Iodine update

2. July 2010 William Davis (30)
As the iodine experience grows, I've made several unique observations.

Up to several times per day, I see people who are responding in some positive way to iodine supplementation. (See previous Heart Scan Blog posts about iodine: Iodine deficiency is REAL and The healthiest people are the most iodine deficient.)

Among the phenomena I've observed:

1) A free T4 thyroid hormone at the low end of normal, or even in the below normal range, along with a highish TSH (usually >1.5 mIU/L) are the most frequent patterns that signal iodine deficiency. Occasionally, a low free T3 value will also increase, though this is the least frequent development.

2) At a dose of 500 to 1000 mcg iodine per day, it requires anywhere from 3 to 6 months to obtain normalization of thyroid measures.

3) Reversal of small goiters also occurs over about 6 months.

4) Iodine intolerance is uncommon. If it occurs, using a low starting dose, e.g., 100-200 mcg per day, usually works. The dose can be increased gradually over the ensuing months.

5) Perceptible benefits of iodine occur only occasionally. The most common perceptible effects are increased energy and increased warmth, especially of the hands and feet.

6) Some people who have taken thyroid hormones for years will develop reduced need for their medication with iodine supplementation. In other words, their physician was inadvertently treating iodine deficiency with thyroid hormone replacement. Anyone already on any thyroid preparation(s), e.g., Synthroid, levothyroxine, Armour thyroid, Naturethroid, etc., should watch for signs of hyperthyroidism when iodine is added. But having your own thyroid gland make its own thyroid hormones is better and healthier than relying on the prescription agents. Just be sure to monitor your thyroid measures.

7) Iodine toxicity can occur--Two people in my clinic population developed iodine toxicity by taking 6000 mcg iodine per day for 6 or more months. (Both patients did it on their own based on something they read). Iodine toxicity is evidenced by shutting down your thyroid, i.e., marked increase in TSH, e.g., 15 mIU/L.


Most of the people in my clinic obtain their iodine from kelp tablets. Some use potassium iodine (KI) drops. A handful have used the high-potency Iodoral (12.5 mg or 12,500 mcg iodine per tablet); this was also the form that generated the toxic effects in the two females.

All in all, iodine deficiency is actually far more common than I ever suspected. Not everybody is iodine deficient. But a substantial minority of the Midwest population I see certainly are.
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Comments (30) -

  • GOJI BERRY

    7/4/2010 10:45:21 AM |

    Its really very much helpful.

  • google

    7/4/2010 12:41:31 PM |

    Initially by eating iodine-rich seaweeds daily, and then by taking 12.5 mg of Iodoral daily, my required T4 dose has decreased dramatically: from 165 ug per day to 100 ug per day so far. None of my doctors have every seen anyone reduce their T4 dose like this.

    It may not be the case that dramatic TSH increase on 12.5 mg or more of Iodoral is a sign of iodine toxicity. The docs with the most experience with mg level iodine supplementation (Abraham, Brownstein, Flechas) seem to agree that sometimes TSH will rise a lot, temporarily, but generally without hypothyroidism. They  believe this is a  functional adaption to the correction of iodine deficiency--i.e., TSH appropriately upregulating various aspects of iodine and thyroid hormone metabolism, including the iodine symporter system. Quite a few people have supplemented with doses of 100 mg per day or more with apparently no signs of iodine toxicity.

    See Dr. David Brownstein's book, "Iodine: Why You Need It, Why You Can't Live Without It," and the articles by Dr. Guy Abraham, the pioneer of modern iodine orthosupplementation, at http://www.optimox.com/pics/Iodine/opt_Research_I.shtml.

  • Anonymous

    7/4/2010 1:17:30 PM |

    Should iodine be taken with something (i.e. oil, etc) to help with absorption?

    -- Boris

  • Lori Miller

    7/4/2010 3:36:45 PM |

    Is iodine stored in fat or fluids? In other words, can a person eat a bunch of iodine-rich seaweed once or twice a week, or should it be eaten every day if you're going that route?

  • Dr. William Davis

    7/4/2010 10:46:22 PM |

    HI, Google--

    Read it. Know his stuff.

