Re: A new presentation against high dose of iodine(found this article in curezon

[Guest guest]

" Toxic multi-nodular goiter " . Almost sounds like a disease. I wonder to what

extent his thyroid gland had atrophied when he was deficient in iodine over his

life before he began the 50mg per day. Maybe it just regenerated a little, back

to something normal. The medical profession makes this sound like something

horrible which it is not. What will be horrible is if he allows them to destroy

some of his thyroid gland with radioactive iodine to treat this supposed

disease. I bet all he needs to do is to back off his iodine dose and/or up his

tyrosine, selenium etc. regimen if he was even taking these adjunct supplements

to begin with.

I have no doubt that one can overdo iodine, and since he was managing his own

intake, he should have adjusted based on the symptoms that he described.

I personally had developed hand tremors over the last 10 years of my life. I

also would trip with some frequency as I just didn't seem to be bringing my leg

up high enough to prevent the toe of my shoe from catching on the ground. I

thought this was just old age. After a month or two into the iodine program, I

was surprised to notice the shakes disappeared 85% and the tripping went away

completely. Then a few months later my hands went back to maybe 70%

improvement. I had also worked my iodine intake up to 50mg daily and some days

also added a 32mg potassium iodide pill putting me around 80mg, but I had not

adjusted up my tyrosine intake. I pulled back for a while on the iodine and my

shakes improved again to about 90%. My conclusion is that my tyrosine intake

was initially sufficient to both be used by my thyroid for more T4 hormone, and

to be used by my nerves and brain as it broke down into l-dopa and dopamine.

But as my iodine intake increased, more and more of the tyrosine was used to

make T4 and less was available to be used by my nervous system. Notice in the

article they say shaking of hands is a symptom of too much iodine; I would bet a

dime to a dollar that he wasn't taking enough tyrosine, if any at all. The

loose bowels was probably his body attempting to rid itself of toxins, which is

what vomiting and loose bowels frequently are; I bet he wasn't doing the detox

either.

I don't doubt the old fellow had the symptoms she described, and I bet it was

due to his own mismanagement of his iodine intake, but the conclusion that high

doses of iodine are a bad thing does not follow. What the conclusion should be

is that iodine intake should be well managed, whether it is on one's own or with

the assistance of someone else. No mention was made of what happened next to

the old fellow, and how these new nodules resolved.

Isn't it ironic that conventional wisdom condemns doses of iodine above 150 mcg

daily, yet encourages doses of fluorine up to 10 mg per day. I don't think many

people would survive a 50mg per day dose of fluoride for very long, but as many

of us know, we can benefit from doses of iodine that high. Just manage it well.

>

> Just found this post in curezone. Please take a look.

>

> http://blog.myintegrativehealth.com/2010/07

>

> Dr. Christianson does thyroid presentation in Portland

> Saturday, July 24th, 2010

>

> Greetings to all!

>

> I just spoke for a wonderful group of doctors on thyroid disease. It was

coordinated by Tori Hudson, ND. She is the director of the Institute of

Women¡¯s Health and Integrative Medicine.

http://www.instituteofwomenshealth.com/torihudson Dr. Hudson is our well loved

and well respected guru on women¡¯s healthcare and she brought together a group

of doctors I was proud to be part of including Teitelbaum, MD who I¡¯ve

studied under in the past on fibromyalgia treatment.

>

> A huge part of the interest was on iodine. I talked about how much we need

and for what and why the current iodine craze was misguided. So much interest

came of it I¡¯m posting an article pre-publication to answer any more questions.

> I love Portland. I pedaled from my hotel to Whole Foods last night in

downtown Portland. Then I proceeded to purchase organic kale and carry it back

in my backpack rather than a plastic bag. As I rode home I wondered if I could

get some kind of environmental gold medal for the trip.

> An awesome bike shop delivered a bike to my hotel for me so I got to keep up

with training. A long ride tomorrow AM and then back home!

> Here¡¯s the full iodine article, enjoy.

> In Health,

> Dr. C

> Iodine, not too much, not too little.

>

>

>

> In Arizona, many retirees spend their summers elsewhere. To me, it marks the

change of seasons to welcome my ¡®snowbirds¡¯ back in the fall and see them off

in the spring.

> Several years ago I had a kind gentleman return for the winter with new

symptoms: watery diarrhea after every meal and a non-intentional tremor of his

hand. The diarrhea started three or four months ago, the tremor, more recently.

Normally in excellent health, ¡®Tim¡¯ joked about getting old and his body

falling apart. He had his screening tests completed before I heard about this.

They were normal besides a suppressed TSH. On his exam, I found several thyroid

nodules that were not present last year and his heart rate was over 100 bpm.

> An ultrasound and second level thyroid tests diagnosed Tim with toxic

multi-nodular goiter. In seniors, this is most common after high dose iodine

exposure such as in imaging contrast. I asked if he had a CT or MRI done

recently. He told me he did not but that he was taking an iodine pill for five

months. Apparently he was tested and found to be low in iodine and was now

taking 1 tablet of Iodoral daily providing 50,000 mcg of iodine.

> Within several months I had roughly the same thing happen to three other

patients, all on high dose iodine, some based on testing, some not. One of

these also had toxic multinodular goiter, one had Grave¡¯s disease and one was

hypothyroid secondary to Hashimoto¡¯s thyroiditis. Since then several more

cases have come in with new thyroid disease after taking high dose iodine.

