What source do you recommend for iodine and what maintainance dose?

I started my paleo diet/lifestyle on Jan 5, 2009 and got labs done TSH: 2.790 (0.270-4.200) Someone commented that I may need Free T3 & T4 for further eval.  I would like to try inc. my iodine since I don't use salt.

Thank you  (my full labs are here -- I am also looking into the cholesterol)

Dr Davis,

I was supplementing with kelp until I read about the arsenic levels found in kelp supplements. Arsenic is a known contributor to diabetes.

I contacted the supplement company and they gave me a run around about the arsenic level. They wouldn't deny it but tried to make it sound like it wasn't anything to worry about.

I wasn't at all happy about this, especially since so many supplements are contaminated with a lot of other substances since they aren't regulated.

Is there any way to get iodine that doesn't expose us to unnecessary amounts of arsenic?

Hi, Jenny--

There are many iodine supplements, such as potassium iodide drops, available widely in health food stores.

Alternatively, of course, you could make a habit of eating kombu or wakame, rich seaweed sources of iodine widely consumed in Japan and available in Oriental food stores or even Whole Foods.

would be very interested in hearing your thoughts on Free T3 measurement.  Many doctors will measure Free t4, and only total free T3 saying there is not much difference between Free T3 and total T3 measurements.  Small protein binding or something to that effect.  Thanks.

Would the RDA levels of iodine in multivitamins be enough to defend against a deficiency?

Are there absorption issues from this form?

I bought some technical grade potassium iodide, some 99.9% metallic iodine and a dropper bottle and made some 50% strength Lugol's iodine.  The recipe is: 2.5g iodine, 5g potassium iodine, add water to total weight of 100g.  I found the full strength solution wasn't dissolving so went for half strength, which still took about a day to finish dissolving.

This makes for about 3.25mg effective iodine per drop (which is quite a bit).  I add one drop of 50% Lugol's to the milk I use to take my vitamins at breakfast.  After three months of that, my dropper bottle is barely lower, but my thyroid panel is notably healthier (was at the bottom edge of "normal" T3/T4).

Also, this stuff is CHEAP!  The $30 worth of iodine/potassium iodide that I bought (100g I2, 200g KI) will make about 4 liters of 50% Lugol's (~80,000 drops).  I've got enough to give myself and my wife a drop a day for the rest of our lives, and have enough left over to make a few dozen 10-day anti-radiation KI courses (130mg/day or 1.3g/course).

I2 is picky about the container (teflon or glass with an airtight seal) but dry KI just needs to be kept dry and cool in a small tupperware container and it's shelf life is "indefinite".

Steve--

Free T3 deficiency will, I believe, prove to be among the most important factors acting as a coronary risk factor.

Plenty more on this issue to come in future.

Taking your ideas to heart about iodine deficiency, I thought I would try seaweed snacks (now I wish I remember where I read about them) and ordered from Amazon based on reviews...Long story short:  Love them.

So much I love them, I just signed up for the 5 box (24 in a box)monthly automatic delivery (2 of the boxes go to my household assistant who has a number of foreign exchange students over the years as part of the church ministry she belongs to, and one student from Korea introducted her to these dried, salted seaweed called nori or kim).  We did a taste test by buying from a local asian/Korean grocery and I was dismayed to find all 5 kinds we bought had corn oil listed as an ingredient, so we are sticking with the Amazon delivery as it is nori, sesame oil, and sea salt. Low carb, low calorie, I think low sodium (60 mg) for whatever floats your diet boat.  

Still I will look into Lugol's or pharmaceutical grade potassium iodine.  One concern:  An upper limit to iodine intake?  I have not seen any data. Thanks.

Off topic but wonder if you have seen this study?

http://www.sciencedaily.com/releases/2009/08/090820124038.htm

Type 1 Diabetes Linked To Immune Response To Wheat

The upper range of dosing for iodine is a hotly-contested question.

For example, take a look at what Dr. David Brownstein (put his name in Google) says. He uses doses of 50 mg (50,000 mcg) or more.

Organic versus Inorganic Arsenic in Herbal Kelp Supplements
Although the report has several methodologic shortcomings, the most serious flaw is the authors’ failure to recognize that the arsenic most commonly found in seaweed and seafood products is relatively nontoxic.
This is in contrast to inorganic arsenic, which has well-documented acute and chronic toxicity.
Amster et al. (2007) did not discuss the possibility that the arsenic measured in the kelp supplement was in the organic form, nor did they address the great variability in toxicity among arsenic compounds.
These two oversights lead to the unsupported conclusion that the arsenic found in kelp is responsible for the unique set of medical conditions observed in their patient.

