The curse of the goitre in Switzerland | Hacker News Reader

The curse of the goitre in Switzerland

lrb.co.uk

610 points_ihaque269 comments

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

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.

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.

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.

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/

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.

Isn't that what the whole article is about?

But the point is that Switzerland's environment is especially poor in iodine hence the specific health problems it used to have, and which were much less serious in neighbouring countries.

While the cases were high in switzerland, they were not unique.

Link to an academic article discussing how the USA is now in the dangerzone of iodine deficiency.

https://link.springer.com/article/10.1007/s12011-018-1606-5#....

Of course they were not unique (though perhaps extreme). I must say I don't get how the replies in this thread relate to my comments...

Definitely if they live in an inland region. Seaweed and fish have abundant iodine.

Aromat uses iodised salt, so despite Zweifel the swiss have nothing to fear

They probably get plenty of iodine from packaged food since it doesn't all come from the same region any more.

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

I-131 also has some interesting history as the very first application of radioactive isotopes in a medical setting. It's used to treat hyperthyroidism and thyroid cancer.

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.

This is different than iodine added to salt, or iodine in liquid form for wounds. I believe it is potassium iodine.

That's correct. Our local public heath department, like many others in communities located near nuclear power plants, has a program for utility-funded distribution of KI to households in designated areas.

It is only taken when the nice person on the radio tells you to do so (you know to tune in from the blaring emergency sirens, tested semiannually). Rather interestingly, the emergency instructions for evacuation state that parents should not go to schools to get their kids, because they'll already be gone: in an emergency, municipal transit buses head to the schools, then take loads of kids to designated areas well upwind of the plant.

All of this info and more is available in a rather well-produced section of the local phone books. Since phone books tend to end up unopened in recycling bins these days, I suspect most newer residents have little idea of what I'm talking about.

Unclear but Germany is monitoring iodine intake and insufficiency is on the rise.

https://www.klartext-nahrungsergaenzung.de/wissen/lebensmitt...

Iodized salt use is decreasing in the US as well. I take a lot of supplements and vitamins and I rarely see iodine as an ingredient so I have placed iodized salt next to my sea salt as I know I do not get enough iodine rich foods in my diet. It's easy to forget about and while I may take things like St Johns and Turmeric daily, I can live without them, iodine not so much.

I take a specific D/K supplement that also has iodine for this reason. It was surprisingly difficult to find one that had it.

[edit]: This one, for the curious, although I get it from Vitamin Shoppe, not direct

https://www.lifeextension.com/vitamins-supplements/item02040...

Morton makes an iodized sea salt

Eat some sushi regularly. Nori has a lot of iodine.

The salt used in processed and prepared foods usually isn't iodized, contributing to declining iodine intake given the increasing consumption of these foods.

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/

Depends on the country. That's the case in the USA but I'm not sure if it applies in Europe.

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.

What are the arguments used against iodised salt? Where would they get their iodine?

I always heard if you eat seafood, you get enough iodine and can stick to plain salt. It looks like milk and eggs are a good source as well.

https://www.medicalnewstoday.com/articles/iodine-rich-foods

I've 100% switched to kosher salt & various sea salts with my own cooking. Not because I'm anti-iodine, but because I like those salts better for cooking purposes. Given how much attention was paid to using kosher salt in cooking by people like Alton Brown over the last 20 years I would expect I'm far from an outlier.

Isn't kosher salt literally just regular salt but in a particular particle size? I also use Himalayan and kosher salt but thats because I eat a ton of junk food which has iodised salt. If you're health conscious and don't do that, it's probably not a bad idea to keep iodised salt and add it in times it's not that important you need to pinch the exact right amount in your fingers or whatever.

You pretty much cannot have too much iodine. It is a good idea to use iodised salt in general.

[edit] fair enough, I need to qualify that. You pretty much cannot get too much iodine with something that looks like a normal diet, and in any case iodised salt is not what push iodine levels over the top. And in a normal diets, iodine deficiency is much, much more likely than iodine overload.

The article states otherwise

>The article states otherwise

No it doesn't. You're ignoring the context.

You can't have too much iodine when it's obtained from iodized salt.

...because you can't handle that much salt.

From the article: 10x'ing the concentration of iodine in salt had no adverse effects. You'd have to eat salt by the pound daily to reach levels where iodine is harmful, but at that point, that'll be the least of your worries.