> Not all patients who take high dose iodine will get thyroid disease and it is

possible that some that I saw may have developed thyroid disease even if not on

iodine. I have seen many other patients taking high dose iodine with no

apparent adverse effects.

> Iodine in doses above physiologic requirements is the single best documented

environmental toxin capable of inducing autoimmune thyroid disease (ATD). 1

> I had dimly been aware of iodine becoming a new topic at holistic conferences.

A little digging quickly revealed that Guy Abraham, MD was the sole source of

the new iodine paradigm.

>

>

>

> Dr. Abraham collectively calls his work the ¡®Iodine Project¡¯. The articles

were originally published in the magazine ¡®The Original Internist¡¯

(http://www.clintpublications.com/), a non-peer reviewed journal circulating

primarily to chiropractors. His ideas are mimicked nearly verbatum in books

from Dr. Brownstein (Iodine: Why You Need It, Why You Can¡¯t Live Without

It) and articles from Drs and Flechas.

>

> Over the next several months I read every word written by Dr. Abraham and his

colleagues. I also read all of their references that were available. Most

referred to their own statements from other sources. I also read everything I

could find from every other source on human iodine requirements. My conclusion

was quite clear, iodine at these new proposed doses was not justified and I have

since counseled patients and peers against it.

>

>

>

> Since these views on iodine are getting more pervasive, I felt compelled to

share my findings and experiences in a broader forum, thus this article came

about.

>

>

> The Iodine Project can be summarized as the following: 2

> 1.High dose iodine helps conditions such fibrocystic breast disease, therefore

these doses are physiologically required.

> 2.The Japanese consume much more iodine than Americans and have lower rates of

thyroid disease and breast cancer.

> 3.Iodine status can be determined by 24 hour urine iodine levels following a

50,000 mcg oral dose. Those excreting a smaller fraction of the dose may have

retained more iodine therefore their bodies needed it.

> 4.Adult humans need 12,500 ¨C 50,000 mcg of iodine for good health.

> 5.Iodine overdose is not a real phenomenon and the ¡®Wolff-Chaikoff¡¯ effect

is a delusional construct resulting from ¡°Iodophobic bioterrorism¡±.

> 6.The topsoil of the Earth was divinely created 6000 years ago with an

extremely high level of iodine which was depleted by the flood of Noah. Human

health has been poorer ever since.

> 7.The current academic views on iodine are distorted by international foreign

powers in order to make ¡®zombies¡¯ out of ¡®Christian America¡¯.

>

> I imagine most who have entertained these ideas had no idea how radical some

of the essential underlying concepts are. I could not make this stuff up. He

rightfully states that the whole body of his work depends on the points 6 and 7

to be valid.

>

> These last points are so extreme, they deserve a few direct quotes from Dr.

Abraham¡¯s work:

>

> ¡°The theory of evolution does not offer an intellectually satisfying answer

to this paradox (humans needing iodine levels greatly in excess of what is found

in sea water, as Dr. Abraham proposes). . . .Therefore, the original planet

earth contained a topsoil rich in iodine, and all elements required for perfect

health of Adam, Eve and their descendants. . . . A sequence of events followed,

culminating in the worldwide flood 4500 years ago. Following this episode, the

receding waters washed away the topsoil with all its elements into oceans and

seas. The new topsoil became deficient in iodine and most likely other essential

elements, whose essentialities are still unknown.¡± 3

>

> ¡°Iodine neglect in the 1930¡¯s by thyroidologists progressed to medical

iodophobia in the late 1940¡¯s and early 1950¡¯s. Following World War II, there

was a systematic attempt to remove iodine from the food supply of Christian

America. Iodophobic misinformation, well synchronized with the introduction of

alternatives to iodine supplementation in medical practice, strongly suggest a

well planned conspiracy by agents of foreign powers planted at strategic

positions in academia and the regulatory agencies.¡± 4

>

> The Iodine Project¡¯s claims that ¡®iodophobia¡¯ is part of a large conspiracy

beginning in the 1930¡äs. He discusses how in the 1960¡äs Americans nearly

became released from the ¡°zombifying¡± clutches of iodophobia:

>

> ¡°In the early 1960¡¯s, potassium iodate was added to bread as a dough

conditioner. This was an oversight by the agents of foreign powers planted at

strategic positions in academia and the regulatory agencies. . . . This amount

of the dezombifier iodine in a major staple food of Christian America could not

be tolerated for long. ¡° 5

>

> My responses to the claims are as follows:

>

> Point 1: Dr. Abraham states that his focus on iodine began after learning

about the role of high dose iodine in treating fibrocycstic breast disease in

women.

>

> The data that high dose iodine can help fibrocystic breast disease is clear.

Dr. Abraham is making the fallacy I have seen others make of confusing a useful

property of a substance with its role as an essential element. Nutrients are

cofactors for physiological functions in the body. Some also happen to have

useful effects when used in doses well in excess of physiologic requirements.

> Take niacin as a case in point. As adults we require only 14-18 mg of niacin

to prevent us from pellegra, a fatal deficiency disease. With a diet high in

the amino acid tryptophan we can do fine on even lower amounts of niacin. It

happens to be that doses of niacin 100-200 times this can act as a gentle HMG

CoA reductase inhibitor. Yet these doses can cause maculopathy in up to 7% of

adult males who take it. 6 Those of you who use niacin in enough people have

likely observed this reaction as I have.

