"Why is a heart surgeon giving a lecture on iodine?"

The following is from a presentation approximately 24 pages long and a link for those who wish to read the entire report.



Iodine in Health and Civil Defense

Presented at the 24th Annual Meeting of Doctors of Disaster Preparedness
at Portland State University, August 6, 2006

by Donald W. Miller, Jr., M.D.

Text for each PowerPoint Slide (with references):

Introduction

When I told my daughter, a Harvard-trained pediatric cardiologist, that I was preparing a talk on iodine for this meeting she left unsaid the question uppermost on her mind, which was “Why is a heart surgeon giving a lecture on iodine?,” and instead confessed, “I don’t know much about iodine.”  She speaks for the medical profession in general, endocrinologists included.  

Iodine in Heart Surgery

Most physicians and surgeons view iodine from a narrow perspective.  It is an antiseptic that disinfects drinking water and prevents surgical wound infections, and the thyroid gland needs it to make thyroid hormones—and that’s it.  Surgeons scrub with it and have their nurse paint iodine on the patient.  Tincture of iodine remains the best antiseptic for preventing wound infections after surgery.  It kills 90 percent of bacteria on the skin within 90 seconds.  

Elements that Compose the Human Body

Iodine is one of 25 elements that make up the human body, number 12 in number of atoms, after magnesium.  It is the largest element in the body and the only one that by itself stops x-rays.

Napoleon and Nuclear Weapons

In 1811, a French chemist discovered iodine brewing soda to make saltpeter for gunpowder that Napoleon needed.

With nuclear weapons scientists found that radioactive iodine-131 is a major component of the radioactive fallout they produce.  This isotope is produced only by nuclear fission, from splitting the nucleus of uranium-235 and plutonium-239.  Taking iodine to block thyroid uptake of its radioactive form in fallout is an essential civil defense measure in a nuclear war.

Iodine in Thyroid Hormones

The thyroid gland produces two thyroid hormones, thyroxine (T4) and triiodothyronine (T3).  Among its 31 atoms, consisting of carbon, hydrogen, oxygen, and nitrogen, T4 has four iodine atoms, which because of their large size comprises 65 percent of thyroxine by weight—and inT3, 59 percent.  The gland synthesizes 100 ug of T4 and 5 ug of T3 each day. [2]

Actions of Triiodothyronine

T-3 is the active form of the hormone.  Cells take up T4 and remove one of its iodine atoms, converting it to T3, which attaches to receptors on the DNA of the genes that control the cell’s metabolism via the mechanisms listed here.  The cell wall and energy-producing mitochondria also have T3 receptors. [3]

IDD: Goiter

When there is too little iodine in the diet for the thyroid to produce enough hormone the gland swells up trying to capture what little there is available.  It becomes a goiter, a visible, noncancerous enlargement of the thyroid gland.  Some them become quite large.

IDD Iceberg

The World Health Organization estimates that 2 Billion people, 30 percent of the world’s population, suffer from iodine deficiency disorders.  More than a billion people have visible goiters and 5.7 million are cretins.  An estimated additional 750 million people without goiters have undiagnosed hypothyroidism [5], and many millions have iodine-related mental retardation.

Hypothyroidism

Symptoms of hypothyroidism include fatigue, impaired concentration, and in some people, frank depression / fibromyalgia, joint pains, and constipations/ a decreased sex drive and an intolerance to cold.  

Signs of hypothyroidism include weight gain and the other ones listed here.  The thyroid gland in reptiles is less active than in humans; and a person with an underactive thyroid gland takes on reptilian features.  The skin becomes dry and thick, and is cold to the touch.  Hair is dry and falls out, reflexes are slow, and the body temperature drops below normal.  Signs of congestive heart failure include difficulty breathing and fluid build up on the lungs.  

