The soil in the Austrian Country of Styria has notoriously low iodine levels. When visiting Styria in 1748, David Hume wrote: 'But as much as the country is agreeable in its wildness, as much are the inhabitants savage, and deformed, and monstrous in their appearance. Very many of them have ugly swelled throats; idiots and deaf people swarm in every village; and the general aspect of the people is the most shocking I ever saw.' [1] That's why some traditional costumes in that region include a so called "Kropfband" (goitre bound). [2] It's fascinating how much one's place of birth used to influence a life and medical biography and in many countries still does. [1] https://www.gutenberg.org/files/42843/42843-h/42843-h.htm https://www.gutenberg.org/files/42843/42843-h/42843-h.htm [2] https://de.wikipedia.org/wiki/Kropfband https://de.wikipedia.org/wiki/Kropfband
pvaldes 3y ago
Some day morbid obesity will be seen in the same way, as a "scar" of the fat tissue caused after some chemical exposure

610 points by _ihaque 3y ago

A really pleasant to read story. It's funny because I live in Switzerland and some of my friends debate the "ioded salt", and prefer to consume "natural salt" without the additives. Funny how history can repeat itself. I'm always impressed with all these doctors that would question the approach, try new protocols, and end up by finding a cure

k__ 3y ago
How come that the disease wasn't widespread earlier?
- marcinzm 3y ago
  Why do you say it wasn't present earlier?
  - k__ 3y ago
    The article made that impression on me.
- zweifuss 3y ago
  This might interest you: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169859/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169859/ "The interests of people in the thyroid gland have always been immense because of the widespread prevalence of its diseases. Therefore the earliest references to the gland date back to 1st century AD. The Chinese, Egyptian, Indian, Greek and Byzantine medicines are especially rich in their knowledge on the subject."
- tekla 3y ago
  I am always flabbergasted when people question incredibly effective public health initiatives. https://en.wikipedia.org/wiki/Goitre#History https://en.wikipedia.org/wiki/Goitre#History https://en.wikipedia.org/wiki/Iodized_salt#In_public_health_initiatives https://en.wikipedia.org/wiki/Iodized_salt#In_public_health_... > Worldwide, iodine deficiency affects two billion people and is the leading preventable cause of intellectual and developmental disabilities.[1][2] According to public health experts, iodisation of salt may be the world's simplest and most cost-effective measure available to improve health, only costing US$0.05 per person per year
  - evanjrowley 3y ago
    It may not be a question of the initiative itself, rather, what conditions in Switzerland at the time led to an uptick in iodine deficiencies.
    - suchire 3y ago
      Maybe they should just RTFA
    - masklinn 3y ago
      There was no uptick, CIDS was endemic to the alps as far back as roman times. Its consequences literally slipped into linguistic vernaculars (e.g. french as the insult "crétin des alpes", lit. "cretin from the alps", and "cretin" was the original term for CIDS-induced mental impairment).
  - raverbashing 3y ago
    Tiktok mind and some angry people can't comprehend how hard it was to actually get to the cause and solution to a lot of diseases
  - k__ 3y ago
    Can I get some benefits of doubt please? :D I don't question the initiative. The article just read like it was some strange illness that affected Switzers around a certain time.
    - hef19898 3y ago
      The article mentions comments from the 19th century about the same subject. I think, that Switzerland, and especially those remote mountain regions, stayed more isolated than similar regions in France or Austria well into the early 20th century, making the issue stand out more in comparison.
      - rurban 3y ago
        French alps had the very same problem. Austria I don't know. Many Austrian had the reverse problem with too much iodin and basedov eyes.
- bee_rider 3y ago
  I think it was. We just don’t think about it because we’ve defeated it completely by putting iodine in the most popular spice, and also people in the past were afflicted by all sorts of horrible illnesses. It doesn’t stand out from the noise of the past being generally a mess.
  - k__ 3y ago
    Ah, okay. The article just read like there were some unusual strange things going on around 1900 in Switzerland.
    - jeffrallen 3y ago
      Swiss geology (retreat of the glaciers 10000 years ago) meant that the normal local products that would give a population iodine (milk and eggs) were themselves iodine-poor. A few parts of Switzerland which were not glaciated (i.e. Jura) did not have iodine deficient populations. Other places in the world had different geology and this different levels of natural iodine.
