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Iodine supplementation has become all the rage in recent years – iodine has been shown to have beneficial effects for conditions like breast and uterine fibroids, breast cancer, and more. When it comes to iodine supplementation in Hashimoto’s patients, however, you need to be very cautious as you risk worsening your autoimmune thyroid condition when done improperly.Attention Hashimoto’s Patients! Do not take iodine supplements in any form, including iodized table salt, before testing to see if there is an actual iodine deficiency! Improper iodine supplementation will most likely aggravate your symptoms.
I’ve done a fair deal of research on the topic of iodine and auto-immune thyroiditis and there is a lot of controversy surrounding iodine supplementation in Hashimoto’s patients. Some recommend that iodine should be completely eliminated from one’s diet if they have Hashimoto’s, others claim that with proper iodine supplementation their condition has improved.
One thing most everyone agrees on is: if you have Hashimoto’s DO NOT take iodine supplements alone, iodine needs to be taken properly with other supplements such as adequate doses of selenium. Read below to learn more about your options.
Iodine and Hashimoto’s Disease
Iodine stimulates the production and activity of TPO (Thyroid Peroxidase). For most patients with Hashimoto’s, TPO is also the site of the auto-immune attack, where surrounding thyroid tissue is damaged in the process. So every time TPO production is stimulated, the immune system, which mistakenly perceives TPO as a foreign invader, responds more aggressively and boosts up the attack, causing flare-ups and worsening your symptoms.
Almost all thyroid support supplements on the market contain iodine with the reasoning that iodine stimulates the activity of the thyroid peroxidase (TPO) enzyme, which triggers thyroid hormone production. And that’s great for 10% of hypothyroidism patients whose hypothyroidism is caused by iodine deficiency. But for the remaining 90% of hypothyroidism patients who have Hashimoto’s (even if they don’t know it) it’s much more complex than that because increased iodine intake, especially in supplement form, can increase the autoimmune attack on the thyroid. Iodine reduces the activity of an enzyme called thyroid peroxidase (TPO), and TPO is required for proper thyroid hormone production.
It’s estimated that 1 in 12 Americans has some form of autoimmune condition, making it more prevalent than cancer and heart disease. While there are differing expert opinions on what has caused the drastic rise in autoimmune conditions, including genetic predisposition, scientists worldwide agree that the root cause is environmental — a result of our Industrial Age and 21st century lifestyles. Exposure to chemicals, toxins, pesticides, and processed foods has caused our immune cells to become confused and for some of us, to launch an attack on our own bodies.
Effects of Iodine Restriction in Hashimoto’s Patients
There are doctors who strictly prohibit iodine supplementation in their Hashimoto’s patients. According to Dr. Datis Kharrazian, DC, there is compelling evidence for avoiding iodine if you have Hashimoto’s.
The study “The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto’s thyroiditis” seems to confirm that iodine restriction can help alleviate hypothyroidism symptoms in Hashimoto’s patients. In this study subjects with Hashimoto’s were divided into two groups. One group ate a normal diet. The other group was put on a diet that strictly avoided iodine so that they consumed less than 100 mcg per day. Eighty percent of the group who avoided dietary iodine experienced complete remission of their thyroid symptoms.
If you experience frequent/long-lasting flare-ups, try eliminating iodine from your diet completely, and see how you feel. This include iodine-rich foods and iodine supplements. Check if your multi-vitamin and proten shake contain iodine, kelp or spirulina. If you want to reintroduce it, you need to do it after proper selenium supplementation – more on this below. Many patients take nutritional supplements that contain iodine with the hope to improve thyroid function, when in reality it’s actually making them feel worse.
The Pro-Iodine Camp
There are doctors who recommend high doses of iodine for Hashimoto’s patients. One such proponent is Dr. David Brownstein. He says, “When you put someone on iodine, who is iodine deficient, the first thing that happens is they start to detox from bromine and fluoride.” These detox symptoms make people feel ill. Common detox signs are headaches, agitation, palpitations, nervousness, the jitters or irritated thyroid symptoms.
