DOSAGE~ How much iodine shall I take?
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some resources on dosage... by wombat 17 year 1 of 1 (100%)
//www.curezone.org/forums/em.asp?i=871848
Ah, yes, the eternal question....DOSING!!!!!
I've gone through the archives and scoured the web and pulled out all of the stuff on dosing that I can find. There seems to be much fear surrounding Iodine supplementation....there is all sorts of conflicting information on the WWW. I can't promise that this post will clear up any of your confusion, you kinda have to decide "who" to believe for yourselves:) BTW, this posting ONLY refers to Lugol's or the tablet equivalent, iodoral. I'll leave the detoxified Iodine stuff up to others....
According to Guy Abraham, MD, 2 drops of Lugol's solution a day is an effective amount for supplementation. HowEVer...higher doses will displace heavier halogens, fluoride, chlorine & bromides..50 mg. per day for 1 to 3 mos. is what I've heard recommended to "flush" out the heavier halogens...and that's what we're after:
http://www.townsendletter.com/Oct2005/gabyrebuttal1005.htm
"Clinical experience has continually shown that iodine/iodide supplementation results in a large urinary excretion of bromide.3,18 When bromide levels begin to decline, the above mentioned adverse effects begin to decline as well. Chloride increases renal clearance of bromide15 and the use of NaCl or ammonium chloride shortens the time required for bromide detoxification with orthoiodosupplementation. Oral administration of sodium chloride (6 to 10 gm/day) increased the renal clearance of bromide by 10 fold with mean serum half-life of 290 hrs in control subjects and 30-65 hrs after chloride administration."
So...2 drops is good, AFTER you've cleared out the heavier halogens, IMO. And 2 drops a day is suffiicient to protect you from radioactive fallout as well:
http://www.townsendletter.com/Oct2005/gabyrebuttal1005.htm
"Protection of the thyroid from radioiodine fall out in cases of nuclear attack and accident would benefit from the recommended daily intake of I, discussed above. The equivalent of 2 drops of Lugol solution (12.5 mg I) daily would maintain a low radioiodine uptake by the thyroid gland (3-4%). Since the greatest damage to the thyroid occurs during the first few hours of radiation"
*****************************************************************************************************************************************************************
First of all, some persective on the fear that surrounds Iodine supplementation...Guy Abraham, MD, "The History of Iodine, Part 3"
http://www.optimox.com/pics/Iodine/IOD-16/PUB_16.htm
"A new syndrome, medical iodophobia, was recently reported. (4) Medicoiodophobes suffer from: 1) split personality which results in iodophobia within the orthoiodosupplementation range previously used safely and successfully in medical practice and iodophylia for megadoses of Iodide (up to 12 g/day); 2) double standards which render those physicians intolerant to the minor side effects of the inorganic forms and extremely tolerant toward severe side effects of the radioactive and organic forms; 3) amnesia toward the inorganic, non-radioactive forms when making therapeutic decisions; 4) confusion, attributing the severe side effects of organic iodine containing drugs to inorganic iodine/iodide; and 5) altered state of consciousness, allowing doublethink, doublespeak, and contradictory logic to become acceptable.
Although the factors involved in medical iodophobia are still unknown, decreased cognition seems involved. Since low iodine intake is associated with intellectual impairment, deficiency of this essential element cannot be ruled out and, if present, would create a self-perpetuating phenomenon. Needless to say that medical iodophobia is contagious and can be transmitted to patients and other physicians (iatrogenic iodophobia). Although there is yet no official report from the Center for Disease Control regarding the prevalence of medical iodophobia in the US medical community, it is likely that this syndrome has reached pandemic proportion.
Medical iodophobia will remain a syndrome until the causes are discovered and effective therapy implemented. The disastrous effect on the US population of the zombification of the medical profession through iodine deprivation is already evident. Implementation of the orthoiodosupplementation program in the medical community is highly recommended. The increased cognition of health care professionals, resulting from orthoiodosupplementation, will eventually trickle down to patients in the form of a more enlightened approach to patient care."
******************************************************************************************************************************************************************
That fear was not always there...
http://panaminstitute.com/de-iodine.htm
"According to Hungarian Nobel Laureate Szent-Györgyi, KI was the
universal medicine in Europe during the late 1800’s and early
1900’s. Szent-Györgyi himself ingested 1 gm of KI [postassium
iodide[ daily to keep himself fit. "
*******************************************************************************************************************************************************************
Words from the wise re: dosing, David Brownstein, MD:
//www.curezone.org/forums/fm.asp?i=836069#i
"After testing individuals and finding low iodine levels, I began to use smaller milligram amounts of iodine/iodide (6.25mg/day). Upon retesting these individuals 1-2 months later, little progress was made. I therefore began using higher milligram doses (6.25-50mg) to increase the serum levels of iodine. It was only with these higher doses that I began to see clinical improvement as well as positive changes in the laboratory tests...
As I started to use larger doses of iodine (12.5-50mg/day), I began to see positive results in my patients. Goiters and nodules of the thyroid shrank. Cysts on the ovaries became smaller and began to disappear. Patients reported increased energy. Metabolism was increased as evidenced by my patients having new success in losing weight. Libido improved in men and women. People suffering with brain fog reported a clearing of their foggy feelings. Patients reported having vivid dreams and better sleep. Most importantly, those with chronic illnesses that were having a difficult time improving began to notice many of their symptoms resolving."
and more...
http://www.optimox.com/pics/Iodine/IOD-09/IOD_09.htm
"My clinical experience with using physiologic doses of iodine/iodide (6.25-50mg/day) has been very positive. To date, in my practice, my partners and I have treated over 3,000 patients. The side effects with using these doses have been minimal. Rarely, have I observed iodism (metallic taste in mouth, frontal sinus pressure/pain, and increased salivation). Iodism is easily rectified by adjusting the dose of iodine down or simply telling the patient to await the resolution of these symptoms which takes approximately 1-3 weeks. True iodine allergy to inorganic, non-radioactive iodine is very rare. In treating over 3,000 patients, I have found three patients with "allergy" to non-radioactive inorganic iodine/iodide. An acupressure technique, NAET (NAET.com) has proven very effective to reverse this allergy. Allergy to fish, shellfish or radioactive iodine does not mean there is an allergy to inorganic non-radioactive iodine. In fact, true inorganic iodine allergy is very rare."
*******************************************************************************************************************************************************************
Drs. Abraham and Brownstein answer Dr. Gaby, a critic:
http://www.townsendletter.com/Oct2005/gabyrebuttal1005.htm
Safety
"Dr. Gaby's editorial claims that the relatively high doses of iodine/iodide used in orthoiodosupplementation may lead to hypothyroidism, goiter or autoimmune thyroid problems. This just is not the case. A review of the literature revealed that the organic forms of iodine were involved in most of these complications.3 Iodine intake has fallen over 50% in the U.S. over the last 30 years.38 During this same time, increases in diabetes, hypertension, obesity, breast and thyroid cancer, and other thyroid disorders, have been reported. It appears to us that iodine deficiency, not iodine excess may be responsible for the increase of these conditions.3,18
As of this writing (7/12/05), the clinical experience with orthoiodosupplementation in approximately 4,000 patients at the Center for Holistic Medicine has clearly shown that orthoiodosupplementation at daily dose of 6.25 to 50mg elemental iodine has not been associated with increases in hypothyroidism, goiter and autoimmune thyroid problems. On the contrary, the use of iodine/iodide has been effective at treating the above conditions with minimal adverse effects.
Dr. Gaby points out that "some people are especially sensitive to the adverse effects of iodine." He is correct. Just as some people are sensitive to Vitamin C, some are sensitive to iodine/iodide. Few holistic physicians would deny the effectiveness of mega doses of Vitamin C, in amounts thousands of times greater than the RDA for Vitamin C, in the treatment of wide range of illnesses. Just as with Vitamin C therapies, individualized doses and proper follow-up visits can help minimize adverse effects of iodine/iodide therapies.
Dr. Gaby writes, "The relative absence of side effects may be due to the use of iodine as part of a comprehensive nutritional program." He is correct. With orthoiodosupplementation the best results do occur when used as part of a comprehensive nutritional program, as do all holistic therapies. We favor a magnesium emphasized total nutritional approach.3
The most common adverse effects of iodine/iodide supplementation observed at the Center for Holistic Medicine has been metallic taste in the mouth and acne. Based on the experience of three clinicians at that Center, with a combined patient population of some 4,000, the prevalence of these side effects is about 1%. This is probably due to a detoxification reaction. The release of bromide may be one cause of this detoxification reaction. Clinical experience has continually shown that iodine/iodide supplementation results in a large urinary excretion of bromide.3,18 When bromide levels begin to decline, the above mentioned adverse effects begin to decline as well. Chloride increases renal clearance of bromide15 and the use of NaCl or ammonium chloride shortens the time required for bromide detoxification with orthoiodosupplementation. Oral administration of sodium chloride (6 to 10 gm/day) increased the renal clearance of bromide by 10 fold with mean serum half-life of 290 hrs in control subjects and 30-65 hrs after chloride administration. Intravenous sodium chloride gives the same results as the oral route.15
In the practice of medicine, we have seen very few natural therapies as safe and effective as orthoiodosupplementation. In the proper forms of iodine (inorganic non-radioactive forms), in daily amounts of iodine for whole body sufficiency and properly monitored, orthoiodosupplementation is not only safe, it is an effective tool for the clinician. Prior to the availability of assays for thyroid hormones and without any test for assessing whole body sufficiency for iodine, our medical predecessors recommended a range of daily iodine intake from Lugol solution (12.5-37.5 mg) exactly within the range required for achieving whole body sufficiency for iodine.3,16 Relying on clinical observation of the patient's overall wellbeing, our predecessors have given us useful information, which we have discarded in favor of preconceived opinions of self-appointed pseudoexperts. This has resulted in pandemic iodine deprivation. Iodine deficiency is misdiagnosed and treated with toxic drugs. Orthoiodosupplementation may be the simplest, safest, most effective and least expensive way to help solve the health care crisis crippling our nation."
*******************************************************************************************************************************************************************
Dr. Abraham on the daily requirement for Iodine:
http://www.optimox.com/pics/Iodine/IOD-02/IOD_02.htm
V. Requirement of the human body for I
"So far, the optimal daily requirement for I has been estimated at 6 mg of Iodide for the thyroid gland and 5 mg of iodine for the mammary glands. The adrenal glands may also require adequate levels of I for normal function. A recent study of female rats exposed to noise stress revealed a decreased adaptability to stress when these rats were placed on an I-deficient diet. There was an attenuation of the pituitary adrenal axis to stress that persisted after functional recovery of the pituitary thyroid axis. Therefore, this effect of I on the adrenal response to stress is totally independent of thyroid hormones.