    - VintageCool 3y ago
      The article referenced mentions of goitre in Switzerland from Victor Hugo in 1839, Mark Twain in 1880, a medical survey in 1883, and Roman authors like Vitrivius and Pliny the Elder. It also mentioned that the iodine idea had been going around for a hundred years before the activities of the heroes of our story. Iodine had not been seen as a successful cure before because excess iodine causes a horrible condition. The key difference here was that Hunziker proposed regular use in minute quantities, and then Bayard tested the hypothesis with careful measurements and convincing evidence.
    - the_mitsuhiko 3y ago
      Goethe wrote in 1779 about his travels to Switzerland: “Die scheußlichen Kröpfe haben mich ganz und gar üblen Humors gemacht (“The horrible goiters have given me a very bad sense of humour”). Definitely plenty of earlier historic evidence.
- gpvos 3y ago
  What makes you think it wasn't? The article doesn't claim so.
- nyokodo 3y ago
  > How come that the disease wasn't widespread earlier? The article makes reference to the Madonna on the Albrecht Dürer’s Dresden Altarpiece having an obvious goiter. That was produced in the late 15th to early 16th century. That’s evidence from the article that the problem was so common then that it was depicted in sacred art.
- kergonath 3y ago
  It was. Cretinism was one of the manifestations of iodine deficiency. The trope of crétin des Alpes (lit. cretin from the Alps) existed for a reason. The manifestation was goitres and stunted development, with people who seemingly stopped growing up around 14. Pretty much the story’s subject. It was a public health problem before iodised salt. https://en.m.wikipedia.org/wiki/Congenital_iodine_deficiency_syndrome https://en.m.wikipedia.org/wiki/Congenital_iodine_deficiency...
- deleted 3y ago
  [deleted]
- srott 3y ago
  In Slovakia, another landlocked country with lack of natural iodine from rainfall or diet, dementia became part of the culture. 30% (!!!) of population suffered from dementia. Iodizing salt raised IQ by 10 point every 10~ years but the damage is irreparable…
  - k__ 3y ago
    In Slovakia dementia is on place 2 of the most common death causes. In Slovenia it's on place 19. Crazy. Oh, and here in Germany it's on place 6?! Wouldn't have guessed!
- ufo 3y ago
  It was widespread but has always been particularly worse in inland mountainous regions. To this day, efforts remain to eliminate iodine deficiency worldwide. Maps with goiter prevalence can be found on the WHO's website: https://www.who.int/teams/nutrition-and-food-safety/databases/vitamin-and-mineral-nutrition-information-system/search-for-maps https://www.who.int/teams/nutrition-and-food-safety/database...
mytailorisrich 3y ago
With the complex supply chains and processed/ready-made food we have nowadays I am wondering how much iodine makes its way into the diet of the Swiss today even without ioded table salt. I suspect that one of the issues was that most/all food used to be sourced locally, especially eggs and milk, which are good sources of iodine, with seafood probably mostly absent from the Swiss diet. Edit: apparently nowadays, and taking animal feed into account, Switzerland imports about 50% of its food.
- bombcar 3y ago
  Most processed food uses uniodized salt iirc, which is actually becoming a problem in parts of the USA where populations eat nothing but processed food.
  - mytailorisrich 3y ago
    My understanding is that in general there no need for supplements with a normal, balanced diet, especially with eggs, dairy products, grains, and others if iodine is naturally present in the environment. So if Switzerland imports a lot of those, raw, or in prepared/processed food, or even the animal feed for its hens and cows the Swiss today probably already get much more iodine in their diet than 100 years ago.
    - dr_kiszonka 3y ago
      I was curious about your point about normal diet and have just looked it up. According to tables 1 and 2 in this article [0], it may be hard for some people to get enough (RDA) iodine from normal, not fortified foods. 0. https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/ https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/
    - oivey 3y ago
      People have been struggling to get enough iodine for a hundred+ years. That’s why it’s added to salt. This isn’t a 21st century problem.
lostlogin 3y ago
What are the arguments used against iodised salt? Where would they get their iodine?
- emmet 3y ago
  they're afraid it'll give them 5G or whatever shite they make up on the spot
- meepmorp 3y ago
  Some people dislike the flavor of iodized salt. But what would you expect from future cretins?
  - ch4s3 3y ago
