Episode 85 also covers this topic though in less detail and not as well researched
The biggest need for iodine is for thyroid hormone production. Deficiency would look like hypothyroid symptoms such as fatigue, brain fog/poor memory, hair loss (including eyelashes), puffiness, cold hands/feet etc. The other reason we need it is to prevent fibrocystic breast disease and as an antimicrobial.
RDA for adults is 150 micrograms per day and is based on studies looking at how much the thyroid gland uses and how much is lost in urine.
It is difficult to get enough iodine from foods because the soil content varies but the most reliable sources of foods are:
milk (20 mcg), yogurt(20mcg), cheese (40mcg per 100g of food).
fish and shellfish have anywhere from 20-100 mcg per 100g of food
Mortons iodized salt has 150mcg in 3.3 grams of salt which is just over ½ tsp of salt.
kelp has 3000 micrograms of iodine per gram
The most reliable way to get enough iodine is to include seaweed in your diet. You can eat things like the sea snacks once per week OR you can use a shaker of Main Coast Sea Seasonings which you can sprinkle on your food and use it like a spice/seasoning daily.
Avoid consuming more than 1000 mcg in one day but up to this amount might make you feel great. You do want to be mindful of causing thyroid antibodies to rise. In some individuals when given microgram amounts you do “stoke the fire” and cause an increase in antibody attack on the thyroid gland.
Eating more than 3 servings per day of cruciferous veggies can interfere with your thyroid being able to use iodine.
Avoid drinking city water that is fluoridated and other fluoride products such as toothpaste and mouthwash.
Avoid bromides- brominated flours from store bought baked goods, vegetable oil, mountain dew and other citrus based sodas, gatorades, conventionally grown strawberries (sprayed with methyl bromide).
Iodine patch test is not valid and there is no scientific research to back up the claims.
Dr. Brownstein suggests
taking in enough iodine to provide enough for thyroid hormone to be made.
Take B2 (riboflavin) and B3 (niacin) to stimulate biochemical processes needed to make thyroid hormone.
take anti-oxidants
get enough magnesium
minimize oxidative stress in the body
If you are wondering about your levels, you can do a 24-hour urine iodine test from LabCorp or Quest which will tell you your status for the day of and the day before the test. It only tests your intake and not whether things like fluoride or bromide are preventing the thyroid from taking it in.
In the early 1900’s there was an issue around the states that border the Great Lakes with people suffering with goiter which is an enlarged thyroid. It was thought that giving these people iodine would decrease the incidence of goiter. Around 1923 iodine was given to kids with goiter and over 4 years of supplementation they saw a 75% improvement.
From what I understand about goiter, it appears that the thyroid enlarges itself to capture as much iodine as possible coming through the blood. The thyroid is the major organ in the body using iodine because you need it to make thyroid hormone. It is actually the only mineral that becomes part of thyroid hormone. T4 or thyroxine is thyroid hormone with 4 iodines attached to it. T3 has 3 iodine molecules attached.
What does deficiency look like? Pretty much hypothyroidism. It is detrimental to babies in the womb and in the first year of life if they are deficient as it can decrease IQ and result in cretinism which is stunted mental and physical growth. If you have hypothyroidism due to iodine deficiency you may also have a goiter which might just feel like a lump in the throat.
Interestingly, because iodine is antimicrobial and hypothyroidism can result from lack of iodine and will cause compromised immune system function, either of these things can increase the risk of infection.
The other big problem for people deficient in iodine is fibrocystic breast disease.
The biggest risk factors for iodine deficiency are eating foods grown in soil deficient in iodine. Soil near the ocean usually is not deficient in iodine because it is in the air, evaporates and lands in the soil. The midwest has soil that is deficient in iodine so it is commonly called the ‘goiter belt’. There is no ocean near the midwest and soil erosion from conventional farming practices will increase the deficiency.
The RDA for iodine is 150 micrograms per day. Just like most RDA levels for vitamins and minerals it is set to the minimum- enough to prevent goiter but maybe not enough to prevent other issues. It is unclear whether the amount consumed in iodized salt is enough or even getting absorbed.
It is thought that 150 micrograms is not enough iodine to make the function of your endocrine and immune systems optimal. One study has shown that the levels of iodine in the general population are deficient and iodized salt does not seem to be doing the trick. It is thought that iodine in salt is not as bioavailable as other kinds.
Getting iodine from food is ideal but like I said, soils where foods are grown can be deficient. Eating fish from oceans and shellfish or seaweed is a good source. Not eating iodized salt (it is better than nothing) and eating a lot of processed flour products that have bromide in them will lead to deficiency. Bromide competes with iodine for entry into the cells. Vegan and vegetarian diets are also lower in iodine. In fact, the bromine that is commonly in baked goods from the store is considered a goitrogen - so it promotes a goiter in the thyroid.
It is said the best way to test for iodine deficiency or iodine status is to do an iodine loading test which is said to provide a picture of what is in the whole body. In this test you take 50mg of iodine and then 24 ours later you pee out what your body can’t use or doesn’t need. You can do the test without taking iodine and it will reflect what was in your diet the day before the test. You can do a 24 our urine test through LabCorp or Quest Diagnostics. This test just shows whether you are getting enough but doesn’t show what is getting into the cells so if you have a diet high in bromine then you may be spilling out more iodine than you should be.
Aside from the thyroid, our breast tissue uses iodine and deficiency is thought to play a role in some breast cancer. Iodine rather than iodide (from salt) is better at reversing pre-cancer cells in animal studies. It is also thought to decrease cellular damage from chemical reactions that damage fats called lipoperoxidation.
I’ll dive a bit deeper into the thyroid and the role iodine plays in its function now.