> Clearly even though niacin may have useful properties in high doses, this does

not mean that recommended intakes for all should be rewritten.

> The majority of adults can tolerate intermittent high doses of iodine with no

adverse effects. Long term elevations, such as Abraham proposes, are different.

Those who are low in iodine, or who have positive thyroid antibodies can have

adverse effects by raising their long term intakes as little as 100 mcg. 7

> Those who are not deficient can manifest toxicity with as little as 600 mcg

daily. The WHO has stated that 1000 mcg is a safe upper limit for most without

thyroid antibodies. Thyroid antibodies are commonly present with normal thyroid

function and can be found in up to 26% of the population. I did not find

recommendations to pre-screen for antibodies prior to treatment in the Iodine

Project. 8

>

> Point #2: Japanese, especially in coastal areas do consume more iodine than

Americans, but have higher rates of thyroid disease. Furthermore their thyroid

disease is highest in their areas of greatest iodine intake. 9 Other populations

whose iodine intakes vary from 100-200 mcg daily also have higher rates of

thyroid disease. 10

> Japanese women used to have lower rates of breast cancer than American women.

This difference declines as they adopt a western diet. Researchers have shown

strong dose related increases in breast cancer among women from different

nations related to dietary fat; and inverse dose related risks to soy food and

green tea. 11, 12, 13

>

>

>

> Point #3 I have been unable to find any sources outside of the Iodine Project

pertaining to the validity of 24 hour loading tests, even after asking directly.

Based on what we know about iodine, this test is not likely meaningful for the

following reasons:

> We excrete iodine in our urine but variable amounts leave though our bowels

and sweat. Sudden large doses can result in fecal loss 400 fold above normal.

It has been stated that unless fecal and urine levels of iodine are measured,

urine is not an accurate biomarker when iodine intake is changed abruptly such

as after a loading dose. 14

>

> The CDC has also documented that a population¡¯s 24 hour urinary iodine output

levels are only meaningful when iodine intake has been steady for six months or

greater. One does not reach steady state in 24 hours. 15

>

> Point #4: Due to predictable thyroid toxicity, no nutritional organization has

endorsed intakes of iodine above 600 mcg daily.

>

>

>

>

> Iodized salt is ideally 1/10000 potassium iodine, but many third world

attempts ended up wrong. Since the WHO has carefully tracked these cases, we

have extensive data regarding changes of iodine intake. Long term intakes above

600 mcg routinely cause higher rates of thyroid disease including hypothyroidism

and hyperthyroidism. 16

> TABLE 1

> Recommended dietary intakes of iodine and upper limits, by group 17

> Group Recommended Intake (mcg/kg/day) Upper limit of safety (mcg/kg/day)

Iodine Project proposed intake (mcg/kg/day for a 60 kg adult female)

> age 13-adult 2 30 208 ¨C 833

>

> Additional data on the long term effects of high dose iodine come from

amiodarone usage. Each 200 mg tablet is roughly 75 mg of organic iodine, 8-12%

of which is released as free iodide yielding an average net dose of 6-12.75 mg

of iodine.

> Dronedarone is a nearly identical molecule to amiodarone minus the iodine. It

shares the same effects and side effects of amiodarone with the exception of

thyroid toxicity. Therefore it has been concluded that the thyrotoxic effects of

amiodarone are attributable solely to the high iodine content. 18

> In a study of 182 patients taking amiodarone, 41% developed hypothyroidism

over a 6 year period. Median time frame of onset for hypothyroidism was 21

months. 59% of patients developed thyrotoxicosis after an average of 29 months.

Note that some cases of thyrotoxicosis culminated in hypothyroidism so the

groups did overlap. 19

> Point #5: The Wolff Chaikoff effect, AKA the ¡®iodine escape mechanism¡¯, has

been verified in vitro and in vivo and is present in all humans without

exceptions or variations. Were such a ¡®fuse¡¯ not in place, normal variation

of iodine intake could induce cardiotoxic hyperthyroidism. This effect is used

when managing patients in a state of hyperthyroid storm. One can suppress

thyroid hormone synthesis with pharmacologic doses of iodine more quickly than

with thionamide drugs due to the Wolff Chaikoff effect.

>

> This also enables a single high dose of potassium iodine (SSKI) to prevent

thyroid cancer after radiation exposure. After taking enough SSKI, the thyroid

iodine uptake is temporarily blocked due the Wolff Chikoff effect. This

prevents the thyroid from absorbing environmental radioactive iodine for roughly

three weeks.

> Point #6: Religious belief, or lack thereof, is a personal matter. Yet

modern medicine is based on biology and biology is based on evolution. If

someone is unwilling to acknowledge the existence of planet earth prior to 6000

BC, then I see little basis on which to have a rational discussion regarding

matters of science.

>

> Point #7: As Naturopathic Physicians, we love to be the purveyors of arcane

knowledge that flies in the face of conventional wisdom, I know I do. Because of

this eagerness, I think we can be vulnerable to embracing such ideas too

uncritically. As Carl Sagan said, great claims require great evidence.

>

> The claim that the last 80 years of accumulated iodine knowledge duplicated

from hundreds of researches in thousands of studies worldwide is all part of a

¡®foreign conspiracy¡¯ would require massive evidence which I find lacking.

> Fibrocystic breast disease can usually be treated with therapeutic doses of

Vitamin E, EPO, a diet high in fiber and avoidance of methyl xanthenes. (Tori

Hudson, ND: personal communication, April 26, 2010) If considering iodine for

resistant cases, pre-screen for antibodies and monitor thyroid function.

