25 Aug '15
Iodine, Are You Getting Enough?
Posted by Karen Dame
The information on iodine is so compelling, I wanted to share it with you. Some important points to note are these, iodine is a critical nutrient with the same antioxidant activity as Vitamin C. Non-radioactive, inorganic iodine/iodide gets blamed for causing thyroid problems that are actually caused by pharmaceuticals containing organic, radioactive iodine. Thousands of hypo and hyper thyroid patients have been using inorganic iodine/iodide successfully for years. The breasts, heart, stomach and prostrate all need inorganic iodine, and its role in immunity may also reduce the risk of diabetes. Toxic halides in the body, exacerbate iodine deficiency.
by Chris D. Meletis, N.D.
Iodine is a non-metallic element discovered in 1811. It is one of the most misunderstood minerals because it's often associated with iodine-containing drugs that use the toxic organic form of radioactive iodine rather than the beneficial inorganic form. People also assume that iodine deficiency is a thing of the past, due to the iodization of salt.
When people do think of iodine, they usually think in terms of its effects on the thyroid gland. But more and more research is pinpointing the ability of inorganic, non-radioactive iodine to play a pivotal role in the health of the brain, heart, breast and prostate as well as the immune system. It's also important not just for hypothyroid patients, but also hyperthyroid patients as well.
In this article, I will discuss all the ways iodine impacts health, as well as the critical nutrients patients may need in addition to iodine in order to experience the most improvement.
Mention antioxidants and iodine probably isn't the first nutrient to come to mind. However, concentrations of iodine as low as 15 micromolar in human serum has similar antioxidant activity as one of the most well-known free-radical fighters - vitamin C.1
Iodine deficient glands contain higher amounts of malondialdehyde, a marker of lipid peroxidation.2 This is because iodine can decrease damage done by oxygen free radicals through its role as an electron donor in the presence of hydrogen peroxide, peroxidase and some polyunsaturated fatty acids.3-4
Iodine/Iodide for Underactive and Overactive Thyroid
The thyroid gland absorbs iodine from the blood and incorporates it into the thyroid hormones T3 and T4, which contain three and four atoms of iodine per molecule, respectively. This mineral is therefore essential to optimal functioning of the thyroid gland and for thyroid hormone production.
Yet, despite its crucial role in thyroid health, inorganic, non-radioactive iodine/iodide has remained a scapegoat blamed for causing problems in the thyroid that, in reality, are often caused by pharmaceuticals containing organic or radioactive iodine.
Up until the early 1900s, thyroidologists recognized inorganic iodine's beneficial role in thyroid health. They used iodine/iodide to treat both hypothyroidism and Grave's disease. But by the 1930s, even though iodine deficiency is the most common cause of hypothyroidism and simple goiter, thyroidologists considered the standard protocol for hypothyroidism to be substituting thyroid extract rather than iodine itself to replenish the deficient hormone. Today, some 80+ years later, endocrinologists are still using this same approach, administering T4 to reduce all symptoms of hypothyroidism and to reduce serum thyroid-stimulating hormone (TSH) concentrations to within the normal range.
Unfortunately, what these conventional endocrinologists often don't fully appreciate is that iodine deficiency in women predisposes them to breast cancer.5 Furthermore, giving T4 to iodine-deficient women further increased their breast cancer risk.6
Not only did iodine/iodide fall out of favor as the primary way to treat hypothyroidism - thyroidologists also stopped using it to treat Grave's disease. Instead, using goitrogens or removing or irradiating the thyroid gland became the treatment of choice for managing patients with Grave's disease. This was unfortunate, because many people who had hyperthyroidism were helped by the iodine/iodide combination previously used to treat the disorder.
For example, before many thyroidologists were erroneously taught to avoid giving inorganic iodine to hyperthyroid patients with Grave's disease, they often administered Lugol's solution, a combination of iodine and iodide. The use of both iodine and iodide in Lugol's solution resulted in a higher success rate with fewer complications than using iodine or iodide alone.7-15
Modern iodine researchers/clinicians using iodine/iodide have treated thousands of patients using this combination of iodine/iodide with success in both Grave's disease and hypothyroidism, especially when iodine is combined with other important nutrients (more on this later).
