Endemic goiter lacks the element iodine. Endemic goiter is a type of goiter associated with dietary iodine deficiency, where soil and water in inland areas are deficient in iodine compounds, especially at high altitudes far from the ocean. The body does not get enough iodine, and the body cannot synthesize enough thyroid hormones when it is iodine-deficient, and stimulation through thyroid-stimulating hormones causes the goiter to enlarge. It is often referred to as endemic goiter because of the regional nature of the condition. Endemicity is more common in females than males, and is common during puberty and pregnancy. Consumption of iodized salt is the most common treatment for this condition, and seafood such as fish and crabs, as well as edible foods grown in marine soils such as kelp, provide the body with a certain amount of iodine, which helps to minimize the adverse symptoms of endemic goiter.