>

>

>

>

> Breast cancer risk can be lowered by exercise, caloric balance, low fat diet,

healthy use of soy and cruciferous veggies and trading alcohol for tea.

>

>

>

>

> Neither require a treatment with a significant risk for generating thyroid

disease. Finally, thyroid function does not improve when iodine consumption

exceeds established ranges.

>

>

>

>

> Given that risks of high dose iodine are irrefutable, long term intake should

be kept at levels of roughly 150 mcg although episodic intake of up to 1000 mcg

is tolerable by most without thyroid antibodies.

>

> For further reading:

> The Iodine Project in its entirety can be found on

http://www.optimox.com/pics/Iodine/opt_Research_I.shtml

> A debate between Dr. Abraham¡¯s and Dr. Alan Gaby can be found on the Townsend

Letter for Doctors and Patients archives:

http://www.townsendletter.com/AugSept2005/gabyiodine0805.htm

> From The Agency for Toxic Substances and Disease Registry (ATSDR) is an

exhaustive over 200 pages of data summarizing human studies on toxicity of

iodine: http://www.atsdr.cdc.gov/toxprofiles/tp158-c3.pdf, and 172 excellent

references on iodine metabolism:

http://www.atsdr.cdc.gov/toxprofiles/tp158-c9.pdf

> CDC report on Iodine requirements in humans:

> http://www.cdc.gov/nutritionreport/part_4a.html

> Iodine status worldwide from the World Health Organization:

> http://www.who.int/vmnis/iodine/status/en/index.html

>

>

>

> International Council for the Control of Iodine Deficiency Disorders, working

to eliminate global iodine deficiency. http://www.iccidd.org/index.php.

> References

> 1. Bahn, R, Chair. Immunogenetics, Epigenetics and Environmental Triggers of

Autoimmune Thyroid Disorders. Paper presented at: Spring Meeting of the

American Thyroid Association Thyroid Disorders in the Era of Personalized

Medicine; May 13-16, 2010; Minneapolis, Minnesota.

> 2. Iodine Publications. Optimox corporation.

http://www.optimox.com/pics/Iodine/opt_Research_I.shtml. Accessed 5/26/2010.

> 3. Abraham G, Brownstein D. Validation of the orthoiodosupplementation

program: A Rebuttal of Dr. Gaby¡¯s Editorial on iodine.

http://www.optimox.com/pics/Iodine/IOD-12/IOD_12.htm. Accessed May 26, 2010.

> 4. Abraham, G.E.,The History of Iodine in Medicine Part III: Thyroid Fixation

and Medical Iodophobia. The Original Internist, 13: 71-78, June 2006.

> 5. Abraham, G.E.,The History of Iodine in Medicine Part III: Thyroid Fixation

and Medical Iodophobia. The Original Internist, 13: 71-78, June 2006.

> 6. Fraunfelder F, Fraunfelder F T, Illingworth D. Adverse ocular effects

associated with niacin therapy. Br J Ophthalmol. 1995 January; 79(1): 54¨C56.

> 7. W Reinhardt, M Luster1, K H Rudorff. Effect of small doses of iodine on

thyroid function in patients with Hashimoto¡¯s thyroiditis residing in an area

of mild iodine deficiency. Euro J Endocrinology 1998. 139 23¨C28.

> 8. Mehran S, Meilahn E, Orchard T, Foley et al. Prevalence of thyroid

antibodies among healthy middle-aged women: Findings from the thyroid study in

healthy women. Ann Epidemiology 1995; 5(3):229-233.

> 9. N Konno, H Makita, K Yuri, N Iizuka et al. Association between dietary

iodine intake and prevalence of subclinical hypothyroidism in the coastal

regions of Japan. J. Clin. Endocrinol. Metab, 78, 393-397.

> 10. Pedersen I, Knudsen N, nson H, et al. Large Differences in Incidences

of Overt Hyper- and Hypothyroidism Associated with a Small Difference in Iodine

Intake: A Prospective Comparative Register-Based Population Survey. J. Clin.

Endocrinol. Metab., October 1, 2002; 87(10): 4462 ¨C 4469.

> 11. Gregorio DI, Emrich LJ, Graham S, et al. Dietary fat consumption and

survival among women with breast cancer. J Natl Cancer Inst. 2003 Jun

18;95(12):906-13.

> 12. LeMarchand L, Kolonel LN, Nomura A. Ethnic differences in survival after

diagnosis of breast cancer¡ªHawaii. JAMA 1985;254:2728.

> 13. Yamamoto S, Sobue T, Kobayashi M, et al. Soy, isoflavones, and breast

cancer risk in Japan. J National Cancer Inst, Vol. 95, No. 12, June 18, 2003.

> 14. Vought R, London W, Brown F, et al. Iodine Intake and Excretion in Healthy

Nonhospitalized Subjects Am. J. Clinical Nutrition, Sep 1964; 15: 124 ¨C 132.

> 15. Toxicological Profile for Iodine. Agency for Toxic Substances and Disease

Registry http://www.atsdr.cdc.gov/toxprofiles/tp158.html Accessed 5/26/2010.

> 16. Roti E, Vagenakis G. Effect of excess iodide: clinical aspects. In:

Braverman

> LE, Utiger RD, eds. The thyroid. A fundamental and clinical text, 8th ed.

> Philadelphia, PA, Lippincott, 2000:316¨C329.

