Why is iodine deficiency common in the United States?
We first need to note that the body produces no iodine, and there is no organ other than the thyroid that can store large quantities of iodine. In some areas of the US, including mountain regions, the Mississippi River Valley, the Ohio River Valley, and the Great Lakes regions, the soil has always had a very low iodine content. But even in other areas of once iodine-rich soil, over farming has frequently depleted this iodine content. Hence, we no longer get adequate iodine via the plants we consume. To compensate for this, iodine was added to salt, bread, and milk. Today iodine is no longer added to bread or to milk, and the amount of iodine added to salt has steadily declined over the years. All of these factors contribute to the current prevalence of iodine deficiency in the United States.
How does iodine deficiency manifest itself?
Research work has shown that iodine deficiency in the thyroid presents as a thyroid goiter (enlargement of the thyroid). In those areas of the world where iodine deficiency is very high, such as in Switzerland and in certain areas of Asia and Africa, there are also higher incidents of thyroid cancer. Iodine is also concentrated by breast tissue, and a lack of iodine in the breasts manifests as fibrocystic breast disease (painful breasts with nodules and cysts and often more symptomatic prior to menstrual periods). 93% of American women have fibrocystic breast disease and the longer this disease exists, the higher the potential risk for development of breast cancer. 20% of all iodine in the human body is stored in the skin, specifically in the sweat glands. Lack of iodine in the sweat glands manifests as dry skin with a decreased ability to sweat.
Iodine can also be concentrated in the stomach tissue, and the lack of iodine in the stomach manifests as achlorhydria (lack of digestive acid production). Iodine is used by the stomach cells, also known as parietal cells, to concentrate chloride which is necessary to produce hydrochloric acid (digestive acid). With the prolonged presence of achlorhydria, there is a much higher incidence of stomach cancer.
Iodine is concentrated in the lacrymal glands of the eye, and a lack of iodine can cause dry eyes.
Iodine can also be concentrated in the parotid and submandibular glands of the mouth, and iodine deficiency here can result in dry mouth. Iodine can be concentrated in the ovaries, and Russian studies done some years ago showed a relationship between iodine deficiency and the presence of cysts in the ovaries. The greater the iodine deficiency, the more ovarian cysts a woman produces. In its extreme form, this condition is known as polycystic ovarian disease.
Is there enough Iodine in our salt?
When people go shopping for salt they will notice there is iodized salt verses regular salt. This is also true for sea salt that is plain sea salt verses sea salt with iodine. There is more iodine in iodized table salt that there is in plain sea salt, which contains very little iodine to start with. Quite frequently we see articles in the local press showing that there is a high amount of iodine in salt and we need to reduce the total amount of salt because of the potential damage from iodine. However, during the last National Nutritional Survey called the NHANES III from 1988 - 1994, the study revealed that 15% of the U. S. adult female population suffered from iodine insufficiency where this was defined as a urine iodine level 60 mg per liter. Another misconception that is out on the market is that high consumption of iodized salt helps prevent iodine deficiency. The fact is that iodized salt contains 74 mg of iodine per gram of salt. The purpose of iodization of salt was to prevent goiter and cretinism and was never meant for optimal iodine requirements by the human body. An example of this would be the ingestion of iodine in order to control fibrocystic breast disease that is a level of five milligrams of iodine per day. In this particular case one would need to consume 68 grams of salt. In Japan, the Japanese population has an intake of around 13.8 milligrams of iodine per day. Among the population of the Earth, the Japanese have the lowest prevalence and incidence of female reproductive organ cancer in their tissues.
Can I use seaweed purchased from the grocery store to supplement my body with iodine?
Seaweed sold in the United States has a tremendous variation in the amount of iodine content. In Japan, the average Japanese eats around 13.8 mg of iodine per day with the vast majority of that iodine coming from seaweed that has been specifically grown and cultured to maximize iodine trapping in the seaweed. This particular type of seaweed is not generally available in the United States.
What about iodine and aging?
