One of the most common clinical problems I seein my practice is thyroid dysfunction. Nearly twenty years ago, while working in Sri Lanka, it was common to see people, the great majority of them women, walking about with huge lumps - some the size of a tennis ball, some closer to a bowling ball - under their chins. These goitres, or enlarged thyroid glands, were for the most part a result of malnutrition, specifically a lack of iodine in the diet.

At the time I was working as an acupuncturist in a rural clinic, and it was possible to achieve considerable success in treating this condition through nutritional advice and acupuncture. The thyroid problems I see today in this country, though, are of a different sort. Rarely are they caused by a simple iodine deficiency.