> 17. Fisher DA, Delange F. Thyroid hormone and iodine requirements in man

> during brain development. In: Stanbury JB et al., eds. Iodine in pregnancy.

> New Delhi, Oxford University Press, 1998:1¨C33.

> 18. Han TS, GR, Vanderpump MP. Benzofuran derivatives and the

thyroid. Department of Endocrinology, Royal Free and University College Medical

School, Royal Free Hospital, Hampstead, London NW3 2QG, UK.

> 19. o E, Bartalena L, Bogazzi F, Braverman

>

[Guest guest]

It's curious. General medicine seems to want to hold iodine practitioners to a

double standard. For example, a patient being seen by a mainstream MD may suffer

severe symptoms and even permanent damage from steroid (prednisone) treatment,

but no one would dare to criticize a medical doctor for prescribing aggressive

amounts of steroids, nor would they try to say that steroids have to be

restricted to 1 mg per day.

You are right on the mark with your comment that iodine therapy has to be well

managed, whether by patient or doctor. When we hear a horror story like, " My

brother-in-law took iodine and then suffered from [blah blah blah], " it's a

foregone conclusion that the iodine intake was not being well managed, and that

was the problem.

> >

> > Just found this post in curezone. Please take a look.

> >

> > http://blog.myintegrativehealth.com/2010/07

> >

> > Dr. Christianson does thyroid presentation in Portland

> > Saturday, July 24th, 2010

> >

> > Greetings to all!

> >

> > I just spoke for a wonderful group of doctors on thyroid disease. It was

coordinated by Tori Hudson, ND. She is the director of the Institute of

Women¡¯s Health and Integrative Medicine.

http://www.instituteofwomenshealth.com/torihudson Dr. Hudson is our well loved

and well respected guru on women¡¯s healthcare and she brought together a group

of doctors I was proud to be part of including Teitelbaum, MD who I¡¯ve

studied under in the past on fibromyalgia treatment.

> >

> > A huge part of the interest was on iodine. I talked about how much we need

and for what and why the current iodine craze was misguided. So much interest

came of it I¡¯m posting an article pre-publication to answer any more questions.

> > I love Portland. I pedaled from my hotel to Whole Foods last night in

downtown Portland. Then I proceeded to purchase organic kale and carry it back

in my backpack rather than a plastic bag. As I rode home I wondered if I could

get some kind of environmental gold medal for the trip.

> > An awesome bike shop delivered a bike to my hotel for me so I got to keep up

with training. A long ride tomorrow AM and then back home!

> > Here¡¯s the full iodine article, enjoy.

> > In Health,

> > Dr. C

> > Iodine, not too much, not too little.

> >

> >

> >

> > In Arizona, many retirees spend their summers elsewhere. To me, it marks

the change of seasons to welcome my ¡®snowbirds¡¯ back in the fall and see them

off in the spring.

> > Several years ago I had a kind gentleman return for the winter with new

symptoms: watery diarrhea after every meal and a non-intentional tremor of his

hand. The diarrhea started three or four months ago, the tremor, more recently.

Normally in excellent health, ¡®Tim¡¯ joked about getting old and his body

falling apart. He had his screening tests completed before I heard about this.

They were normal besides a suppressed TSH. On his exam, I found several thyroid

nodules that were not present last year and his heart rate was over 100 bpm.

> > An ultrasound and second level thyroid tests diagnosed Tim with toxic

multi-nodular goiter. In seniors, this is most common after high dose iodine

exposure such as in imaging contrast. I asked if he had a CT or MRI done

recently. He told me he did not but that he was taking an iodine pill for five

months. Apparently he was tested and found to be low in iodine and was now

taking 1 tablet of Iodoral daily providing 50,000 mcg of iodine.

> > Within several months I had roughly the same thing happen to three other

patients, all on high dose iodine, some based on testing, some not. One of

these also had toxic multinodular goiter, one had Grave¡¯s disease and one was

hypothyroid secondary to Hashimoto¡¯s thyroiditis. Since then several more

cases have come in with new thyroid disease after taking high dose iodine.

> > Not all patients who take high dose iodine will get thyroid disease and it

is possible that some that I saw may have developed thyroid disease even if not

on iodine. I have seen many other patients taking high dose iodine with no

apparent adverse effects.

> > Iodine in doses above physiologic requirements is the single best documented

environmental toxin capable of inducing autoimmune thyroid disease (ATD). 1

> > I had dimly been aware of iodine becoming a new topic at holistic

conferences. A little digging quickly revealed that Guy Abraham, MD was the

sole source of the new iodine paradigm.

> >

> >

> >

> > Dr. Abraham collectively calls his work the ¡®Iodine Project¡¯. The

articles were originally published in the magazine ¡®The Original Internist¡¯

(http://www.clintpublications.com/), a non-peer reviewed journal circulating

primarily to chiropractors. His ideas are mimicked nearly verbatum in books

from Dr. Brownstein (Iodine: Why You Need It, Why You Can¡¯t Live Without

It) and articles from Drs and Flechas.

> >

> > Over the next several months I read every word written by Dr. Abraham and

his colleagues. I also read all of their references that were available. Most

referred to their own statements from other sources. I also read everything I

could find from every other source on human iodine requirements. My conclusion

was quite clear, iodine at these new proposed doses was not justified and I have

since counseled patients and peers against it.