To be fair to the interlocuters, kergonath left the salt out of his or her or their comment.

I think that depends on the concentration of the iodine in the salt

Right, but that's a standardized fortification so any iodized salt you get anywhere in the world now would make that statement true.

Well, the article brings up iodine overdose from popular medications at the time, but you pretty much can't get too much iodine from iodized salt without having consumed way too much salt.

> You pretty much cannot have too much iodine.

Based on what reasoning?

In reference to iodized salt, you would die of salt overdose before there are ill effects from iodine.

What's stopping salt from having a much higher concentration of iodine than the normal advertised value?

e.g. manufacturing error such that a dangerous amount of iodine is accidentally added.

I benefit from a very robust set of regulatory controls ensuring that food products are as advertised and generally safe for me to consume?

'generally safe' implies that some small number of folks still suffer from excess iodine due to contamination, manufacturing errors, etc...

It's probably reasonable for 999 999 people to benefit in exchange for 1 person being very unlucky, but that's a different argument that needs to be made.

Whats stopping non-iodine salt from being poisoned by Cadmium or mercury? You can make up imaginary risks for pretty much everything.

I guess the same mechanisms that stop manufactures accidentally adding poison to their product.

Which is nothing? There's a clearly non-zero rate of dangerous contamination in food products, in a market as large as the US, that nobody is able to fully prevent.

Simply never way anything and you'll be safe!

Like I mentioned to the other replier, a probabilistic argument is fine, and I would even agree it's reasonable for 999 999 people to benefit in exchange for 1 person being very unlucky, but that's a different argument that needs to be made.

And nobody, in this post at least, has made that argument, nor has anyone even linked to such.

> You pretty much cannot have too much iodine

You may wish to research the Wolff-Chaikoff effect.

That’s fine for people who have a balanced diet rich enough in iodine. Which, to be fair, should be most people bothering about sea salt in the first place. For those who do not, it’s unfortunate, though. There is a reason why adding iodine is a good idea in the first place.

Sea salt and kosher salt also come iodized, it's an independent feature.

Pretty much the same as against fluorine in water in the States: it’s unnatural/a globalist conspiracy/killing our traditional way of life/a plot to subdue the people for <reasons>.

There is no scientifically sound reason against it.

Not to argue about dosing water, but fluoride has no value ingested and is poisonous at low doses. It's best to moderate your arguments against the anti-fluoride mob or you're too easily dismissed yourself.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956646/

> Public health approaches for global dental caries reduction that do not involve systemic ingestion of fluoride are urgently needed.

https://en.wikipedia.org/wiki/Fluoride_toxicity

You forgot "sap and impurify all of our precious bodily fluids"

That's why I use ed, the standard text editor

I deny them my essence.

We’re still not sure what that last bit means.

There’s scientifically sound reasons for not wanting to drink fluorine, namely that the science is still out for whether it’s useful when used alongside regular topical applications. Not to mention excessive fluorine can stain or pit the teeth, and that it may even destroy nerve tissue.

https://www.hsph.harvard.edu/magazine/magazine_article/fluor...

> the science is still out for whether it’s useful when used alongside regular topical applications.

That’s a meaningless comparison. The whole point is that people aren’t doing topical application.

A similar debate to this is the adding folate to flour or bread.

Don't most (all?) toothpastes contain fluoride?

The LD50 of fluoride in drinking water is actually lower than the LD50 of water itself - drink enough fluoridated water to die from fluoride poisoning and you'll die from water poisoning first

Things can have negative health effects without killing you, so the LD50 is not particularly helpful in this context.

Only the measurable decrease in IQ from municipal water fluoridation, which can seen when comparing Portland, where they do not fluoridate, to similar large cities in the PNW where they do.

There is scientific reason against it, just not matching many of the conspiracy nuts’ rhetoric.

Most of Western Europe bans fluoridation. It can make your bones a little less elastic and a little more brittle, and there are a few other known or potential negative effects.

There are also just better ways to prevent cavities.

This seems like the sane, boring reality. People with modern dental routines probably don't benefit from the original purposes of fluoridation the same way people in the early 1900s only just getting electricity did.

But people only just getting electricity in the early 1900s easily benefited more than were harmed by such things. Poor dental health gets scary quick.

