Recently, among the patients I see in the clinic, I am often asked why I have Great Neck Disease. Is it because I take too much iodine? Great neck disease is the common name for what is medically known as nodular goiter. Due to advances in medical care, the vast majority of patients are treated before the typical presentation of a large neck. However, the cause is still iodine deficiency. Some people ask, “Why am I still iodine deficient when I eat iodized salt every day? This is because there are two causes of iodine deficiency: one is that not enough iodine is being consumed into the body, and the other is that the body cannot absorb or use it effectively. The second condition is more insidious and easy to ignore. It is like eating the same meal, why some people get fat, but others are fine. The first type of iodine deficiency is easy to deal with and can be corrected by eating iodized salt or seafood, while the latter is more difficult to solve. Currently, most of the patients who come to the clinic are caused by the latter. However, I would suggest that for daily life one should still use iodized salt, which has been historically proven to be effective in preventing most nodular goiter. As for nodular goiter caused by poor iodine utilization, it is still in the minority. The best way at present is to use iodine-containing foods in the diet, such as seafood, and secondly, if the nodules are too large, they can be surgically removed without too much tension Han Chengxin, General Surgery Department, Armed Police General Hospital