Thyroxine or T4 has 4 atoms of iodine which is why it is called T4. When you have a medication called levothyroxine that means it is hormone replacement of T4 only. Triiodothyronine is T3 which has 3 atoms of iodine attached to it. If you are deficient in iodine, you cannot make thyroid hormone in amounts needed for it to function well.
I mentioned goiter before which is the swelling of your thyroid and is generally a sign your body needs iodine. Deficiency also leads to hypothyroidism not caused by Hashimoto’s. Some experts believe deficiency also causes the autoimmune attack that happens in both Hashi’s and Graves disease as well as thyroid cancer.
What I am understanding is that your thyroid holds around 20 mg of iodine but can hold up to 50mg. There is a transportation system in the body called the sodium iodide symporter that transports iodine into cells in tissues. It is important for your body to have optimal thyroid function because every cell in the body has receptors for thyroid hormone.
Lugols iodine is a very popular form of iodine and in my nutrition certification I was taught that painting a patch of this on your skin and seeing how long it took for it to disappear was an indication of iodine deficiency. I’ve since found out that this test has zero validity and isn’t telling you anything about your cellular iodine status. Lugol’s is named after Jean Lugol, a French doctor who studied iodine and its effects in 1829. He found that adding potassium iodide to water allowed for iodine to become soluble in water and he treated all kinds of infections with this solution. Just 2 drops of his 5% solution provides enough for the body to have sufficient iodine status which is greater than the RDA of 150mcg. The thyroid uses iodide and breast tissue uses iodine so having this combo is ideal.
Dr. Brownstein claims that you can take higher doses of iodine with Hashimoto’s and Grave’s if monitored well. His clinical experience has had him checking every patient he has for autoimmune thyroid conditions which he finds in many of his patients so he believes its prevalence is much higher than the statistics given by various organizations. He says low iodine levels is the reason for increased autoimmunity.
The National Health and Nutrition Examination Survey (NHANES) shows deficiency in iodine is rising. He claims the hypothesis that giving iodine to people induces autoimmune thyroid conditions. If iodine deficiency is more prevalent, why is autoimmunity increasing? The World Health Organization says iodide excretion below 50 micrograms per liter equals a moderate to severe iodide deficiency. A study out of Denmark shows that lower iodine levels are associated with a huge increase in hyperthyroidism in one town compared to lower incidence of hyperthyroidism in a town with higher iodine levels in patients.
Medical schools are teaching that you should not supplement with iodine and that we all get enough from iodized salt. The original treatment for Grave’s disease was iodine in the 1800’s and doctors were having success. Brownstein does say that iodine supplementation can raise TSH but if you have normal T4 and T3 lab results, this doesn’t mean you have made yourself hypothyroid. TSH is expected to fall back to normal ranges after a certain amount of time.
The complete opposite side of this topic is coming from several internet health practitioners that say you should not ever take iodine if you are dealing with autoimmune thyroid issues. One practitioner is adamant that you must not treat one thing in a thyroid patient. For example, you should not be given one single nutrient such as iodine or an herb to see if it makes a difference for the client. You must take a whole body approach. I do agree with this and Dr. Brownstein is not just supplementing his patients with iodine. He does also take a whole body approach.
Dr. Kharrazian firmly believes that it is dangerous to use iodine in thyroid conditions. He believes it is an outdated form of therapy. He says iodine is not caused by an iodine deficiency and that all the things that cause Hashimoto’s in a person are affected in a positive way by iodine supplementation. He says iodine supplementation will flare up someone with Hashimoto’s causing further destruction of the thyroid gland. He also says that doctors prescribing iodine are on the verge of malpractice. So he’s pretty confident in his stance.
Some of the research shows that supplementing with iodine triggers autoimmunity and activation of TPO antibodies. This causes destruction of the thyroid gland. He explains that when iodine is supplemented, it goes to the thyroid gland and the oxidative reactions take place which is normal and which is why we need selenium because it neutralizes the hydrogen peroxide that is formed during this chemical reaction. So you have the oxidation, damage to the thyroid cells, destruction of thyroid peroxidase, and thyroglobulin (the protein used to make T4 and T3). The supplemental iodine causes further damage to the thyroid gland.
He claims through research he has read that iodine supplementation causes TSH to be lower, not higher as Brownstein claims. And Kharrazian is saying iodine will just increase inflammation throughout the body. He says you can have normal labs but antibodies will increase and you won’t even realize it. Dr. Brownstein doesn’t discuss antibody testing in his book.
Kharrazian offers multiple studies in the course I took from him on how iodine supplementation is just bad for the thyroid. One study took 40 patients with high TPO antibodies with normal TSH and no symptoms and gave them 250 micrograms of iodine where 1 tsp of salt provides around the same amount or a little more. They took the iodine for 4 months and after that time period, 6 of the 40 ended up with subclinical hypothyroidism and 1 patient ended up with hypothyroidism. Another study found that iodine supplementation resulted in quicker profression to hypothyroidism. Dr. Brownstein’s argument is that you need to take higher doses in the milligrams and not micrograms but he doesn’t offer much in the way of papers to back that up. Kharrazian offers enough evidence to keep me from trying it on myself because I’m in a good place aside from a little struggle with energy but I honestly think it is a genetic thing in my family because my brother, niece and one of my kids really struggle with energy levels.
So, I leave you informed, maybe confused. I’m going to keep looking for info on this topic and hopefully you have some information that can help you make an informed decision.
If you want to test your iodine status, the best test is a urine test and you can order it from Ulta Labs - the 24 hour urine test for iodine. You have to go to the draw center to get a container and then you just pee in it for a day and bring it in. Kind of gross but at least you can do it at home. Then you can tell if there is a deficiency. You can try the loading test as described earlier too. I’m doing the urine test on my daughter who does have slight elevations in thyroid antibodies to see her iodine status. I’ll keep you updated.