I guess the question becomes how low do you lower the bar for those who would willingly devoid themselves of sane things to include in their lives. How much freedom does one man have to harm his self, though he thinks as a self, costs to him are more often than not also costs incurred to society (and usually a society that'd prefer to not see people do self harmful things)

At least in the US though, it seems that popular opposition to fluoridation started with cold war era conservative conspiracies (precious bodily fluids). So, you know.

In Deutschland, the iodized salt is nearly always iodized+fluoridated, whereas the only other option is plain salt with neither.

https://shop.rewe.de/p/bad-reichenhaller-marken-jodsalz-500g...

Iodized salt with nothing else should be available in most supermarkets.

Well, fluoridated water tastes really… well, special, and it almost feels like an indirect subsidy for the water filter industry. Iodine in salt is (to my taste) pretty neutral in comparison.

[EDIT: as pointed out in a child comment, the taste actually comes from chlorine, not fluoride.]

Isn't that taste chlorine from the sanitation process?

Either way I actually do assume water filter companies lobby to keep public water as subpar an option as possible, there's certainly no incentive not to.

Yes, you're right, I mixed up fluoride and chlorine. And thus my previous comment doesn't make sense any more. My apologies!

It doesn't bother me for drinking, but I've gotten in the habit of keeping an open (loosely covered would probably work too) pitcher of water in the fridge for making coffee, so it sits at least overnight before use, and dissipates some (having already served its purpose.)

Somehow I doubt “Big Filter” has the kind of money and clout they would need to pull that off. I’d accept being proven wrong, but I just doubt it in the absence of seeing proof.

Most of the taste problem that’s in our water “on purpose” is chlorine and it’s not added out of spite, it’s added for sanitary reasons.

Apart from me mixing up chlorine and fluoride, my comment was a bit hyperbolic - of course, there's no Big Filter industrial complex :)

I haven't done a lot of research on how to clean water, but e.g. in Germany, tap water isn't chlorinated and thus has a much more neutral taste. And it's very much regulated to a high standard.

This from a country where tapwater unfortunately typically tastes like crap?

(b/c it is chlorinated)

Unless it is significantly over chlorinated tasting like crap isn't because of the chlorine, in general the causation will be reversed here. Places that use a lot of chlorine are typically trying to kill off things that both taste bad and will try to kill you.

Depends on the salt, there are few that hardly contain more then dairy, but some salts contain enough to make it make sense.

My main issue with normal salt is the anti-caking ingredient needed to not have it stick together, in general not needed with sea salt and a real grinder.

You hate sand, huh.

Most common one used here is Sodium Ferrocyanide : https://en.wikipedia.org/wiki/Sodium_ferrocyanide

Also used as a coating in welding among other things. And like other commentor said, a nephew of cyanide.

Now Im sure most of us will be fine, but I prefer not to eat that a few times a day. If you think that makes me foolish, be my guest.

It's also not needed, there are plenty of other sources of Iodine, and sea salt from the grinder is perfectly fine.

You can actually consume a _lot_ of cyanide without negative consequences, your body can detoxify it easily in small quantities. You can dissolve a lethal dose of cyanide in a bottle of water, and you'll be fine if you drink it in small sips over the course of a day.

Cyanide is so toxic because it has a high affinity for iron ions, so it deactivates iron-containing enzymes that are crucial for respiration. But in ferrocyanide it is _already_ combined with iron.

Ferrocyanide compounds like Prussian blue are even sometimes used as an antidotes for heavy metal poisoning.

Yeah, just because it doesn't directly harm a human in small dosis, doesn't mean it's a good idea to just add it to the daily diet of a human.

We simply don't know, and haven't research the longterm effect of small dosis on a daily intake. Especially combined with other conservatives & chemical additives in small dosis.

You can't deny there are some major diseases in the modern world on a rise and we have no idea why.

Yet here everyone always so sure that everything we're doing with food additives, pesticides and chemical processing is super safe.

There's just no need to eat these things, just eat normal food.

> We simply don't know, and haven't research the longterm effect of small dosis on a daily intake.

For cyanide? We actually do. Cassava roots contain quite a bit of it, and they are used as a staple in some places in Africa. You can indeed can get chronic poisoning, but it requires A LOT of cyanide.

