05Jan/16

Hypothyroidism, Hashi’s and Iodine

It has been known for many years that a lack of iodine can create a goiter.  What is a goiter you ask?  A goiter is the swelling of the thyroid gland in an attempt to capture more iodine from the blood stream in a deficient state.  Goiter is more common in 3rd world countries where overall nutrition  is lacking.  We saw it in the United States prior to the addition of iodized salt into the American diet.  The image below represents a goiter in a child.  The next image is a severe case.  The fear of iodine has instituted the reemergence of goiter in our modern society.  Look around you.  You will begin to see it especially in women.

Goiter large

The picture below is me in 1999 when my son (my first) was born.  No one noticed the nodule on my neck combined with the goiter.    It turned into thyroid cancer.  I believe it could have been avoided.

Dawson birth

Supplementation with iodine will work to eliminate goiters.  But what about other thyroid conditions?  In this blog we will consider hypothyroidism, hashimotos, and thyroid cancer.  Hyperthyroidism and graves will be covered in a future blog. These diseases all share a common issue – Iodine deficiency – while the symptoms manifest in different ways.

Hypothyroidism is defined as the body’s inability to produce sufficient thyroid hormones.  The hypothalamus creates thyrotropin releasing hormone (TRH) which acts upon the pituitary gland to regulate the release of TSH (Thyroid Stimulating Hormone).   Thyroid hormone creation is stimulated by the TSH action on the thyroid gland.   The pituitary gland bombards the thyroid with this hormone when it gets behind telling it to make more.  The higher the TSH lab number the more there is an indication that it is screaming at the gland “I NEED HORMONES NOW”.   The TSH hormone also stimulates the Sodium Iodine Symporters (NIS) to take in iodine when the follicular cells “see” it pass by in the blood.  Once inside the thyroid cell, the iodine is acted upon by several chemical processes and is bound to tyrosine and thyroglobulin to form Thyroxine (T4) and Tri-iodothyronine (T3).  The thyroid gland creates 20% of the T3 directly in the thyroid gland.  The remaining 80% is converted from T4 in the liver and kidneys.  T3 is the active metabolic hormone.  If iodine is not supplied in sufficient amounts, then hormone levels fall and the entire body spirals into illness.

Another complication to hypothyroidism is an autoimmune form called Hashimotos which was named for Dr Hashimoto in Japan, who discovered the disease.  Hashimotos is diagnosed by lab tests measuring thyroid peroxidase antibodies (TPO Ab) and thyroglobulin antibodies (Tg Ab).  The first antibody, TPO, is an attack against the oxidation process where iodine is converted to iodide and bound to the proteins for hormone creation.  The Tg Ab is an attack on the thyroglobulin protein.  Both hormone synthesis processes can be seen in the diagram below.

synthesis

Why does the body create antibodies?  For more information on why the body attacks itself in an autoimmune disease please visit this page from the NIH.  Basically it is a sign that something has gone wrong and is out of balance.  Many things can contribute to autoimmune thyroid disease (AIT).  One of the key elements is a lack of iodine.

When the oxidation process occurs in the follicle colloid, hydrogen peroxide acts upon iodine to change it to iodide which is when it iodinates the proteins.  When iodine is missing the body attempts to make thyroid hormones but the main component is missing.  It is believed that in a deficient state the oxidation continues out of control which causes inflammation and damage to the cells.  The body views the cells as an invader because they are not normal and creates antibodies to attack it.  The key to combating this is in iodine supplementation.  When supplied in amounts 100x the RDA (.150 mgs) or more, iodolipids are created which is the control mechanism on the oxidation process in the cells.  The increase iodine level not only allows for hormone creation but also iodolipid creation.  What the exact value in milligrams is to create this “brake” reaction is not definable.  There are too many variables for each individual to predict.  At this point it is a matter of trial followed by laboratory testing to determine the appropriate amount.  The diagram below shows iodine entering the cell and then combining with Tg and being acted upon by TPO.