Certain roles of I in wellbeing and protection against infections, degenerative diseases and cancer may not involve its action on specific organs and tissues. Instead, such properties of I, affecting every cell in the human body, may depend on its concentration in biological fluids. Derry (54) has reviewed some beneficial properties of I: the antimicrobial effect of I in organs capable of concentrating it to reach effective I levels; the apoptotic property of I in the body’s surveillance mechanism against abnormal cells; the ability of I to trigger differentiation, moving the cell cycle away from the undifferentiated characteristic of breast cancer, for that matter of all cancer. Besides, as a halogen, and because of its large size, I has the ability to markedly enhance the excited singlet to triplet radiationless transition (55). Reactive oxygen species causing damage to DNA and other macromolecules, are usually excited singlet with a high energy content released rapidly, and characterized by fluorescence, whereas the corresponding triplet state contains lower energy levels which are released slowly, expressed as phosphorescence. Such an effect of I would depend on its concentration in biological fluids. Using a rudimentary phosphoroscope, Szent-Gyorgy was able, 50 years ago, to demonstrate this effect of I on the singlet ® triplet radiationless transition, at a concentration of 10-5 M (56). It is likely that this effect would persist at 10-6 M, which would correspond to a serum I level of 12.7 ug/100 ml. Such a level is easily achieved with I intake in the range consumed by mainland Japanese. This effect of I would markedly decrease the oxydative burden of the body, having a beneficial impact upon degenerative diseases and cancer. Protection of the thyroid from radioiodine fall out in cases of nuclear attack and accident would benefit from the recommended daily intake of I, discussed above. The equivalent of 2 drops of Lugol solution (12.5 mg I) daily would maintain a low radioiodine uptake by the thyroid gland (3-4%). Since the greatest damage to the thyroid occurs during the first few hours of radiation
exposure (57), this recommended level of I would serve as a prevention in cases of unexpected exposure.
Collective experience may have played a role in the choice of 2 drops of Lugol daily for I supplementation (43). Amazingly, 0.1 ml (2 drops) of Lugol contains 5 mg iodine and 7.5 mg Iodide as the potassium salt, the near perfect total amount of I and ratio of iodine over iodide, for sufficiency of the thyroid and mammary glands. This amount of Lugol solution would then represents an ideal form of orthoiodosupplementation. Based on the above criteria for I sufficiency of the whole human body, the mainland Japanese represent the only population in the world consuming adequate amounts of I. Thyroid function is higher in normal Japanese woman, a low risk population for Breast Cancer than in normal British women who are at high risk for Breast Cancer (11). When 5 different ethnic groups living in Hawaii were compared with British women and mainland Japanese women, the latter showed the highest serum levels of Free T4. There was a significant and inverse correlation (p<0.001) between serum Free T4 and the incidence of Breast Cancer in these 7 groups with mainland Japanese women showing the lowest incidence (11,12). Since T4 therapy in I-deficient women increased their risk for breast cancer (17), the significant correlation between serum Free T4 and breast cancer is not necessarily indicative of a protective role of T4. Instead, this correlation may point to the higher I levels in Japanese women, expressed as increased thyroid function. Prasad et al (58) reported significantly lower serum T4 and higher serum T3 levels in 40 women with histologically confirmed breast cancer, compared to 10 normal controls. Although these authors did not measure urine I levels in those cases, the pattern they reported in women with breast cancer is typical of I deficiency: increased T3 levels and lower T4 levels to compensate for the limited availability of I" (30).
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The current iodine protocol for breast cancer patients calls for 50 mg. iodoral per day, and I've heard rumblings that that may be upped to 100 mg:
http://www.breastcancerchoices.org/iprotocol.html
* 50 mg Iodoral minimum for Breast Cancer (may start with 12.5 mg).
Some practitioners may recommend another form of iodine such as
Lugol's solution. Iodoral is the Lugol's formula in tablet form.
* Vitamin C - 3,000 mg per day (more may be necessary to detox bromide).
* 300-600 mg magnesium oxide or comparable magnesium supplement.
* 200 mcg selenium.
* 625 mg inositol hexaniacinate twice a day. (Some patients cannot tolerate
this supplement so it may be best added after a month of iodine therapy to
distinguish niacin side effects from iodine side effects.)
* A comprehensive vitamin and nutrition program.
*******************************************************************************************************************************************************************
And FBD has been cured at much lower doses...or has it? I don't know that these women were followed after the studies:
http://iodine4health.com/body/breast/eskin_ghent_breast.htm
The dosing device that they used this the study had 13.65 total mg. of iodine. per 70 ml.(aqueous solution, I believe) The unit was designed to dispense 50 doses of 20 ml, totalling 1000 ml. The patients recieved one dose per day, could be doubled if no effects observed. Sooo, according to MY math(highly questionable), each dose provided .273 mg. of iodine.
In this link:
http://www.findarticles.com/p/articles/mi_m0ISW/is_256/ai_n6258834
The dosage was 0.08 mg/kg of body weight. 50 kg = 110 lbs. which would be only four milligrams a day. I need 4.912(5) mg.(I weigh 135) , according to that study.
So, two studies, two vastly different amounts used for dosing. We also have the daily requirement for iodine(NOT the U.S. RDA, which is set criminally low), which, in all of my reading, seems to be from 12-15 mg. for women(8-12 mg. for men).
******************************************************************************************************************************************************************
Now, some stuff on low dosing:
http://panaminstitute.com/de-iodine.htm
"The medical use of Iodine and iodides has more than a 100 year
history. Rural Medicine Editor of Medical World, Dr. DeForest
Clinton Jarvis, born in 1881, a member of the Academy of
Ophthalmology and Otolaryngology, the American Medical
Association and other leading medical societies of the time was a
great user and advocate of Lugol's solution. His interest in the folk
medicine of Vermont began soon after the start of his medical
practice. To counter the effects of iodine loss, Dr. Jarvis
recommended various methods including: (1) Eating foods rich in
iodine: food from the ocean, radishes, asparagus, carrots,
tomatoes, spinach, rhubarb, potatoes, peas, strawberries,
mushrooms, lettuce, bananas, cabbage, egg yolk, and onions; (2)
Painting a small area of the body with tincture of iodine; and (3)
taking preparations known to be rich in iodine, including cod liver
oil, kelp tablets ...
But he was particularly keen on the power of Lugol's iodine, for
treating various illnesses, including colds and flu, and for
countering the effects of stress: "Supposing you do follow the
suggestions outlined above and find that some weeks the pressures
of your private and your business life are causing you to lose the
ability to bounce back. Then you should add a drop of Lugol's
solution of iodine to your glass of apple or grape juice at breakfast,
or you may take it in the mixture of apple cider vinegar and water.
The point is that the potassium in the solution (Lugol's is 5%
potassium iodine) blocks off the body mechanism that organizes for
aggressive action, releasing its hold on the body when opportunity
for rest and relaxation arises. The iodine swings into action the
body and the building up and storing of body reserves. When
working under pressure, include the Lugol's solution dose each day
until the period of pressure passes. If it should happen that your
body becomes saturated with iodine, you will find that there is an
increase of moisture in the nose. If this occurs, omit the iodine until
the nose is normal."
http://lewisford.info/files/The_Basic_Program_from_Feeling_Young_and_In_Love2.pdf
Pp. 15 - 25 cover iodine. I have never come across Lewis Ford before, he does sell his own iodine supplements, so of course he will espouse ideas that promote that. He is in agreement, however, with the thought that we are woefully deficient in iodine. Lots of interesting reading here, do give it a look.
He says that the best *final* dosage of iodine for women is 12 mg. per day, for men, 8-12 mg.
I found this interesting:
(in reference to *final* dosage) "About 90-95% of American Adults can start right at those final high doses with no health problems...
Even 1 mg. per day, however, is still too high a dosage for about 5 - 10% of American adults to BEGIN with. It may take months, or even years, for the millions of Americans suffering from more severe thyroid problems and/or "diabetic neuropathy" to get used to eating that much iodide. This is because as dying peripheral nerves start being revived with more optimal iodide levels and metabolism, they usually do not function normally for months or even years. Instead, they tend to signal to the brain sensations of intense itching/phantom pains. To help reduce these very distracting and painful problems, it is more comfortable to start with just 1/2 mg. iodide per day. This is about 3-4 times as much as most Americans are currently getting, but it is still a low enough dosage not to overly aggravate the peripheral itching and pain problems."
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For those of you that are nervous on iodine supplementation, just start slow. I was nervous as I was uninformed. The more I learned, the less fear I had. I have upped my dose slowly over 3 1/2 months time, I'm now at 50 mg. Whether that was the best thing to do, I don't know. My "detox" symptoms have been quite manageable, so I guess that it has worked for me. I have seen that people here usually experience the worst detox symptoms the first week or so. If your "detox" becomes too uncomfortable, just back off or take a break. We're all using iodine for different reasons. I have FBD so I'm in it for the long haul...I don't want to end up with breast cancer... :)
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All wombat's Answers
//www.curezone.org/forums/em.asp?i=871848
Ah, yes, the eternal question....DOSING!!!!!
I've gone through the archives and scoured the web and pulled out all of the stuff on dosing that I can find. There seems to be much fear surrounding Iodine supplementation....there is all sorts of conflicting information on the WWW. I can't promise that this post will clear up any of your confusion, you kinda have to decide "who" to believe for yourselves:) BTW, this posting ONLY refers to Lugol's or the tablet equivalent, iodoral. I'll leave the detoxified Iodine stuff up to others....
According to Guy Abraham, MD, 2 drops of Lugol's solution a day is an effective amount for supplementation. HowEVer...higher doses will displace heavier halogens, fluoride, chlorine & bromides..50 mg. per day for 1 to 3 mos. is what I've heard recommended to "flush" out the heavier halogens...and that's what we're after:
http://www.townsendletter.com/Oct2005/gabyrebuttal1005.htm
"Clinical experience has continually shown that iodine/iodide supplementation results in a large urinary excretion of bromide.3,18 When bromide levels begin to decline, the above mentioned adverse effects begin to decline as well. Chloride increases renal clearance of bromide15 and the use of NaCl or ammonium chloride shortens the time required for bromide detoxification with orthoiodosupplementation. Oral administration of sodium chloride (6 to 10 gm/day) increased the renal clearance of bromide by 10 fold with mean serum half-life of 290 hrs in control subjects and 30-65 hrs after chloride administration."
So...2 drops is good, AFTER you've cleared out the heavier halogens, IMO. And 2 drops a day is suffiicient to protect you from radioactive fallout as well:
http://www.townsendletter.com/Oct2005/gabyrebuttal1005.htm
"Protection of the thyroid from radioiodine fall out in cases of nuclear attack and accident would benefit from the recommended daily intake of I, discussed above. The equivalent of 2 drops of Lugol solution (12.5 mg I) daily would maintain a low radioiodine uptake by the thyroid gland (3-4%). Since the greatest damage to the thyroid occurs during the first few hours of radiation"
*****************************************************************************************************************************************************************
First of all, some persective on the fear that surrounds Iodine supplementation...Guy Abraham, MD, "The History of Iodine, Part 3"
http://www.optimox.com/pics/Iodine/IOD-16/PUB_16.htm
"A new syndrome, medical iodophobia, was recently reported. (4) Medicoiodophobes suffer from: 1) split personality which results in iodophobia within the orthoiodosupplementation range previously used safely and successfully in medical practice and iodophylia for megadoses of Iodide (up to 12 g/day); 2) double standards which render those physicians intolerant to the minor side effects of the inorganic forms and extremely tolerant toward severe side effects of the radioactive and organic forms; 3) amnesia toward the inorganic, non-radioactive forms when making therapeutic decisions; 4) confusion, attributing the severe side effects of organic iodine containing drugs to inorganic iodine/iodide; and 5) altered state of consciousness, allowing doublethink, doublespeak, and contradictory logic to become acceptable.