In essence these are good signs as it shows the iodine is working and the body is attempting to cleanse the source of the problem.
Toxic halides like chlorine, fluoride and bromine come from unavoidable sources like shower and bath water, drinking water, toothpaste, bread and even float in the air.”
Dr. Brownstein says, “I suggest starting a teaspoon or two of unrefined salt a day before you start iodine. Selenium is another strong antioxidant for the thyroid gland that can help that detox reaction, vitamin C, a good B complex, and then you can start iodine a couple of weeks later. I see the same with Graves Disease as with Hashimoto’s.”
He also advises against using iodized salt because it is contaminated with many substances like ferrocyanide, chlorine derivatives and aluminum in the form of Sodium Silicoaluminate, an anti-caking agent.
However, some people with Hashimoto’s have increased antibodies when they supplement with iodine. Both Dr. Datis Kharrazian and Dr. Izabella Wentz say they both see increased numbers in Hashimoto’s who supplement.
Dr. Datis Kharrazian states, “I don’t wish to be seen as the anti-iodine thyroid doctor because that is not the truth. I have family members who take iodine with good benefit. I simply believe, based on my research and clinical experience, that iodine is an unnecessary risk when managing Hashimoto’s, especially since we have safer and more effective ways to work with an improperly functioning immune system.
The antibody tests for Hashimoto’s are affordable and easy. If you have Hashimoto’s and you or your doctor insists on iodine supplementation, do yourself a favor and monitor your antibody levels, your TSH, and your thyroid symptoms, and don’t be too quick to pass off negative effects as a detox.”
How to Test for Iodine Deficiency
Before supplementing with iodine, check to see if you are iodine-deficient. However, the blood test for iodine that your doctor might order is not very accurate. The best way to determine iodine status is with a 24-hour urine loading test. This involves taking a large dose of iodine and collecting your urine for 24 hours afterward. If you are iodine deficient, you’ll retain more of the ingested iodine than you should and the level of iodine excreted in the urine will be lower than expected.
Proper Iodine Supplementation in Hashimoto’s patients
If you have Hashimoto’s disease, it’s almost certain that eating iodine-rich foods or taking iodine supplements will cause a flare-up. That is, unless you have sufficient amounts of Selenium in your system before introducing Iodine. Selenium is required for the production, activation and metabolism of thyroid hormone. Selenium is required by the enzyme that converts T4 thyroid hormone into its active form, T3. If you are deficient in selenium you will not be able to manufacture sufficient T3 and you may experience the symptoms of an under-active thyroid gland, such as fatigue, muscle weakness, easy weight gain, depression and scalp hair loss. A selenium deficiency can also contribute to the development of autoimmune thyroid conditions, such as Hashimoto’s disease and Graves’ disease.
Some patients report a significant improvement after taking iodine together with selenium. In my experience it’s better if you apply a multi-prong approach to treating auto-immunity, where you work on healing your immune system simultaneously.
You can decide for yourself if you’d like to try iodine supplemantation, and I’ve outlined the right way to do it below.
This is what to do if you have Hashimoto’s and you’d like to try iodine supplementation:
- Determine if you have Hashimoto’s – this is how to get a correct diagnosis; determine if you’re iodine-deficient and selenium-deficient by having the necessary testing performed by your doctor.
- If diagnosed with Hashimoto’s, eliminate all iodine from your diet, including iodized table salt, and iodine-rich foods such as seaweed, kelp, spirulina, etc.
- Begin taking 200mcg Selenium. You can take selenium in a supplement form or by eating 3-4 Brazil Nuts (note that selenium content in Brazil nuts can vary); Optimize Vitamin D3, B12 and Magnesium levels as well – Hashimoto’s patients are usually deficient. This multi-vitamin is specifically formulated for Hashimoto’s patients.