> >

> >

> >

> > Since these views on iodine are getting more pervasive, I felt compelled to

share my findings and experiences in a broader forum, thus this article came

about.

> >

> >

> > The Iodine Project can be summarized as the following: 2

> > 1.High dose iodine helps conditions such fibrocystic breast disease,

therefore these doses are physiologically required.

> > 2.The Japanese consume much more iodine than Americans and have lower rates

of thyroid disease and breast cancer.

> > 3.Iodine status can be determined by 24 hour urine iodine levels following a

50,000 mcg oral dose. Those excreting a smaller fraction of the dose may have

retained more iodine therefore their bodies needed it.

> > 4.Adult humans need 12,500 ¨C 50,000 mcg of iodine for good health.

> > 5.Iodine overdose is not a real phenomenon and the ¡®Wolff-Chaikoff¡¯ effect

is a delusional construct resulting from ¡°Iodophobic bioterrorism¡±.

> > 6.The topsoil of the Earth was divinely created 6000 years ago with an

extremely high level of iodine which was depleted by the flood of Noah. Human

health has been poorer ever since.

> > 7.The current academic views on iodine are distorted by international

foreign powers in order to make ¡®zombies¡¯ out of ¡®Christian America¡¯.

> >

> > I imagine most who have entertained these ideas had no idea how radical some

of the essential underlying concepts are. I could not make this stuff up. He

rightfully states that the whole body of his work depends on the points 6 and 7

to be valid.

> >

> > These last points are so extreme, they deserve a few direct quotes from Dr.

Abraham¡¯s work:

> >

> > ¡°The theory of evolution does not offer an intellectually satisfying answer

to this paradox (humans needing iodine levels greatly in excess of what is found

in sea water, as Dr. Abraham proposes). . . .Therefore, the original planet

earth contained a topsoil rich in iodine, and all elements required for perfect

health of Adam, Eve and their descendants. . . . A sequence of events followed,

culminating in the worldwide flood 4500 years ago. Following this episode, the

receding waters washed away the topsoil with all its elements into oceans and

seas. The new topsoil became deficient in iodine and most likely other essential

elements, whose essentialities are still unknown.¡± 3

> >

> > ¡°Iodine neglect in the 1930¡¯s by thyroidologists progressed to medical

iodophobia in the late 1940¡¯s and early 1950¡¯s. Following World War II, there

was a systematic attempt to remove iodine from the food supply of Christian

America. Iodophobic misinformation, well synchronized with the introduction of

alternatives to iodine supplementation in medical practice, strongly suggest a

well planned conspiracy by agents of foreign powers planted at strategic

positions in academia and the regulatory agencies.¡± 4

> >

> > The Iodine Project¡¯s claims that ¡®iodophobia¡¯ is part of a large

conspiracy beginning in the 1930¡äs. He discusses how in the 1960¡äs Americans

nearly became released from the ¡°zombifying¡± clutches of iodophobia:

> >

> > ¡°In the early 1960¡¯s, potassium iodate was added to bread as a dough

conditioner. This was an oversight by the agents of foreign powers planted at

strategic positions in academia and the regulatory agencies. . . . This amount

of the dezombifier iodine in a major staple food of Christian America could not

be tolerated for long. ¡° 5

> >

> > My responses to the claims are as follows:

> >

> > Point 1: Dr. Abraham states that his focus on iodine began after learning

about the role of high dose iodine in treating fibrocycstic breast disease in

women.

> >

> > The data that high dose iodine can help fibrocystic breast disease is clear.

Dr. Abraham is making the fallacy I have seen others make of confusing a useful

property of a substance with its role as an essential element. Nutrients are

cofactors for physiological functions in the body. Some also happen to have

useful effects when used in doses well in excess of physiologic requirements.

> > Take niacin as a case in point. As adults we require only 14-18 mg of

niacin to prevent us from pellegra, a fatal deficiency disease. With a diet

high in the amino acid tryptophan we can do fine on even lower amounts of

niacin. It happens to be that doses of niacin 100-200 times this can act as a

gentle HMG CoA reductase inhibitor. Yet these doses can cause maculopathy in up

to 7% of adult males who take it. 6 Those of you who use niacin in enough people

have likely observed this reaction as I have.

> > Clearly even though niacin may have useful properties in high doses, this

does not mean that recommended intakes for all should be rewritten.

> > The majority of adults can tolerate intermittent high doses of iodine with

no adverse effects. Long term elevations, such as Abraham proposes, are

different. Those who are low in iodine, or who have positive thyroid antibodies

can have adverse effects by raising their long term intakes as little as 100

mcg. 7

> > Those who are not deficient can manifest toxicity with as little as 600 mcg

daily. The WHO has stated that 1000 mcg is a safe upper limit for most without

thyroid antibodies. Thyroid antibodies are commonly present with normal thyroid

function and can be found in up to 26% of the population. I did not find

recommendations to pre-screen for antibodies prior to treatment in the Iodine

Project. 8

> >

> > Point #2: Japanese, especially in coastal areas do consume more iodine than

Americans, but have higher rates of thyroid disease. Furthermore their thyroid

disease is highest in their areas of greatest iodine intake. 9 Other populations

whose iodine intakes vary from 100-200 mcg daily also have higher rates of

thyroid disease. 10

> > Japanese women used to have lower rates of breast cancer than American

women. This difference declines as they adopt a western diet. Researchers have

shown strong dose related increases in breast cancer among women from different

nations related to dietary fat; and inverse dose related risks to soy food and

green tea. 11, 12, 13

> >

> >

> >

> > Point #3 I have been unable to find any sources outside of the Iodine

Project pertaining to the validity of 24 hour loading tests, even after asking

directly. Based on what we know about iodine, this test is not likely meaningful

for the following reasons:

> > We excrete iodine in our urine but variable amounts leave though our bowels

and sweat. Sudden large doses can result in fecal loss 400 fold above normal.