The full text is online and it is worth reading.

Sorry I meant to add
this is the form of kelp I use $3.76 and code WAB666 would save you $5 if you ordered something else as well.
How about being really extravagant and ordering a years 360 X 5000iu Vitamin D3 olive-oil based gelcaps for $14.98
2 years supply of iodine + 1yrs vitamin d3 for less than $20.
UK readers may be interested to know the cheapo German supermarket Lidl does iodised salt for 15p pack, it's probably worth decanting it into a airtight container as kitchens can be humid and iodine in salt will not be stable over time so Salt Pigs are possibly not the best way to retain the iodine in iodised salt.

I'm going to ask my doctor for a script for an iodine test next time I see him. I think a 24 hour, urine test is the only way to measure it properly. Serum isn't so accurate, if I remember right, although it certainly would be less of a hassle.

Anyone know what is the optimal level of iodine status? Top of normal range, or anywhere in range?

I take a couple drops per day of an iodine supplement called "Iosol," and I really like it. It's only 12 bucks a bottle (1,830 mcg per drop, 610 drops per bottle). You can find it here: http://www.iherb.com/TPCS-Iosol

It's not potassium iodide, but rather a combination of iodine (extracted from kelp as unbound iodine) and ammonium iodide. Some think this is better than potassium iodide. You can read why here: http://www.byronrichards.com/index.php/thyroid_leptin/entry/what_is_iosol_iodine/

Hi Jenny,

I supplement with 325 mcg Kelp caps from Now.  Amster et al. 2007 reports that the arsenic most commonly found in seaweed and seaweed products is relatively non-toxic. For example,the level of concern for total arsenic in crustaceans is 86 ppm,a concentration 10 times higher than  the amount found in kelp supplements.  I had diabetes type 2 for 20 years.  My last 3 A1c tests indicated levels of 4.7, 4.8 and 5.0.  So much for contribution to diabetes.

Thank you for making light of this!

Iodine & Vitamin D supplementation is making a dramatic difference in the way I feel. Mood and concentration have improved, not to mention my blood pressure has normalised (especially around meal time).

Get your levels tested and if in doubt!

Thanks, Ted. Great summary of the evidence.

Also, the Japanese include kombu, wakame, and other seaweeds in their daily diet in quantities that far exceed a kelp tablet or two without arsenic toxicity.

you might be interested in this article on the relationship between increased fructose consumption and iodine deficiency: http://www.raisin-hell.com/2009/06/why-iodine-is-being-added-to-your-daily.html

Can you address sea salt use? I've steered completely away from table salt and into sea salt. Some sea salt, such as the pink Himalayan variety, boasts something like 80 some odd minerals present in it. Is there adequate iodine in sea salts, if any?

would be interested in hearing from Chole J which of the healthy seaweed snacks she gets from Amazon

My take on Nori:  It is basically a potatoe chip from the sea.  So it has iodine in it, so the arsenic may not be harmful.  So.....what oil did they use?  Sesame oil is not that good for you.  Did they keep the oil below it's smoke point?  How often do they change it?  Where did the seaweed come from?  Downstream from the Chinese Drywall factory? Even sushi grade Nori smells rancid to me.  No thanks, I just don't think it is a health food.

This site info is great !  Thanx all.  In case you plan to make your own mixture (I do, eventually), people may think you are actually a trouble maker and not a health nut:  I learned that Iodine is use illegally to make d-methamphetamine.  Here is a govt site telling of that issue.   Who'd have guessed !
Smile.

You can buy "wild crafted" seaweed from domestic sources in remote California or Maine sources if you want to avoid unknown sources from overseas.

I have a variety of hand harvested and naturally dried seaweed products from Mendocino Sea Veggetable Company (www.seaweed.net).   They sell a small booklet with recipes, too.  

We especially love the Mendocino Miracle Mix (ground mixed seaweeds) sprinkled over our morning eggs.  I put MMM in everything from homemade condiments (mayonnaise, ketchup, mustard and salsa) to soups.  MMM is also great mixed 30/30/30% with coarse Mendocino or Atlantic sea salt  and sesame seeds for a great seasoning shake.

There is another company I haven't yet tried, but it is also recommended by a Mendocino friend, Ocean Harvest Sea Vegetable Company http://www.ohsv.net/ .

I add some kombu to my homemade bone broths and often add crunchy dried seaweed to salads instead of croutons.  Some seaweeds can be soaked  a few minutes to plump back up and tossed into a salad.  When I make sashimi I also serve a salad of just seaweed with a ginger-(wheat-free) raw tamari vinaigrette.   Once you get over the unfamiliarity with sea vegetable it becomes quite ordinary and not much different to eat than land vegetables.