Tg TPO

Now lets assume that hashimotos goes undetected or untreated and no iodine is supplied.  The thyroid struggles and struggles to keep up.  The person must keep moving so the body now draws off of the adrenals to pick up the slack.  But the adrenals are the sprinters and not the marathon runners and they will eventually crash and burn resulting in complete adrenal fatigue.  These glands also need iodine and since the thyroid is grabbing all it can they are left deficient too.

Inside the thyroid gland, the TPO, Tg or both types of antibodies are attacking the gland.  This results in more and more damage that can develop into nodules on the gland.  At first they can be benign in nature but eventually they run the risk of becoming malignant in the form of thyroid cancer.  There are several forms of thyroid cancer;  Papillary, Follicular, and Medullary being the most common.  Papillary and Follicular are treated using radioactive iodine (RAI) because the cancer cells will take up the iodine and be killed.  Medullary thyroid cancer originates in the “C” cells of the thyroid which is where calcitonin is created.  This form of thyroid cancer seems to be unrelated to iodine status although the maintenance of normal cell structure is part of iodine’s “job” in the body so it may play a role.

I mentioned in passing that RAI was used for the treatment of papillary and follicular thyroid cancer.  It is used because the goal of the treatment is to kill off any remaining thyroid and cancer cells after a total thyroidectomy.  They then use the Tg levels to monitor if there is cancer or not (assuming that RAI killed all the cells off) because only these cells create the Tg protein.  This is great in concept if the cells do, in fact, take up the radioactive iodine.  In my case they did not.  I had 0.2 and 0.3% uptake in my scans.  My doctors reaction each time was to get a bigger stick.  I went from 100 mCi’s to 150 mCi’s and then finally 250 mCi’s in an attempt to beat the cells into submission (aka death) after 3 recurrences.  It did not work.  Endocrinologists call this “iodine resistance”.  I believed my case was hopeless…… but then I met Dr David Brownstein.

The testing Dr Brownstein did on me may have revealed the reason for this resistance.  It was a component that the majority of thyroid disease sufferers are also afflicted with.  It’s bromide poisoning.  When the body is deficient in iodine it attempts to find the next closest halide to replace it.  Most of us are toxic in this halide so our receptors are being blocked by bromide which stops what little iodine that enters the blood stream from being taken into the cells until very large amounts of iodine are supplied.  In my case it took 125 mgs which resulted in 66 mgs / L (toxic = >5 mgs / L) of bromide being release during my 24 hour Iodine Loading test.  We’ll talk about testing in a future post so don’t panic.  I believe that my high toxicity stopped all RAI treatments from working to kill the cells.  Now combine that with the low iodine diets I was forced to do for 6 weeks prior to treatment and then never supplementing to put it back in and you have a recipe for disaster.  The reason I say this is because iodine is needed for the P53 gene.  This gene is called the Keeper of the Genetic Code.  It is needed in the process known as apoptosis (programmed cell death) that occurs when a cell becomes abnormal.  So I was toxic, radiating my body and depleting it of a much needed whole body nutrient.   I believe this was why my cancer kept returning – each time stronger.  It was non-radioactive iodine that was a key component in eliminating my thyroid cancer in 3 years.

Hopefully you can now see why iodine is important in managing thyroid disease.

Next blog:  Bromide toxicity

 

 

 

04Jan/16

The Power of Iodine

 

iodine-bottles

Few people know about the amazing element iodine and the importance it holds in maintaining good health.  My goal over the next few weeks is to offer a multi-part blog series on the topic of iodine so that you can “digest” the information slowly.  It can get confusing and to those who are new to the topic can feel overwhelming.  So let’s start with the basics.

If you bring up the topic of iodine to a medical professional he or she will undoubtedly link it to the function of the thyroid gland and they would be partially correct.  The thyroid is the primary consumer of iodine within the body.  When fully saturated it can hold 50 mgs of iodine.

The thyroid gland is a butterfly shaped gland that sits in the neck just above the collar bone and wraps around the windpipe.  It is responsible for controlling the bodies metabolic rate.  You cannot live without this gland.  If it is removed you will be forced to take a thyroid hormone replacement medication for life.  Before I forget….. Just to dispel a common belief about iodine for the thyroidless – yes you still need it.  But that’s for a future blog post.