    There's literally no way anyone can taste the difference between iodized and non iodized table salt blind to the source. There's just so little there, it seems the Swiss standard is something like 25 mg/kg. There's probably more plastic in the salt than iodine at this point.
    - tonfa 3y ago
      > There's probably more plastic in the salt than iodine at this point. Probably not in swiss salt tho (it's usually mountain salt, not sea salt).
      - ch4s3 3y ago
        I thought it was clear that I meant that in jest. My point was that the amount of iodine is imperceptibly small.
        masklinn 3y ago
        People almost certainly confuse iodine with anticaking agents.
        tonfa 3y ago
analog31 3y ago
They probably get plenty of iodine from packaged food since it doesn't all come from the same region any more.
- wahern 3y ago
  The salt used in processed and prepared foods usually isn't iodized, contributing to declining iodine intake given the increasing consumption of these foods.
  - tomjakubowski 3y ago
    industrially farmed cattle are often fed iodized salt, which can make their dairy products a good source of iodine. depends on the farm's practices though https://pubmed.ncbi.nlm.nih.gov/29221567/ https://pubmed.ncbi.nlm.nih.gov/29221567/
  - ufo 3y ago
    Depends on the country. That's the case in the USA but I'm not sure if it applies in Europe.
  - analog31 3y ago
    Good point. I'd hope that there are other sources of iodine than salt in regions that have higher iodine content -- after all, salt was just the vehicle chosen for the supplement. But I can also see what you say about prepared foods.
- chasil 3y ago
  One interesting use of iodine supplementation is during nuclear accidents, where it is given to flood the thyroid and prevent unstable iodine isotopes from being taken up. "Iodine-131 (usually as iodide) is a component of nuclear fallout, and is particularly dangerous owing to the thyroid gland's propensity to concentrate ingested iodine and retain it for periods longer than this isotope's radiological half-life of eight days. For this reason, people at risk of exposure to environmental radioactive iodine (iodine-131) in fallout may be instructed to take non-radioactive potassium iodide tablets... Ingestion of [a] large dose of non-radioactive iodine minimises the uptake of radioactive iodine by the thyroid gland." https://en.wikipedia.org/wiki/Iodine#Other_formulations https://en.wikipedia.org/wiki/Iodine#Other_formulations
WirelessGigabit 3y ago
I (while not living in Switzerland) am one of those people. I don't want to eat salt with iodine. I don't like the taste. Too metallic, like in baking powder with aluminum.
- nielsole 3y ago
  The article mentions iodine is apparently not changing the taste of salt in blind tasting. Do you have information to the contrary?
  - jmnicolas 3y ago
    Table salt has not only iodine added but anti-caking agents too so it might be what OP is tasting.
  - WirelessGigabit 3y ago
    I don't. Personally I can taste the metallic taste. But then again, so can I after using baking powder. Maybe I'm more sensitive to it?
    - wholinator2 3y ago
      You should conduct a blind test! (If you haven't already). Conducting blind tests on my perceptual preferences has been incredibly eye opening. It's especially illuminating for cooking with spices. Trying to identify spices by taste is something i never though to do but really helped me elevate my cooking from, "i guess we'll try this", to intentionally placing and making informed decisions. I bet the same thing could be done with regular salt and iodized salt. Maybe a couple tests, straight, in water, baked in a cookie, put on an hors d'ouvres (who really knows how to spell that) or something. Could be fun!
      - babarock 3y ago
        It's spelled _Hors d'œuvre_ in French, using the weird ligature of o and e[1]. According to the Wikipedia article: > A number of words written with œ were borrowed from French and from Latin into English, where the œ is now rarely written. Modern American English spelling usually substitutes e, so diarrhœa has become diarrhea, although there are some exceptions, such as _phoenix_. In modern British English, the spellings generally keep the o but remove the ligature (e.g. diarrhoea). In the case of _Hors d'oeuvre_, it seems like the english wikipedia keeps the _o_. [2] [1]: https://en.wikipedia.org/wiki/%C5%92 https://en.wikipedia.org/wiki/%C5%92 [2]: https://en.wikipedia.org/wiki/Hors_d%27oeuvre https://en.wikipedia.org/wiki/Hors_d%27oeuvre
teew 3y ago
If you read German, the posted book review seems to me to be a trimmed-down version of this article (also written by the author) from 2022: https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die-schweiz-vom-kropf-erloesten-581754522295 https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die...

