1. Authors defined the cut-off for ‘inadequate iodized salt’, and ‘insufficient urinary iodine excretion (UIE)’. But further cutoffs for defining the severity as well as toxicity levels are not provided. Their description in methodology will be an ease for readers. Also, UIE <200 µg/L was considered "insufficient" by the authors, whereas WHO as well as NIDCP uses UIE <100 µg/L for defining the same [2-4]. Using a different cut-off will change the prevalence and its public health implications.

2. The median UIE level of the population was 175 µg/L, which signifies ‘adequate iodine nutrition’ in the population [2,4]. The results of individual patient/subgroup should not be used for drawing the conclusion as the results of spot sample may vary significantly among different specimens from the same individual [4].

3. As per WHO, if the median UIE levels of a population are ‘insufficient’ the level of iodization of salt, along with factors affecting the utilization of iodized salt (production level quality, packaging, and transport methods, salt intake and cooking habits) should be reassessed [4]. In this study, all households were using packed salt but there is no mention whether it was iodized or not. Also, 432 (80%) out of 540 samples were inadequately iodized at the consumer level. If these levels are despite using iodized salt, it raises serious concern at the level of iodization at production, packing, transport and storage level, and warrants urgent administrative action.

4. A majority (80%) of the population was using inadequately iodized salt, but 36% of children had UIE in toxic level. How can this finding be explained?

5. The authors used only semi-quantitative rapid test kits for iodine estimation of the salt. WHO recommends using quantitative titration method for iodine analysis in sub-sample of salt that has been analyzed by rapid kit [4].