It has been stated that unless fecal and urine levels of iodine are measured,

urine is not an accurate biomarker when iodine intake is changed abruptly such

as after a loading dose. 14

> >

> > The CDC has also documented that a population¡¯s 24 hour urinary iodine

output levels are only meaningful when iodine intake has been steady for six

months or greater. One does not reach steady state in 24 hours. 15

> >

> > Point #4: Due to predictable thyroid toxicity, no nutritional organization

has endorsed intakes of iodine above 600 mcg daily.

> >

> >

> >

> >

> > Iodized salt is ideally 1/10000 potassium iodine, but many third world

attempts ended up wrong. Since the WHO has carefully tracked these cases, we

have extensive data regarding changes of iodine intake. Long term intakes above

600 mcg routinely cause higher rates of thyroid disease including hypothyroidism

and hyperthyroidism. 16

> > TABLE 1

> > Recommended dietary intakes of iodine and upper limits, by group 17

> > Group Recommended Intake (mcg/kg/day) Upper limit of safety (mcg/kg/day)

Iodine Project proposed intake (mcg/kg/day for a 60 kg adult female)

> > age 13-adult 2 30 208 ¨C 833

> >

> > Additional data on the long term effects of high dose iodine come from

amiodarone usage. Each 200 mg tablet is roughly 75 mg of organic iodine, 8-12%

of which is released as free iodide yielding an average net dose of 6-12.75 mg

of iodine.

> > Dronedarone is a nearly identical molecule to amiodarone minus the iodine.

It shares the same effects and side effects of amiodarone with the exception of

thyroid toxicity. Therefore it has been concluded that the thyrotoxic effects of

amiodarone are attributable solely to the high iodine content. 18

> > In a study of 182 patients taking amiodarone, 41% developed hypothyroidism

over a 6 year period. Median time frame of onset for hypothyroidism was 21

months. 59% of patients developed thyrotoxicosis after an average of 29 months.

Note that some cases of thyrotoxicosis culminated in hypothyroidism so the

groups did overlap. 19

> > Point #5: The Wolff Chaikoff effect, AKA the ¡®iodine escape mechanism¡¯,

has been verified in vitro and in vivo and is present in all humans without

exceptions or variations. Were such a ¡®fuse¡¯ not in place, normal variation

of iodine intake could induce cardiotoxic hyperthyroidism. This effect is used

when managing patients in a state of hyperthyroid storm. One can suppress

thyroid hormone synthesis with pharmacologic doses of iodine more quickly than

with thionamide drugs due to the Wolff Chaikoff effect.

> >

> > This also enables a single high dose of potassium iodine (SSKI) to prevent

thyroid cancer after radiation exposure. After taking enough SSKI, the thyroid

iodine uptake is temporarily blocked due the Wolff Chikoff effect. This

prevents the thyroid from absorbing environmental radioactive iodine for roughly

three weeks.

> > Point #6: Religious belief, or lack thereof, is a personal matter. Yet

modern medicine is based on biology and biology is based on evolution. If

someone is unwilling to acknowledge the existence of planet earth prior to 6000

BC, then I see little basis on which to have a rational discussion regarding

matters of science.

> >

> > Point #7: As Naturopathic Physicians, we love to be the purveyors of arcane

knowledge that flies in the face of conventional wisdom, I know I do. Because of

this eagerness, I think we can be vulnerable to embracing such ideas too

uncritically. As Carl Sagan said, great claims require great evidence.

> >

> > The claim that the last 80 years of accumulated iodine knowledge duplicated

from hundreds of researches in thousands of studies worldwide is all part of a

¡®foreign conspiracy¡¯ would require massive evidence which I find lacking.

> > Fibrocystic breast disease can usually be treated with therapeutic doses of

Vitamin E, EPO, a diet high in fiber and avoidance of methyl xanthenes. (Tori

Hudson, ND: personal communication, April 26, 2010) If considering iodine for

resistant cases, pre-screen for antibodies and monitor thyroid function.

> >

> >

> >

> >

> > Breast cancer risk can be lowered by exercise, caloric balance, low fat

diet, healthy use of soy and cruciferous veggies and trading alcohol for tea.

> >

> >

> >

> >

> > Neither require a treatment with a significant risk for generating thyroid

disease. Finally, thyroid function does not improve when iodine consumption

exceeds established ranges.

> >

> >

> >

> >

> > Given that risks of high dose iodine are irrefutable, long term intake

should be kept at levels of roughly 150 mcg although episodic intake of up to

1000 mcg is tolerable by most without thyroid antibodies.