NelsonMinar 3y ago

Lovely article. It reminds me of the relationship of scurvy and Vitamin C. Despite scurvy being largely understood around 1750 the knowledge was forgotten or replaced with wrong theories as late as 1911. https://idlewords.com/2010/03/scott_and_scurvy.htm https://idlewords.com/2010/03/scott_and_scurvy.htm

routerl 3y ago
Lovely. Thanks for posting that. With all our popular narratives about the inevitability of scientific progress, it's always refreshing (from a historical point of view) and important (from a personal, ethical perspective) to remember that there's no guarantee that chronologically later developments will necessarily be improvements on earlier conclusions. It brings to mind our current replication crises in science.
- vladms 3y ago
  Depends what you mean by "development", as the article does not describe developments on treating scurvy, but rather somehow random actions based on wrong assumptions (ex: limes are the same as lemons; acidity is all that matters). And even if in this case the initial solution was correct, it was still observing a correlation, as they had no clue why lemons do the job. My conclusion based on the article is that just experimenting is not enough, you also need to develop and test a complex understanding of the system. We probably don't cherish enough as a society, that some of us (as in: trained researchers, etc.) have a mindset that expects both replication and understanding, even if being humans we don't always reach this ideal.
chihuahua 3y ago
The article you're linking to is one of my favorite pieces of writing ever.
- NelsonMinar 3y ago
  Maciej has a real gift for writing. His three part travelogue of visiting Yemen has been on my mind a lot recently. He published the first installment just a few months before the civil war started. https://idlewords.com/2015/05/ta_izz.htm https://idlewords.com/2015/05/ta_izz.htm

bill38 3y ago

Goitre and cretinism was present in French Alps too.

eep_social 3y ago
> In the last ice age, a permanent ice sheet formed over the Alps. Up to one kilometre thick, its tremendous weight ground against the terrain. It thawed and refroze in stages, and with every thaw, meltwater washed out the rubble. Over the course of 100,000 years, this ice sheet tore the top 250 metres of rock and soil from the surface of the Swiss Central Plateau. At its peak, about 24,000 years ago, it extended across all the northern cantons. It did not reach the Jura or Ticino. In 1964, Dr Franz Merke, a Basel surgeon, showed that the extent of the ice sheet ‘corresponded precisely’ with the prevalence of goitre: Switzerland had been stripped of its iodine.
skrebbel 3y ago
Nothing in the article suggests it magically stopped at the border.
GuB-42 3y ago
Hence the insult "crétin des Alpes". For many, the meaning has been lost, and it became a generic term to designate an idiot. Despite having heard and even used the expression many times, I think the popular character "Captain Haddock" and his expletives from the "Tintin" comics made it popular. Yet, I only came to the true meaning very recently.

catgary 3y ago

That was a fascinating read - there’s even a great villain in Eugene Bircher (not to get into politics, but he definitely seems to have trailblazer the “right wing populist attacks successful public health measures” strategy).

karmakurtisaani 3y ago
Not to be confused with Max Bircher-Benner, the inventor of Birchermuesli.
rdevsrex 3y ago
It's so sad how many people's heath is affected by assholes trying to protect their ego.
Shacklz 3y ago
I always find it fascinating that we don't "anti-celebrate" such obvious failures in history more. I remember reading the original article of the author (linked in another comment in here) in German and I haven't ever heard of Bircher before. Peddling nonsense against better knowledge that causes this amount of suffering deserves ridicule in posterity. We shouldn't just celebrate those who do great things for humanity, but also "anti-celebrate" those who do great harm.
- throwaway8877 3y ago
  National shaming day.
  - hef19898 3y ago
    I am affraid some people would take this and turn it into a day of celibration...
- lostlogin 3y ago
  If be more in favour of anti-celebrating the bad idea than of pillorying the individual. Though there is the odd individual who needs more criticism.

