Dr's Casebook: Mystery of Derbyshire neck in the 18th and 19th centuries

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We spent last week in Derbyshire. Apart from the glorious scenery I found myself looking at people’s necks.

Dr Keith Souter writes: Now you may think that sounds odd but I was doing so out of medical interest.

You see, the old medical textbooks all talk about Derbyshire neck, which was the name given for an excessively large goitre, which is a swelling of the thyroid gland in the neck.

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It was particularly common in the county of Derbyshire back in the 18th and 19th centuries.

Woman with enlarged hyperthyroid gland. Photo: AdobeStockWoman with enlarged hyperthyroid gland. Photo: AdobeStock
Woman with enlarged hyperthyroid gland. Photo: AdobeStock

Goitres are not in themselves uncommon but Derbyshire neck goitres were huge.

In 1769 J Pilkington described them as being ‘so large that they were like the flap or dew-cap of a turkey’s neck.’

He also said that they could cause difficulty with breathing when people exerted themselves.

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Clearly, they were a real problem and far more extreme than anything that we see today.

Indeed, the incidence has been declining since the 1930s.

The reason that people developed Derbyshire Neck in the old days was because of iodine deficiency.

There simply was not enough iodine in the diet.

The reason there wasn’t enough is thought to be because there was not enough iodine in the water or in the soil.

Locally produced foods were therefore iodine deficient and people reacted to their iodine deficient diet by developing a goitre.

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Nowadays, people do not depend upon the food that they grow or which is grown locally, but obtain it from shops. And iodine is added to foods by manufacturers.

So really, I was not surprised that I failed to see anyone with Derbyshire Neck.

Yet it set me thinking about whether the iodine content of the soil in Derbyshire is still low, or if indeed there was any research done on it.

I found that this had actually been looked at in a study at the University of Derby.

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The researchers developed what they called a PBET test, which stands for Physiologically Based Extraction Test.

It was a test designed to simulate the way in which minerals can be absorbed into the food chain.

They looked at soil samples from all over the Peak District.

Interestingly, it is not that the soil is low in iodine; it is just in a form that is not easily absorbed by plants.

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