    I think he's got a lot of great lessons to teach us. But not in this case. This was a clear-cut instance of extreme TSH elevation with prolonged iodine. This was not the phenomenon that David Brownstein describes  of modest TSH increase in the face of early iodine supplementation, an effect I see every day with great frequency.

  • Anonymous

    7/5/2010 1:17:30 AM |

    Dr Davis

    Regarding your post "This was a clear-cut instance of extreme TSH elevation with prolonged iodine"

    Can you please explain more in layman's term?

    So iodine meds supplementation should not be whole year round?

    But iodine foods can be eaten everyday?

  • Garry

    7/5/2010 1:19:20 AM |

    Are there cases of patients being "allergic" to iodine?  I'm thinking of those who have reacted to some form of seafood in the past and now might be reluctant to try iodine supplementation.

  • Samantha

    7/5/2010 1:15:39 PM |

    What do you think about iodine and hashimotos´s? Should they supplement too? Regular medical advice seems to dissuade.

  • WilliamS

    7/5/2010 2:15:30 PM |

    Hi Dr. Davis,

    I'm curious if your patients with high TSH levels also showed clinical signs of hypothyroidism. I ask because I've read all the work I can find from the three docs most experienced with iodine supplementation (Abraham, Brownstein, and Flechas) and I don't recall any of them reporting any cases of iodine-induced clinical hypothyroidism—elevated TSH, yes, but clinical illness, no. And they use much higher iodine does than you do, in some cases ten to twenty times higher, for years.

    I'm also curious if you are aware of any plausible mechanism for iodine-induced hypothryroidism at the doses you are using. Other than than the mythical Wolf-Chaikoff effect (see http://www.optimox.com/pics/Iodine/IOD-04/IOD_04.html), I'm not aware of any.

    Since, as with Vitamin D, iodine deficiency appears to be extremely widespread and perhaps just as dangerous, clarifying any potential for toxicity that might discourage supplementation seems worthwhile.

    Thanks.

  • Anonymous

    7/5/2010 7:38:05 PM |

    What advantage does kelp have over something like potassium iodide?

    Although kelp is natural, it also tends to collect lead, etc. from the environment, which may not be so healthy.

  • Dr. William Davis

    7/5/2010 8:33:27 PM |

    Hi, Garry--

    My understanding of the iodine allergy issue is that, not being a protein, there is no such thing as genuine iodine allergy.

    There is something called "anaphylactoid reactions" to iodine-containing x-ray dye, which is not iodine allergy, but a reaction to the osmolality of the solution.

    There also seems to be allergy to iodine-modified proteins that can occur in fish and shellfish. Most of these people, in my experience, can safely take an iodine supplement. After all, most of these people use iodized salt.

    Very rarely, for reasons I do not understand, there seems to be a genuine allergy to iodinated compounds. I have met one or two people like this.

  • rmarie

    7/5/2010 8:36:35 PM |

    I have been taking an iodine supplement in liquid form called 'Iosol' off and on for years. It has been around a long time yet I have never seen it mentioned in any blogs. It is said to be water soluable, that is if the body doesn't need it it is excreted...so it's fairly safe to take. Here are two links for more info.

    The company that makes it http://www.tpcsdirect.com/

    and a good description on Byron Richard's site:
    http://www.wellnessresources.com/products/iosol_iodine.php

    Are you familiar with it Dr. Davis? Or anyone else?

  • William Trumbower

    7/5/2010 10:43:47 PM |

    I use Iosol quite frequently in my practice.  Particularly if the patient is on thyroid medication, as too high a dose can trigger hyperthyroid symptoms.  Some people will get acne on higher dose of I, probably due to excretion of other Halogens such as Bromine from the tissues.  I never use the 12.5mg dose to start.  My usual routine is Iosol 1drop daily increasing to 4 drops over 4-6 weeks (1drop=180mcg) and then switch to TriIodine capsules 6.25mg daily (available at our local health food store).  The only drawback to Iosol is that it does not contain Iodide as does Iodoral or TriIodine.  The other benefit to Iodine is the reduction in fibrocystic breast change and probably  breast cancer and prostate cancer.   I have only been doing Iodine for the past year, so I can't comment on cancer prevention results, but one of my pts. who was getting mammograms/MRI scans every 6 months for dense breast tissue with a terrible family history of Ca, has been on triIodine for 6 mon.  The radiologist asked to see her ID as her films did not look like they did 6 mon ago!   I also recommend VitD and correction of progesterone deficiency (estrogen dominence) to decrease breast cancer risk.