attachedhead 3y ago

This seems to be a slightly shortened version of an earlier article by the same author. The swiss weekly magazine "Das Magazin" published a german translation of this longer version in 2019 [1]. It is an absolutely fascinating read. Since the article from OP is relatively short on images, the following are links to more images from the german article, with captions translated into english. Warning: images contain depictions of the medical condition discussed in the article. YMMV, but i don't consider them 'gross' or NSFW. Image 1: https://cdn.unitycms.io/images/EzdPT4pM4HAAzsQiwi_L2d.jpg https://cdn.unitycms.io/images/EzdPT4pM4HAAzsQiwi_L2d.jpg Caption: Woman with goitre in Frienisberg, 1921. Image 2: https://cdn.unitycms.io/images/5PhByWEba4W8L0W1EnHXiE.jpg https://cdn.unitycms.io/images/5PhByWEba4W8L0W1EnHXiE.jpg Caption: Woman with cretinism, 1928. (Today the word has a derogatory connotation, but primarily describes an illness of great cruelty). Image 3: https://cdn.unitycms.io/images/Bu0SX8WY4gK8jMZgebpyss.jpg https://cdn.unitycms.io/images/Bu0SX8WY4gK8jMZgebpyss.jpg Caption: Six women with cretinism, ca. 1920. Image 4: https://cdn.unitycms.io/images/8qBQEgsuqq-BMdsEAPN63U.jpg https://cdn.unitycms.io/images/8qBQEgsuqq-BMdsEAPN63U.jpg Caption: Found the solution to Switzerland's original curse: Heinrich Hunziker from Adliswil ZH, drawn by Marianne Zumbrunn in 1977. Image 5: https://cdn.unitycms.io/images/7tdlChuPq-3AIeFiSvh5U1.jpg https://cdn.unitycms.io/images/7tdlChuPq-3AIeFiSvh5U1.jpg Caption: Experiments with the snow shovel: the Valais country doctor Otto Bayard, 1937. Image 6: https://cdn.unitycms.io/images/5JGFFaXN48BA4xOsHXf0Zu.jpg https://cdn.unitycms.io/images/5JGFFaXN48BA4xOsHXf0Zu.jpg Caption: Sun-tanned outdoorsman: the Herisau general practitioner and later chief physician Hans Eggenberger, undated. [1] https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die-schweiz-vom-kropf-erloesten-581754522295 https://www.tagesanzeiger.ch/wie-drei-heldenhafte-aerzte-die... or https://archive.is/rHzSV https://archive.is/rHzSV edit: formatting, removed german caption texts

zwirbl 3y ago
For German speakers there's also this 'Geschichten aus der Geschichte' Podcast episode on the matter which does a fairly good job telling the story IMO. https://www.geschichte.fm/archiv/gag368/ https://www.geschichte.fm/archiv/gag368/
- arlcode 3y ago

bee_rider 3y ago

I think, outside Europe, this afflicted lots of places away from the coast, right? Like the middle part of the US. I’ve always wondered if the iodine in the air is part of the allure of the seaside. Coastal areas of course have produced a huge number of successful countries. Most of that must be the trade and logistics advantages. I wonder if getting the iodine right out of the air was another hidden major advantage though.

ajuc 3y ago
There are health resorts here in Poland where the whole reason is for them to exist in these particular places is because air there has a lot of iodine and other minerals from sea salt. I've been to one in Kołobrzeg as a child because of my asthma. There are also inland health resorts where they build huge salt evaporation walls so that people don't have to drive all the way to the sea to breath sea air- for example in Ciechocinek. And it's not modern technology - they have been built in early 19th century already. https://en.wikipedia.org/wiki/Ciechocinek_graduation_towers https://en.wikipedia.org/wiki/Ciechocinek_graduation_towers https://pl.wikipedia.org/wiki/Ciechocinek#/media/Plik:Teznie2007.JPG https://pl.wikipedia.org/wiki/Ciechocinek#/media/Plik:Teznie...
- jongjong 3y ago
  Sounds similar to many parts of eastern Europe and Russia. People go to health retreats to drink water from specific natural springs that are high in minerals.
  - ajuc 3y ago
    Yeah we have that too, but this is about evaporating it to make the air healthy to breathe. Different benefits compared to drinking. Here's more about the mechanism: https://en.wikipedia.org/wiki/Graduation_tower https://en.wikipedia.org/wiki/Graduation_tower Apparently the first such towers were built in 1600s.
contingencies 3y ago
Yes. It was also common in mountainous areas of western China and Tibet.

simtel20 3y ago

This brought back memories of being told that my grandfather had invested in a factory to make iodized salt in china - probably in the Shanghai area, pre-ww2. I do not believe it was a good business for him, but that is how these things go sometimes. My mother didn't have the visual or historical resources to really show me, as a child, what goiters were. I never really got it until reading this article. But I've always made sure to have some iodized salt as I cook just to make sure we don't end up deficient, understanding that there was some easily avoided consequences at basically no cost.

hsuduebc2 3y ago

Very nice story. Love this stories of scientific progress. Thank you. And after reading it whole I must say. Fuck you Bircher.

pkdpic 3y ago

Great read, but I'm wondering why this began in the 1920's? Or was it always an issue for human beings living in Switzerland?

