An Iodine Primer

Allow me to go off topic for a post. While this has nothing to do with wheat and its destructive effects on human health, the issue of thyroid dysfunction and failed weight loss come up often enough that I thought it would be helpful to cover this important topic.

What if your diet is perfect–no wheat, no junk carbohydrates like that from corn or sugars, you are physically active–yet you fail to lose weight? Or you hit a plateau after an initial loss?

First think iodine.

Iodine is an essential nutrient. It is no more optional than, say, celebrating your wedding anniversary or obtaining vitamin C. If you forget to do something nice for your wife on your wedding anniversary, I would fear for your life. If you develop open sores all over your body and your joints fall apart, you could undergo extensive plastic surgery reconstruction and joint replacement . . . or you could just treat the scurvy causing it from lack of vitamin C.

Likewise iodine: If you have an iodine deficiency, you experience lower thyroid hormone production, since T3 and T4 thyroid hormones require iodine (the “3″ and “4″ refer to the number of iodine atoms per thyroid hormone molecule). This leads to lower energy (since the thyroid controls metabolic rate), cold hands and feet (since the thyroid is thermoregulatory, i.e., temperature regulating), and failed weight loss. So iodine deficiency is one of the items on the list of issues to consider if you eliminate wheat with its appetite-stimulating opiate, gliadin, and high-glycemic carbohydrate, amylopectin A, and limit other carbohydrates, yet still fail to lose weight. A perfect diet will not fully overcome the metabolism-limiting effects of an underactive thyroid.

Given sufficient time, an enlarged thyroid gland, or goiter, develops, signaling longstanding iodine deficiency. (The treatment? Iodine, of course, not thyroid removal, as many endocrinologists advocate.) Your risk for heart attack, by the way, in the presence of a goiter is increased several-fold. Goiters are becoming increasingly common and I see several each week in my office.

Iodine is found in the ocean and thereby anything that comes from the ocean, such as seafood and seaweed. Iodine also leaches into the soil but only does so coastally. It means that crops and livestock grown along the coasts have some quantity of iodine. Humans hunting and foraging along the coast will be sufficient in iodine, while populations migrating inland will not.

It also means that foods grown inland do not have iodine. This odd distribution for us land dwelling primates means that goiters are exceptionally common unless iodine is supplemented. Up to 25% of the population can develop goiters without iodine supplementation, a larger percentage experiencing lesser degrees of iodine deficiency without goiter.

In 1924, the FDA became aware of the studies that linked goiters to lack of iodine, reversed with iodine supplementation. That’s why they passed a regulation encouraging salt manufacturers to add iodine, thought to be an easy and effective means for an uneducated, rural populace to obtain this essential nutrient. Their message: “Use more iodized salt. Keep your family goiter free!” That was actually the slogan on the Morton’s iodized salt label, too.

It worked. The rampant goiters of the first half of the 20th century disappeared. Iodized salt was declared an incredible public health success story. Use more salt, use more salt.

You know the rest. Overuse of salt led to other issues, such as hypertension in genetically susceptible people, water retention, and other conditions of sodium overexposure. The FDA then advises Americans to slash their intake of sodium and salt . . . but make no mention of iodine.

So what recurs? Iodine deficiency and goiters. Sure, you eat seafood once or twice per week, maybe even have the nori (sheet seaweed) on your sushi once in a while . . . but that won’t do it for most. Maybe you even sneak some iodized salt into your diet, but occasional use is insufficient, especially since the canister of iodized salt only contains iodine for around 4 weeks, given iodine’s volatile nature. (Iodized salt did work when everybody in the house salted their food liberally and Mom had to buy a new canister every few weeks.)

Iodine deficiency is common and increasing in prevalence, given the widespread avoidance of iodized salt. So what happens when you become iodine deficient? Here’s a partial list:

–Weight loss is stalled or you gain weight despite your efforts.
–Heart disease risk is escalated
–Total and LDL cholesterol and triglyceride values increase
–Risk of fibrocystic breast disease and possibly breast cancer increase (breast tissue concentrates iodine)
–Gingivitis and poor oral health increase (salivary glands concentrate iodine)

(Naturopathic doctor Lyn Patrick, ND, has written a very nice summary available here.)