Although the factors involved in medical iodophobia are still unknown, decreased cognition seems involved. Since low iodine intake is associated with intellectual impairment, deficiency of this essential element cannot be ruled out and, if present, would create a self-perpetuating phenomenon. Needless to say that medical iodophobia is contagious and can be transmitted to patients and other physicians (iatrogenic iodophobia). Although there is yet no official report from the Center for Disease Control regarding the prevalence of medical iodophobia in the US medical community, it is likely that this syndrome has reached pandemic proportion.
Medical iodophobia will remain a syndrome until the causes are discovered and effective therapy implemented. The disastrous effect on the US population of the zombification of the medical profession through iodine deprivation is already evident. Implementation of the orthoiodosupplementation program in the medical community is highly recommended. The increased cognition of health care professionals, resulting from orthoiodosupplementation, will eventually trickle down to patients in the form of a more enlightened approach to patient care."
******************************************************************************************************************************************************************
That fear was not always there...
http://panaminstitute.com/de-iodine.htm
"According to Hungarian Nobel Laureate Szent-Györgyi, KI was the
universal medicine in Europe during the late 1800’s and early
1900’s. Szent-Györgyi himself ingested 1 gm of KI [postassium
iodide[ daily to keep himself fit. "
*******************************************************************************************************************************************************************
Words from the wise re: dosing, David Brownstein, MD:
//www.curezone.org/forums/fm.asp?i=836069#i
"After testing individuals and finding low iodine levels, I began to use smaller milligram amounts of iodine/iodide (6.25mg/day). Upon retesting these individuals 1-2 months later, little progress was made. I therefore began using higher milligram doses (6.25-50mg) to increase the serum levels of iodine. It was only with these higher doses that I began to see clinical improvement as well as positive changes in the laboratory tests...
As I started to use larger doses of iodine (12.5-50mg/day), I began to see positive results in my patients. Goiters and nodules of the thyroid shrank. Cysts on the ovaries became smaller and began to disappear. Patients reported increased energy. Metabolism was increased as evidenced by my patients having new success in losing weight. Libido improved in men and women. People suffering with brain fog reported a clearing of their foggy feelings. Patients reported having vivid dreams and better sleep. Most importantly, those with chronic illnesses that were having a difficult time improving began to notice many of their symptoms resolving."
and more...
http://www.optimox.com/pics/Iodine/IOD-09/IOD_09.htm
"My clinical experience with using physiologic doses of iodine/iodide (6.25-50mg/day) has been very positive. To date, in my practice, my partners and I have treated over 3,000 patients. The side effects with using these doses have been minimal. Rarely, have I observed iodism (metallic taste in mouth, frontal sinus pressure/pain, and increased salivation). Iodism is easily rectified by adjusting the dose of iodine down or simply telling the patient to await the resolution of these symptoms which takes approximately 1-3 weeks. True iodine allergy to inorganic, non-radioactive iodine is very rare. In treating over 3,000 patients, I have found three patients with "allergy" to non-radioactive inorganic iodine/iodide. An acupressure technique, NAET (NAET.com) has proven very effective to reverse this allergy. Allergy to fish, shellfish or radioactive iodine does not mean there is an allergy to inorganic non-radioactive iodine. In fact, true inorganic iodine allergy is very rare."
*******************************************************************************************************************************************************************
Drs. Abraham and Brownstein answer Dr. Gaby, a critic:
http://www.townsendletter.com/Oct2005/gabyrebuttal1005.htm
Safety
"Dr. Gaby's editorial claims that the relatively high doses of iodine/iodide used in orthoiodosupplementation may lead to hypothyroidism, goiter or autoimmune thyroid problems. This just is not the case. A review of the literature revealed that the organic forms of iodine were involved in most of these complications.3 Iodine intake has fallen over 50% in the U.S. over the last 30 years.38 During this same time, increases in diabetes, hypertension, obesity, breast and thyroid cancer, and other thyroid disorders, have been reported. It appears to us that iodine deficiency, not iodine excess may be responsible for the increase of these conditions.3,18
As of this writing (7/12/05), the clinical experience with orthoiodosupplementation in approximately 4,000 patients at the Center for Holistic Medicine has clearly shown that orthoiodosupplementation at daily dose of 6.25 to 50mg elemental iodine has not been associated with increases in hypothyroidism, goiter and autoimmune thyroid problems. On the contrary, the use of iodine/iodide has been effective at treating the above conditions with minimal adverse effects.
Dr. Gaby points out that "some people are especially sensitive to the adverse effects of iodine." He is correct. Just as some people are sensitive to Vitamin C, some are sensitive to iodine/iodide. Few holistic physicians would deny the effectiveness of mega doses of Vitamin C, in amounts thousands of times greater than the RDA for Vitamin C, in the treatment of wide range of illnesses. Just as with Vitamin C therapies, individualized doses and proper follow-up visits can help minimize adverse effects of iodine/iodide therapies.
Dr. Gaby writes, "The relative absence of side effects may be due to the use of iodine as part of a comprehensive nutritional program." He is correct. With orthoiodosupplementation the best results do occur when used as part of a comprehensive nutritional program, as do all holistic therapies. We favor a magnesium emphasized total nutritional approach.3
The most common adverse effects of iodine/iodide supplementation observed at the Center for Holistic Medicine has been metallic taste in the mouth and acne. Based on the experience of three clinicians at that Center, with a combined patient population of some 4,000, the prevalence of these side effects is about 1%. This is probably due to a detoxification reaction. The release of bromide may be one cause of this detoxification reaction. Clinical experience has continually shown that iodine/iodide supplementation results in a large urinary excretion of bromide.3,18 When bromide levels begin to decline, the above mentioned adverse effects begin to decline as well. Chloride increases renal clearance of bromide15 and the use of NaCl or ammonium chloride shortens the time required for bromide detoxification with orthoiodosupplementation. Oral administration of sodium chloride (6 to 10 gm/day) increased the renal clearance of bromide by 10 fold with mean serum half-life of 290 hrs in control subjects and 30-65 hrs after chloride administration. Intravenous sodium chloride gives the same results as the oral route.15
In the practice of medicine, we have seen very few natural therapies as safe and effective as orthoiodosupplementation. In the proper forms of iodine (inorganic non-radioactive forms), in daily amounts of iodine for whole body sufficiency and properly monitored, orthoiodosupplementation is not only safe, it is an effective tool for the clinician. Prior to the availability of assays for thyroid hormones and without any test for assessing whole body sufficiency for iodine, our medical predecessors recommended a range of daily iodine intake from Lugol solution (12.5-37.5 mg) exactly within the range required for achieving whole body sufficiency for iodine.3,16 Relying on clinical observation of the patient's overall wellbeing, our predecessors have given us useful information, which we have discarded in favor of preconceived opinions of self-appointed pseudoexperts. This has resulted in pandemic iodine deprivation. Iodine deficiency is misdiagnosed and treated with toxic drugs. Orthoiodosupplementation may be the simplest, safest, most effective and least expensive way to help solve the health care crisis crippling our nation."
*******************************************************************************************************************************************************************
Dr. Abraham on the daily requirement for Iodine:
http://www.optimox.com/pics/Iodine/IOD-02/IOD_02.htm
V. Requirement of the human body for I
"So far, the optimal daily requirement for I has been estimated at 6 mg of Iodide for the thyroid gland and 5 mg of iodine for the mammary glands. The adrenal glands may also require adequate levels of I for normal function. A recent study of female rats exposed to noise stress revealed a decreased adaptability to stress when these rats were placed on an I-deficient diet. There was an attenuation of the pituitary adrenal axis to stress that persisted after functional recovery of the pituitary thyroid axis. Therefore, this effect of I on the adrenal response to stress is totally independent of thyroid hormones.
Certain roles of I in wellbeing and protection against infections, degenerative diseases and cancer may not involve its action on specific organs and tissues. Instead, such properties of I, affecting every cell in the human body, may depend on its concentration in biological fluids. Derry (54) has reviewed some beneficial properties of I: the antimicrobial effect of I in organs capable of concentrating it to reach effective I levels; the apoptotic property of I in the body’s surveillance mechanism against abnormal cells; the ability of I to trigger differentiation, moving the cell cycle away from the undifferentiated characteristic of breast cancer, for that matter of all cancer. Besides, as a halogen, and because of its large size, I has the ability to markedly enhance the excited singlet to triplet radiationless transition (55). Reactive oxygen species causing damage to DNA and other macromolecules, are usually excited singlet with a high energy content released rapidly, and characterized by fluorescence, whereas the corresponding triplet state contains lower energy levels which are released slowly, expressed as phosphorescence. Such an effect of I would depend on its concentration in biological fluids. Using a rudimentary phosphoroscope, Szent-Gyorgy was able, 50 years ago, to demonstrate this effect of I on the singlet ® triplet radiationless transition, at a concentration of 10-5 M (56). It is likely that this effect would persist at 10-6 M, which would correspond to a serum I level of 12.7 ug/100 ml. Such a level is easily achieved with I intake in the range consumed by mainland Japanese. This effect of I would markedly decrease the oxydative burden of the body, having a beneficial impact upon degenerative diseases and cancer. Protection of the thyroid from radioiodine fall out in cases of nuclear attack and accident would benefit from the recommended daily intake of I, discussed above. The equivalent of 2 drops of Lugol solution (12.5 mg I) daily would maintain a low radioiodine uptake by the thyroid gland (3-4%). Since the greatest damage to the thyroid occurs during the first few hours of radiation
exposure (57), this recommended level of I would serve as a prevention in cases of unexpected exposure.
Collective experience may have played a role in the choice of 2 drops of Lugol daily for I supplementation (43). Amazingly, 0.1 ml (2 drops) of Lugol contains 5 mg iodine and 7.5 mg Iodide as the potassium salt, the near perfect total amount of I and ratio of iodine over iodide, for sufficiency of the thyroid and mammary glands. This amount of Lugol solution would then represents an ideal form of orthoiodosupplementation. Based on the above criteria for I sufficiency of the whole human body, the mainland Japanese represent the only population in the world consuming adequate amounts of I. Thyroid function is higher in normal Japanese woman, a low risk population for Breast Cancer than in normal British women who are at high risk for Breast Cancer (11). When 5 different ethnic groups living in Hawaii were compared with British women and mainland Japanese women, the latter showed the highest serum levels of Free T4. There was a significant and inverse correlation (p<0.001) between serum Free T4 and the incidence of Breast Cancer in these 7 groups with mainland Japanese women showing the lowest incidence (11,12). Since T4 therapy in I-deficient women increased their risk for breast cancer (17), the significant correlation between serum Free T4 and breast cancer is not necessarily indicative of a protective role of T4. Instead, this correlation may point to the higher I levels in Japanese women, expressed as increased thyroid function. Prasad et al (58) reported significantly lower serum T4 and higher serum T3 levels in 40 women with histologically confirmed breast cancer, compared to 10 normal controls. Although these authors did not measure urine I levels in those cases, the pattern they reported in women with breast cancer is typical of I deficiency: increased T3 levels and lower T4 levels to compensate for the limited availability of I" (30).