samus 3y ago
The condition has been described since Roman times, but not only in Switzerland. The problem also exists in other regions in the Alps and other mountain chains across the world.
- masswerk 3y ago
  Speaking of the Alps and related regions, this was also considered a condition typical for Styrians (inhabitants of the country of Styria) in Austria.
- masklinn 3y ago
  > The problem also exists in other regions in the Alps and other mountain chains across the world. As well as in the lowlands, far enough away from the sea to not have easy access to produces or sea salt through trade. It used to be common in the english midlands and the US midwest (as well as the appalachia and rockies).
dougmwne 3y ago
The Victor Hugo quote in the article was from 1839. Biologically speaking, this must have always been an issue. The iodine had washed away from the area long before human settlement. Before modern medicine, it would have been difficult to collect the data and even establish the pattern. People did not travel much in pre-modern times and many of these mountain villages would receive highly educated visitors very infrequently. They may have been barely aware that their situation was anything other than normal. The world was beset with maladies and this was just one medical mystery among all the others. In 1875, life expectancy in Switzerland was just 38, so life must have been harsher than any modern person can imagine.
- margalabargala 3y ago

phkahler 3y ago

I am increasingly convinced that the "thyroid hormones" T1, T2, T3, and T4 are simply a place to store iodine. When iodine is needed somewhere in the body it can be taken from T4, converting it to T3. But it's not the case that "T3 is the active form" as you'll read in the literature, it's that the removed iodine is the active or useful thing. Changing the ratio of T3/T4 does cause a change in TSH (thyroid stimulating hormone) but that's IMHO simply a signal that the iodine is getting used, so please send us more. There are other tissues in the body that need iodine, as evidenced by the sodium-iodine symporter present on those cells, so to set the recommended daily iodine intake based solely on what the thyroid can use is IMHO a huge mistake. Some things with interesting iodine research: skin cancer, breast cancer, type 2 diabetes, asthma, polycystic ovaries, fibrocystic breast disease, other cancers. But yeah, it cures goiter...

samus 3y ago
... and congenital deafness, low length growth, neurological impairment, and other symptoms known as Congenital iodine deficiency syndrome.
lostlogin 3y ago
> Some things with interesting iodine research: skin cancer, breast cancer, type 2 diabetes, asthma, polycystic ovaries, fibrocystic breast disease, other cancers. But yeah, it cures goiter... When I search for breast cancer and iodine, I find links that suggest iodine may help prevent that disease - and Japan’s low rate of the condition is potentially related to high consumption of iodine. Are you saying that all those conditions are due to excess iodine?
- vulcan01 3y ago
  Based on their third paragraph, I assume they mean that people are not eating enough iodine.
  - lostlogin 3y ago
    I interpreted that as the opposite - just because the iodine is getting used, it doesn’t mean it should have more. I certainly find more on positive effects of iodine so I think I’ve misunderstood OP.

jazzkingrt 3y ago

I'm Swiss. My grandfather has stories of family members afflicted with Goitre. What a great read!

jackcosgrove 3y ago

The use of the term cretin for those with stunted growth due to iodine deficiency was not a pejorative. Cretin is a different spelling of Chretien, French for Christian. It was short for "poor Christian", a term for those suffering misfortune.

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philwelch 3y ago
This whole time I thought it was an ethnic slur against the people of Crete.

tim333 3y ago

Paywall free https://archive.ph/3wrzh https://archive.ph/3wrzh > in 1921, in the city of Bern, 94 per cent of schoolchildren had some swelling of the neck and almost 70 per cent had a goitre. Gosh - it's surprising that years after discovering relativity and the like they were still figuring that out. (Einstein lived in Bern from 1903 to 1905 and developed his Theory of Relativity there).

unnamed76ri 3y ago

I wonder if this was at least a factor in Switzerland remaining neutral in both world wars. If a significant portion of your military age men are unfit for military duty due to goiters, that would certainly affect your ability to conduct a war.

ng12 3y ago
Switzerland had a very active and well trained military during both World Wars. In fact Swiss neutrality is at least partly rooted in the historical role of Swiss mercenaries -- it was a lot easier to sell your mercenaries if you weren't involved in the war.
tonfa 3y ago
> I wonder if this was at least a factor in Switzerland remaining neutral in both world wars probably has more to do with 1515 (Marignano) and 1815 (Congress of Vienna, which secured Switzerland as an independent state, while enforcing neutrality).
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btbuildem 3y ago