Iodine - More Than Just a Thyroid Mineral
In people who are iodine sufficient, only 30 percent of the iodine in the body is found in the thyroid tissue and thyroid hormones. The remaining iodine concentrates in tissues of the breast, eyes, gastric mucosa, cervix and salivary glands. Therefore, iodine deficiency can have disastrous consequences on more than just thyroid health.
The Breasts and Iodine
The breasts are more efficient in capturing and collecting molecular iodine compared to the thyroid gland.16 So it's not surprising that there is a strong connection between breast health and iodine.
Autoimmune thyroid disease occurs more often in patients with breast cancer. Researchers have found a significant link between breast cancer and Hashimoto's thyroiditis. They compared 100 breast cancer patients to 100 matched controls. Hashimoto's thyroiditis occurred in only two percent of the control group. However, 13.7 percent in the breast cancer group had the disorder. Goiter - a marker of iodine deficiency - occurred in only 11 percent of controls but in 27.4 percent of the breast cancer patients.17
Furthermore, in a clinical study, iodine levels in breast tissue were lower in women diagnosed with breast cancer than in women with normal breasts or benign fibroadenoma. Other studies have found that iodine-deficient breasts develop tumors as well as pathological changes in RNA/DNA ratios and estrogen receptor proteins.18-19
Iodine's role in breast health extends beyond preventing tumor formation. In a study of women who had fibrocystic breast disease, the subjects improved when supplemented with iodide, although side effects were common. When a combination of iodine and iodide was given to these patients, symptoms resolved or were reduced in most of the patients without the side effects that occur when supplementing with iodide alone.20-21
A Hidden Cause of Heart Trouble
Thyroid disorders caused by iodine deficiency decrease myocardial contractility, increase peripheral vascular resistance and are associated with disturbances in lipid metabolism.22
In one study of 42 patients with cardiovascular disease, the patients were divided into five subgroups based on the type of cardiovascular condition they suffered from:
congestive heart failure
The researchers then measured urinary iodine concentrations in the subjects. The lowest urinary iodine concentration was detected in the subgroups with arrhythmia and congestive heart failure. An elevated TSH level was found in three patients. High cholesterol and triglycerides were associated with all subgroups without arrhythmia.22
The researchers concluded, “The occurrence of iodine deficiency in cardiovascular disease is frequent. Iodine supplementation might prevent the worsening effect of iodine deficiency on cardiovascular disease.”
Iodine's presence in the gastric mucosa and its ability to act as an antioxidant explains why there is a strong relationship between stomach cancer and iodine deficiency. Researchers have found a greater incidence of severe iodine deficiency (49 percent) in stomach cancer patients compared to the control group (19.1 percent).23 There also is a link between self-reported goiter and upper gastrointestinal cancer.24
Boosting Cognitive Health
Iodine deficiency results in cognitive impairment, as noted in a number of studies. When patients who are testing as iodine deficient start supplementing with inorganic iodine, their brain fog often lifts. Additionally, studies have noted psychological disorders in adult subjects suffering from iodine deficiency.25 A review of the medical literature published in April 2013 found that IQ scores were 6.9 to 10.2 points lower in iodine-deficient children compared with iodine-sufficient children.26
Iodine deficiency also is linked to autism. In one study in Egypt, iodine deficiency was prevalent in autistic children and their mothers and was inversely related to disease severity. The study authors suggest that iodine deficiency could be involved in the development of autism.27
Goitrogens can weaken myeloperoxidases, which are involved in the defense mechanism against infections. Myeloperoxidase is found in high concentrations in polymorphonuclear leukocytes and monocytes.28 Leukocytes have the ability to concentrate iodide 300-fold during phagocytosis.29 They also can deiodinate thyroid hormones to generate inorganic iodide when iodide levels are low.30 Researchers have found that iodide can enhance the antimicrobial activity of myeloperoxidase in leukocytes.30
Other Iodine Deficiency Conditions
Like the breasts, the prostate gland stores iodine, and this mineral is equally critical for prostate health. Researchers studied the effects of iodide or iodine on two types of human prostate cancer cells and non-cancerous cells. They found that iodine, in a dose-dependent manner, had anti-proliferative effects. When the scientists transplanted one of the cancerous cell lines into mice, iodine supplementation in the mice reduced growth of the prostate cancer cells.31
Another disease linked to iodine-deficiency is diabetes. Researchers compared 52 diabetic children (insulin-dependent) with 386 non-diabetic children, 11- to 13-years-old. Thyroglobulin autoantibodies were positive in 33 percent of the diabetics versus 14 percent in the control group, and thyroid peroxidase autoantibodies were positive in 38 percent of the diabetic children compared to six percent of the controls.32
Additionally, anti-thyroid antibodies and goiter prevalence are significantly higher in polycystic ovary syndrome (PCOS) patients, suggesting iodine deficiency may play a role in this condition as well.33
What Causes Iodine Deficiency?