*******************************************************************************************************************************************************************
The current iodine protocol for breast cancer patients calls for 50 mg. iodoral per day, and I've heard rumblings that that may be upped to 100 mg:
http://www.breastcancerchoices.org/iprotocol.html
* 50 mg Iodoral minimum for Breast Cancer (may start with 12.5 mg).
Some practitioners may recommend another form of iodine such as
Lugol's solution. Iodoral is the Lugol's formula in tablet form.
* Vitamin C - 3,000 mg per day (more may be necessary to detox bromide).
* 300-600 mg magnesium oxide or comparable magnesium supplement.
* 200 mcg selenium.
* 625 mg inositol hexaniacinate twice a day. (Some patients cannot tolerate
this supplement so it may be best added after a month of iodine therapy to
distinguish niacin side effects from iodine side effects.)
* A comprehensive vitamin and nutrition program.
*******************************************************************************************************************************************************************
And FBD has been cured at much lower doses...or has it? I don't know that these women were followed after the studies:
http://iodine4health.com/body/breast/eskin_ghent_breast.htm
The dosing device that they used this the study had 13.65 total mg. of iodine. per 70 ml.(aqueous solution, I believe) The unit was designed to dispense 50 doses of 20 ml, totalling 1000 ml. The patients recieved one dose per day, could be doubled if no effects observed. Sooo, according to MY math(highly questionable), each dose provided .273 mg. of iodine.
In this link:
http://www.findarticles.com/p/articles/mi_m0ISW/is_256/ai_n6258834
The dosage was 0.08 mg/kg of body weight. 50 kg = 110 lbs. which would be only four milligrams a day. I need 4.912(5) mg.(I weigh 135) , according to that study.
So, two studies, two vastly different amounts used for dosing. We also have the daily requirement for iodine(NOT the U.S. RDA, which is set criminally low), which, in all of my reading, seems to be from 12-15 mg. for women(8-12 mg. for men).
******************************************************************************************************************************************************************
Now, some stuff on low dosing:
http://panaminstitute.com/de-iodine.htm
"The medical use of Iodine and iodides has more than a 100 year
history. Rural Medicine Editor of Medical World, Dr. DeForest
Clinton Jarvis, born in 1881, a member of the Academy of
Ophthalmology and Otolaryngology, the American Medical
Association and other leading medical societies of the time was a
great user and advocate of Lugol's solution. His interest in the folk
medicine of Vermont began soon after the start of his medical
practice. To counter the effects of iodine loss, Dr. Jarvis
recommended various methods including: (1) Eating foods rich in
iodine: food from the ocean, radishes, asparagus, carrots,
tomatoes, spinach, rhubarb, potatoes, peas, strawberries,
mushrooms, lettuce, bananas, cabbage, egg yolk, and onions; (2)
Painting a small area of the body with tincture of iodine; and (3)
taking preparations known to be rich in iodine, including cod liver
oil, kelp tablets ...
But he was particularly keen on the power of Lugol's iodine, for
treating various illnesses, including colds and flu, and for
countering the effects of stress: "Supposing you do follow the
suggestions outlined above and find that some weeks the pressures
of your private and your business life are causing you to lose the
ability to bounce back. Then you should add a drop of Lugol's
solution of iodine to your glass of apple or grape juice at breakfast,
or you may take it in the mixture of apple cider vinegar and water.
The point is that the potassium in the solution (Lugol's is 5%
potassium iodine) blocks off the body mechanism that organizes for
aggressive action, releasing its hold on the body when opportunity
for rest and relaxation arises. The iodine swings into action the
body and the building up and storing of body reserves. When
working under pressure, include the Lugol's solution dose each day
until the period of pressure passes. If it should happen that your
body becomes saturated with iodine, you will find that there is an
increase of moisture in the nose. If this occurs, omit the iodine until
the nose is normal."
http://lewisford.info/files/The_Basic_Program_from_Feeling_Young_and_In_Love2.pdf
Pp. 15 - 25 cover iodine. I have never come across Lewis Ford before, he does sell his own iodine supplements, so of course he will espouse ideas that promote that. He is in agreement, however, with the thought that we are woefully deficient in iodine. Lots of interesting reading here, do give it a look.
He says that the best *final* dosage of iodine for women is 12 mg. per day, for men, 8-12 mg.
I found this interesting:
(in reference to *final* dosage) "About 90-95% of American Adults can start right at those final high doses with no health problems...
Even 1 mg. per day, however, is still too high a dosage for about 5 - 10% of American adults to BEGIN with. It may take months, or even years, for the millions of Americans suffering from more severe thyroid problems and/or "diabetic neuropathy" to get used to eating that much iodide. This is because as dying peripheral nerves start being revived with more optimal iodide levels and metabolism, they usually do not function normally for months or even years. Instead, they tend to signal to the brain sensations of intense itching/phantom pains. To help reduce these very distracting and painful problems, it is more comfortable to start with just 1/2 mg. iodide per day. This is about 3-4 times as much as most Americans are currently getting, but it is still a low enough dosage not to overly aggravate the peripheral itching and pain problems."
******************************************************************************************************************************************************************
For those of you that are nervous on iodine supplementation, just start slow. I was nervous as I was uninformed. The more I learned, the less fear I had. I have upped my dose slowly over 3 1/2 months time, I'm now at 50 mg. Whether that was the best thing to do, I don't know. My "detox" symptoms have been quite manageable, so I guess that it has worked for me. I have seen that people here usually experience the worst detox symptoms the first week or so. If your "detox" becomes too uncomfortable, just back off or take a break. We're all using iodine for different reasons. I have FBD so I'm in it for the long haul...I don't want to end up with breast cancer... :)
Viewed 110786 times
All wombat's Answers
Information if favor of not megadosing on iodine by MsPep 11 year 1 of 3 (33%)
Many thanks to my Doctor, Alan Christianson, for sharing his very informative article on Iodine!
Iodine, not too much, not too little
In Arizona, many retirees spend their summers elsewhere. To me, it marks the change of seasons to welcome my 'snowbirds' back in the fall and see them off in the spring.
Several years ago I had a kind gentleman return for the winter with new symptoms: watery diarrhea after every meal and a non-intentional tremor of his hand. The diarrhea started three or four months ago, the tremor, more recently. Normally in excellent health, 'Tim' joked about getting old and his body falling apart. He had his screening tests completed before I heard about this. They were normal besides a suppressed TSH. On his exam, I found several thyroid nodules that were not present last year and his heart rate was over 100 bpm.
An ultrasound and second level thyroid tests diagnosed Tim with toxic multi-nodular goiter. In seniors, this is most common after high dose Iodine exposure such as in imaging contrast. I asked if he had a CT or MRI done recently. He told me he did not but that he was taking an Iodine pill for five months. Apparently he was tested and found to be low in Iodine and was now taking 1 tablet of Iodoral daily providing 50,000 mcg of iodine.
Within several months I had roughly the same thing happen to three other patients, all on high dose iodine, some based on testing, some not. One of these also had toxic multinodular goiter, one had Grave's disease and one was hypothyroid secondary to Hashimoto's thyroiditis. Since then several more cases have come in with new thyroid disease after taking high dose iodine.
Not all patients who take high dose iodine will get thyroid disease and it is possible that some that I saw may have developed thyroid disease even if not on iodine. I have seen many other patients taking high dose iodine with no apparent adverse effects.
Iodine in doses above physiologic requirements is the single best documented environmental toxin capable of inducing autoimmune thyroid disease (ATD).
I had dimly been aware of iodine becoming a new topic at holistic conferences. A little digging quickly revealed that Guy Abraham, MD was the sole source of the new iodine paradigm.
Dr. Abraham collectively calls his work the 'Iodine Project'. The articles
were originally published in the magazine 'The Original Internist' (http://www.clintpublications.com/), a non-peer reviewed journal circulating primarily to chiropractors. His ideas are mimicked nearly verbatum in
books from Dr. David Brownstein (Iodine: Why You Need It, Why You Can't
Live Without It) and articles from Drs Donald Miller and Jorge Flechas.
Over the next several months I read every word written by Dr. Abraham and his colleagues. I also read all of their references that were available.
Most referred to their own statements from other sources. I also read everything I could find from every other source on human iodine requirements. My conclusion was quite clear, iodine at these new proposed doses was not justified and I have since counseled patients and peers against it.
Since these views on iodine are getting more pervasive, I felt compelled to share my findings and experiences in a broader forum, thus this article came about.
The Iodine Project can be summarized as the following:
1. High dose iodine helps conditions such fibrocystic breast disease,
therefore these doses are physiologically required.
2. The Japanese consume much more iodine than Americans and have lower
rates of thyroid disease and breast cancer.
3. Iodine status can be determined by 24 hour urine iodine levels
following a 50,000 mcg oral dose. Those excreting a smaller fraction of
the dose may have retained more iodine therefore their bodies needed it.
4. Adult humans need 12,500 - 50,000 mcg of iodine for good health.
5. Iodine overdose is not a real phenomenon and the 'Wolff-Chaikoff'
effect is a delusional construct resulting from "Iodophobic bioterrorism".
6. The topsoil of the Earth was divinely created 6000 years ago with an
extremely high level of iodine which was depleted by the flood of Noah.
Human health has been poorer ever since.
7. The current academic views on iodine are distorted by international
foreign powers in order to make 'zombies' out of 'Christian America'.
I imagine most who have entertained these ideas had no idea how radical some of the essential underlying concepts are. I could not make this stuff up. He rightfully states that the whole body of his work depends on the
points 6 and 7 to be valid.
These last points are so extreme, they deserve a few direct quotes from Dr. Abraham's work:
"The theory of evolution does not offer an intellectually satisfying answer
to this paradox (humans needing iodine levels greatly in excess of what is found in sea water, as Dr. Abraham proposes). . . .Therefore, the original planet earth contained a topsoil rich in iodine, and all elements required for perfect health of Adam, Eve and their descendants. . . . A sequence of events followed, culminating in the worldwide flood 4500 years ago.
Following this episode, the receding waters washed away the topsoil with all its elements into oceans and seas. The new topsoil became deficient in iodine and most likely other essential elements, whose essentialities are still unknown."
"Iodine neglect in the 1930’s by thyroidologists progressed to medical iodophobia in the late 1940’s and early 1950’s. Following World War II, there was a systematic attempt to remove iodine from the food supply of Christian America. Iodophobic misinformation, well synchronized with the introduction of alternatives to iodine supplementation in medical practice, strongly suggest a well planned Conspiracy by agents of foreign powers planted at strategic positions in academia and the regulatory agencies."
The Iodine Project's claims that 'iodophobia' is part of a large Conspiracy beginning in the 1930's. He discusses how in the 1960's Americans nearly became released from the "zombifying" clutches of iodophobia:
"In the early 1960’s, potassium iodate was added to bread as a dough conditioner. This was an oversight by the agents of foreign powers planted at strategic positions in academia and the regulatory agencies. . . . This amount of the dezombifier iodine in a major staple food of Christian America could not be tolerated for long."