What an interesting read! Fascinating to see how the theory was conceived, tested, and put into practice -- and all that in the backdrop of other approaches, even with the spectre of iodine as a poison!

boobsbr 3y ago

Happened in the French Alps as well. Captain Haddock, from Tin Tin used to call people 'crétin des Alpes'.

rmason 3y ago

My father told me that goitre's were quite common when he was growing up as a boy in Detroit in the 1920's. In my generation it was totally unknown. Yet I remember people affected by polio as a boy quite well. But I bet that millennials have no personal experience with it at all. Each generation moves forward and I can only hope there is a day when no one has any first hand experience with either cancer or Alzheimer's.

masklinn 3y ago
> But I bet that millennials have no personal experience with it at all. Mass vaccination started in the late 50s and especially early 60s (with Sabin’s oral vaccine). Millennials start in 1981, so they would / could well have known affected adults.
- ponector 3y ago
  Considering current antivax movement, it is not unusual for people to get sick with polio, even some got paralyzed. It is hard to understand for me how people can intentionally increase risks of deadly diseases for their children.
  - arlcode 3y ago
    Complacency and political/financial benefits for some of the people paddling that shit, a world where public policy is only a team sport and everybody's opinion on expert topics is equally "valuable". I really hope we find a way out of this before to long. In the end (polio) vaccines work and praying/magic doesn't, so I'm positive we will be able to learn the same lessons our ancestors did.
  - bequanna 3y ago
    Antivax movement? Are you assuming everyone who was not interested in the COVID vaccine just plain doesn’t believe in vaccines?
    - ponector 3y ago

dghughes 3y ago

I had to start taking synthroid since about 5 years in my mid 40s. In my mid 20s I was into Tae Kwon Do and while sparring a guy taller and much heavier punch my in my neck. I have to wonder if he damaged my thyroid.

ufo 3y ago
I'd assume that the null-hypothesis is that it's unrelated. The most common cause of hypo is Hashimoto's thyroiditis, an autoimmune condition. More likely to appear the older you get.

more_corn 3y ago

Iodine deficiency for everyone not willing to wade through the story.

speeder 3y ago

This article made me a little sad. The article is about how people with a fear of iodine overdose resisted the idea of adding it to salt on first place. I spent my childhood in Brazil, a country where there are a good amount of natural iodine. Yet the government decided to ignore the risks, seemly well known for more than a century, and jack up the iodine in the salt to levels beyond what any international standard recommend or tested. And now I hypothyroidism caused by iodine overdose.

d0gsg0w00f 3y ago
To be fair, there was known evidence at the time that large iodine doses were harmful. Very little research had been done for small doses. There was cause for scrutiny.

tweetle_beetle 3y ago

For anyone interested in this area, I would highly recommend following the work of Iodine Global Network (and donating if possible). They work with politicians and industry in a very targetted way to increase the use of iodised salt in food production where it is most needed in the world. They don't directly fund any of the activities, but create the relationships, conditions and understanding for it to happen - meaning they are an extremely effective charity, creating population scale change with very modest funding. They also do lots of work to try to map the global picture of iodine intake from the very varied data available. Some of the results might surprise you - https://ign.org/scorecard/ https://ign.org/scorecard/

timClicks 3y ago

It's fascinating how determined people are with their positions, even in the face of overwhelming evidence that their position causes harm. We see similar arguments today against folate fortification of bread and fluoridation of water.

teslabox 3y ago
Flour is fortified with folic acid because it is more stable. People who are poor methylators can’t transform folic acid into folate, ergo they are harmed by folic acid fortification.

AlbertCory 3y ago

I'll always be grateful to the doctor who just noticed my throat being very slightly enlarged, even though I wasn't complaining. I had my TSH tested and found that I needed the synthetic thyroid hormone. It's cheap and you just take it once a day. Iodine deficiency is ONE cause of goiter, but not the only one. https://www.healthline.com/health/hypothryroidism/hashimotos-vs-hypothyroidism#hashimotos-disease https://www.healthline.com/health/hypothryroidism/hashimotos...

agnosticmantis 3y ago

Reminds me of John Snow's discovery and demonstration of the cause of cholera, which I learned about in the context of casual inference in this excellent paper by statistician David Freedman: https://psychology.okstate.edu/faculty/jgrice/psyc5314/Freedman_1991A.pdf https://psychology.okstate.edu/faculty/jgrice/psyc5314/Freed... Actual science looks nothing like the shoddy paper churning that we see in much of econ and social science using questionable and assumption-heavy casual inference methods.

