March 2024

At IGN, when we talk about the economic cost of iodine deficiency, our thoughts are immediately drawn to the loss of learning ability in children and how it impacts their lives.

But beyond the clear imperative of protecting children’s brains through adequate iodine nutrition, we know that even the prevalence of mild iodine deficiency disorders results in significant health care costs.  Some of these will be discussed in our upcoming report on iodine deficiency in Europe, due for release in May 2024.

But there are already some insights into treatment costs related to mild iodine deficiency.  A recent article in The Lancet on Iran[1], a country that struggled with iodine deficiency for many years, shows that investment in a salt iodization program in 1990, accompanied by educational campaigns to the public, policy makers and health care workers, as well as partnerships with international organizations, led to 90% of people incorporating iodized salt into their diets.

After more than 30 years with improved iodine nutrition, the article estimates that Iranian children have collectively gained approximately 90 million IQ points. 30 million cases of goitre and thousands of thyroid surgeries have been prevented, with an approximate savings of more than $25 billion in health care expenditure.


A 2020 study[3] in Germany, where some 30% of the population suffered from mild iodine deficiency, concluded that iodization potentially saves cost if even a minimum of iodine deficiency disorders could be avoided. The paper estimates that diagnosis and treatment of goiter could be costing more than 2 billion Euros per year.  Germany had no data on IDD prevalence and incidence before and after the introduction of iodized salt, but using a Danish study for comparison, they estimated that about 814,000 cases of goiter annually had likely been prevented due to the introduction of salt iodization, and that in this case, salt iodization in Germany would already be cost-saving.

If we look at benefits globally, a review of the health and benefits of salt iodization programs to correct iodine deficiency between 1993 and 2019 concluded that 720 million clinical cases of iodine deficiency have been prevented. The impact in terms of cognitive development and future earnings was estimated then as an economic benefit of nearly $33 billion.

The global campaign to address the problem of iodine deficiency was based largely around the imperative to protect the developing brains of children, and most cost estimates were based on the effects on cognition and school performance.  These studies, and our upcoming report on iodine deficiency in Europe, show that the costs clearly go beyond that, making the case for improved iodine nutrition even more urgent.

[1] Azizi, Fereidoun, et al. “Iodine status in Iran: from deficient to replete.” The Lancet Diabetes & Endocrinology 11.12 (2023): 903-904.

[2] Vandevijvere S, Annemans L, Van Oyen H, Tafforeau J, Moreno-Reyes R. Projected reduction in healthcare costs in Belgium after optimization of iodine intake: impact on costs related to thyroid nodular disease. Thyroid. 2010 Nov;20(11):1301-6. doi: 10.1089/thy.2010.0133. PMID: 21062196

[3] Schaffner M, Rochau U, Mühlberger N, Conrads-Frank A, Qerimi Rushaj V, Sroczynski G, Koukkou E, Thuesen BH, Völzke H, Oberaigner W, Siebert U. The economic impact of prevention, monitoring and treatment strategies for iodine deficiency disorders in Germany. Endocr Connect. 2021 Jan;10(1):1-12. doi: 10.1530/EC-20-0384. PMID: 33263563; PMCID: PMC7849460.