The debate regarding iodine and the thyroid is more polarized than that of democrats and republicans within the healthcare community. With each side is very adept at supporting their view with numerous studies, it becomes very confusing as to whether iodine is good or bad. Sometimes during the debate they claim expertise. It is interesting to compare their knowledge to reality. To see what happens when their recommendations are compared to lab testing. Iodine and the Thyroid: Part 2 Iodine vs. Antibody Testing
My decision is based on two events that occurred in my life. While attending chiropractic college, we were told iodine was necessary for proper thyroid function, therefore use iodine for hypothyroid. As a result of this I recommended the iodine patch test to treat thyroid patients. One woman I made this recommendation to seemed to respond well intitially. I say initially because she returned six months later looking in horrible shape. Eyes protruding, almost bald, 30 pounds heavier complaining of constant fatigue. What happened? I noticed a brown spot on her arm and thought it was an old bruise. She replied, she had just applied her iodine and it had not absorbed in yet. When asked why she had continued the iodine, she said she felt so good on it in the beginning, she decided to stay on it. She had been on the web and self-diagnosed herself with Candida attributing that to her current state of health. I decided then and there to never recommend iodine again until I understood what had happened.
The second incident involved my own health. At the same time I recommended her use of iodine, I was using progesterone. Why, because a well known book recommended progesterone for men. Shortly after this I attended Dr. Kharrazian’s Functional Endocrinology course. Imagine my horror as he described what happens to those using progesterone inappropriately, which coincidentaly was how I was feeling. In addition to this, he described what occurs with inappropriate use of iodine, with shouting erupting from three doctors saying they have used iodine for 30 years of collective practice and not once had there been any ill effects. After the shouting subsided, Dr. K calmly said he would not debate the issue in that venue and asked them to order TPO antibody tests on all of their patients using iodine. Then next year he would discuss iodine with them. The following year, the three were again sitting together and as Dr. K brought up the iodine topic I turned to view their response. All three were shaking their head in unison agreeing with Dr. K.
“No battle plan survives contact with the enemy”
All nutritional or hormonal theories are based upon optimal body function through the vitalistic view where the nutrient or hormones interact in a perfect environment. Treatment plans for iodine and hormones are made based upon optimal function in a perfect environment. Who among us has optimal body function in a perfect environment, with disease and inflammation as are our enemies?
When your plan meets your enemies in the real world, the real world wins. Nothing goes as planned. Errors pile up. Mistaken suppositions come back to bite you. The most brilliant plan loses touch with reality. However, the reliance on these treatment plans, especially with the incongruence between plan and reality is usually an exercise in self-delusion. When plans meet the real world, it’s not the real world that will yield to your plan. You must adapt whatever you’re doing to the circumstances truly at hand. This is where Functional Medicine shines.
Before the 1920s, iodine deficiency was common in the Great Lakes, Appalachian, and Northwestern U.S. regions and in most of Canada. Treatment of iodine deficiency by the introduction of iodized salt has eliminated the “goiter belt” in these areas. To this day, iodine deficiency is almost none existant with the introduction of iodized salt. But the notion of iodine deficiency carries on today.
Iodine you may know is one of the most important minerals for proper functioning of the thryoid. Iodine is an essential element that enables the thyroid gland to produce thyroid hormones. The plan is then extrapolated by iodine proponents into iodine makes the thyroid work better therefore use iodine supplementation. While in reality, iodine, which is high up on the atomic scale requires near perfect pH for its assimilation into the body. But, the thyroid doesn’t get access to iodine unless the body pH is near perfect in addition to many other factors.
Why Do People Feel Better on Iodine?
If you are hyperthyroid you will feel better through the Wolff-Chaikoff effect. The Wolff-Chaikoff1-8 effect is used to describe hypothyroidism caused by ingestion of a large amount of iodine. Hyperthyroidism is the term for overactive tissue within the thyroid gland causing an overproduction of thyroid hormones (thyroxine or “T4” and/or triiodothyronine or “T3”).