I ended up with hypotension from cutting out salt in my paleo diet and it was not fun. I now eat seaweed, but you have to be careful with that too. A seaweed-loving friend of mine now has hyperthyroidism!

Yeah, thanx Melissa -- everyone is tempted to recommend a "one-size-fits-all" diet but I bet it is more complicated than that.
All this feedback is very helpful.  
One person says take tons of iodine, the next says it can cause thyroid disorders, we must be very careful when taking advice on the internet (or anywhere else, for that matter).

Thanks for the reminder, I've been trying various seaweeds and sea vegetables but ran out while the local samphire was in season (I think it was a previous post by Anna that turned me on to these), I just put them on tomorrow's shopping list.

Dr. Davis,
I dont know where to put this article, which is  helpfull in the times of H1N1. I am just going to copy it here and leave it for you to decide the place for this please.
Vitamin D is also is major immune system booster.
http://www.starfireresearch.com/health/topics/swineflu.html

Iodine: the Forgotten Weapon
Against Influenza Viruses


David Derry, MD, PhD
332 – 425 Simcoe Street
Victoria BC V8V 4T3

Correspondence: Dr. David Derry dderry@shaw.ca


Background: After the 1918 Influenza Pandemic which killed an estimated 30 million people, governments financed research on the Pandemic’s causes. Over 25 years, influenza viruses were isolated and methods for killing them with various agents discovered. Iodine was the most effective agent for killing viruses, especially influenza viruses. Aerosol iodine was found to kill viruses in sprayed mists, and solutions of iodine were equally effective. In 1945, Burnet and Stone found that putting iodine on mice snouts prevented the mice from being infected with live influenza virus in mists. They suggested that impregnating masks with iodine would help stop viral spread. They also recommended that medical personnel have iodine-aerosol-treated rooms for examination and treatment of highly infected patients. Current methods of dealing with influenza infection are isolation, hand washing, antiviral drugs, and vaccinations. All of these methods can be improved by incorporating iodine into them. When impregnated with iodine, masks become much more effective, and hand washing is more effect when done with mild iodine solutions. Isolation techniques coupled with aerosol iodine would make them safer for patients, medical personnel, and all persons working with the public. Public health authorities could organize the distribution of iodine and at the same time educate the public in the effective use of iodine. Oral iodine might also boost body defense mechanisms in the upper oral and respiratory mucus. Conclusion: Iodine incorporated into masks, solutions, aerosols, and oral preparations could help to kill influenza viruses and fight off an H1N1 Pandemic.

Keywords. H1N1 • Influenza virus • iodine • aerosols • immunization • isolations • masks • prevention

Derry, D.: Iodine: the Forgotten Weapon Against Influenza Viruses.

I wonder if eliminating gluten would clean up that T3 issue. Yesterday I read that Celiac Disease can cause hypothyroidism.

Kurt's thyroid function normalized to nearly ideal levels just with iodine replacement. (The free T3, while improved, remains low; an issue for another day!)

Jenny!
I just started the NOW kelp w/ dulse caps, 325mcg iodine.  How do they work for you?  The supplement world is soooo confusing and overwhelming!!  I'm wondering if I can take two of these a day, one in am and one in pm?
Thanks for any insight you can provide!
Katie

The advice given by thyroid docs, at least the kind that understand more about it than average and are willing to prescribe Armour, etc, is that you should reduce goitrogen intake while you are first starting treatment for hypothyroidism and/or iodine deficiency, then they're OK to have more of in your diet. The goitrogenic effect of most of them is minimised or negated by cooking anyway. Mine did advise that soy could be a bit more problematic and you should avoid consuming any within four hours of taking your thyroid medication, if you swallow the medication instead of taking it sublingually.

Very interesting!  I was hoping you would follow up your iodine/goiter posts with something about goitrogens.  I'd like to read up on the human trials, if there's anything more than abstracts available.  Any urls handy?  Also, just wanted to say I really appreciate your blog, and thank you.

I have Hashimoto's thyroiditis and my endocrinologist (who is fantastic; she titrates my dose to my symptoms, and has me on Armor) has suggested that I want to take the following two precautions around goitrogens:

a) Don't eat the "biggies" such as soy within four hours of taking my thyroid medication.

b) Eat them moderately and fairly steadily; a serious pig-out on raw broccoli or edamame after weeks without may cause a swing, but a normal diet that includes them is no big deal.  This means that I actively want to include these things in my diet (which is good, because I both like them and they are good for me.)  If I keep the amount steady then we can just balance my dose against any goitrogenic effect they might have.