fuzztester 3y ago

In India iodized salt is common these days, in such table salts as Tata Salt. Salt started being iodized only around 15 or so years back, IIRC.

rldjbpin 3y ago
the regular table salt has been iodized for a long time, as pointed out by another comment. although the rock salts of the world don't seem to be iodized iirc.
Scoundreller 3y ago
Israel notably iodizes very little of its salt and it’s hard to find. Combined with desalinated water consumption, their iodine deficiency rates are through the roof. https://www.haaretz.com/science-and-health/2017-03-27/ty-article/study-israelis-have-among-worlds-worst-iodine-deficiency/0000017f-e116-d9aa-afff-f95e8c5c0000 https://www.haaretz.com/science-and-health/2017-03-27/ty-art... https://ijhpr.biomedcentral.com/articles/10.1186/s13584-020-00367-4 https://ijhpr.biomedcentral.com/articles/10.1186/s13584-020-...
- fuzztester 3y ago
  That's interesting, and surprising for such a technologically advanced country.
truban 3y ago
"India was one of the first countries in the world to have initiated a salt iodisation programme 1962." https://www.livemint.com/news/india/why-should-india-revisit-its-food-iodine-programme-after-pandemic-11625469128805.html https://www.livemint.com/news/india/why-should-india-revisit...
- fuzztester 3y ago
  Oh wow, I didn't know it went that for back. But I am fairly sure I only noticed it in shops around 15 years ago as I said. Okay, maybe 20 or a bit more.

AiaAidan 3y ago

https://archive.ph/3wrzh https://archive.ph/3wrzh

Solortho 3y ago

I take Lugol's iodine almost everyday (with Selenium). It dramatically upgraded my life. The first week could be wild (fever is expected) but people should know how this cheap supplement can help them.

ufo 3y ago
Lugol's iodine is usually not recommended because a single drop has dozens of times the daily recommended dose of iodine. That can cause bad side effects (as discussed in the article)
- Solortho 3y ago
  Not dozens but thousands!
- infertainment 3y ago
  Yes, a minority of people (less than 2%) have Hashimoto's Thyroditis, some without knowing about it, and a large dose of iodine could cause damage to their thyroid, I think through some sort of auto-immune process. The selenium helps prevent that. It's a shame because the remaining 98% could get a lot of benefit and (setting aside the above) iodine is supposed to be the least toxic pure element. In the past Lugol's iodine was used as an antiseptic to put on cuts so I guess a fair amount got absorbed that way.

emmelaich 3y ago

As a kid we always used iodised salt. Now, people seem to buy rock salt and variations with no indication of additives. Does anyone have an idea of how much potassium iodide they might have, if any?

bored2sleep 3y ago

[flagged]

trackofalljades 3y ago

There's an amazing episode of Revisionist History about this. https://www.pushkin.fm/podcasts/revisionist-history/way-to-go-ohio https://www.pushkin.fm/podcasts/revisionist-history/way-to-g...

PlunderBunny 3y ago

New Zealand soil is naturally low in iodine, so by law iodine is added to certain foods (e.g. salt, bread): https://www.mpi.govt.nz/food-safety-home/nutrients-added-food/iodine-added-food/ https://www.mpi.govt.nz/food-safety-home/nutrients-added-foo...

jhoho 3y ago

The soil in the Austrian Country of Styria has notoriously low iodine levels. When visiting Styria in 1748, David Hume wrote: 'But as much as the country is agreeable in its wildness, as much are the inhabitants savage, and deformed, and monstrous in their appearance. Very many of them have ugly swelled throats; idiots and deaf people swarm in every village; and the general aspect of the people is the most shocking I ever saw.' [1] That's why some traditional costumes in that region include a so called "Kropfband" (goitre bound). [2] It's fascinating how much one's place of birth used to influence a life and medical biography and in many countries still does. [1] https://www.gutenberg.org/files/42843/42843-h/42843-h.htm https://www.gutenberg.org/files/42843/42843-h/42843-h.htm [2] https://de.wikipedia.org/wiki/Kropfband https://de.wikipedia.org/wiki/Kropfband

pvaldes 3y ago

Some day morbid obesity will be seen in the same way, as a "scar" of the fat tissue caused after some chemical exposure