- Begin taking 2,000 mg vitamin C powder per day
- Two weeks after starting Selenium and Vit C, introduce iodine in a very small dose, preferably in the form of toxin-free sea vegetables like kelp or spirulina. I personally take a tablespoon of spirulina per day, mixed in orange juice. The dose will depend on the brand you choose. Start with the smallest dose possible and increase gradually, while monitoring how you feel. Be cautious – some kelp supplements on the market were found to contain arsenic – read about it here. And some spirulina is contaminated with heavy metals and high levels of radiation. Make sure to select a clean and organic product. Some patients have reported success using Lugol’s 2% Iodine but I have not tried it so cannot comment on it.
There’s also a controversy regarding optimal iodine dosage. Dr. Flechas, specializing in Iodine Therapy for thyroid and breast disorders, insists severe iodine deficiency is rampant and believes the current US daily recommended allowance (RDA) for iodine may be completely insufficient for overall physical health and prevention of diseases such as thyroid disease, fibromyalgia and cancer. It is important to realize that the RDA for iodine is not in milligram doses but in micrograms:
- 150 micrograms (mcg) per day for adult men and women
- 220 mcg for pregnant women
- 290 mcg for lactating/breastfeeding women
Dr. Flechas recommends 12.5 milligrams (mg)/day. As you’ve probably come to find out, there’s no “one fits all” approach when dealing with Hashimoto’s. What works for some patients may not work for others. But by trial and error you can figure out what works best in your case.
As stated above start with small amounts of iodine and increase gradually; it would be also helpful if you repeat your lab tests 10 weeks after starting this protocol to see how your values are.
Other tips to improve your well-being include:
- Eat organic as often as possible. Wash all produce thoroughly to minimize your pesticide exposure. Use GSE (grapefruit seed extract) to was your produce.
- Avoid eating or drinking from (or storing food and water in) plastic containers, especially if you’re refrigerating or freezing them. Use glass and safe ceramic containers.
- Avoid gluten.
- Avoid soda. Drink natural, filtered water instead.
- If you own a hot tub, look into an ozone purification system. Such systems make it possible to keep the water clean with minimal chemical treatments.
- When in a car or a building, open windows as often as possible, preferably on opposing sides of the space for cross ventilation. Utilize fans to circulate the air. Chemical pollutants are in much higher concentrations inside buildings (and cars) than outside.
- The cookware you use is just as important as the food you cook in it. Almost every home has non-stick cookware. But as convenient as these are, much has been said about the safety of cooking in them in recent years. Natural News has a nice article on the subject – “Be Informed – non-stick pans pose danger”, that you can read here.
It’s especially important to avoid non-stick cookware if you’re hypothyroid – non-stick cookware releases fluoride in your food, suppressing your thyroid even further. According to the Environmental Working Group (EWG), every time an empty nonstick coated pan is used on medium to high heat the surface emits a toxic chemical called perfluorooctanoic acid, or PFOA. PFOA has recently been labeled a likely human carcinogen by the US Environmental Protection Agency. You can make your own decision in regards to using non-stick cookware, I personally use stainless steel, glass and ceramic cookware. Cast iron is another great alternative.
- Check if your public water supply is fluoridated – Two-thirds of US public water supply is. Fluoride was used to treat hyperthyroidism (or an overactive thyroid) in the 1950s. It may hinder the gland’s activity by suppressing the activity of various enzymes, causing physical damage or interfering with the absorption and use of iodine. Use a water filter or buy spring water.
Doctors and practitioners who advise Hashimoto’s patients to take iodine supplements may be causing more harm than good by amping up the autoimmune attack on thyroid tissue. In addition, lots of people who have Hashimoto’s don’t know that they have it because no one has tested for it even though they have signs and symptoms. Therefore determining if you have Hashimoto’s is extremely important before taking iodine in any form. Iodine should always be taken with appropriate doses of selenium. It really comes down to a case-by case basis, and testing for iodine deficiency is important before going on supplementation.