  • Anonymous

    7/5/2010 10:49:33 PM |

    Dr. Davis,

    Am I too presumptuous to assume that part of America's obesity crisis is due to our inefficient metabolisms caused, in part, by an iodine deficiency?

  • Catherine

    7/6/2010 1:17:02 AM |

    Anyone with a high Reverse T3 problem needs to be careful with iodine.  There are quite a few reports coming in on the thyroid forums that it increases RT3.  Apparently, if you have a problem converting T4 into RT3 instead of T3, it will sometimes encourage the RT3 conversion. Would love to hear any feedback/experiences from docs or thyroid patients on this.
    Warm regards, Catherine
    (I think we have 3 or 4 different Catherines posting here!)

  • MissPkm

    7/6/2010 1:21:07 PM |

    Great post, I am taking kelp at this point and you are so right - the energy I get from it is amazing! I am still very confused about the T3, T4, and TSH - what is normal, what is preferred and so on. What should I look for when I have a test done? If possible can anyone direct me to a easy to read basics on thyroid health and kelp/iodine supplement that describes the test results? I would like to go to the doctor to have some new tests done but if I can't understand the results then what good do they do?! Don't even know for sure that my doctor would be able to explain it to me...

  • Anonymous

    7/6/2010 2:04:03 PM |

    My two main concerns would be Hashimotos and potential pre-cancerous cells... both of which may be aggravated by iodine supplementation.  Do you make a point to rule both of these out before beginning supplements?

  • julianne

    7/7/2010 12:58:00 AM |

    I have Auto-immune thryroid disease, and have elevated anti-bodies, TSH,normal T4 and T3.
    I started taking a highish dose of iodine and my thryoid started enlarging and TSH shot up. As soon as I decreased the dose to RDI the enlargement stopped - in fact it's a little smaller.

    Can you explain more about your recommendations for AITD (Hashimotos)
    I am taking omega 3, vit D selenium, iodine, zinc, magnesium and doing strict paleo especially strict no gluten as I know there is a connection. I am not overweight, and have only mild thyroid symptoms sometimes.

  • Anonymous

    7/7/2010 4:11:00 AM |

    Hi
    I've been reading you're thyroid articles so I went out and bought a thermometer.
    Seems my temperature throught the day varies from 35.5C to 36.8C. (just measured today)
    That would sounds like possible hypothyroidism accoridng to your other articles.
    But reading arround I've seen lower body temperatures are typical when on calories restriction diets which I kinda do. And also that lower levels of T3 when under calorie restriction diet is one of the possible benefits of it.
    Anyway I'll go out and get some blood tests to get more information about my thyroid.
    But would like to know if you have data on body temperature of people on calorie restricted diets with healty thyroid.

  • Jim

    7/7/2010 12:36:19 PM |

    @Julianne,

    There's a newly posted series about iodine and AITD over at The Healthy Skeptic.

    The first of the three is at http://thehealthyskeptic.org/the-most-important-thing-you-may-not-know-about-hypothyroidism

  • Daniel

    7/7/2010 5:54:15 PM |

    Your post contains opposite advice to that given in this blog post at healthyskeptic:

    http://thehealthyskeptic.org/iodine-for-hypothyroidism-like-gasoline-on-a-fire

  • J. Huggins

    7/7/2010 6:01:11 PM |

    William Trumbower recommended using Trilodine capsules after a few weeks of Iosol for people who are presently on thyroid medication. I am presently taking Synthroid and have been for many years now. I have tried to find the Trilodine but with no success.  Is there another name or product that will do the same thing, or could you advise me as where I can purchase it?