So how do you ensure that you obtain sufficient iodine every day? You could, of course, eat something from the ocean every day, such as coastal populations such as the Japanese do. Or you could take an inexpensive iodine supplement. You can get iodine in a multivitamin, multimineral, or iodine drops, tablets, or capsules.

What is the dose? Here’s where we get very iffy. We know that the Recommended Daily Allowance (RDA), the intake to not have a goiter, is 150 mcg per day for adults (220 mcg for pregnant females, 290 mcg for lactating females). Most supplements therefore contain this quantity.

But what if our question is what is the quantity of iodine required for ideal thyroid function and overall health? Ah, that’s where the data are sketchy. We know, for instance, that the Japanese obtain somewhere between 3,500 and 13,000 mcg per day (varying widely due to different habits and locations). Are they healthier than us? Yes, quite a bit healthier, though there may be other effects to account for this, such as a culture of less sweet foods and more salty, less wheat consumption, etc. There are advocates in the U.S., such as Dr. David Brownstein in Michigan, who argues that some people benefit by taking doses in the 30,000 to 50,000 mcg per day range (monitored with urinary iodine levels).

As is often the case with nutrients, we lack data to help us decide where the truly ideal level of intake lies. So I have been using and advocating intakes of 500 to 1000 mcg per day from iodine capsules, tablets, or drops. A very easy way to get this dose of iodine is in the form of kelp tablets, i.e., dried seaweed, essentially mimicking the natural means of intake that also provides iodine in all its varied forms (iodide, sodium iodate, potassium iodide, potassium iodate, iodinated proteins, etc.) This has worked out well with no ill effects.

The only concern with iodine is in people with Hashimoto’s thyroiditis or (rarely) an overactive thyroid nodule. Anyone with these conditions should only undertake iodine replacement carefully and under supervision (monitoring thyroid hormone levels).

Iodine is inexpensive, safe, and essential to health and weight management. If it were a drug, it would enjoy repeated expensive marketing and a price tag around $150 per month. But it is an essential nutrient that enjoys none of the attention-getting advantages of drugs, and therefore is unlikely to be mentioned by your doctor, yet carries great advantage for helping to maintain overall health.

This entry was posted in Iodine, Thyroid disease, Weight loss. Bookmark the permalink.

201 Responses to An Iodine Primer

  1. Susanne says:

    Any suggestion for HYPERthyroid? I have more than enough iodine!

  2. Boundless says:

    While looking for something else, I found this recent response on another topic:
    in which the reader reported an apparent direct correlation between fluoridated water exposure and thyroid problems.

    I’m wondering some things:
    1. Is fluoridated water a significant contributor to our widespread thyroid problems?
    2. Should people on such water systems take steps to avoid drinking it, and switch to bottled* water?
    3. Does toothpaste contain a metabolically significant amount of fluoride?

    Fluoride is added to water and toothpaste to reduce cavities. People on diets free of grains and simple saccharides (sugar) are probably getting vastly more immunity to cavities than fluoride provides.
    * which opens the question of whether the bottled water is also free of adverse halides, given that a lot of brands are from “municipal sources”.

  3. Robie says:

    Dear Dr. Davis,
    I regularly read your blog, have bought both your books, and I have been wheat free for more than two years with greatly improved health and a loss of 21 pounds.

    I am writing about a friend with hyperparathyroidism.
    It is a disease which exhibits , among others , symptoms of high calcium levels and high parathyroid hormone levels as well as extreme fatigue. She has been diagnosed with osteoporosis and is also a diabetic who is taking insulin injections. She is taking 2000 IU of vitamin D and takes insulin injections at mealtimes.
    A scan has not revealed any tumour on the parathyroid glands.
    Have you encountered anyone who obtained relief from symptoms of this disease by withdrawing wheat from the diet?
    I would like to hear any positive comments to pass along to her. She has yet to be convinced that wheat is unhealthful.
    Robie from Canada

    • Boundless says:

      > … hyperparathyroidism …

      Not being a medical professional, I’m completely unqualified to diagnose or prescribe anything related to this condition. Indeed, this is the first I’ve heard of it.

      > … relief from symptoms of this disease by withdrawing wheat from the diet?

      Why not try it for 90 days and find out? Nobody, as in no one, NEEDS to have wheat in their diet. And wheat is a subset of the wider truth that no one needs carbs generally. Of the three macronutrients, carbs are the only one that people can live entirely without (as many peoples do, if they are beyond the reach of Twinkies).