My responses to the claims are as follows:
Point 1: Dr. Abraham states that his focus on iodine began after learning
about the role of high dose iodine in treating fibrocycstic breast disease
in women.
The data that high dose iodine can help fibrocystic breast disease is
clear. Dr. Abraham is making the fallacy I have seen others make of
confusing a useful property of a substance with its role as an essential element. Nutrients are cofactors for physiological functions in the body.
Some also happen to have useful effects when used in doses well in excess of physiologic requirements.
Take niacin as a case in point. As adults we require only 14-18 mg of
niacin to prevent us from pellegra, a fatal deficiency disease. With a
diet high in the amino acid tryptophan we can do fine on even lower amounts
of niacin. It happens to be that doses of niacin 100-200 times this can
act as a gentle HMG CoA reductase inhibitor. Yet these doses can cause maculopathy in up to 7% of adult males who take it. Those of you who use niacin in enough people have likely observed this reaction as I have.
Clearly even though niacin may have useful properties in high doses, this does not mean that recommended intakes for all should be rewritten.
The majority of adults can tolerate intermittent high doses of iodine with
no adverse effects. Long term elevations, such as Abraham proposes, are different. Those who are low in iodine, or who have positive thyroid antibodies can have adverse effects by raising their long term intakes as little as 100 mcg. 7
Those who are not deficient can manifest toxicity with as little as 600 mcg daily. The WHO has stated that 1000 mcg is a safe upper limit for most without thyroid antibodies. Thyroid antibodies are commonly present with
normal thyroid function and can be found in up to 26% of the population. I did not find recommendations to pre-screen for antibodies prior to treatment in the Iodine Project.
Point #2: Japanese, especially in coastal areas do consume more iodine than Americans, but have higher rates of thyroid disease. Furthermore their thyroid disease is highest in their areas of greatest iodine intake. Other populations whose iodine intakes vary from 100-200 mcg daily also have higher rates of thyroid disease.
Japanese women used to have lower rates of Breast Cancer than American women. This difference declines as they adopt a western diet. Researchers have shown strong dose related increases in Breast Cancer among women from different nations related to dietary fat; and inverse dose related risks to soy food and green tea.
Point #3 I have been unable to find any sources outside of the Iodine Project pertaining to the validity of 24 hour loading tests, even after asking directly. Based on what we know about iodine, this test is not likely meaningful for the following reasons:
We excrete iodine in our urine but variable amounts leave though our bowels
and sweat. Sudden large doses can result in fecal loss 400 fold above
normal. It has been stated that unless fecal and urine levels of iodine
are measured, urine is not an accurate biomarker when iodine intake is
changed abruptly such as after a loading dose.
The CDC has also documented that a population's 24 hour urinary iodine
output levels are only meaningful when iodine intake has been steady for
six months or greater. One does not reach steady state in 24 hours.
Point #4: Due to predictable thyroid toxicity, no nutritional organization
has endorsed intakes of iodine above 600 mcg daily.
Iodized salt is ideally 1/10000 potassium iodine, but many third world
attempts ended up wrong. Since the WHO has carefully tracked these cases,
we have extensive data regarding changes of iodine intake. Long term
intakes above 600 mcg routinely cause higher rates of thyroid disease
including hypothyroidism and hyperthyroidism.
Additional data on the long term effects of high dose iodine come from amiodarone usage. Each 200 mg tablet is roughly 75 mg of organic iodine, 8-12% of which is released as free Iodide yielding an average net dose of 6-12.75 mg of iodine.
Dronedarone is a nearly identical molecule to amiodarone minus the iodine.
It shares the same effects and side effects of amiodarone with the exception of thyroid toxicity. Therefore it has been concluded that the thyrotoxic effects of amiodarone are attributable solely to the high iodine content.
In a study of 182 patients taking amiodarone, 41% developed hypothyroidism over a 6 year period. Median time frame of onset for hypothyroidism was 21 months. 59% of patients developed thyrotoxicosis after an average of 29
months. Note that some cases of thyrotoxicosis culminated in hypothyroidism, so the groups did overlap.
Point #5: The Wolff Chaikoff effect, AKA the 'iodine escape mechanism', has
been verified in vitro and in vivo and is present in all humans without exceptions or variations. Were such a 'fuse' not in place, normal variation of iodine intake could induce cardiotoxic hyperthyroidism. This effect is used when managing patients in a state of hyperthyroid storm.
One can suppress thyroid hormone synthesis with pharmacologic doses of
iodine more quickly than with thionamide drugs due to the Wolff Chaikoff effect.
This also enables a single high dose of potassium iodine ( SSKI ) to prevent thyroid cancer after radiation exposure. After taking enough SSKI , the thyroid iodine uptake is temporarily blocked due the Wolff Chikoff effect.
This prevents the thyroid from absorbing environmental radioactive iodine for roughly three weeks.
Point #6: Religious belief, or lack thereof, is a personal matter. Yet modern medicine is based on biology and biology is based on evolution. If someone is unwilling to acknowledge the existence of planet earth prior to
6000 BC, then I see little basis on which to have a rational discussion regarding matters of science.
Point #7: As Naturopathic Physicians, we love to be the purveyors of arcane knowledge that flies in the face of conventional wisdom, I know I do.
Because of this eagerness, I think we can be vulnerable to embracing such ideas too uncritically. As Carl Sagan said, great claims require great evidence.
The claim that the last 80 years of accumulated iodine knowledge duplicated from hundreds of researches in thousands of studies worldwide is all part of a 'foreign conspiracy' would require massive evidence, which I find lacking.
Fibrocystic breast disease can usually be treated with therapeutic doses of Vitamin E, EPO, a diet high in fiber and avoidance of methyl xanthenes.
FYI- A new study in the American Journal of Clinical Nutrition showed high rate of thyroid symptoms and disease when supplementing 400 mcg iodine daily. Ideal dose is reported to be 150 mcg daily, exactly what I recommend. Many don't know this, but if you're on dessicated thyroid, you already get iodine in it, roughly 130 mcg per 1 grain (60-65mg)
Here's a write up on the study: http://www.reuters.com/article/2012/01/17/us-iodine-howmuch-idUSTRE80G1OZ20120117?feedType=nl&feedName=ushealth1100
More from Dr. C on iodine testing/selenium and iodine ratios:
A lab that tests iodine just completed a study on 24 hour iodine challenge testing. The proponents of this test claim that 90% of the iodine is eliminated in the first 24 hours. The study showed that iodine elimination goes on for many days at high levels, proving the test is not accurate. It also proves that normal healthy people would be mistakenly shown to be deficient on this test. Some have argued about a certain ratio needed for selenium to iodine. It is true that selenium deficiencies worsens both iodine toxicity and iodine deficiency. However, since they cannot both be tested by similar methods, ratios are not meaningful. Take home message: get 200 - 400 mcg selenium and keep iodine as low as practical if you are on thyroid replacement. Thyroid meds already contain substantial amounts of iodine, more is counterproductive.
Info on iodine loading test, 3/2/13-I predicted that the iodine loading test was not accurate. Last month, for the first time, a study was done on it and showed that it was not. http://www.townsendletter.com/Jan2013/iodine0113.html
.
Viewed 64720 times
All MsPep's Answers
Many thanks to my Doctor, Alan Christianson, for sharing his very informative article on Iodine!
Iodine, not too much, not too little
In Arizona, many retirees spend their summers elsewhere. To me, it marks the change of seasons to welcome my 'snowbirds' back in the fall and see them off in the spring.
Several years ago I had a kind gentleman return for the winter with new symptoms: watery diarrhea after every meal and a non-intentional tremor of his hand. The diarrhea started three or four months ago, the tremor, more recently. Normally in excellent health, 'Tim' joked about getting old and his body falling apart. He had his screening tests completed before I heard about this. They were normal besides a suppressed TSH. On his exam, I found several thyroid nodules that were not present last year and his heart rate was over 100 bpm.
An ultrasound and second level thyroid tests diagnosed Tim with toxic multi-nodular goiter. In seniors, this is most common after high dose Iodine exposure such as in imaging contrast. I asked if he had a CT or MRI done recently. He told me he did not but that he was taking an Iodine pill for five months. Apparently he was tested and found to be low in Iodine and was now taking 1 tablet of Iodoral daily providing 50,000 mcg of iodine.
Within several months I had roughly the same thing happen to three other patients, all on high dose iodine, some based on testing, some not. One of these also had toxic multinodular goiter, one had Grave's disease and one was hypothyroid secondary to Hashimoto's thyroiditis. Since then several more cases have come in with new thyroid disease after taking high dose iodine.
Not all patients who take high dose iodine will get thyroid disease and it is possible that some that I saw may have developed thyroid disease even if not on iodine. I have seen many other patients taking high dose iodine with no apparent adverse effects.
Iodine in doses above physiologic requirements is the single best documented environmental toxin capable of inducing autoimmune thyroid disease (ATD).
I had dimly been aware of iodine becoming a new topic at holistic conferences. A little digging quickly revealed that Guy Abraham, MD was the sole source of the new iodine paradigm.
Dr. Abraham collectively calls his work the 'Iodine Project'. The articles
were originally published in the magazine 'The Original Internist' (http://www.clintpublications.com/), a non-peer reviewed journal circulating primarily to chiropractors. His ideas are mimicked nearly verbatum in
books from Dr. David Brownstein (Iodine: Why You Need It, Why You Can't
Live Without It) and articles from Drs Donald Miller and Jorge Flechas.
Over the next several months I read every word written by Dr. Abraham and his colleagues. I also read all of their references that were available.
Most referred to their own statements from other sources. I also read everything I could find from every other source on human iodine requirements. My conclusion was quite clear, iodine at these new proposed doses was not justified and I have since counseled patients and peers against it.
Since these views on iodine are getting more pervasive, I felt compelled to share my findings and experiences in a broader forum, thus this article came about.
The Iodine Project can be summarized as the following:
1. High dose iodine helps conditions such fibrocystic breast disease,
therefore these doses are physiologically required.
2. The Japanese consume much more iodine than Americans and have lower
rates of thyroid disease and breast cancer.
3. Iodine status can be determined by 24 hour urine iodine levels
following a 50,000 mcg oral dose. Those excreting a smaller fraction of
the dose may have retained more iodine therefore their bodies needed it.
4. Adult humans need 12,500 - 50,000 mcg of iodine for good health.
5. Iodine overdose is not a real phenomenon and the 'Wolff-Chaikoff'
effect is a delusional construct resulting from "Iodophobic bioterrorism".
6. The topsoil of the Earth was divinely created 6000 years ago with an
extremely high level of iodine which was depleted by the flood of Noah.
Human health has been poorer ever since.
7. The current academic views on iodine are distorted by international
foreign powers in order to make 'zombies' out of 'Christian America'.
I imagine most who have entertained these ideas had no idea how radical some of the essential underlying concepts are. I could not make this stuff up. He rightfully states that the whole body of his work depends on the
points 6 and 7 to be valid.