Iodine's role in so many areas of health makes its widespread deficiency particularly concerning. Iodine deficiency persisted even after the iodization of salt in the 1920s. Even though the amount used in salt is enough to prevent goiter, it's not enough to ensure other tissues are exposed to a nourishing supply of iodine.
Furthermore, hypertensive patients usually cut back on salt, further ensuring a lower iodine intake. And many people consume sea salt, which often has no iodine added. Plus, the amount of iodine in soil is low and varies substantially by region.34
Making things worse is that many substances we are exposed to daily compete with iodine for absorption in the body. These items are known as goitrogens. Some of the foods your patients consider to be the healthiest such as the cruciferous family of vegetables - broccoli, arugula, cabbage and Brussels sprouts - are all goitrogens. Spinach and peaches also act as weak goitrogens.
Additionally, iodine is a halide and other members of the halide family - bromide, chlorine and fluoride - compete with iodine for absorption. When iodine is deficient, these other halides, each of them toxic, will take iodine's place.35
You are exposed to these toxic halides daily. Bromide replaced iodine as a dough conditioner in many bread products. Bromide also is a common fire retardant and is found in most new plastics, carpets, household goods and new cars. It's also in some sodas such as Mountain Dew® and Sun Drop®, as well as some Gatorade® products and other citrus-flavored beverages, and is commonly used in hot tubs and spas. Additionally, vegetables are often contaminated, thanks to the practice of using methyl bromide as a fumigant in agriculture. People are exposed to other halides when they drink water containing fluoride and chlorine or use fluoride-containing toothpaste or dental products.
Another common environmental toxin - perchlorate - interferes with the thyroid's ability to use iodine. Dairy products can become contaminated with perchlorate and it's also found in many crops (including organic crops) due to irrigation with water that contains it.
In a study published in May 2013, thyroxine concentrations were five percent lower in 1,939 subjects with high perchlorate levels compared to 2,084 subjects with low perchlorate. In 62 subjects who had low iodine levels combined with high perchlorate along with high thiocyanate (a toxin derived from the diet and cigarettes that acts as a pseudohalide), thyroxine concentrations were 12.9 percent lower compared to the 376 subjects with low perchlorate, low thiocyanate and adequate iodine.36
Restoring Iodine Levels
The first step is to test for whole body iodine sufficiency as determined by an iodine/iodide loading test. One test that has been used over the years consists of ingesting four tablets of a total of 50 mg iodine/iodide. Urinary iodide levels are then measured in the following 24-hour collection.
The iodine/iodide loading test is based on the concept that the normally functioning human body has a mechanism to retain ingested iodine until whole body sufficiency for iodine is achieved. As the body iodine content increases, the percent of the iodine load retained decreases with a simultaneous increase in the amount of iodide excreted in the 24-hour urine collection. Whole body sufficiency for iodine/iodide has been proposed to be 90 percent or more of the ingested amount excreted in the 24-hour urine collection. However, clinically, these levels are very hard to achieve.
This historical gold standard test has new competitors in the laboratory marketplace. These other tests are also gaining popularity, and it appears at this point in time, there is no perfect test for iodine sufficiency testing.