Huh, why do they use that in the EU over silicates? (That was why I referenced sand btw).

Also, not sure what the relevance to iodine is?

Incidentally, iodine isn't easily sourced in some countries, due to soils that contain very little of it. My country (NZ) used to have a very real goitre problem until the introduction of iodised salt in the 1920s.

The anti caking I commonly see in salt is potassium cyanide [ferrocyanide, actually, see below].

https://en.m.wikipedia.org/wiki/Potassium_ferrocyanide

I'm sure you're aware that ferrocyanide is not the same thing as cyanide - the cyanide is bound so tightly to the iron center that it is nontoxic.

> However, like all ferrocyanide salt solutions, addition of an acid or exposure to UV light can result in the production of hydrogen cyanide gas, which is extremely toxic.

Now that does seem like a bit of a concern, doesn’t it?

It's a matter of quantity, like all things toxicity.

That is not potassium cyanide.

Yes, sorry, shouldn't post in a hurry. I amended my post. I'm not worried about the stuff at all, I buy salt with it all the time. But it's not sand, that's all I wanted to say.

they're afraid it'll give them 5G or whatever shite they make up on the spot

Some people dislike the flavor of iodized salt. But what would you expect from future cretins?

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.

> 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).

I thought it was clear that I meant that in jest. My point was that the amount of iodine is imperceptibly small.

People almost certainly confuse iodine with anticaking agents.

But microplastic in sea salt is a real thing (and might be a bit worrying, personally I now always go for mountain salt, deposited pre-anthropocene era)

What an absurd thing to fixate on. There are a million other things you consume that are going to have more microplastics in them.

Haha, I totally agree.

Sure. Even still you’re talking about a highly abrasive product often packed in plastic. But none of that is material to my point.

Sadly, this is the argument that people give ¯\_(ツ)_/¯

The article mentions that blind taste testing couldn’t detect it at 10x the strength.

Surely people test before claiming such things?

“Unicef, concerned about the sensitivity of children to odd flavours, commissioned a study in which rice was prepared with salt iodised at ten times the maximum recommended concentration. In double-blind taste tests, the iodine was undetectable.”

Iodized salt is almost always the industrially produced variety, pure NaCL and much more salty than the natural varieties - either sea or mountain salts that typically include other minerals and are milder in flavor.

We have iodised sea salt around here, and it’s not more nor less industrial than standard sea salt. It’s true that the flavour is different than hand-processed sea salt or fleur de sel because of those impurities (which include microplastics and other less-than-ideal compounds, though, even though I love and use mostly barely-processed sea salt), but it is neither more nor less salty.

That is more about crystal size and roughness than anything else. Some companies are working on nanoscale crystals of salt that allow you to use significantly less salt for the same saltiness profile based on these properties.

Cool! Where do I sign up for the salt innovation newsletter? I want to try this when it comes out.

Just run regular salt for a few seconds in a blender. I'm not joking, I prefer using powdered salt when seasoning sliced tomatoes and the like, and it does make a difference in perception vs. dose.

FWIW, that was addressed in the article:

> Whatever chefs might claim, this fact is well established: in 1995, Unicef, concerned about the sensitivity of children to odd flavours, commissioned a study in which rice was prepared with salt iodised at ten times the maximum recommended concentration. In double-blind taste tests, the iodine was undetectable.

I'm just repeating what people have told me.

In this instance it seems you should avoid this habit.

In your head, did that sound wittier than it reads?

Certainly wittier than the repetition of ignorant nonsense.

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...

How come that the disease wasn't widespread earlier?

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.

Ah, okay.

The article just read like there were some unusual strange things going on around 1900 in Switzerland.

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.

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.

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.

Is that a pun in German as well or is it just funny coincidence of translation?

I am always flabbergasted when people question incredibly effective public health initiatives.

https://en.wikipedia.org/wiki/Goitre#History

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

This was pre-internet and in remote areas where there is a distrust of central authority.

And there are loads of examples through history up till current day that show that blindly trusting authorities is naive. Heck, even in the article, some doctors were poisoning their patients with iodine. It is not far fetched that some people in these areas were informed of these problems. So a tiny amount kills us... and so you are saying any even tinier amount will save us. I'd be pretty skeptical too.

It seems that when presented well and with personally verifiable evidence, people were willing to accept.