These last points are so extreme, they deserve a few direct quotes from Dr. Abraham's work:
"The theory of evolution does not offer an intellectually satisfying answer
to this paradox (humans needing iodine levels greatly in excess of what is found in sea water, as Dr. Abraham proposes). . . .Therefore, the original planet earth contained a topsoil rich in iodine, and all elements required for perfect health of Adam, Eve and their descendants. . . . A sequence of events followed, culminating in the worldwide flood 4500 years ago.
Following this episode, the receding waters washed away the topsoil with all its elements into oceans and seas. The new topsoil became deficient in iodine and most likely other essential elements, whose essentialities are still unknown."
"Iodine neglect in the 1930’s by thyroidologists progressed to medical iodophobia in the late 1940’s and early 1950’s. Following World War II, there was a systematic attempt to remove iodine from the food supply of Christian America. Iodophobic misinformation, well synchronized with the introduction of alternatives to iodine supplementation in medical practice, strongly suggest a well planned Conspiracy by agents of foreign powers planted at strategic positions in academia and the regulatory agencies."
The Iodine Project's claims that 'iodophobia' is part of a large Conspiracy beginning in the 1930's. He discusses how in the 1960's Americans nearly became released from the "zombifying" clutches of iodophobia:
"In the early 1960’s, potassium iodate was added to bread as a dough conditioner. This was an oversight by the agents of foreign powers planted at strategic positions in academia and the regulatory agencies. . . . This amount of the dezombifier iodine in a major staple food of Christian America could not be tolerated for long."
My responses to the claims are as follows:
Point 1: Dr. Abraham states that his focus on iodine began after learning
about the role of high dose iodine in treating fibrocycstic breast disease
in women.
The data that high dose iodine can help fibrocystic breast disease is
clear. Dr. Abraham is making the fallacy I have seen others make of
confusing a useful property of a substance with its role as an essential element. Nutrients are cofactors for physiological functions in the body.
Some also happen to have useful effects when used in doses well in excess of physiologic requirements.
Take niacin as a case in point. As adults we require only 14-18 mg of
niacin to prevent us from pellegra, a fatal deficiency disease. With a
diet high in the amino acid tryptophan we can do fine on even lower amounts
of niacin. It happens to be that doses of niacin 100-200 times this can
act as a gentle HMG CoA reductase inhibitor. Yet these doses can cause maculopathy in up to 7% of adult males who take it. Those of you who use niacin in enough people have likely observed this reaction as I have.
Clearly even though niacin may have useful properties in high doses, this does not mean that recommended intakes for all should be rewritten.
The majority of adults can tolerate intermittent high doses of iodine with
no adverse effects. Long term elevations, such as Abraham proposes, are different. Those who are low in iodine, or who have positive thyroid antibodies can have adverse effects by raising their long term intakes as little as 100 mcg. 7
Those who are not deficient can manifest toxicity with as little as 600 mcg daily. The WHO has stated that 1000 mcg is a safe upper limit for most without thyroid antibodies. Thyroid antibodies are commonly present with
normal thyroid function and can be found in up to 26% of the population. I did not find recommendations to pre-screen for antibodies prior to treatment in the Iodine Project.
Point #2: Japanese, especially in coastal areas do consume more iodine than Americans, but have higher rates of thyroid disease. Furthermore their thyroid disease is highest in their areas of greatest iodine intake. Other populations whose iodine intakes vary from 100-200 mcg daily also have higher rates of thyroid disease.
Japanese women used to have lower rates of Breast Cancer than American women. This difference declines as they adopt a western diet. Researchers have shown strong dose related increases in Breast Cancer among women from different nations related to dietary fat; and inverse dose related risks to soy food and green tea.
Point #3 I have been unable to find any sources outside of the Iodine Project pertaining to the validity of 24 hour loading tests, even after asking directly. Based on what we know about iodine, this test is not likely meaningful for the following reasons:
We excrete iodine in our urine but variable amounts leave though our bowels
and sweat. Sudden large doses can result in fecal loss 400 fold above
normal. It has been stated that unless fecal and urine levels of iodine
are measured, urine is not an accurate biomarker when iodine intake is
changed abruptly such as after a loading dose.
The CDC has also documented that a population's 24 hour urinary iodine
output levels are only meaningful when iodine intake has been steady for
six months or greater. One does not reach steady state in 24 hours.
Point #4: Due to predictable thyroid toxicity, no nutritional organization
has endorsed intakes of iodine above 600 mcg daily.
Iodized salt is ideally 1/10000 potassium iodine, but many third world
attempts ended up wrong. Since the WHO has carefully tracked these cases,
we have extensive data regarding changes of iodine intake. Long term
intakes above 600 mcg routinely cause higher rates of thyroid disease
including hypothyroidism and hyperthyroidism.
Additional data on the long term effects of high dose iodine come from amiodarone usage. Each 200 mg tablet is roughly 75 mg of organic iodine, 8-12% of which is released as free Iodide yielding an average net dose of 6-12.75 mg of iodine.
Dronedarone is a nearly identical molecule to amiodarone minus the iodine.
It shares the same effects and side effects of amiodarone with the exception of thyroid toxicity. Therefore it has been concluded that the thyrotoxic effects of amiodarone are attributable solely to the high iodine content.
In a study of 182 patients taking amiodarone, 41% developed hypothyroidism over a 6 year period. Median time frame of onset for hypothyroidism was 21 months. 59% of patients developed thyrotoxicosis after an average of 29
months. Note that some cases of thyrotoxicosis culminated in hypothyroidism, so the groups did overlap.
Point #5: The Wolff Chaikoff effect, AKA the 'iodine escape mechanism', has
been verified in vitro and in vivo and is present in all humans without exceptions or variations. Were such a 'fuse' not in place, normal variation of iodine intake could induce cardiotoxic hyperthyroidism. This effect is used when managing patients in a state of hyperthyroid storm.
One can suppress thyroid hormone synthesis with pharmacologic doses of
iodine more quickly than with thionamide drugs due to the Wolff Chaikoff effect.
This also enables a single high dose of potassium iodine ( SSKI ) to prevent thyroid cancer after radiation exposure. After taking enough SSKI , the thyroid iodine uptake is temporarily blocked due the Wolff Chikoff effect.
This prevents the thyroid from absorbing environmental radioactive iodine for roughly three weeks.
Point #6: Religious belief, or lack thereof, is a personal matter. Yet modern medicine is based on biology and biology is based on evolution. If someone is unwilling to acknowledge the existence of planet earth prior to
6000 BC, then I see little basis on which to have a rational discussion regarding matters of science.
Point #7: As Naturopathic Physicians, we love to be the purveyors of arcane knowledge that flies in the face of conventional wisdom, I know I do.
Because of this eagerness, I think we can be vulnerable to embracing such ideas too uncritically. As Carl Sagan said, great claims require great evidence.
The claim that the last 80 years of accumulated iodine knowledge duplicated from hundreds of researches in thousands of studies worldwide is all part of a 'foreign conspiracy' would require massive evidence, which I find lacking.
Fibrocystic breast disease can usually be treated with therapeutic doses of Vitamin E, EPO, a diet high in fiber and avoidance of methyl xanthenes.
FYI- A new study in the American Journal of Clinical Nutrition showed high rate of thyroid symptoms and disease when supplementing 400 mcg iodine daily. Ideal dose is reported to be 150 mcg daily, exactly what I recommend. Many don't know this, but if you're on dessicated thyroid, you already get iodine in it, roughly 130 mcg per 1 grain (60-65mg)
Here's a write up on the study: http://www.reuters.com/article/2012/01/17/us-iodine-howmuch-idUSTRE80G1OZ20120117?feedType=nl&feedName=ushealth1100
More from Dr. C on iodine testing/selenium and iodine ratios:
A lab that tests iodine just completed a study on 24 hour iodine challenge testing. The proponents of this test claim that 90% of the iodine is eliminated in the first 24 hours. The study showed that iodine elimination goes on for many days at high levels, proving the test is not accurate. It also proves that normal healthy people would be mistakenly shown to be deficient on this test. Some have argued about a certain ratio needed for selenium to iodine. It is true that selenium deficiencies worsens both iodine toxicity and iodine deficiency. However, since they cannot both be tested by similar methods, ratios are not meaningful. Take home message: get 200 - 400 mcg selenium and keep iodine as low as practical if you are on thyroid replacement. Thyroid meds already contain substantial amounts of iodine, more is counterproductive.
Info on iodine loading test, 3/2/13-I predicted that the iodine loading test was not accurate. Last month, for the first time, a study was done on it and showed that it was not. http://www.townsendletter.com/Jan2013/iodine0113.html
.
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Information if favor of not megadosing on iodine by MsPep 11 year 1 of 3 (33%)
Many thanks to my Doctor, Alan Christianson, for sharing his very informative article on Iodine!
Iodine, not too much, not too little
In Arizona, many retirees spend their summers elsewhere. To me, it marks the change of seasons to welcome my 'snowbirds' back in the fall and see them off in the spring.
Several years ago I had a kind gentleman return for the winter with new symptoms: watery diarrhea after every meal and a non-intentional tremor of his hand. The diarrhea started three or four months ago, the tremor, more recently. Normally in excellent health, 'Tim' joked about getting old and his body falling apart. He had his screening tests completed before I heard about this. They were normal besides a suppressed TSH. On his exam, I found several thyroid nodules that were not present last year and his heart rate was over 100 bpm.
An ultrasound and second level thyroid tests diagnosed Tim with toxic multi-nodular goiter. In seniors, this is most common after high dose Iodine exposure such as in imaging contrast. I asked if he had a CT or MRI done recently. He told me he did not but that he was taking an Iodine pill for five months. Apparently he was tested and found to be low in Iodine and was now taking 1 tablet of Iodoral daily providing 50,000 mcg of iodine.
Within several months I had roughly the same thing happen to three other patients, all on high dose iodine, some based on testing, some not. One of these also had toxic multinodular goiter, one had Grave's disease and one was hypothyroid secondary to Hashimoto's thyroiditis. Since then several more cases have come in with new thyroid disease after taking high dose iodine.
Not all patients who take high dose iodine will get thyroid disease and it is possible that some that I saw may have developed thyroid disease even if not on iodine. I have seen many other patients taking high dose iodine with no apparent adverse effects.
Iodine in doses above physiologic requirements is the single best documented environmental toxin capable of inducing autoimmune thyroid disease (ATD).
I had dimly been aware of iodine becoming a new topic at holistic conferences. A little digging quickly revealed that Guy Abraham, MD was the sole source of the new iodine paradigm.
Dr. Abraham collectively calls his work the 'Iodine Project'. The articles
were originally published in the magazine 'The Original Internist' (http://www.clintpublications.com/), a non-peer reviewed journal circulating primarily to chiropractors. His ideas are mimicked nearly verbatum in
books from Dr. David Brownstein (Iodine: Why You Need It, Why You Can't
Live Without It) and articles from Drs Donald Miller and Jorge Flechas.
Over the next several months I read every word written by Dr. Abraham and his colleagues. I also read all of their references that were available.
Most referred to their own statements from other sources. I also read everything I could find from every other source on human iodine requirements. My conclusion was quite clear, iodine at these new proposed doses was not justified and I have since counseled patients and peers against it.
