It seems like a brilliantly simply idea. Indian women with iodine deficiencies could be spared severe medical conditions, says an advertising agency, if they use a special version of an everyday beauty accessory: the Jeevan Bindi or the Life-Saving Dot. The firm says it has handed out packets of iodine-coated bindis to women in rural areas, which will provide users with their daily dose of the essential element through the skin on their foreheads. "It's the difference between life and death," Grey For Good, the philanthropic arm of Singapore-based direct marketing and advertising firm Grey Group, claimed in a video that has received wide media coverage. But is it?

The Jeevan Bindi is supposed to function on the same principle as the iodine patch test, in which a solution of iodine is applied to an arm or abdomen. If the iodine disappears, the person who is undergoing the test may have an iodine deficiency, which is indicated by the fact that the solution was quickly absorbed by the skin. However, medical literature is also replete with references to how most of any iodine solution applied to the skin evaporates and less than 12% is actually absorbed by the body. If 150 micrograms had to be available in the thyroid gland and other tissues where iodine is processed, a far bigger dose may be required on the skin.

“The body will take up only what it requires but it has to go internally first,” said Dr Chandrakant Pandav, head of the Centre for Community Medicine at the All India Institute of Medical Sciences and the IGN's Regional Coordinator for South Asia. "If I have 500 micrograms and my body needs only 150 micrograms, the rest will be excreted in urine." Pandav said applying iodine to the skin might work, provided that it is in a high concentration. There are instances in historical records of people applying Lugol’s solution, a concentrated iodine solution, to the neck area where the thyroid gland is located. But Pandav questions the use of the iodine bindi when it has been well established that ingesting iodine orally with salt or bread or even toffees is effective.

No follow-up

A solution to a medical problem like iodine deficiency typically needs many tests and the success of the Jeevan Bindi would depend on passing those tests. “A urinary iodine estimation is the gold standard to know what is happening to the iodine metabolism,” said Pandav. “The second study we do is radio-iodine uptake, and the third is the thyroid hormones.” There has been no follow-up in the Jeevan Bindi campaign to see if the bindi-wearing women’s iodine-related health problems have been addressed.

Harish Bijoor, management consultant and brand domain specialist, said that many companies and advertising agencies are intent on creating a “soft aura” about themselves. “Due diligence needs to be done very, very keenly by marketers and their advertising agencies before embarking on campaigns which touch people so intrusively, especially when it comes to health,” he said.