My understanding of the cruciferous vegetable family is that their goitrogenic effect is negated or at least minimized by cooking or fermentation.

Hi Dr Davis,

FYI - in case you are not aware, the home testing kit shopping area is not working.  At least I've tried ordering with two different computers with out luck.

Flit--

Thanks for your comments.

I like option "b", the most practical and logical.

Anon--

I believe that the lab test area should be working now.

We are in the process of transferring all files over to a new website and servers. There may therefore be momentary glitches that shouldn't last more than a few minutes while the programmers make the switch.

On the bright side, the new website will be more user-friendly.

Max--

The easiest way is to just go to PubMed.gov and enter the relevant search terms.

You will find oodles of studies, many in mice or in vitro preparations, a few in humans. You can specify which--mouse vs. human, for instance, in your choice of search terms.

The researchers claim that the findings provide little evidence that "in euthyroid, iodine-replete individuals, soy foods, or isoflavones adversely affect thyroid function."
The researchers also stated that "there remains a theoretical concern based on in vitro and animal data that in individuals with compromised thyroid function and/or whose iodine intake is marginal soy foods may increase risk of developing clinical hypothyroidism. Therefore, it is important for soy food consumers to make sure their intake of iodine is adequate." They also claim that "some evidence suggests that soy foods, by inhibiting absorption, may increase the dose of thyroid hormone required by hypothyroid patients."

This study is suggesting that soy is safe -- unless you have a thyroid condition, or iodine deficiency. It also suggests that soy foods can inhibit absorption of thyroid medication.
The study doesn't address the fact that it's estimated that as much as one-fourth of the U.S. population is now iodine deficient, and that the number is on the rise. At the same time, many millions of Americans also have undiagnosed autoimmune thyroid disease. At minimum, if you accept the premise of this study, that means that more than 75 million Americans with iodine deficiency may be at risk of thyroid problems from soy consumption. If you include the up to 60 million Americans who have a diagnosed or undiagnosed thyroid condition, almost half of all Americans could be at risk of soy-related thyroid problems.

It's also troubling to note that the author of this study -- and several other recent studies claiming soy is not a danger to the thyroid, is Mark Messina, PhD. Messina, though not a medical doctor, also goes by the name "Dr. Soy." Messina had been in charge of grant funding at the National Institutes of Health (NIH), where he oversaw a $3 million grant for soy studies. Soon after he left NIH, he was hired to serve on the scientific advisory boards of both the United Soybean Board, and international soy agribusiness Archer Daniels Midland. He still serves on both scientific advisory boards as a paid advisor. In addition to his work on these advisory boards, Messina is a consultant to the United Soybean Board and editor of its soy-related newsletter, and serves as a paid speaker and consultant to promote the positive benefits of soy for the United Soybean Board's "Soy Connection.". Messina has also published a number of books promoting soy. The "Political Friendster" website, which tracks corporate influence, has documented the close relationship between Messina and the various corporate players in the soy industry.

the full 5 page article can be read at.
http://thyroid.about.com/cs/soyinfo/a/soy.htm?nl=1

Help, I am so confused!

I have a goiter and nodules diagnosed via an ultrasound screen. I have an appt with my MD to take the next step to do lab etc. I am hoping the goiter is caused by iodine deficiency and not Hashimotos. I have been reading about supplementing with iodine but some folks say take lots (12+ mgs) others say taking more will exacerbate a hypothyroid condition. I have been taking kelp capsules 4 daily supplying 1600 mcg. I have been tempted to up the dose but don't want to mess things up. Should I wait until test results come back, then if it is negative for Hashi's go ahead and do mega doses? or should I not be afraid to supplement?

Thanks for this blog, and thanks for all the intelligent comments through-out. I have learned so much.

Laura in Arizona

Hi again Dr Davis,

I was the one that wrote earlier about having troubles ordering testing kits.  The system still is having trouble - at least with my computers, at home and work.  Thought you might want to know.  
The error occurs after pressing the submit order button.  

Below is a cut and paste of what the error says.  Hope this helps!    

Server Error in '/' Application.
Retrieving the COM class factory for component with CLSID {17B9BE57-09EA-11D5-897B-0010B5759DED} failed due to the following error: 80040154.
Description: An unhandled exception occurred during the execution of the current web request. Please review the stack trace for more information about the error and where it originated in the code.