As most of us know, hypertension (high blood pressure) often becomes an issue as we age. Because of this, many are being told that they need to decrease the total amount of salt in their diet. However, we must realize that most people over age 60 are becoming depleted of iodine due to the lack of iodine in the diet and that this particular group of individuals is also the group with the highest occurrence of thyroid nodules and goiters. Also of interest is that 25% of the people in this age category will become senile as a result of low thyroid (hypothyroidism). Iodine supplementation may alleviate these iodine-related maladies, but iodine testing and thyroid studies such as a thyroid ultrasound and thyroid lab tests should be conducted prior to beginning iodine supplementation therapy.
Can Iodine be used while a woman is pregnant?
In Japan, the average Japanese woman is eating 13.8 mg of iodine per day while the average American woman consumes 100 times less iodine per day (approximately 0.138 mg per day). For iodine supplementation, I have been prescribing Iodoral, a product made by the Optimox Corporation. Iodoral contains a 12.5 mg combination of iodine/iodide per tablet. Iodine is very crucial in the first three years of life from the development of the fetus inside the womb until two years after birth. In the development of a child's IQ, I feel that it would be very advantageous for the mother to supplement her diet during pregnancy and, if she is nursing the child, for the first two years after pregnancy.
What happens to thyroid hormone production in the presence of iodine supplementation?
Iodine supplementation should be prescribed only when iodine testing indicates iodine deficiency. Iodine testing kits can be ordered from my office (828 684 3233) by individuals or by medical practitioners. Traditional medical literature indicates that patients who have thyroid nodules or thyroid goiter may have the potential to develop hyperthyroidism when supplementing with iodine. Hence, before commencing iodine supplementation, it would be advantageous for a person to have their primary care doctor order a thyroid ultrasound to rule out the possibility of preexisting goiter or thyroid nodules. The primary care doctor should also order thyroid lab work (to be used as a baseline) before prescribing iodine therapy and this lab work should be repeated and followed at regular intervals during the patient's iodine therapy. For iodine therapy patients not also on thyroid hormone replacement therapy, adjustments to the iodine therapy should be made if signs of hyperthyroidism should occur. Should signs of hyperthyroidism occur in patients who are taking thyroid hormone replacement therapy as well as taking iodine supplementation, the physician should first recommend an adjustment in the thyroid hormone therapy rather than in the iodine supplementation. This adjustment in therapy is recommended because iodine is required not only by the thyroid but is required for the proper functioning of many other tissues. The presence of preexisting thyroid nodules or goiter does not preclude the patient from iodine supplementation therapy. In fact, in the extensive research with iodine therapy done in my office, I have seen many cases of preexisting thyroid nodules and goiter shrink in the presence of iodine therapy.
Does everyone need iodine supplementation?
Iodine supplementation should be prescribed only if indicated by the results of iodine testing. Iodine testing kits may be ordered from my office (828-684-3233) by individuals or by health care professionals. If ordered by an individual, test results will be returned to the individual; if ordered by a health care provider, test results will be returned to the health care provider and to the individual. A cost of $75 per kit covers the cost of the testing kit, testing services, and return postage (charges for additional postage will apply if mailed to location outside the US)
Iodine Research Sources
- Effect of daily ingestion of a tablet containing 5mg Iodine and 7.5mg Iodide as the potassium salt, for a period of 3 months, on the results of thyroid function tests and thyroid volume by ultrasonometry in ten euthyroid Caucasian Women. Guy. E. Abraham M.D., Jorge D. Flechas MD, and John C. Hakala R.Ph., The Original Internist 9: 6-20, 2002.
- Iodine sufficiency of the whole human body Guy. E. Abraham MD, Jorge D. Flechas MD and John C. Hakala R.Ph., The Original Internist 9: 30-41, 2002.
- Effect of daily ingestion of Iodoral Guy. E. Abraham MD, Jorge D. Flechas MD and John C. Hakala R.Ph.
- The Wolff-Chaikoff Effect: Crying Wolf? Guy E. Abraham, MD.
- The safe and effective implementation of orthoiodo supplementation in medical practice. Guy E. Abraham, MD, The Original Internist, Vol. 11, No. 1, March 2004. Pages 17-36.