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Iodine: Cure for Hypothyroidism Or Hidden Danger?

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Posted Friday, Jan. 14th, 2011

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If you are like most Americans, you’ve likely struggled for years with your weight.  No matter what you do, you just cannot seem to drop those extra pounds.

On top of that, you are tired all the time and get frequent muscle aches, so forget about dragging yourself to the gym.  Plus, you suspect your hair is thinning, or at least it’s really dry, as is your skin.  And the cold just rips right through you.

No wonder you are irritable, depressed, and have no sex drive.  Who would?

But what if all this wasn’t just a series of coincidences?  What if these were symptoms of an underlying condition named hypothyroidism, or underactive thyroid?

Do You have Hypothyroidism?

Nearly 1 in 10 women over the age of 60 have subclinical hypothyroidism,1 which means they have several symptoms, but have not been diagnosed with the disease.

Hypothyroidism occurs when you have low levels of blood thyroid hormone.  Clinical hypothyroidism includes many of the symptoms described earlier, as well as constipation, irregular menstrual cycle, infertility, and even high cholesterol levels.

A thyroid-stimulating hormone (TSH) test is most often used to determine if you have hypothyroidism.  However, the medical community is divided on what that number or range should be.

Some conventional doctors and labs say anything from 0.5-5.5 (or even 6.0) is “normal.”  The American Association of Clinical Endocrinologists (the thyroid people) say 0.3-3.0 should be the range.  The more alternative-minded folks say 0.5-2.0 is more accurate.

Regardless of the mixed signals, the key information to take away here is that even if your TSH is 3.2, you may have a hypothyroid condition, but you will likely go undiagnosed.  Even a 2.5 could fall under the radar.

Common sense says that a TSH over 2.0 may indicate, at the least, subclinical hypothyroidism, and would warrant a conversation with your doctor on how to gain additional testing (T3 and T4 readings) and insights into your thyroid health.

Once you get your TSH status figured out, you will likely start researching thyroid treatments.  Maybe that’s what led you to this article.

Your doctor also likely recommended that you start a thyroid replacement therapy plan, such as one that uses Synthroid — or, if you are really lucky, a natural option such as Armour.  While these may work, they don’t really address the underlying issue or issues of WHY your thyroid is going haywire in the first place.

Here’s where it really gets tricky.  There can be many causes of hypothyroidism, including iodine deficiency.  In fact, many health experts preach that supplementing with iodine can help eradicate hypothyroidism.

But, like everything involving thyroid function, the answers aren’t so simple…or agreed upon.

The Iodine Controversy…

The only thing more controversial in the thyroid world than how to properly interpret TSH readings is the use of supplemental iodine for treating hypothyroid.

Iodine is the most critical nutrient for proper thyroid function.  It is essential for the production of the hormone thyroxin, which your thyroid uses to regulate many bodily functions, including metabolism.

If you don’t have enough iodine, your body cannot produce adequate levels of thyroxin.  This leads to the symptoms commonly associated with hypothyroidism.  In fact, even small iodine deficiencies can have profound effects on thyroid function.

For example, in the 1920s, there was an increasing incidence of goiter.  This is a circumstance in which the thyroid enlarges as it works to kick out more and more thyroxin without the necessary raw materials (namely iodine) to make the hormone.

To counteract this, U.S. health officials dictated that all table salt had to be fortified with iodine.  (If you always wondered why you have iodized salt, now you know!)  Soon after, the prevalence of hypothyroidism decreased.

While all of this is common knowledge, and quite interesting, does the research back it up or is this simply folklore?  Let’s find out.

Iodine’s Role in Thyroid Health…

One study2 from the University of Tennessee Health Science Center details the cases of three women, aged 24 to 38 years of age.  All three lived in iodine-rich areas, yet exhibited signs of iodine-deficiency disorders.  Two of the three had hypothyroidism with a goiter.

After receiving dietary iodine supplementation, all three had complete remission of their iodine-deficiency disorders, including the two women with hypothyroidism.  Researchers concluded, “These cases underscore the need for considering iodine deficiency in the etiologic diagnosis of goiter and hypothyroidism, even in iodine-sufficient regions.”

Although this study profiled only three subjects, this is a real world example of how a lack of iodine can lead to hypothyroidism, and how adding the iodine supplements can bring thyroid levels back to the normal range.  Still, it would be nice to see a gold-standard, large-scale study that evaluated the effects of iodine versus placebos on people with hypothyroidism.

One of the reasons we haven’t seen any, at least that we could find, is that it appears that supplemental iodine, in some cases, can cause hypothyroidism.

Too Much of Anything Can be Bad…

While iodine-deficiency can lead to hypothyroidism, taking iodine when not deficient can, ironically, have the exact same effect.

A study from China3 exemplifies this well.  Researchers followed more than 3,000 people from three different regions of China.  All of these people had differing levels of iodine intake, which ranged from mildly deficient to adequate or excessive.

At the end of the five-year period, researchers observed an increase in hypothyroidism and autoimmune thyroiditis in those areas with more than adequate or excessive iodine intake.

