12Jun/16

Let’s Talk Iodine & Hashimotos

The topic of iodine and hashimotos disease stirs up something deep in me.  I think it is because of the constant warnings I see from thyroid “specialists” that assert that using iodine with hashimotos is like throwing gas on a fire when it isn’t… well it can be if done incorrectly, but I’ll share that in a few minutes.

Iodine levels have dropped 50% over the last 30 years yet the incidence of thyroid disease has increased at an alarming rate.  Many people are suffering more than ever from hypothyroidism and at its worst autoimmune thyroid disease and cancer.  It is estimated that 20 million Americans have a form of thyroid disease.  Up to 60% of those with the disease are unaware they have a condition.  Women are 5-8 times more likely to have a thyroid problem than men are.  With these numbers how can iodine be to blame when it has been removed from our food supply and is depleted in our soils?  It isn’t – it has been wrongly accused of a crime it did not commit.

So lets talk about what happens in an autoimmune thyroid condition.  Autoimmune conditions in general in the body represent something that is not normal.  The body’s immune system is intelligent in knowing that it doesn’t belong.  With an autoimmune thyroid condition this is often related to the thyroid tissue itself.  The tissue undergoes oxidative stress due to inflammation within the cells.  This can cause mutations of the tissue which results in antibodies coming to the rescue of the body to “attack it” and get it back in order.  However in a thyroid autoimmune condition this state can continue to be an issue despite the best efforts of the antibodies to remove the problem.  One underlying cause of hashimoto’s is an iodine deficiency.

Please excuse the drawings but I wanted to relay specific information and every pre-made drawing did not share the total picture I wanted to convey.

So let’s walk through the process of iodide in the cells.   Please keep in mind that this is not a detailed “walk through” but one to get the general pathway.  The pituitary gland stimulates the TSHR via TSH.  This then acts upon the NIS (Na+I-) symporter to tell the cell to take iodide into the cell.  The NIS is located at the basolateral membrane.  This process of pulling into the cell requires ATPase.   Iodide is pulled into the thyroid follicular cell where thyroglobulin is made in the endoplasmic reticulum (left center of the cell).   Then comes the oxidation of iodide.  Iodide within the follicular cell moves to the apical surface of the plasma membrane before entering into the follicular lumen.  This transport is regulated by a sodium independent iodide/chloride transporter called pendrin.  Iodide is then oxidized to iodine.

Then organification of thyroglobulin occurs where iodination of tyrosine residues within the thyroglobulin (Tg) molecule occurs.

Organification is where iodine becomes a part of lipids, proteins and cholesterol.  Organification signals a binding to an organic molecule.  So in this case iodine is bound to thyroglobulin to make hormones.  Another  critical thing can occur at this point when enough iodine is supplied, and it is the often an excluded topic in this discussion.  When iodine is available in amounts of at least 100x the RDA (15 mgs) iodo-lipids like delta-iodolactone are created.   This is the process of iodine being organified to lipids.  Without higher levels of iodine available, insignificant amounts are created.  The RDA was defined as a method by which the body would create thyroid hormones and prevent goiter.  No consideration was given for these iodolipids and their thyroid cell regulatory effect.

The first iodination that occurs forms monoiodotyrosine or MIT.  The second is diiodityrosine or DIT.  MIT  forms T1, DIT forms T2 and then the MIT and DIT couple together to form thyroid hormones T3 and T4.  One MIT + one DIT form T3.  Two DITs form T4.  This reaction is activated by thyroid peroxidase (TPO).  The H2O2 used in this process is a result of the NADPH Oxydase system.  [1]  This process is inhibited by certain iodolipids.  [2-3]  The same iodolipids appear to control damage from excess iodine.

The indirect action of I2 could be exerted by its formation of covalent bonds to specific lipids such as arachidonic acid (AA) or eicosapentaenoic acid, forming 6-iodo-5-hydroxy-8,11,14-eicosatrienoic acid (also called 6-iodolactone; 6-IL) or alpha-iodohexadecanal, respectively. These iodocompounds have been detected in thyroid tissue of rat, pig, horse, and human origin, and they mimic some of the inhibitory effects of excess I? on several thyroid parameters. [6]

Thyroid hormone creation is the only result of iodide being supplied at the RDA of 150 mcgs.   Thyroid hormones are then stored inside thyroid follicles as colloid.  These hormones can meet the potential thyroid hormone needs for several months.  We’ll stop with the pathway description at this point since we have covered both the areas of concern in hashimotos.  The Tg and TPO processes.  It is TPO Ab and Tg Ab that are measured in Hashimotos conditions.

Iodine Thyroid

When we look at the image below we can see the two areas that experience oxidative stress.  The first is at the follicular cell level with damage to the nucelus / DNA.  This results in nodular goiters and eventually thyroid cancer.  Several things like heavy metals, halide toxicity and low nutrient levels can cause this damage in the cells.  But for the purpose of evaluating TPO and Tg Ab’s we will look to the other area.  The oxidative stress in the thryoid hormone creation is the main area of concern.