IDD: Mental Retardation

Iodine deficiency has caused mental retardation in 50 million children worldwide, including 10 million in China. [6]  

A study done in Sicily showed that two-thirds of children born in an iodine deficient area had attention deficit and hyperactivity disorders (ADHD), whereas none of the children born in an iodine-sufficient area had this disorder.  In addition to ADHD, their IQs were 20 points lower.  On average, the IQs of children born and raised in an iodine-deficient area are 13.5 points lower than children not deprived of iodine. [7]

IDD: Cretinism

Cretinism is the most severe iodine deficiency disorder, mental retardation combined with physical deformities. [5]

Worldwide Iodine Nutrition

The thyroid gland needs only 70 ug of iodine a day to synthesize T4 and T3.  Health organizations consider iodine nutrition to be sufficient if urinary excretion is greater than 100 ug/L, which is said to correspond to an iodine intake of 150 ug/day.  The International Council for the Control of Iodine Deficiency Disorders defines optimal intake as 150 to 299 ug/day.  It judges intake to be excessive if it is greater than 750 ug a day. [8]   Note that the Japanese consume an “excess” amount of iodine.

RDI for Iodine

Starting in 1980, medical authorities in the United States and Europe have established a Reference Daily Intake (RDI), formerly called the Recommended Daily Allowance (RDA) for iodine of 100-150 ug/day.  In milligrams, this is 0.1 to 0.15 mg/day, a tiny fraction of the amount that mainland Japanese consume.  Authorities recommending this amount of iodine include the American Medical Association, NIH National Research Council, Institute of Medicine, UN Food and Agricultural Organization, WHO Expert Committee, and the European Union International Programme on Chemical Safety. [5, 9]  Now that’s a consensus.

This is the standard medical view of iodine—thyroid-based and focused on the three mentioned iodine deficiency disorders.

Derry’s Book

But there is growing evidence that iodine provides important extrathyroidal benefits when taken in milligram amounts.  David Derry’s book, Breast Cancer and Iodine introduced me to this side of iodine.  A fellow Dartmouth-educated physician, Brad Weeks, who practices “corrective” medicine, recommended it.   The book is a bit disorganized, has references at the end of each chapter not cited in the text, and no index; but it was an eye-opener nonetheless. [10]

Iodine Intake in Japan

The first thing I checked out was Japanese iodine consumption.  Seaweed is a potent source of iodine, and the Japanese eat a lot of it.  More than 95 percent of the iodine they consume comes from seaweed, which includes kelp (brown algae); nori sheets (red algae), with sushi; and chlorella (green algae).

The nutrition section of Japan’s Bureau of Public Health did a study on Japanese food consumption, published in 10064, and found that they eat 4.5 gm of seaweed a day. [11]   Saltwater fish contain iodine, but one would have to eat 15-25 pounds of fish to obtain 13 mg of iodine from this source.  

According to health department officials, Japanese consumption of seaweed in 2001 was 14.6 grams a day.  Assuming similar iodine content, this amount contains 43.8 mg of iodine. [12]

Studies measuring urine concentration of iodine confirm that the Japanese consume iodine in milligram amounts. [13]  Residents on the coast of Hokkaido consume 200 mg of iodine a day. [14]

Iodine Intake in the US

The average daily intake of iodine in the U.S. is 240 ug—a quarter of a mg.   This is half the amount Americans consumed 30 years ago, when iodine was used more widely in the diary industry and as a dough conditioner for making bread.  Now it is only added to table salt, and 45 percent of American households purchase salt without iodine.   Furthermore, since the 1980s those who do use iodized table salt have decreased their use of it by 65 percent.  As a result, 15 percent of the U.S. adult female population, 1 in 7, suffer from iodine deficiency and have a urinary iodine concentration less than 50 ug/L. [15,16]  The same percentage of American women, it turns out, will develop breast cancer during their lifetime. [17]  

Health Comparisons: U.S. and Japan

The incidence of breast cancer in the U.S. is the highest in the world, and in Japan was, until recently, the lowest.  Japanese women who emigrate from Japan or consume a Western style diet have a higher rate of breast cancer, decreasing the likelihood of there being a genetic component in the low incidence. [19, 20]

Life expectancy in the U.S. is 77.85 years, and in Japan, 81.25 years, the highest in the industrialized countries but slightly behind such places as San Marino, Singapore, and Hong Kong.
 
The infant mortality rate in Japan is the lowest in the world, half that in the United States. [21]