Screening patients for iodine deficiency

It takes just three minutes. The physician, Dr. Amir Sabet, coats his patient’s throat with a gel before carefully moving the ultrasound transducer into place above it. On the monitor, Dr. Joachim Schwab’s thyroid gland appears. Schwab is a department head for Cologne’s district government. His responsibilities include environmental protection and occupational health and safety, and today he’s setting a good example: “We invited the ThyroMobil to our health days,” he says as he rises from the examination table and lets the physician explain his diagnosis.

The ThyroMobils — there are currently three — have been on the road since 1993. Christian Schintag from Merck is responsible for their deployment. “The idea originally arose when we wanted to collect data on iodine deficiency and related thyroid problems,” recalls Schintag, a certified biologist and health care economist.

Deficiency illnesses in industrialized countries? Yes, they occur, at least when we’re talking about the trace element iodine. Iodine was first isolated in 1811, from the ashes of marine algae. The body requires between 150 and 200 micrograms of this element daily in order to produce the thyroid hormones. These hormones control oxygen consumption and heat production, and affect many other bodily functions — from growth to the central nervous system. If there is insufficient iodine, the first signs of a thyroid problem often soon follow, including swollen eyelids, or a feeling of fatigue and lack of motivation.

As the illness progresses, a goiter — referred to as a “struma” by physicians — can develop. It’s the clearest, most visible result of iodine deficiency, which is the cause of nine out of ten goiter cases. The only effective preventive measure against iodine deficiency is to provide supplements of the element. But that isn’t always easy in a normal diet. The last ice age washed the element out and into the sea. As a result, most natural foods are low in iodine, except for seafood, fish, and algae.

“People who don’t eat enough fish and don’t use an iodine-enriched table salt may find their thyroids are deficient in iodine,” says Schintag. It’s up to the ThyroMobils to detect this problem. The vehicles are mobile physicians’ offices built on the basis of Mercedes 3120 vans — including air conditioning and a refrigerator — and they are equipped with everything needed to thoroughly screen about 120 people a day.