Since these views on iodine are getting more pervasive, I felt compelled to share my findings and experiences in a broader forum, thus this article came about.
The Iodine Project can be summarized as the following:
1. High dose iodine helps conditions such fibrocystic breast disease,
therefore these doses are physiologically required.
2. The Japanese consume much more iodine than Americans and have lower
rates of thyroid disease and breast cancer.
3. Iodine status can be determined by 24 hour urine iodine levels
following a 50,000 mcg oral dose. Those excreting a smaller fraction of
the dose may have retained more iodine therefore their bodies needed it.
4. Adult humans need 12,500 - 50,000 mcg of iodine for good health.
5. Iodine overdose is not a real phenomenon and the 'Wolff-Chaikoff'
effect is a delusional construct resulting from "Iodophobic bioterrorism".
6. The topsoil of the Earth was divinely created 6000 years ago with an
extremely high level of iodine which was depleted by the flood of Noah.
Human health has been poorer ever since.
7. The current academic views on iodine are distorted by international
foreign powers in order to make 'zombies' out of 'Christian America'.
I imagine most who have entertained these ideas had no idea how radical some of the essential underlying concepts are. I could not make this stuff up. He rightfully states that the whole body of his work depends on the
points 6 and 7 to be valid.
These last points are so extreme, they deserve a few direct quotes from Dr. Abraham's work:
"The theory of evolution does not offer an intellectually satisfying answer
to this paradox (humans needing iodine levels greatly in excess of what is found in sea water, as Dr. Abraham proposes). . . .Therefore, the original planet earth contained a topsoil rich in iodine, and all elements required for perfect health of Adam, Eve and their descendants. . . . A sequence of events followed, culminating in the worldwide flood 4500 years ago.
Following this episode, the receding waters washed away the topsoil with all its elements into oceans and seas. The new topsoil became deficient in iodine and most likely other essential elements, whose essentialities are still unknown."
"Iodine neglect in the 1930’s by thyroidologists progressed to medical iodophobia in the late 1940’s and early 1950’s. Following World War II, there was a systematic attempt to remove iodine from the food supply of Christian America. Iodophobic misinformation, well synchronized with the introduction of alternatives to iodine supplementation in medical practice, strongly suggest a well planned Conspiracy by agents of foreign powers planted at strategic positions in academia and the regulatory agencies."
The Iodine Project's claims that 'iodophobia' is part of a large Conspiracy beginning in the 1930's. He discusses how in the 1960's Americans nearly became released from the "zombifying" clutches of iodophobia:
"In the early 1960’s, potassium iodate was added to bread as a dough conditioner. This was an oversight by the agents of foreign powers planted at strategic positions in academia and the regulatory agencies. . . . This amount of the dezombifier iodine in a major staple food of Christian America could not be tolerated for long."
My responses to the claims are as follows:
Point 1: Dr. Abraham states that his focus on iodine began after learning
about the role of high dose iodine in treating fibrocycstic breast disease
in women.
The data that high dose iodine can help fibrocystic breast disease is
clear. Dr. Abraham is making the fallacy I have seen others make of
confusing a useful property of a substance with its role as an essential element. Nutrients are cofactors for physiological functions in the body.
Some also happen to have useful effects when used in doses well in excess of physiologic requirements.
Take niacin as a case in point. As adults we require only 14-18 mg of
niacin to prevent us from pellegra, a fatal deficiency disease. With a
diet high in the amino acid tryptophan we can do fine on even lower amounts
of niacin. It happens to be that doses of niacin 100-200 times this can
act as a gentle HMG CoA reductase inhibitor. Yet these doses can cause maculopathy in up to 7% of adult males who take it. Those of you who use niacin in enough people have likely observed this reaction as I have.
Clearly even though niacin may have useful properties in high doses, this does not mean that recommended intakes for all should be rewritten.
The majority of adults can tolerate intermittent high doses of iodine with
no adverse effects. Long term elevations, such as Abraham proposes, are different. Those who are low in iodine, or who have positive thyroid antibodies can have adverse effects by raising their long term intakes as little as 100 mcg. 7
Those who are not deficient can manifest toxicity with as little as 600 mcg daily. The WHO has stated that 1000 mcg is a safe upper limit for most without thyroid antibodies. Thyroid antibodies are commonly present with
normal thyroid function and can be found in up to 26% of the population. I did not find recommendations to pre-screen for antibodies prior to treatment in the Iodine Project.
Point #2: Japanese, especially in coastal areas do consume more iodine than Americans, but have higher rates of thyroid disease. Furthermore their thyroid disease is highest in their areas of greatest iodine intake. Other populations whose iodine intakes vary from 100-200 mcg daily also have higher rates of thyroid disease.
Japanese women used to have lower rates of Breast Cancer than American women. This difference declines as they adopt a western diet. Researchers have shown strong dose related increases in Breast Cancer among women from different nations related to dietary fat; and inverse dose related risks to soy food and green tea.
Point #3 I have been unable to find any sources outside of the Iodine Project pertaining to the validity of 24 hour loading tests, even after asking directly. Based on what we know about iodine, this test is not likely meaningful for the following reasons:
We excrete iodine in our urine but variable amounts leave though our bowels
and sweat. Sudden large doses can result in fecal loss 400 fold above
normal. It has been stated that unless fecal and urine levels of iodine
are measured, urine is not an accurate biomarker when iodine intake is
changed abruptly such as after a loading dose.
The CDC has also documented that a population's 24 hour urinary iodine
output levels are only meaningful when iodine intake has been steady for
six months or greater. One does not reach steady state in 24 hours.
Point #4: Due to predictable thyroid toxicity, no nutritional organization
has endorsed intakes of iodine above 600 mcg daily.
Iodized salt is ideally 1/10000 potassium iodine, but many third world
attempts ended up wrong. Since the WHO has carefully tracked these cases,
we have extensive data regarding changes of iodine intake. Long term
intakes above 600 mcg routinely cause higher rates of thyroid disease
including hypothyroidism and hyperthyroidism.
Additional data on the long term effects of high dose iodine come from amiodarone usage. Each 200 mg tablet is roughly 75 mg of organic iodine, 8-12% of which is released as free Iodide yielding an average net dose of 6-12.75 mg of iodine.
Dronedarone is a nearly identical molecule to amiodarone minus the iodine.
It shares the same effects and side effects of amiodarone with the exception of thyroid toxicity. Therefore it has been concluded that the thyrotoxic effects of amiodarone are attributable solely to the high iodine content.
In a study of 182 patients taking amiodarone, 41% developed hypothyroidism over a 6 year period. Median time frame of onset for hypothyroidism was 21 months. 59% of patients developed thyrotoxicosis after an average of 29
months. Note that some cases of thyrotoxicosis culminated in hypothyroidism, so the groups did overlap.
Point #5: The Wolff Chaikoff effect, AKA the 'iodine escape mechanism', has
been verified in vitro and in vivo and is present in all humans without exceptions or variations. Were such a 'fuse' not in place, normal variation of iodine intake could induce cardiotoxic hyperthyroidism. This effect is used when managing patients in a state of hyperthyroid storm.
One can suppress thyroid hormone synthesis with pharmacologic doses of
iodine more quickly than with thionamide drugs due to the Wolff Chaikoff effect.
This also enables a single high dose of potassium iodine ( SSKI ) to prevent thyroid cancer after radiation exposure. After taking enough SSKI , the thyroid iodine uptake is temporarily blocked due the Wolff Chikoff effect.
This prevents the thyroid from absorbing environmental radioactive iodine for roughly three weeks.
Point #6: Religious belief, or lack thereof, is a personal matter. Yet modern medicine is based on biology and biology is based on evolution. If someone is unwilling to acknowledge the existence of planet earth prior to
6000 BC, then I see little basis on which to have a rational discussion regarding matters of science.
Point #7: As Naturopathic Physicians, we love to be the purveyors of arcane knowledge that flies in the face of conventional wisdom, I know I do.
Because of this eagerness, I think we can be vulnerable to embracing such ideas too uncritically. As Carl Sagan said, great claims require great evidence.
The claim that the last 80 years of accumulated iodine knowledge duplicated from hundreds of researches in thousands of studies worldwide is all part of a 'foreign conspiracy' would require massive evidence, which I find lacking.
Fibrocystic breast disease can usually be treated with therapeutic doses of Vitamin E, EPO, a diet high in fiber and avoidance of methyl xanthenes.
FYI- A new study in the American Journal of Clinical Nutrition showed high rate of thyroid symptoms and disease when supplementing 400 mcg iodine daily. Ideal dose is reported to be 150 mcg daily, exactly what I recommend. Many don't know this, but if you're on dessicated thyroid, you already get iodine in it, roughly 130 mcg per 1 grain (60-65mg)
Here's a write up on the study: http://www.reuters.com/article/2012/01/17/us-iodine-howmuch-idUSTRE80G1OZ20120117?feedType=nl&feedName=ushealth1100
More from Dr. C on iodine testing/selenium and iodine ratios:
A lab that tests iodine just completed a study on 24 hour iodine challenge testing. The proponents of this test claim that 90% of the iodine is eliminated in the first 24 hours. The study showed that iodine elimination goes on for many days at high levels, proving the test is not accurate. It also proves that normal healthy people would be mistakenly shown to be deficient on this test. Some have argued about a certain ratio needed for selenium to iodine. It is true that selenium deficiencies worsens both iodine toxicity and iodine deficiency. However, since they cannot both be tested by similar methods, ratios are not meaningful. Take home message: get 200 - 400 mcg selenium and keep iodine as low as practical if you are on thyroid replacement. Thyroid meds already contain substantial amounts of iodine, more is counterproductive.
Info on iodine loading test, 3/2/13-I predicted that the iodine loading test was not accurate. Last month, for the first time, a study was done on it and showed that it was not. http://www.townsendletter.com/Jan2013/iodine0113.html
.
Viewed 64750 times
All MsPep's Answers
Many thanks to my Doctor, Alan Christianson, for sharing his very informative article on Iodine!
Iodine, not too much, not too little
In Arizona, many retirees spend their summers elsewhere. To me, it marks the change of seasons to welcome my 'snowbirds' back in the fall and see them off in the spring.
Several years ago I had a kind gentleman return for the winter with new symptoms: watery diarrhea after every meal and a non-intentional tremor of his hand. The diarrhea started three or four months ago, the tremor, more recently. Normally in excellent health, 'Tim' joked about getting old and his body falling apart. He had his screening tests completed before I heard about this. They were normal besides a suppressed TSH. On his exam, I found several thyroid nodules that were not present last year and his heart rate was over 100 bpm.
An ultrasound and second level thyroid tests diagnosed Tim with toxic multi-nodular goiter. In seniors, this is most common after high dose Iodine exposure such as in imaging contrast. I asked if he had a CT or MRI done recently. He told me he did not but that he was taking an Iodine pill for five months. Apparently he was tested and found to be low in Iodine and was now taking 1 tablet of Iodoral daily providing 50,000 mcg of iodine.
Within several months I had roughly the same thing happen to three other patients, all on high dose iodine, some based on testing, some not. One of these also had toxic multinodular goiter, one had Grave's disease and one was hypothyroid secondary to Hashimoto's thyroiditis. Since then several more cases have come in with new thyroid disease after taking high dose iodine.