Oxidative Stress

So what goes wrong in an autoimmune thyroid condition?

  1.  Oxidative damage – This can result from too much H2O2 that damages TPO.
  2. Selenium deficiency – Selenium is a key nutrient in approximately 11 different enzymes.  There are two selenoenzymes involved in the thyroid process.  Glutathione peroxidase and iodothyronine deiodinase.  The important selenoenzyme in autoimmune conditions is Glutathione peroxidase.  It contains both antioxidant and protective properties from oxidative damage.  Glutathione peroxidase can react with the H202 to reduce it to water.   This is a valuable function in the reduction of the oxidation in the cells which can cause inflammation.  This is why selenium is recommended as part of the iodine supplementing protocol.
  3. Iodine deficiency – remember those iodolipids we discussed earlier?  Here’s why it matters.  If you supplement with iodine in doses less than the 15 mgs (or more – because one size never fits all) you will begin the journey of iodine through the cells to where the oxidation process begins.  But how does the body deal with that oxidation and limiting the damage to the cells?  The first thing thing is the glutathione peroxidase that we just discussed.  The other are iodolipids – specifically delta iodolactone.  When you supply low amounts of iodide you are stoking the fire and it is like putting fuel on the flame because no iodolipids – or too few are created.  But when you give the body more than it needs for thyroid hormone creation you get a bonus – iodolipids that work to  protect the thyroid gland from the damage.  These iodolipids also work at the cellular regulatory level in inducing apoptosis (programmed cell death) of any abnormal cells that may be created.  Thus the body doesn’t need to use antibodies to ‘clean up the mess’.    [5]  The inflammatory process can be reduced and the oxidative damage will also be reduced resulting in relief of the antibody attack.
  4. The other issue – Magnesium.   It is recommended that magnesium is used as part of the full protocol .  Magnesium is also important in numerous enzyme reactions in the body.  If we look at the oxidation process we will see that calcium is part of it.  When the oxidation is too high,  another “antidote” to this is to supply magnesium.

Organification(Thank you to Dr Brownstein who created this format for illustration)

5.  Finally Vitamin C – This is another nutrient that is recommended in the protocol that helps to maintain balance.  Vitamin C offers support against oxidant stress on the thyroid gland.  It also works to heal the symporters that pull iodine into the cells.  Many of the thyroid cells especially in thyroid cancer lose their ability to uptake iodine.

You may also see B2 and B3 mentioned in relation to iodine and hashimotos.  These nutrients can be beneficial in supporting the ATPase process to support the uptake of iodine.  In individuals with hashimotos it may help to increase energy and the feeling of well being.

I realize this is a tough subject to work your way through but I hope that this has helped to start the process of understanding why doctors such as Dr David Brownstein and his partners have had incredible success in supplementing with iodine in their autoimmune thyroid patients.  Other less vocal doctors using iodine in their practices in high doses are seeing benefits as well.  The key is to follow the protocol of support nutrients along with not being timid about the dosing of iodine.  Have no fear.  Iodine has been used safely and effectively for 200 years!

My hope is that all of you find healing and happiness and I believe that iodine can be a big part of that healing.

Stephanie 

[1]  Identification of delta-iodolactone in iodide treated human goiter and it inhibitory effect on proliferation of human thyroid follicles.

[2] Thyroid autoregulation: evidence for an action of iodoarachidonates and iodide at the cellular membrane level.

[3] Thyroid autoregulation Inhibition of goiter growth and of cyclic AMP formation in rat thyroid by iodinated derivatives of arachidonic acid.

[4] Evidence that iodolactones are the mediators of inhibition by iodine on thyroid

[5]  The role of iodine and delta-iodolactone in growth and apoptosis of malignant thyroid epithelial cells and breast cancer cells.

10Apr/16

Kelp Is Not a Good Way to Get Iodine

 

kelp powder

After constantly being asked about kelp and other sea vegetables in the context of iodine supplementation, I decided that it was time to address the elephant in the room.  The constant push to take Kelp and other Sea Vegetables to supply iodine in the diet has been concerning to me.  While sea vegetables may offer iodine and other nutrients, they also risk a high exposure to toxins.

Natural News Labs published this article on the testing they performed that showed high levels of cadmium, arsenic, lead, mercury and copper.

A UC Davis study finds high arsenic levels in kelp supplements.  

A recently published study of herbal kelp products by UC Davis public health expert Marc Schenker concludes that some kelp supplements may cause inadvertent arsenic poisoning and health dangers for consumers, especially when overused. Schenker and two researchers evaluated nine typical herbal kelp products and found higher than acceptable arsenic levels in eight of them.

