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Cretinism is a severe disorder caused by congenital hypothyroidism, a condition in which the thyroid gland fails to produce sufficient amounts of thyroid hormones from birth. Thyroid hormones, mainly thyroxine (T4) and triiodothyronine (T3), are essential for normal growth, brain development, metabolism, and maturation of body tissues. If this deficiency is not detected and treated during early infancy, it results in permanent physical and mental disabilities. The term "cretinism" is now largely replaced in medical practice by the term congenital hypothyroidism because it is more accurate and less stigmatizing. However, the term cretinism is still used in educational and historical contexts to describe the severe manifestations of untreated congenital hypothyroidism. From the perspective of community nutrition, cretinism is an important public health problem because one of its major causes is iodine deficiency. Iodine is an essential micronutrient required for the synthesis of thyroid hormones. In regions where the soil and water are deficient in iodine, people consume inadequate amounts of this nutrient, leading to iodine deficiency disorders (IDD). Cretinism represents the most severe form of iodine deficiency disorder. It is entirely preventable through adequate iodine intake and effective public health interventions. There are two major forms of cretinism. The first is neurological cretinism, which is characterized by severe intellectual disability, deaf-mutism, squint, spasticity, and motor abnormalities. This type mainly results from iodine deficiency during early pregnancy when fetal brain development depends on maternal thyroid hormones. The second is myxedematous cretinism, which is characterized by severe hypothyroidism, short stature, delayed skeletal development, dry skin, puffy face, and mental retardation. Individuals with this form may also have enlarged thyroid glands or goiter due to prolonged iodine deficiency. The causes of cretinism include congenital absence of the thyroid gland (athyreosis), underdeveloped thyroid gland (hypoplasia), abnormal development or location of the thyroid gland (ectopic thyroid), inherited defects in thyroid hormone synthesis, maternal iodine deficiency during pregnancy, maternal use of antithyroid drugs, radioactive iodine exposure, congenital defects in hormone metabolism, and severe iodine deficiency in the community. Among these causes, iodine deficiency remains the most significant nutritional factor, especially in developing countries. Iodine deficiency develops when dietary intake of iodine is consistently below the body's requirement. Since the human body cannot synthesize iodine, it must be obtained from food and water. The recommended dietary allowance varies according to age and physiological status. Pregnant and lactating _____ __________ ______ ____ _________ ___ ______ ____ _____ ______ ___.
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