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Goiter classification: Grade 0: No palpable or visible goiter Grade 1: Not visible with neck in normal position. Mass moves upwards when subject swallows. Nodular changes can occur when goiter is not visible Grade 2: A swelling in the neck that is visible when the neck is in the normal position and is consistent with enlarged thyroid by palpitation. Urinary iodine: <25 microgram/l  - severe deficiency, urgent intervention required <50 microgram/l  - unacceptably low >100 microgram/l  - sufficient levels Readings: * UNICEF 1991, Training course for ultrasonography for endemic goiter ** UNICEF 1994, Indicators for assessing iodine deficiency disorders and their control through salt iodization, NY