Testing patients for bromide levels is also prudent. For patients who test high in bromide, it's important to detoxify the body, otherwise a detoxification reaction can occur as the iodine pushes bromide off the iodine receptors. Usually, the body expels high levels of bromide as the dose of iodine increases, as demonstrated in lab tests.
Chloride competes with bromide in the kidneys and increases the renal clearance of bromide.37-38 Therefore, one of the best ways to rid the body of bromide is to undertake salt loading for a week. If you have tested high for bromide, take 1/4 to 1/2 teaspoon unprocessed sea salt dissolved in half cup warm water. Immediately drink 12-16 ounces pure water. If copious urination doesn't begin within 30 to 45 minutes, repeat. You can repeat this protocol several times per day until you start to urinate profusely. Sodium chloride at 10 grams/day for one week results in a marked increase in urine bromide levels and a sharp drop in serum bromide.
Fatigue can temporarily worsen as the patient expels bromide from the body. Other symptoms such as facial and body acne can also appear until the bromide is cleared.
In hypertensive individuals, this protocol should only be undertaken using potassium chloride in place of sodium chloride.
To restore iodine levels, supplementing with an iodide/iodine combination rather than just iodine alone is the optimal strategy. Seaweed isn't the best choice to replenish iodine/iodide levels. With the widespread pollution of our oceans, especially after the Fukushima disaster, seaweed often contains toxic contaminants (including high concentrations of bromine) and is therefore not a trusted source of iodine.39
A Complete Program
It is important to remember that any nutrient must be supplemented in a balanced fashion with other critical cofactors. In the case of iodine/iodide, sufficient selenium, magnesium and co-factors that support synthesis, metabolism and organification of iodine/iodide are essential for positive results.
A number of nutrients should be given in conjunction with iodine, especially if you are not responding to iodine supplementation. In more than 4,000 iodine-loading tests of patients in the Flechas Family Practice Laboratory, Dr. Flechas and his colleagues have found that some patients have a normal gastrointestinal absorption of iodine, but a defective iodine retention system, where the absorbed iodine is excreted in the urine with little or no retention.
In these rare cases, the loading test will suggest whole body iodine sufficiency (90 percent or more excreted), but the serum inorganic iodide levels 24 hours after the iodine load will remain low (less than 0.13 mg/L).40 Dr. Flechas has found that the iodine transport damage was corrected at least partially by administration of the antioxidant vitamin C in a sustained released form at three grams/day for three months.
Iodine deficiency is a common but often undetected problem. Here's how to determine if you need to supplement with this critical nutrient.
Test for iodine sufficiency using an iodine loading test and 24-hour urine collection.
Based on the results, start supplementing with iodine/iodide, 12.5-50 mg per day.
Test patients for bromide toxicity, and if the results warrant, recommend salt loading to expel the bromide.
Recommend other supportive nutrients including:
B Complex Vitamins and ATP Cofactors for those with Auto Immune Disease
Elevated bromide levels could be to blame for this defect in iodine cellular transport since high bromide levels were observed in urine and serum samples of patients with this defect, at 20 times the levels reported in the literature in normal subjects.
Therefore, in these patients, it is helpful to try a salt loading test (as described above), along with vitamin C.
An emphasis on magnesium rather than calcium is another important aspect of iodine supplementation. Low iodine levels combined with magnesium deficiency and high cytosolic free calcium cause oxidative damage to the thyroid gland through excess production of H2O2. This oxidative damage ultimately results in an autoimmune reaction and may contribute to Hashimoto's thyroiditis.
Selenium is another nutrient important for thyroid function and using it along with iodine, vitamin C and magnesium can improve results.
Finally, a good detoxification supplement can help escort perchlorate from the body.
Iodine deficiency may be the hidden cause behind many individual's health concerns. Testing for iodine deficiency can help determine supplemental needs while at the same time monitoring patients for bromide toxicity will dictate whether a detoxification program needs to be implemented. In patients who have thyroid conditions, low and slow dosing is always the best approach while at the same time monitoring TSH, free T4, free T3, reverse T3, thyroid peroxidase antibodies, anti-thyroglobulin antibodies and other indices as appropriate on a regular basis before, during and throughout treatment.