Dr Alexander Haskell states in one of his youtube videos on iodine that he attempted to obtain a 3 mg capsule of kelp from Gaia Herbs to use in his practice.  After much investigation, Gaia returned to him and stated that attempting to put this amount of kelp in a capsule would put them over the legally allowed limit for arsenic.

Our seas are becoming so polluted with chemicals, heavy metals and pesticides.  The organization Sea Web offers some troubling information about what we are facing with anything that comes from the sea – be it sea veggies or seafood products.

From an old blog from Dr Brownstein in 2007 that is no longer online:

Caution With Kelp Supplements

My research has shown that after testing over 4,000 patients for their Iodine levels, over 96% of those tested are significantly low in iodine. Many patients ask me if they can take kelp instead of iodine. The amount of iodine in kelp can be variable. Furthermore, I was always concerned that kelp supplements may contain toxic amounts of arsenic or halides. I have tested 2 kelp supplements and found very elevated arsenic levels in both items. Both of these products were marketed heavily and sales in the millions of dollars were reported. When I contacted he manufactures of these products, neither returned my phone calls. Remember, if kelp is grown in a polluted area of the ocean, it may contain elevated amounts of these pollutants. New research has validated my findings.

Researchers at the University of California/Davis found that eight out of nine kelp supplements contained abnormal levels of arsenic (Env. Health Perspectives, April, 2007). The researchers began to look at kelp supplements after a patient presented to the UC Davis clinic with a myriad of complaints including memory loss, hair loss and fatigue. She was found to have very high arsenic levels which was traced to a kelp supplement she was taking. After stopping the kelp supplement, her arsenic levels gradually declined and her symptoms improved.

So, what can you do? IF you are low in iodine, take a pure iodine product that is not contaminated. Lugol’s solution or tableted Lugol’s solution (Iodoral®) have both proven safe and effective in my practice. Kelp can be an appropriate iodine source if the kelp has been tested and found free of toxic elements. I would be very cautious about taking a kelp supplement unless the manufacture is consistently testing the kelp for purity and consistency.

 Another research article on the Safe Use of Kelp Supplements shares that arsenic is indeed found in these supplements.  While they are not totally negative on the issue it does reinforce that arsenic is an issue.

Fukushima continues to be an issue especially for those on the west coast.   The nuclear reactors continue to leak toxic radioactive materials and have been since 2011.  Even in March of 2016 we see news reports of its toxic waste dump into the ocean.

While health food enthusiasts continue to support the use of kelp for iodine let’s put this into perspective – toxins aside.  Sea vegetables on average have 500% of the RDI of iodine for a daily diet.  That may sound like alot, but the RDI is 0.150 mcg of iodine.  500% of that would be 0.750 mcg of iodine.  This is far from a high amount when considering that the iodine doctors (Dr Abraham, Brownstein and Flechas) have been using amounts from 12.5 mgs up to 300 mgs (for cancer patients) in their practice for years as a daily supplementing dosage.  The average member of my Facebook Iodine group is reporting daily supplementing of 50-150 mgs + per day.  You would have to eat a lot of sea veggies to match this level.

Final Thoughts:  If you are determined to consume these products, then I would suggest that you do a few things.  Contact the manufacturer and ask them what testing is done.  Ask them to see the reports outlining the levels of halides and other nutrients.  Also ask them if they test for radiation exposure.  If they cannot provide these things then I would pass on purchasing and consuming their products.

If you are looking to supplement with iodine the best way to do this is through an Iodine supplement like the ones I offer in my store.    Make sure your supplement is Lugol’s formula for both iodine and iodide because the body needs both forms.  (See my previous blogs on iodine for more information on supplementing).

14Jan/16

Children and Iodine

Before I begin this post I want to stress that the information I will share with you is based on the experience I had with my own children who are under the care of a very qualified iodine and thyroid literate doctor.  Please do not take this information and apply it to your children.  We have done lab tests to evaluate their specific nutritional needs as they have grown.  What we did will not represent what is needed for all children.  

pregnancy

 

As I began to research iodine for children, my journey began with pregnancy.  There was a lot of talk of cretinism which is what occurs in severely iodine deficient states resulting in mental retardation.  While I appreciated this information and understood the danger, I wanted to know about the reality of what we were facing in a deficient country that was not producing these severe cases.  What was happening from our deficient state that maybe we were not recognizing as iodine deficiency.  What I found was that my gut instincts were right.  Once again pharmaceutical drugs were being used on children who had underlying nutritional deficiencies.