I am really flabbergasted when people blindly accept in mass what authorities tell us.

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.

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.

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.

The country: Switzerland The people: Swiss

The word Switzer isn’t in use since a very long time :)

Sorry, I was lazy and just translated Schweizer without checking :D

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.

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).

Maybe they should just RTFA

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

> I am always flabbergasted when people question incredibly effective public health initiatives.

I think it comes from a generalised distrust of governments/big institutions. Which comes from hearing (often heavily distorted) stories about things like Tuskegee Syphilis, MKULTRA, CIA vaccinators in Afghanistan and Thalidomide.

This might interest you: 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."

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...

Why do you say it wasn't present earlier?

The article made that impression on me.

> 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.

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/database...

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…

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!

What makes you think it wasn't? The article doesn't claim so.

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.

The article mentions iodine is apparently not changing the taste of salt in blind tasting. Do you have information to the contrary?

Table salt has not only iodine added but anti-caking agents too so it might be what OP is tasting.

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?

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!

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 [2]: https://en.wikipedia.org/wiki/Hors_d%27oeuvre

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

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.

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.

It's worth noting the critical details: how to prevent scurvy was understood, but the underlying mechanisms were not. This mattered because it meant why the treatment worked was not understood, with the result being a resurgence when a supposedly effective treatment turned out to be ineffectual.

Basically, it's easy to think we understand something when we have a solution to it, but the two should not be automatically conflated.

Before the internet I was like "how could we lose information like that and replace it with junk", but now I'm like "oh, I see exactly how that happens"

The article you're linking to is one of my favorite pieces of writing ever.

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

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.

My father also grew up in Detroit and also told me about goiters being common when he was young.

Apparently Michigan helped normalize the ionization of salt in the US: https://www.michiganradio.org/show/stateside/2022-05-12/once...

There’s an entire area of the US that was called the Goiter Belt. Basically the top half. It was really common.

Only if sensible people continue to run the public health authorities.

You now have people that refuse to vaccinate their children against measles, COVID vaccine hesitancy is a widespread phenomenon with some people resorting to heresay remedies like horse dewormers instead, an anti-vaccine conspiracy theorist is running for US president and polling with double digit numbers.

Health-related insights are particularly susceptible to targeted misinformation. And in an era of social media, this can quickly become a majority opinion.

A large number of people have refused the COVID vaccine for completely valid reasons. The vast majority of that group absolutely vaccinates their children against polio, measles, etc.

They aren’t the anti science luddites your comment paints them as. They are (rightly) skeptical of “the science” which often isn’t very scientific at all.

As we’ve seen, the medical science community is heavily motivated by profit and prestige, but unfortunately not always truth.

New discoveries in that field are often revealed to be bullshit. They deserve skepticism, not blind compliance.

Well said. I am a strong believer in vaccines.

Injecting code that causes all of your cells to mass produce spike protines to train your body to fight the spike proteins that your cells are producing just seems really questionable and the VAERS db seems to support my skepticism.

When I started reading the details of how this vaccine worked from the pro-mrna sites, my engineer side started ringing alarm bells and noped right out of it.

When google and others started silencing alternative viewpoints and major govt related employers mandated it, I dusted off my tinfoil hat.

They should have just let the information be free (bad or good) and not pushed so hard. Now they have created distrust.

> 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.

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.

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.

Antivax movement?

Are you assuming everyone who was not interested in the COVID vaccine just plain doesn’t believe in vaccines?

There is a difference in "not interested in receiving COVID vaccine" and fighting against vaccination in general, refusing to vaccinate children with mandatory shots like MMR or polio.

Yes, there absolutely is a difference and the second group is incredibly small.

I think it is important to make that distinction.

It is not small. Have you heard that vaccines cause autism? It is a popular believe of antivaxxers. So popular that >25% of kids in London are not vaccinated. 1/4 is huge and could compromise herd immunity.

> Only 74% of children under five in London have received both doses of the MMR vaccine – 9.1 points lower than in 2013–14.

I'm born around that time although before 1981.

I had some elderly neighbors with this condition and I think they lived long enough (1990 maybe?) that my two next younger brothers might have visited them too. (Why I don't know: they were not relatives or anything, my mom and aunt just used to visit them to be nice to them, so I suspect when I started school they might have taken my place.)