It is an autoregulatory phenomenon which inhibits formation of thyroid hormones inside of the thyroid follicle. This becomes evident secondary to elevated levels of circulating iodide. Wolff-Chaikoff effect lasts several days (around 10 days), after which it is followed by an “escape phenomenon”, which is described by resumption of normal organification of iodine and normal thyroid peroxidase function. High levels of intracellular iodide are known to suppress the transcription of thyroid peroxidase (TPO) enzyme, along with NADPH oxidase. The suppresion of the enzymes that attach iodide to thyroglobulin causes a reduction in the production of the downstream product, thyroxin (T4).
Wolff-Chaikoff is observed in individuals without an obvious thyroid disorder, and especially in patients with autoimmune thyroiditis or those previously treated for thyroid diseases (Graves’ disease, subacute or pospartum thyroiditis, iatrogenic thyroid dysfunction.)
The hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks if iodine usage is withdrawn, but transient T4 replacement therapy may be required in some patients. The patients who develop transient iodine-induced hypothyroidism must be followed long term thereafter because many will develop permanent primary hypothyroidism. Continued use of iodine supplementation will cause the Jod-Basedow phenomenon to occur.
If you are hypthyroid, iodine usage increases thyroid production of T4. The thyroid gland actively takes up iodine and incorporates iodine into thyroid hormone. This provokes the thyroid into hyperfunction with out any feedback control. Think of it like putting your car in cruise control and never touching the brakes. Long term use of iodine then drives a person into the Jod-Basedow phenomenon AKA Iodine-Induced Thyrotoxicosis.
Jod-Basedow9-19 phenomenon, a thyrotoxic condition caused by exposure to increased amounts of iodine, has historically been reported in regions deficient in iodine. However, when a person is given iodine supplements combined with dietary intake on a continual basis without monitoring, they develop a hyperfunction autoimmune response. It causes an increased activity of TPO antibodies that multiply dramatically with iodine supplements.
IODINE SKIN PATCH TEST
In addition to driving a person first into a Wolff-Chaikoff effect, then into a Jod-Basedow phenomenon and eventually into iodine-induced autoimmune disease. The iodine supplementation or the skin patch test will not in any way show a person what their TPO antibodies are and will be different for each person due to different rates of absorption and elimination.
IT IS TIME FOR A REALITY CHECK!
Knowing we don’t have an optimally functioning body in an imperfect environment, the rules for normal don’t apply. The urinary clearance tests are only as good as their liver is able to detoxify. This makes iodine clearance testing suspect.
The proponents of iodine will quote studies supporting iodine use but start stammering and yammering like they have a swollen tongue (probably due to their iodine deficiency) when asked about the studies reporting autoimmune thyroid caused by iodine. I have to question why iodine proponents discredit testing for thyroid antibodies. I think an autoimmune disease takes precedence over an alleged deficiency. To paraphrase the Lay’s Chip ad, “You can’t have just one autoimmunity.” Wouldn’t you want to know?
The other side is not anti-iodine but pro-proper use. There are cases where a person is found to be Primary Hypothyroid through lab testing, where limited supplementation of iodine is recommended. Hashimoto’s disease is the most common cause of hypothyroidism in the United States. Hashimoto’s disease is an autoimmune disorder in which your immune system inappropriately attacks your thyroid gland, causing damage to your thyroid cells and upsetting the balance of chemical reactions in your body. The inflammation caused by Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, often leads to an underactive thyroid gland (hypothyroidism).
Most people who have Hashimoto’s thyroiditis never actually develop overactive thyroid symptoms. Over time they start to develop the symptoms of low thyroid function and have their TSH measured. Their TSH will usually be found to be high and they are typically diagnosed as primary hypothyroid and placed on thyroid hormone replacement.
The issue of their autoimmune attack is not addressed. Instead, the medical community considers your thyroid condition managed by having a normalized TSH from thyroid hormone replacement. While the alternative and iodine proponents consider it managed by iodine supplementation. At least the medical community is using lab testing.
You decide whether you want someone managing your health were everything is an iodine deficiency or someone who looks for the true underlying cause of your health condition.
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