  • Maniek

    7/9/2010 5:13:48 PM |

    http://curezone.com/upload/_I_J_Forums/Iodine/Maniek/flechas_questions_answers_2006_lynn.doc

    http://curezone.com/upload/_I_J_Forums/Iodine/Maniek/Iodine_New_Member.doc

    Rread frends Smile

  • WilliamS

    7/10/2010 12:47:31 AM |

    I came across an account of Dr. Flechas's views on iodine-induced hyperthyroidism (he's one of the docs most experienced with iodine supplementation). Apparently it does happen on occasion, but it's not necessarily a reason to discontinue iodine. The source for this is:

    http://curezone.com/upload/_I_J_Forums/Iodine/Maniek/flechas_questions_answers_2006_lynn.doc



    What happens to thyroid hormone production in the presence of iodine supplementation?

    Iodine supplementations should be prescribed only when iodine testing indicates iodine deficiency. Iodine testing kits can be ordered from my office (828 684 3233) by individuals or by medical practitioners.

    Traditional medical literature indicates that patients who have thyroid nodules or thyroid goiter may have the potential to develop hyperthyroidism when supplementing with iodine. Hence, before commencing iodine supplementation, it would be advantageous for a person to have their primary care doctor order a thyroid ultrasound to rule out the possibility of pre-existing goiter or thyroid nodules.
    The primary care doctor should also order thyroid lab work (to be used as a baseline) before prescribing iodine therapy and this lab work should be repeated and followed at regular intervals during the patient's iodine therapy.

    For iodine therapy patients not also on thyroid hormone replacement therapy, adjustments to the iodine therapy should be made if signs of hyperthyroidism should occur.

    Should signs of hyperthyroidism occur in patients who are taking thyroid hormone replacement therapy as well as taking iodine supplementation, the physician should first recommend an adjustment in the thyroid hormone therapy rather than in the iodine supplementation.

    This adjustment in therapy is recommended because iodine is required not only by the thyroid but is required for the proper functioning of many other tissues.

    The presence of pre-existing thyroid nodules or goiter does not preclude the patient from iodine supplementation therapy. In fact, in the extensive research with iodine therapy done in my office, I have seen many case of pre-existing thyroid nodules and goiter shrink in the presence of iodine therapy.

    Hyperthyroid patients. Graves disease patients and other with autoimmune disease take iodine also but use lithium and copper among other minerals (he didn't say) to decrease the overproduction of thyroid hormones. Iodine isn't reduced because it's the neutralizer of the thyroid.  Patients in a thyroid storm with high heartbeats are given iodine to calm it down as normal medical practice.


    Goiters. In some patients with goiters the iodine will stimulate it to produce more thyroid hormone and the patient will suddenly look hyperthyroid with elevated T4 and losing weight. As the goiter shrinks this normalizes. 


    http://www.helpmythyroid.com/iodine.htm

  • WilliamS

    7/10/2010 12:48:03 AM |

    I came across an account of Dr. Flechas's views on iodine-induced hyperthyroidism (he's one of the docs most experienced with iodine supplementation). Apparently it does happen on occasion, but it's not necessarily a reason to discontinue iodine. The source for this is:

    http://curezone.com/upload/_I_J_Forums/Iodine/Maniek/flechas_questions_answers_2006_lynn.doc



    What happens to thyroid hormone production in the presence of iodine supplementation?

    Iodine supplementations should be prescribed only when iodine testing indicates iodine deficiency. Iodine testing kits can be ordered from my office (828 684 3233) by individuals or by medical practitioners.

    Traditional medical literature indicates that patients who have thyroid nodules or thyroid goiter may have the potential to develop hyperthyroidism when supplementing with iodine. Hence, before commencing iodine supplementation, it would be advantageous for a person to have their primary care doctor order a thyroid ultrasound to rule out the possibility of pre-existing goiter or thyroid nodules.
    The primary care doctor should also order thyroid lab work (to be used as a baseline) before prescribing iodine therapy and this lab work should be repeated and followed at regular intervals during the patient's iodine therapy.

    For iodine therapy patients not also on thyroid hormone replacement therapy, adjustments to the iodine therapy should be made if signs of hyperthyroidism should occur.