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.

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://pl.wikipedia.org/wiki/Ciechocinek#/media/Plik:Teznie...

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.

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

Apparently the first such towers were built in 1600s.

> I think, outside Europe, this afflicted lots of places away from the coast, right? Like the middle part of the US.

That's exactly where it afflicted people in europe as well, mountainous regions tend to be inlands, and from their remoteness don't have the opportunity for incidental iodine through trade, so they worsen the odds, but historically distance from the sea (and thus lack of sea products) has absolutely been the primary issue. CIDS was also endemic to the english midlands for instance.

> I’ve always wondered if the iodine in the air is part of the allure of the seaside.

No, intake from air is considered insignificant.

intake from air is considered insignificant

But, intake from air is how the soil & plants get it, over long time scales…

It’s always possible that a simple indirect selection is at play, e.g. people who simply love the sea breeze (for no particular reason) are more successful because they get enough iodine. Then, the next generation is more likely to love the sea breeze.

> But, intake from air is how the soil & plants get it, over long time scales…

Plants get it from the soil, onto which the iodine gets deposited. There is no breathing apparatus involved.

> It’s always possible that a simple indirect selection is at play, e.g. people who simply love the sea breeze (for no particular reason) are more successful because they get enough iodine.

What part of “intake from air is considered insignificant“ did you fail to understand? You don’t breathe in iodine, it’s been observed to not be a thing.

1) your great grandparents loved the ocean air and thus moved near the coast

2) plants near the coast have iodine because iodine has been blowing in from the ocean and depositing on the soil for eons

3) you eat those plant

4) you don’t have an iodine deficiency because your ancestors moved to live by the sea

Yes. It was also common in mountainous areas of western China and Tibet.

To broaden the question; is it proven that sea air is healthier? The top search results point in both directions.

It is not. This kind of ideas is the remnant of the “bad air” theory of diseases propagation, which is not actually a thing and was displaced by germ theory at some point in the 19th century. People clung on to this belief because why not (and there was money to be made bringing rich people to countryside or seaside resorts) but there is no real rational justification. That’s not to say that the atmosphere cannot be harmful locally, but the seaside is not particularly healthy.

The rational justification is that seaside has often wind from the sea which bring cleaner air. There are no car exhaust, no power plant emissions, no factories, no dust in the sea.

Air quality in any coastal city in Poland is much much better than in Warsaw/Krakow/Wrocław which are quite far away from the Baltic sea.

In my family there is definitely memory of this . My grandmothers generation has seen the old folks with the enlarged neck

I remember it from my grand-grandparents. It wasn't common-common like in late 19th century Switzerland, but there was at least one case close enough to come across yourself.

I am coming directly north from Switzerland I assume that iodization did become common only later especially for the masses.

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...

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 Caption: Woman with goitre in Frienisberg, 1921.

Image 2: 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 Caption: Six women with cretinism, ca. 1920.

Image 4: 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 Caption: Experiments with the snow shovel: the Valais country doctor Otto Bayard, 1937.

Image 6: 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... or https://archive.is/rHzSV

edit: formatting, removed german caption texts

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/

Can absolutely recommend that one.

A fascinating story overall and a reminder of just one of a number of everyday sicknesses we (as a society) have been able to overcome through science and understanding, despite the occasional step backwards.

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/

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...

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.

Supplementation with T3 yields a rapid correction in bradycardia and hypothermia caused by hypothyroidism. We treat with T4 because it has a longer physiological halflife and thus yields more consistent serum levels; but the evidence is incredibly clear that it's T3 which is having an effect, not T4.

How does the T3 produce the result? Is it possible that conversion to T2 - liberation of iodine - is what does it? I have not head of this condition so I'll do some reading. Also, does simple iodine supplementation help?

https://en.wikipedia.org/wiki/Thyroid_hormone_receptor

https://www.thyroidmanager.org/chapter/cellular-action-of-th...

T3 hormone binds to thyroid hormone receptors in the cell's nucleus, which regulates gene expression. These TH receptors are present all over the place; thyroid hormone has wide ranging effects on the body.

The most common cause of hypothyroidism is the autoimmune destruction of the thyroid gland. No amount of Iodine helps; you need T3 (usually administered as T4 which is then converted to T3 endogenously).