Not all patients who take high dose iodine will get thyroid disease and it is possible that some that I saw may have developed thyroid disease even if not on iodine. I have seen many other patients taking high dose iodine with no apparent adverse effects.
Iodine in doses above physiologic requirements is the single best documented environmental toxin capable of inducing autoimmune thyroid disease (ATD).
I had dimly been aware of iodine becoming a new topic at holistic conferences. A little digging quickly revealed that Guy Abraham, MD was the sole source of the new iodine paradigm.
Dr. Abraham collectively calls his work the 'Iodine Project'. The articles
were originally published in the magazine 'The Original Internist' (http://www.clintpublications.com/), a non-peer reviewed journal circulating primarily to chiropractors. His ideas are mimicked nearly verbatum in
books from Dr. David Brownstein (Iodine: Why You Need It, Why You Can't
Live Without It) and articles from Drs Donald Miller and Jorge Flechas.
Over the next several months I read every word written by Dr. Abraham and his colleagues. I also read all of their references that were available.
Most referred to their own statements from other sources. I also read everything I could find from every other source on human iodine requirements. My conclusion was quite clear, iodine at these new proposed doses was not justified and I have since counseled patients and peers against it.
Since these views on iodine are getting more pervasive, I felt compelled to share my findings and experiences in a broader forum, thus this article came about.
The Iodine Project can be summarized as the following:
1. High dose iodine helps conditions such fibrocystic breast disease,
therefore these doses are physiologically required.
2. The Japanese consume much more iodine than Americans and have lower
rates of thyroid disease and breast cancer.
3. Iodine status can be determined by 24 hour urine iodine levels
following a 50,000 mcg oral dose. Those excreting a smaller fraction of
the dose may have retained more iodine therefore their bodies needed it.
4. Adult humans need 12,500 - 50,000 mcg of iodine for good health.
5. Iodine overdose is not a real phenomenon and the 'Wolff-Chaikoff'
effect is a delusional construct resulting from "Iodophobic bioterrorism".
6. The topsoil of the Earth was divinely created 6000 years ago with an
extremely high level of iodine which was depleted by the flood of Noah.
Human health has been poorer ever since.
7. The current academic views on iodine are distorted by international
foreign powers in order to make 'zombies' out of 'Christian America'.
I imagine most who have entertained these ideas had no idea how radical some of the essential underlying concepts are. I could not make this stuff up. He rightfully states that the whole body of his work depends on the
points 6 and 7 to be valid.
These last points are so extreme, they deserve a few direct quotes from Dr. Abraham's work:
"The theory of evolution does not offer an intellectually satisfying answer
to this paradox (humans needing iodine levels greatly in excess of what is found in sea water, as Dr. Abraham proposes). . . .Therefore, the original planet earth contained a topsoil rich in iodine, and all elements required for perfect health of Adam, Eve and their descendants. . . . A sequence of events followed, culminating in the worldwide flood 4500 years ago.
Following this episode, the receding waters washed away the topsoil with all its elements into oceans and seas. The new topsoil became deficient in iodine and most likely other essential elements, whose essentialities are still unknown."
"Iodine neglect in the 1930’s by thyroidologists progressed to medical iodophobia in the late 1940’s and early 1950’s. Following World War II, there was a systematic attempt to remove iodine from the food supply of Christian America. Iodophobic misinformation, well synchronized with the introduction of alternatives to iodine supplementation in medical practice, strongly suggest a well planned Conspiracy by agents of foreign powers planted at strategic positions in academia and the regulatory agencies."
The Iodine Project's claims that 'iodophobia' is part of a large Conspiracy beginning in the 1930's. He discusses how in the 1960's Americans nearly became released from the "zombifying" clutches of iodophobia:
"In the early 1960’s, potassium iodate was added to bread as a dough conditioner. This was an oversight by the agents of foreign powers planted at strategic positions in academia and the regulatory agencies. . . . This amount of the dezombifier iodine in a major staple food of Christian America could not be tolerated for long."
My responses to the claims are as follows:
Point 1: Dr. Abraham states that his focus on iodine began after learning
about the role of high dose iodine in treating fibrocycstic breast disease
in women.
The data that high dose iodine can help fibrocystic breast disease is
clear. Dr. Abraham is making the fallacy I have seen others make of
confusing a useful property of a substance with its role as an essential element. Nutrients are cofactors for physiological functions in the body.
Some also happen to have useful effects when used in doses well in excess of physiologic requirements.
Take niacin as a case in point. As adults we require only 14-18 mg of
niacin to prevent us from pellegra, a fatal deficiency disease. With a
diet high in the amino acid tryptophan we can do fine on even lower amounts
of niacin. It happens to be that doses of niacin 100-200 times this can
act as a gentle HMG CoA reductase inhibitor. Yet these doses can cause maculopathy in up to 7% of adult males who take it. Those of you who use niacin in enough people have likely observed this reaction as I have.
Clearly even though niacin may have useful properties in high doses, this does not mean that recommended intakes for all should be rewritten.
The majority of adults can tolerate intermittent high doses of iodine with
no adverse effects. Long term elevations, such as Abraham proposes, are different. Those who are low in iodine, or who have positive thyroid antibodies can have adverse effects by raising their long term intakes as little as 100 mcg. 7
Those who are not deficient can manifest toxicity with as little as 600 mcg daily. The WHO has stated that 1000 mcg is a safe upper limit for most without thyroid antibodies. Thyroid antibodies are commonly present with
normal thyroid function and can be found in up to 26% of the population. I did not find recommendations to pre-screen for antibodies prior to treatment in the Iodine Project.
Point #2: Japanese, especially in coastal areas do consume more iodine than Americans, but have higher rates of thyroid disease. Furthermore their thyroid disease is highest in their areas of greatest iodine intake. Other populations whose iodine intakes vary from 100-200 mcg daily also have higher rates of thyroid disease.
Japanese women used to have lower rates of Breast Cancer than American women. This difference declines as they adopt a western diet. Researchers have shown strong dose related increases in Breast Cancer among women from different nations related to dietary fat; and inverse dose related risks to soy food and green tea.
Point #3 I have been unable to find any sources outside of the Iodine Project pertaining to the validity of 24 hour loading tests, even after asking directly. Based on what we know about iodine, this test is not likely meaningful for the following reasons:
We excrete iodine in our urine but variable amounts leave though our bowels
and sweat. Sudden large doses can result in fecal loss 400 fold above
normal. It has been stated that unless fecal and urine levels of iodine
are measured, urine is not an accurate biomarker when iodine intake is
changed abruptly such as after a loading dose.
The CDC has also documented that a population's 24 hour urinary iodine
output levels are only meaningful when iodine intake has been steady for
six months or greater. One does not reach steady state in 24 hours.
Point #4: Due to predictable thyroid toxicity, no nutritional organization
has endorsed intakes of iodine above 600 mcg daily.
Iodized salt is ideally 1/10000 potassium iodine, but many third world
attempts ended up wrong. Since the WHO has carefully tracked these cases,
we have extensive data regarding changes of iodine intake. Long term
intakes above 600 mcg routinely cause higher rates of thyroid disease
including hypothyroidism and hyperthyroidism.
Additional data on the long term effects of high dose iodine come from amiodarone usage. Each 200 mg tablet is roughly 75 mg of organic iodine, 8-12% of which is released as free Iodide yielding an average net dose of 6-12.75 mg of iodine.
Dronedarone is a nearly identical molecule to amiodarone minus the iodine.
It shares the same effects and side effects of amiodarone with the exception of thyroid toxicity. Therefore it has been concluded that the thyrotoxic effects of amiodarone are attributable solely to the high iodine content.
In a study of 182 patients taking amiodarone, 41% developed hypothyroidism over a 6 year period. Median time frame of onset for hypothyroidism was 21 months. 59% of patients developed thyrotoxicosis after an average of 29
months. Note that some cases of thyrotoxicosis culminated in hypothyroidism, so the groups did overlap.
Point #5: The Wolff Chaikoff effect, AKA the 'iodine escape mechanism', has
been verified in vitro and in vivo and is present in all humans without exceptions or variations. Were such a 'fuse' not in place, normal variation of iodine intake could induce cardiotoxic hyperthyroidism. This effect is used when managing patients in a state of hyperthyroid storm.
One can suppress thyroid hormone synthesis with pharmacologic doses of
iodine more quickly than with thionamide drugs due to the Wolff Chaikoff effect.
This also enables a single high dose of potassium iodine ( SSKI ) to prevent thyroid cancer after radiation exposure. After taking enough SSKI , the thyroid iodine uptake is temporarily blocked due the Wolff Chikoff effect.
This prevents the thyroid from absorbing environmental radioactive iodine for roughly three weeks.
Point #6: Religious belief, or lack thereof, is a personal matter. Yet modern medicine is based on biology and biology is based on evolution. If someone is unwilling to acknowledge the existence of planet earth prior to
6000 BC, then I see little basis on which to have a rational discussion regarding matters of science.
Point #7: As Naturopathic Physicians, we love to be the purveyors of arcane knowledge that flies in the face of conventional wisdom, I know I do.
Because of this eagerness, I think we can be vulnerable to embracing such ideas too uncritically. As Carl Sagan said, great claims require great evidence.
The claim that the last 80 years of accumulated iodine knowledge duplicated from hundreds of researches in thousands of studies worldwide is all part of a 'foreign conspiracy' would require massive evidence, which I find lacking.
Fibrocystic breast disease can usually be treated with therapeutic doses of Vitamin E, EPO, a diet high in fiber and avoidance of methyl xanthenes.
FYI- A new study in the American Journal of Clinical Nutrition showed high rate of thyroid symptoms and disease when supplementing 400 mcg iodine daily. Ideal dose is reported to be 150 mcg daily, exactly what I recommend. Many don't know this, but if you're on dessicated thyroid, you already get iodine in it, roughly 130 mcg per 1 grain (60-65mg)
Here's a write up on the study: http://www.reuters.com/article/2012/01/17/us-iodine-howmuch-idUSTRE80G1OZ20120117?feedType=nl&feedName=ushealth1100
More from Dr. C on iodine testing/selenium and iodine ratios:
A lab that tests iodine just completed a study on 24 hour iodine challenge testing. The proponents of this test claim that 90% of the iodine is eliminated in the first 24 hours. The study showed that iodine elimination goes on for many days at high levels, proving the test is not accurate. It also proves that normal healthy people would be mistakenly shown to be deficient on this test. Some have argued about a certain ratio needed for selenium to iodine. It is true that selenium deficiencies worsens both iodine toxicity and iodine deficiency. However, since they cannot both be tested by similar methods, ratios are not meaningful. Take home message: get 200 - 400 mcg selenium and keep iodine as low as practical if you are on thyroid replacement. Thyroid meds already contain substantial amounts of iodine, more is counterproductive.
Info on iodine loading test, 3/2/13-I predicted that the iodine loading test was not accurate. Last month, for the first time, a study was done on it and showed that it was not. http://www.townsendletter.com/Jan2013/iodine0113.html
.
Viewed 64750 times
All MsPep's Answers