In other words, those with some iodine (mildly deficient) didn’t show the disease, while those groups with the above average intake of iodine had significantly higher incidences of the disease.

Another study4 looked at iodine restriction and whether or not it could reverse hypothyroidism in people with Hashimoto’s thyroiditis, a condition caused when the body’s own immune system accidentally attacks the thyroid.

Researchers randomly divided 45 people with hypothyroidism due to Hashimoto’s thyroiditis into two groups.  Half were on iodine restriction (less than 100 mcg/day) and the other group had no restrictions.

At the end of three months, more than 78 percent of those people in the iodine-restriction group regained a normal thyroid state, as compared to 45 percent in the non-restricted group.

That’s a pretty compelling result.  Still, it would be interesting to see the study done with hypothyroidism from any cause, not just limited to Hashimoto’s thyroiditis.

A retrospective study5 from Denmark looked at thyroid disease in general and the role iodine may or may not play.  They found that epidemiological studies ( a fancy way of saying the study of a disease in a population) have shown that “hypothyroidism is more prevalent in populations with a high iodine intake.”

Similarly, they observed that in populations with a high iodine intake, the average thyroid-stimulating hormone (TSH) level tends to increase with a person’s age.  Remember, high TSH often corresponds to hypothyroidism as your pituitary gland, which is what secretes TSH, senses that you have low thyroid production.  It then cranks up production of TSH in an attempt to get your thyroid to secrete more thyroid hormones.

They concluded, “Iodine intake of a population should be kept within a relatively narrow interval where iodine deficiency disorders are prevented, but not higher.”  In other words, if there is a deficiency, fix it.  But don’t overdo it or you can tip the scales the other way.

Lastly, research from the Institutes of Medicine’s Food and Nutrition Board6 has reported similar findings.  They too have found that excess iodine intake is most commonly associated with elevated blood levels of thyroid stimulating hormone (TSH), hypothyroidism, and goiters.

In fact, in iodine-sufficient adults, elevated TSH levels have been found at iodine intakes between 1,700 and 1,800 mcg/day.

To help minimize the risk of developing hypothyroidism, the Food and Nutrition Board set a tolerable upper level of intake for iodine at 1,100 mcg/day for adults.

So, is Taking Iodine a Go or No-Go?

So, given all this, what the heck are you supposed to do?  Too little and you may develop hypothyroidism.  Too much and, BAM, the same thing!

The key, not surprisingly, is balance and moderation.  First and foremost, iodine deficiency is a rarity in the U.S.  There are a large number of commonly consumed foods that contain iodine, including:

  • Baked potato (with skin)
  • Cow’s milk (from grass-fed cows)
  • Cooked navy beans
  • Seaweed
  • Clams
  • Oysters
  • Lobster
  • Sardines
  • Saltwater fish

Plus, there is the whole “iodine in salt” thing, and we know how much Americans like their salt!  Most multivitamins contain the recommended daily allowance of iodine (150 mcg).  Therefore, unless you have a known iodine deficiency, there is no reason to supplement with iodine.

The only time when iodine supplementation seems to make sense is if you have hypothyroidism and are sure you also have an iodine deficiency.

In this case, you may want to consider short-term iodine supplementation.  If you aren’t sure whether this applies to you, ask your doctor to test your thyroid antibodies (thyroid peroxidase and thyroglobulin).

Remember, while correcting an iodine deficiency can help improve hypothyroidism, it’s important to note that an excess of iodine can also limit the body’s production of thyroid hormone.  Therefore, do not exceed 1,000 mcg of iodine for any length of time (i.e., more than three months).

At the end of that time, have your urine iodine level tested to determine if you are still deficient or in the normal range.

Determining thyroid disease is not easy — nor, unfortunately, is the treatment of it.  However, by becoming an educated advocate for your own health, you will quickly discover the difference between what is purely hype, and what is backed by science.  You’ll then know what path to choose for optimal health and wellness.

As always, make sure you consult with your doctor before embarking on any new treatments — natural, conventional or otherwise.

References:

1Canaris GJ, et al. “The Colorado thyroid disease prevalence study.” Arch Intern Med 2000; 160:526–533.

2Nyenwe, EA and Dagogo-Jack, S. “Iodine deficiency disorders in the iodine-replete environment.” Am J Med Sci. 2009 Jan; 337(1):37-40.

3Teng, W, et al. “Effect of iodine intake on thyroid disease in China.” N Engl J Med. 2006 Jun 29:354(26):2783-93.

4Yoon, SJ, et al. “The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto’s thyroiditis.” Yonsei Medical Journal. 2003; 44(2)227-35.

5Laurberg, P, et al. “Iodine intake as a determinant of thyroid disorders in populations.” Best Pract Res Clin Endocrinol Metab. 2010 Feb; 24(1):13-27.

6Food and Nutrition Board, Institute of Medicine. Iodine. Dietary reference intakes for vitamin A, vitamin K, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc.  Washington, D.C.: National Academy Press; 2001:258-289.

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