Let’s talk a little about pregnancy.  A mother who is iodine deficient prior to becoming pregnant, more than likely has a sub-optimal functioning thyroid.  When a woman is first pregnant, the baby’s thyroid gland is not functional so it draws off the mothers thyroid hormones until the 3rd tri-mester.  A deficient mother leaves the child deficient and unable to develop from a neurological perspective.  Research studies I have read stress the importance of obtaining enough iodine prior to the end of the 2nd trimester or irreparable damage occurs.   Myelin sheath development requires iodine sufficiency.  Japanese women on average consume approximately 12-13 mgs / day of iodine via sea veggies.  Based on this standard the Iodine doctors agreed at the 2007 Iodine Conference that this could be used as an acceptable amount for those beginning supplementing for the first time during pregnancy and lactation.

What is the result of iodine deficiency more commonly seen in our 1st world countries?  First, I believe that there are many un-diagnosed hypothyroid children.  Symptoms of a hypothyroid children (based on my own experience and that of others I have talked to with confirmed diagnoses) include:  slow growth, cold / under blankets even when 80 degrees, low tolerance to change, frequent “meltdowns”, crying uncontrollably for seemingly no reason, thin body type, bed-wetting, and the inability to focus or sit still (ADD/ ADHD).

The following image is of a spelling test my son took when he was in 2nd grade.  He was diagnosed hypothyroid when he was in 1st grade (7 yrs old).  He was 8 yrs old at the time of this test.  He was going through a growth spurt.  We had a parent / teachers conference when the test on the left was presented to us with concern from the teacher.  He was a good speller and rarely missed more than one word.  On this test he missed 6.  We increased his thyroid hormone 1/4 grain and then 8 days later I had him take the test again.  We did not review one word.  This clearly demonstrates the importance of proper thyroid function.  The sad thing is that he was being labeled as ADD / ADHD.  It wasn’t.  It was an iodine deficiency combined with low thyroid.  You can see the brain fog confusion that so many of us have experienced.

Spelling Test

My children were diagnosed with a thyroid problem when they were 4 and 7 yrs old.  Their body temperatures were registering at 96.1 (4yr old daughter) and 95.7 (7 yr old son).  Basal body temperatures should be 97.8 or higher when thyroid levels are optimal.

I should probably back up a bit and share why my children ended up in crisis.  I was diagnosed with thyroid cancer 4 months after my son was born.  In the pictures taken of me and my son shortly after his birth, you can clearly see a goiter with a nodule.  So while I was pregnant with him I was low thyroid, had hashimotos and was toxic in mercury and bromide.  By the time I had my daughter 2 1/2 years later I had been treated with 2 rounds of radioactive iodine (one with a low iodine diet) which left me very depleted.

Now for what we did.  Dr Brownstein writes about children in chapter 10 of the 5th edition of his Iodine Why You Need it Why You Can’t Live Without It book.  His recommendation for dosing is 0.11 mg/lb/day (0.25 mg/kg/day) adding that appropriate laboratory testing should accompany this prior to starting supplementation.

We started both of my children on 6.25 mgs of Iodoral.  I crushed the tablets in applesauce.  We added the following supplements to the iodine.

Selenium (methylselenocystine)  100 mcg  3x / week
Vitamin C – Metagenics Ultra Potent C chewable – 1 / day
Magnesium – came from their multivitamin.  We used Nordic Naturals Nordic Berries
Course Ground Salt – Celtic Sea Salt – I placed it in dipping cups and they ate and used as they desired.
We added DHA Fish Oils for my son to help with his attention issues.

For small children – I have a great new product form Hakala Research.  It is a 3.125 mg chewable tablet.

At the age of 9 years my son continued to struggle with focus and behavior.  We decided to do a 24 hour loading test.  When we ran it, the bromide levels showed that he was at 45 mgs / L with toxic being any level over 5 mg / L.  His levels rivaled the breast cancer patients test we were running that day.  Unfortunately we made a mistake in the lab and did not obtain his saturation levels.  Based on this toxicity we decided to increase him to 25 mgs where he stayed until this year right before his 16th birthday when we increased him to 37.5 mgs.

Both of my children (13 and 16 yrs)  are on 37.5 mgs.  They continue to take selenium and a multivitamin.  I don’t have any recommendations for teens at this point because I am struggling with their inability to swallow pills so I am searching for a high quality and potency option.  I have not found anything I am thrilled with.  Their protocol is based on their own specific needs based on laboratory values so I will refrain from sharing what they take.  They are basically adult dosing now since they are both adult size.

Is there hope for children who did not get iodine in the womb?  Yes there is.  Children 2 and under receive the most benefit.  But children and adults of all ages can also benefit from this element.  It may not increase IQ’s but it can help the cells in our body to remain healthy and happy.

Please make sure that you read the previous blogs on the topic of iodine.
You can also join the Facebook Iodine group for additional support.

For further reading consider:

Dietary Iodine:  Why are so many mothers not getting enough?
The influence of components of diet on the symptoms of ADHD in children
Reflections on mental retardation and congenital hypothyroidism:  effects of trace mineral deficiencies