    Should signs of hyperthyroidism occur in patients who are taking thyroid hormone replacement therapy as well as taking iodine supplementation, the physician should first recommend an adjustment in the thyroid hormone therapy rather than in the iodine supplementation.

    This adjustment in therapy is recommended because iodine is required not only by the thyroid but is required for the proper functioning of many other tissues.

    The presence of pre-existing thyroid nodules or goiter does not preclude the patient from iodine supplementation therapy. In fact, in the extensive research with iodine therapy done in my office, I have seen many case of pre-existing thyroid nodules and goiter shrink in the presence of iodine therapy.

    Hyperthyroid patients. Graves disease patients and other with autoimmune disease take iodine also but use lithium and copper among other minerals (he didn't say) to decrease the overproduction of thyroid hormones. Iodine isn't reduced because it's the neutralizer of the thyroid.  Patients in a thyroid storm with high heartbeats are given iodine to calm it down as normal medical practice.


    Goiters. In some patients with goiters the iodine will stimulate it to produce more thyroid hormone and the patient will suddenly look hyperthyroid with elevated T4 and losing weight. As the goiter shrinks this normalizes. 


    http://www.helpmythyroid.com/iodine.htm

  • Anonymous

    7/10/2010 12:48:29 AM |

    I came across an account of Dr. Flechas's views on iodine-induced hyperthyroidism (he's one of the docs most experienced with iodine supplementation). Apparently it does happen on occasion, but it's not necessarily a reason to discontinue iodine. The source for this is:

    http://curezone.com/upload/_I_J_Forums/Iodine/Maniek/flechas_questions_answers_2006_lynn.doc



    What happens to thyroid hormone production in the presence of iodine supplementation?

    Iodine supplementations should be prescribed only when iodine testing indicates iodine deficiency. Iodine testing kits can be ordered from my office (828 684 3233) by individuals or by medical practitioners.

    Traditional medical literature indicates that patients who have thyroid nodules or thyroid goiter may have the potential to develop hyperthyroidism when supplementing with iodine. Hence, before commencing iodine supplementation, it would be advantageous for a person to have their primary care doctor order a thyroid ultrasound to rule out the possibility of pre-existing goiter or thyroid nodules.
    The primary care doctor should also order thyroid lab work (to be used as a baseline) before prescribing iodine therapy and this lab work should be repeated and followed at regular intervals during the patient's iodine therapy.

    For iodine therapy patients not also on thyroid hormone replacement therapy, adjustments to the iodine therapy should be made if signs of hyperthyroidism should occur.

    Should signs of hyperthyroidism occur in patients who are taking thyroid hormone replacement therapy as well as taking iodine supplementation, the physician should first recommend an adjustment in the thyroid hormone therapy rather than in the iodine supplementation.

    This adjustment in therapy is recommended because iodine is required not only by the thyroid but is required for the proper functioning of many other tissues.

    The presence of pre-existing thyroid nodules or goiter does not preclude the patient from iodine supplementation therapy. In fact, in the extensive research with iodine therapy done in my office, I have seen many case of pre-existing thyroid nodules and goiter shrink in the presence of iodine therapy.

    Hyperthyroid patients. Graves disease patients and other with autoimmune disease take iodine also but use lithium and copper among other minerals (he didn't say) to decrease the overproduction of thyroid hormones. Iodine isn't reduced because it's the neutralizer of the thyroid.  Patients in a thyroid storm with high heartbeats are given iodine to calm it down as normal medical practice.


    Goiters. In some patients with goiters the iodine will stimulate it to produce more thyroid hormone and the patient will suddenly look hyperthyroid with elevated T4 and losing weight. As the goiter shrinks this normalizes. 


    http://www.helpmythyroid.com/iodine.htm

  • WilliamS

    7/10/2010 12:55:25 AM |

    Sorry for the multiple identical posts regarding Dr. Flechas. Google (Blogger) kept giving an error that made it seem the posts hadn't been published.

  • mtflight

    9/16/2010 6:20:25 PM |

    I second the healthy skeptic post.  In the presence of TPO auto antibodies (Hashimoto's), it could backfire as the autoimmune attack may worsen.

    I've read that autoimmune thyroid disease is more common in iodine sufficient areas, which correlates too.

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