Exception Details: System.Runtime.InteropServices.COMException: Retrieving the COM class factory for component with CLSID {17B9BE57-09EA-11D5-897B-0010B5759DED} failed due to the following error: 80040154.

Source Error:

Line 146:
Line 147:    Public Function ProcessCC(ByVal PaymentObject As PaymentObjCC) As ArrayList
Line 148:        Dim pfpro As New PFPro
Line 149:        Dim Response As String
Line 150:        Dim pCtlx As Integer


Source File: E:inetpubwwwrootTYPTYP_MainApp_CodePayflowProPFProProcessor.vb    Line: 148

Stack Trace:

[COMException (0x80040154): Retrieving the COM class factory for component with CLSID {17B9BE57-09EA-11D5-897B-0010B5759DED} failed due to the following error: 80040154.]
   PayFlowPro.PFPro..ctor() +13
   PFProProcessor.ProcessCC(PaymentObjCC PaymentObject) in E:inetpubwwwrootTYPTYP_MainApp_CodePayflowProPFProProcessor.vb:148
   Checkout.CompleteOrderCC() in E:inetpubwwwrootTYPTYP_MainproductsCheckout.aspx.vb:970
   Checkout.btnSubmitOrder_Click(Object sender, EventArgs e) in E:inetpubwwwrootTYPTYP_MainproductsCheckout.aspx.vb:1113
   System.Web.UI.WebControls.Button.OnClick(EventArgs e) +111
   System.Web.UI.WebControls.Button.RaisePostBackEvent(String eventArgument) +110
   System.Web.UI.WebControls.Button.System.Web.UI.IPostBackEventHandler.RaisePostBackEvent(String eventArgument) +10
   System.Web.UI.Page.RaisePostBackEvent(IPostBackEventHandler sourceControl, String eventArgument) +13
   System.Web.UI.Page.RaisePostBackEvent(NameValueCollection postData) +36
   System.Web.UI.Page.ProcessRequestMain(Boolean includeStagesBeforeAsyncPoint, Boolean includeStagesAfterAsyncPoint) +1565


Version Information: Microsoft .NET Framework Version:2.0.50727.3082; ASP.NET Version:2.0.50727.3082

What a great resource!

How about humans? The few trials conducted in humans have shown little or no effect. In most instances, the adverse effects of goitrogens have been eliminated with supplemental iodine. In other words, goitrogens seem to exert their ill thyroid effects when iodine deficiency is present. Restore iodine . . . no more goitrogens (with rare exceptions).

ABOUT THE QUESRCETIN has also been identified as a goitrogen (Giuliani C et al 2008).

WOW, this is the most detailed information I have seen so far  online about the Resveratrol and flavonoids being goitrogenic,

I have been searching and searching, as I just had read briefly of an experiment with rats that showed Resveratrol (red wine + grape seeds extract) was causing the thyroid gland to enlarge
I really appreciate you posting this info

I have hypothyroidism, I take small doses of Armour and it really works great for me, and was taking Resveratrol too, (which by the way, it seemed to help me a lot, especially with giving strength and gloss to my hair)
So when i heard about this experiment i was shocked. Then I found out that even all kind of fruits are goitrogenic (as you point out) and tea and greens and garlic and onion and potatoes and beans, but above all, fruit and grapes.

Is so hopeless, I in fact, by fear, suspended the resveratrol, and now, and is funny, as now I am experiencing some minor hair loss, I am sure due to that I stopped taking this amazing supplement which was helping my hair to grow strongly

So I am so confused, my doctor as most of doctors, do not have a clue, as there is no enough info about all this and also no willingness to look into this research as well

He told me to stop taking it
But as you point out, then we should also stop eating then, as it seems that for one reason or another ,, all food is goitrogenic, soy, brassica greens, all greens, and veggies and fruit and also chickens and animals that seems are fed with goitrogenic grass and seeds
So what choice do we have?
ALSO I found this experiment on same PubMed which seems contradictory, I am not a doctor but it seems that it helps to add iodide (which is in iodine)  to the thyroid???

IS there any MD on this site who might throw some light on this???

or anyone here who has read more on this quercetin or Resveratrol? or knows about where to find more info about real evidence that flavonoids really work that way in humans????
(by the way thank you for posting the Giuliani experiment, was that on humans or rats?)

Does anyone knows of a good medical website or any that provides more information about this confusing subject?
Please, help, let me know,
Thank you
Nella

OOPS
about the QUERCETIN

here is that experiment URL
http://www.ncbi.nlm.nih.gov/pubmed/20151827

Spontaneous human Combustion is something that has always captured all my attention. Thank you for the interesting post, it's been a real pleasure reading it.

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