      If people with rare conditions wait until all the facts are in from randomized double-blind tests conducted on low-carb populations, most of them will be dead first. Relief from condition XYZZY upon going wheat-free may be anecdotal, but when you are the one with XYZZY, and the symptoms come roaring back on re-exposure, it’s all the hard data you need.

  4. Robie says:

    Has anyone seen my previous comments?
    I would like an opinion if possible from someone who has encountered this problem.

    • Neicee says:

      Robie, since you’ve asked about hyperparathyroidism here are my thoughts. A year ago October I had had a few heart palpitations which interestingly calmed down with calcium. Went to see a GP and the tests came back of huge numbers of calcium in the blood. She shuttled me off to a endo that immediately ordered another regular blood test in his onsite lab. Still showed calcium loss in the blood serum. The endo was convinced it was my parathyroid. Immediately sent me off to a surgeon and they refused surgery until after $6000 in scans and other tests. Then the surgeon ordered two ionized blood tests a week apart. The scans and ionized blood tests shot the theory of needing surgery for parathyroidism to pieces. But, I do have osteoporosis. Then, the prescription for Fosamax and possible injections. I refused the prescription and came home to read hundreds of articles about osteoporosis. I have a niece that had taken Fosamax and is a mess. So, I’ve added a number of minerals and supplements, the heart palpitations are gone, I’ve been wheat free for close to 3 years, grain free for 2 years, and no sugar for 1 year. My triglycerides consistently come in at 55-60 and that’s with a couple of glasses of wine with dinner. Magnesium is your friend along with Vita K-2. Hope your friend is doing well and didn’t get shuttled off for a surgery that may, or may not have been warranted and has to take medication the rest of their lives. Oh, I also eat shellfish a couple of times a week, salmon or other fatty fish at least once a week. That and a few drops of Lugol a day is all I’ve done but feel terrific after weight bearing exercises. Read and read some more.

  5. Suzanne says:

    What is the significance of taking the kelp tablets when you do have hashiomotos ? Verses just having hypothyroidism.

    • Boundless says:

      > What is the significance of taking the kelp tablets when you do have hashiomotos ?
      > Verses just having hypothyroidism.

      If you actually have Hashimotos or Graves, more iodine can aggravate the condition.

      You can find massive amounts of frequently contradictory advice about this on this on the web. Most of the saner advice starts with:
      1. get your iodine level test (urine test) and see if you actually are deficient
      2. get your thyroid competently assessed

      I have no idea what a correct #1 Iodine baseline is. I can tell you that getting #2 results is a battle. The standard panel, as with the standard lipid panel, is close to worthless. See:

  6. Gill says:

    I have Hashimotos Hypothyroidism and with it the total sensitivity to iodine. My thyroid function is poor not due to iodine deficiency but due to genetis and a faulty gene. This has killed my thyroid and stops me converting normal thyroid medication (Levothyroxine – T4) into the active hormone that your body needs (Liothyronine T3).
    Taking iodine quickly brings back all my hypothyroidism symptoms and makes me feel very ill.
    I notice the question and response on 3 Jan 2014 but would be happier if there was a rider on the actual blog about this to prevent others having potentially severe reactions to taking iodine with a low thyroid.
    Eliminating wheat from my diet has helped me to manage my thyroid, to lose weight and to reduce the thyroid anti-bodies that are destroying my health. This will all slow down the progression of this auto immune illness.
    I have a great life now and the knowledge I have gained, I share at, will help me to keep an active life for as long as possible.

    • Boundless says:

      > … would be happier if there was a rider on the actual blog about this to prevent
      > others having potentially severe reactions to taking iodine with a low thyroid.

      Both the base article here on iodine, and
      include appropriate cautions. I make a point of it in my chatter here (and if I don’t, be sure to scold me :)).

      The thyroid diagnosis and treatment situation is at least as screwed up as the diet and cardiovascular situations. There are multiple books and web sites concerning it. A typical book title: “Stop the Thyroid Madness” (Bowthorpe).

  7. Sandra says:

    Need advise, had throidectomy because of thyroid cancer, preparing for RAI treatment and am on low iodine diet. Not easy to combine with GF and high protein low carb…any suggestions? Thanks!