If this were true, it would mean that people with hypothyroidism could simply supplement iodine rather than needing to replace the hormones.

For some symptoms it may be true, for others not? Some hypothyroidism can be fixed by supplementing iodine. Some are due to other causes. Also, some of the things thyroid hormone seems to do can also be achieved by iodine supplements, and some not. It's very complicated.

In that case the thyroid is not, in fact, “simply” a mechanism to store and distribute iodine, is it?

> 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?

Based on their third paragraph, I assume they mean that people are not eating enough iodine.

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.

>> Are you saying that all those conditions are due to excess iodine?

No, the opposite. I'm suggesting they are due to low iodine intake.

... and congenital deafness, low length growth, neurological impairment, and other symptoms known as Congenital iodine deficiency syndrome.

The thyroid is by far the largest consumer of iodine. It stores iodine in thyroglobulin, which is the precursor to thyroid hormone. I don't know the numbers, but I wouldn't be surprised if the thyroid released more iodine by breaking down thyroglobulin than breaking down thyroid hormone.

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.

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

[2] https://de.wikipedia.org/wiki/Kropfband

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

There's an amazing episode of Revisionist History about this.

https://www.pushkin.fm/podcasts/revisionist-history/way-to-g...

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.

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.

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.

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.

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/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.

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.

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.

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).

That jumped out at me as well -- the parallels (and political alignments) are unmistakeable. We see the same today with the current plague.

It's so sad how many people's heath is affected by assholes trying to protect their ego.

Not to be confused with Max Bircher-Benner, the inventor of Birchermuesli.

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.

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.

National shaming day.

I am affraid some people would take this and turn it into a day of celibration...

My first thought when Bircher's political, and other, actiobs where mentioned in the article, was: Why am I not surprised?

Opposition to public health measures doesn’t seem to be related to left or right politics as far as I can tell - there are numerous examples in both directions and the history is long. Early examples that come to mind include opposition to sewers and small pox vaccines.

It feels like occasional people have to be reminded of consequences.

Otherwise polio, measles and the like are still as dangerous as they ever were and are ready to make their big return if vaccination rates drop too much. I'm certain even small pox is lurking somewhere out there.

It seems like, unfortunately, humanities book of learned lessons gets reprinted in pain and suffering once in a while.

He was reminded every day as his home canton still had high rates of gout and children being born deaf/mute.

Since he offered treatment packages, that meant a larger customer base?

Like dentists who are against fluoride in water, I guess.

Fluoride in water is different so, as the better alternative is adding it to tooth paste.

I don't understand why tacit support of leftism is allowed but if I counter it, I am immediately flagged.

Very unfair that this is still happening on a site with so many smart people on it.

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-foo...

https://archive.ph/3wrzh

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.

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)

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.

Not dozens but thousands!

Paywall free 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).

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?

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.

> In 1875, life expectancy in Switzerland was just 38

As is usually the case with numbers like this from the past, this is a mean value, not a median value, that is massively skewed downwards by having upwards of 50% child mortality by age 4.

A typical Swiss person in 1875 who had already turned 30 could be expected to live to be 70.

Here's an article talking about this phenomenon [0]. They term it "adult modal age at death", i.e. at what age do people tend to die once they have survived childhood? In Sweden, in 1875 an adult woman could be expected to live to be 72, and an adult man to be 69. But the average life expectancy in Sweden in 1875 was only 44.

Per the same article, the modal age at death for adults in Switzerland in 1875 was 70 for both men and women.

[0] https://www.cairn-int.info/article-E_POPU_1204_0683--the-mos...

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.

> 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).

Speaking of the Alps and related regions, this was also considered a condition typical for Styrians (inhabitants of the country of Styria) in Austria.

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.

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-art...

https://ijhpr.biomedcentral.com/articles/10.1186/s13584-020-...

That's interesting, and surprising for such a technologically advanced country.

"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...

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.

*that far back

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.

Happened in the French Alps as well.

Captain Haddock, from Tin Tin used to call people 'crétin des Alpes'.

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.

> 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).

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.

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!

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?

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

Very nice story. Love this stories of scientific progress. Thank you.

And after reading it whole I must say. Fuck you Bircher.

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

Goitre and cretinism was present in French Alps too.

> 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.

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.

Nothing in the article suggests it magically stopped at the border.

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.

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

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