Iodine is used within the thyroid follicular cells.  It enters into the cell through the Na/I Symporter (NIS) or sodium iodine symporter located on the basolateral membrane.  Iodine enters from the blood stream through the NIS which acts as a pump to pull it into the cell.  Once iodine passes through the NIS, it enters into the follicular cell.  It then moves to the follicle colloid where a hydrogen peroxide reaction occurs on it converting it to iodide.  This is then used in the thyroid hormone creation process.  When you see the hormones T4 or T3, the number represents the number of iodide molecules in that hormone.  The process is  a little more complex than what I have described here but this gives you the basic concept.  You can look at the diagram below for more detail.

iodine path

Iodine levels in the soils have become depleted over the years and in some areas, like the goiter belt, they have historically been low.  The area depicted in pink in the image below has been described as the deficient area.   Currently it expands to pretty much all of the states in the union.  It was in the 1930’s that the government decided to try adding iodine to the salt in order to eliminate goiters in school children and it worked.  This is how we obtained iodized salt.

Goiter Belt

After the release of a research paper in 1948 which described a phenomenon called the “Wolff-Chaikoff effect”, iododphobia (as Dr Guy Abraham describes it) became rampant.  In this paper, they described how ingesting “too much” iodine would shut down the thyroid hormone creation process causing hypothyroidism.  The problem was that it was a transient event and the levels eventually normalized.  An update to this research was posted at a later date but the damage had already been done.   Even today this study is used as defense against milligram supplementation of iodine.  You can read more about this in Dr Guy Abraham’s article, The Wolff-Chaikoff Effect:  Crying Wolf.  Because of the W-C effect fear, the usage of iodine in foods became less and less and with its restriction came an increase in thyroid disease.

When the thyroid gland has too little iodine, the result can be goiter, nodules, cysts, hypothryoidism, hyperthryoidism, autoimmune thyroid disease (Hashimotos and Graves) and at its worst, thyroid cancer.

Iodine is antimicrobial, antibacterial, anticancer, antiparasitical, and antiviral.  It’s a powerhouse in an element.

Today, there are a few doctors who are returning to the old methods of supplementation and discovering the amazing benefits.  Many patients are going it alone because finding support in the medical arena can prove to be challenging.  That is why I created the Facebook Iodine group in 2009.  It now has almost 13,000 members.  It exists to teach individuals about the benefits of iodine supplementation and how to put it into practice safely and effectively.

You can join us by going to the IODINE Facebook group.

If you want to get a head start on reading about iodine, you can download the guide to supplementing that I share on my group.  It is located in the resources of this site.

Next blog post:  Thyroid Disease and Iodine

01Dec/15

THM Mock Toll House Chocolate Chip Cookies – S (GF/SF)

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2 Cups Trim Health Mama Baking Blend
1 Cup Butter (softened)
2 Eggs
1 Tsp Vanilla Extract
1 Tsp Caramel Flavoring
1 Tbs Water
3 “scant” TBS of Sweet Blend
1/2 tsp Molasses
1/2 tsp Sea Salt
1 tsp Baking Soda
1 Cup Lily’s Dark Chocolate Chips

THM Products can be purchased in their store (affiliate link).

Preheat the oven to 350 degrees.

Mix the butter, eggs, sweet blend, vanilla, water, caramel and molasses together in a mixer until smooth and creamy.

In a separate bowl combine the baking soda, salt and baking blend together.  Add the baking blend mixture slowly to the butter mixture while continuing to mix in the mixer bowl.

Place the scoops of dough on the silpat mats.  Press them down and even out the corners.  These do not spread out when you bake them so if you don’t press them down before placing them in the oven they will remain in a ball.

Bake for 14 minutes* (longer if you want them more “dry”) until the edges get lightly browned.  Makes 20 cookies if you use the scoop.

*NOTE:  If you do not use the Silpat, I would advise using parchment paper.  The baking time may be reduced to approx 10 mins.  The mats require time to heat up which would not be the case with parchment paper .

Enjoy!

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Special Notes:

I used Silpat mats.  I find these work best for gluten free / grain free items in baking them more evenly.

I also use cookie scoops to make them uniform in size.  I have the small and medium.  I used the medium one for this recipe.