> >

> > For further reading:

> > The Iodine Project in its entirety can be found on

http://www.optimox.com/pics/Iodine/opt_Research_I.shtml

> > A debate between Dr. Abraham¡¯s and Dr. Alan Gaby can be found on the

Townsend Letter for Doctors and Patients archives:

http://www.townsendletter.com/AugSept2005/gabyiodine0805.htm

> > From The Agency for Toxic Substances and Disease Registry (ATSDR) is an

exhaustive over 200 pages of data summarizing human studies on toxicity of

iodine: http://www.atsdr.cdc.gov/toxprofiles/tp158-c3.pdf, and 172 excellent

references on iodine metabolism:

http://www.atsdr.cdc.gov/toxprofiles/tp158-c9.pdf

> > CDC report on Iodine requirements in humans:

> > http://www.cdc.gov/nutritionreport/part_4a.html

> > Iodine status worldwide from the World Health Organization:

> > http://www.who.int/vmnis/iodine/status/en/index.html

> >

> >

> >

> > International Council for the Control of Iodine Deficiency Disorders,

working to eliminate global iodine deficiency. http://www.iccidd.org/index.php.

> > References

> > 1. Bahn, R, Chair. Immunogenetics, Epigenetics and Environmental Triggers

of Autoimmune Thyroid Disorders. Paper presented at: Spring Meeting of the

American Thyroid Association Thyroid Disorders in the Era of Personalized

Medicine; May 13-16, 2010; Minneapolis, Minnesota.

> > 2. Iodine Publications. Optimox corporation.

http://www.optimox.com/pics/Iodine/opt_Research_I.shtml. Accessed 5/26/2010.

> > 3. Abraham G, Brownstein D. Validation of the orthoiodosupplementation

program: A Rebuttal of Dr. Gaby¡¯s Editorial on iodine.

http://www.optimox.com/pics/Iodine/IOD-12/IOD_12.htm. Accessed May 26, 2010.

> > 4. Abraham, G.E.,The History of Iodine in Medicine Part III: Thyroid

Fixation and Medical Iodophobia. The Original Internist, 13: 71-78, June 2006.

> > 5. Abraham, G.E.,The History of Iodine in Medicine Part III: Thyroid

Fixation and Medical Iodophobia. The Original Internist, 13: 71-78, June 2006.

> > 6. Fraunfelder F, Fraunfelder F T, Illingworth D. Adverse ocular effects

associated with niacin therapy. Br J Ophthalmol. 1995 January; 79(1): 54¨C56.

> > 7. W Reinhardt, M Luster1, K H Rudorff. Effect of small doses of iodine on

thyroid function in patients with Hashimoto¡¯s thyroiditis residing in an area

of mild iodine deficiency. Euro J Endocrinology 1998. 139 23¨C28.

> > 8. Mehran S, Meilahn E, Orchard T, Foley et al. Prevalence of thyroid

antibodies among healthy middle-aged women: Findings from the thyroid study in

healthy women. Ann Epidemiology 1995; 5(3):229-233.

> > 9. N Konno, H Makita, K Yuri, N Iizuka et al. Association between dietary

iodine intake and prevalence of subclinical hypothyroidism in the coastal

regions of Japan. J. Clin. Endocrinol. Metab, 78, 393-397.

> > 10. Pedersen I, Knudsen N, nson H, et al. Large Differences in

Incidences of Overt Hyper- and Hypothyroidism Associated with a Small Difference

in Iodine Intake: A Prospective Comparative Register-Based Population Survey. J.

Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4462 ¨C 4469.

> > 11. Gregorio DI, Emrich LJ, Graham S, et al. Dietary fat consumption and

survival among women with breast cancer. J Natl Cancer Inst. 2003 Jun

18;95(12):906-13.

> > 12. LeMarchand L, Kolonel LN, Nomura A. Ethnic differences in survival after

diagnosis of breast cancer¡ªHawaii. JAMA 1985;254:2728.

> > 13. Yamamoto S, Sobue T, Kobayashi M, et al. Soy, isoflavones, and breast

cancer risk in Japan. J National Cancer Inst, Vol. 95, No. 12, June 18, 2003.

> > 14. Vought R, London W, Brown F, et al. Iodine Intake and Excretion in

Healthy Nonhospitalized Subjects Am. J. Clinical Nutrition, Sep 1964; 15: 124 ¨C

132.

> > 15. Toxicological Profile for Iodine. Agency for Toxic Substances and

Disease Registry http://www.atsdr.cdc.gov/toxprofiles/tp158.html Accessed

5/26/2010.

> > 16. Roti E, Vagenakis G. Effect of excess iodide: clinical aspects. In:

Braverman

> > LE, Utiger RD, eds. The thyroid. A fundamental and clinical text, 8th ed.

> > Philadelphia, PA, Lippincott, 2000:316¨C329.

> > 17. Fisher DA, Delange F. Thyroid hormone and iodine requirements in man

> > during brain development. In: Stanbury JB et al., eds. Iodine in pregnancy.

> > New Delhi, Oxford University Press, 1998:1¨C33.

> > 18. Han TS, GR, Vanderpump MP. Benzofuran derivatives and the

thyroid. Department of Endocrinology, Royal Free and University College Medical

School, Royal Free Hospital, Hampstead, London NW3 2QG, UK.

> > 19. o E, Bartalena L, Bogazzi F, Braverman

> >

>

[Guest guest]

Two things occurred to me:

Maybe the type of iodine that is beneficial for one constitutional type is bad

for another sort of person.

Second, to have the iodine (or any other mineral or supplement) work well in

your body, you need to have a well-functioning liver. In both natural and

Chinese medicine, there is a condition called " liver congestion " or " liver

stagnation " . I'd suggest that the majority of people have this to a greater or

lesser degree (I was diagnosed by a doctor of Chinese medicine with this

condition) and therefore that may be one reason they struggle with iodine

dosage.