Iodine: an environmental trigger of thyroiditis.

PubMed link
http://www.ncbi.nlm.nih.gov/pubmed/12849065?dopt=Abstract
>>>Abstract

Like most autoimmune diseases of humans, chronic lymphocytic (Hashimoto's) thyroiditis results from the combination of a genetic predisposition and an environmental trigger. A body of clinical and epidemiologic evidence points to excessive ingestion of iodine as an environmental agent. In genetically determined thyroiditis in animals, iodine enrichment has been shown to increase the incidence and severity of disease.<<<

Food manufactures may or may not use iodized salt, the problem is they are not required to tell us. Look at any label and you will see sodium, never iodine. It's a hidden peril for those of us sensitive to iodine. We need just enough, and not too much.

I am a long term Graves' disease patient in a long remission after years of medication and diet modifications. Most peoples bodies store iodine and use it as needed. So fish on Friday and they're good for the week. Keep in mind all foods we eat have varying iodine levels, partly determined by where it is grown ( the iodine content of the soil) and partly by the ability of the individual plant to uptake iodine. Asparagus in the champ in this regard. Iodine content of animals, poultry, and dairy products vary by the diet of the animal and how the product is processed.

As a Graves' patient my body does not store iodine well. If I am accidentally fed a product with hidden iodine my body seems to utilize it right away.... Flushing and heart palpitations . Uncomfortable, but a much bigger problem for those with an iodine allergy, though they tend to need larger amounts to react.

Graves' and Hashimoto's ( hypo thyroid) are autoimmune diseases. Higher the needed iodine intake increases the antibodies and can worsen the condition. Lots of studies over at PubMed to confirm this.

In my experience I can not trust any manufactures to be consistent in the type of salt they use. A product may not cause problems for years.. then a batch appears with hidden iodized salt, then later the same product is safe for me again.

Obviously home cooking only is my answer, but if they were required by law to properly control the type of salt used, and to have accurate labels...we wouldn't be flying blind here. And I would be able to purchase a few of their products once in awhile.

I don't expect this to happen to protect a minatory of people,due to their initial costs , but maybe if the average consumer became more aware of the importance of iodine they could be made to comply with what I view as a basic right to know.

Given the health problems suffered due to lack of such information being available, I'll never understand why at the very least our health care professionals don't seem to care. They certainly have the organizations and money to back up such a request to the FDA.

Pam

Next.. from a site regarding sodium and high blood pressure, I see more fun facts. Remember.. sodium and iodine are separate things.


Salt, hypertension and salt toxicity,

http://docs.google.com/viewer?a=v&q=cache:asZmBhD2UwEJ:foodandhealth.com/cpecourses/salt.pdf+Hypertension+and+Salt+Toxicity+available+free+at+foodandhealth.com&hl=en&gl=us&pid=bl&srcid=ADGEEShGofy9HHAfdyADC04REsxgCXX6aaGbzgMLuGfdy_617mThUDa9kY2mvF9wDeuVX5IO7peakqCSdnCQZVp6AeVcMzU7CeUotmlaRxYJlA_ASlLQ9Kzj4nSoPjekOyvZ_PcINOJE&sig=AHIEtbRayBDAHKwM_3B6afJrFPMBBHv8Og

this is a google doc..look at the first pictures ! They show that 75% of Americans salt intake is from processed foods. Notice the next picture.. Americans compared to the rest of the world.

Easy enough to see that as far as what we eat, just focusing on whole foods and skipping the kelp and seafood is going to give us a more than manageable way to use a lower dose of our ATD and reach and maintain remission. This is not a restrictive diet.

This site will not allow my long link above.
Just Google
Salt, hypertension and salt toxicity,
and it should show up.

If you followed the link in the last posting, regarding the large amount of sodium in a typical American diet, this next entry will help to show why.

Book: "Hungry Planet: What the World Eats",
http://www.everybodygoto.com/what-people-eat-around-the-world

photographer Peter Menzel and writer Faith D'Aluisio.
Easiest viewing of photos here at a personal blog. Permission has been granted by authors to blog owner.

Back-up source :
Time magazine part one
http://www.time.com/time/photogallery/0,29307,1626519_1373664,00.html

andTime magazine part two
http://www.time.com/time/photogallery/0,29307,1645016,00.html

Many, many ads on the Time magazine links

As you have seen a higher iodine diet contributes to both hyperthyroidism and hypothyroidism.

As a Graves' patient in long term remission , I wish to stress highly how important becoming familiar with where the iodine is, will help new patients proceed through this journey with fewer problems. It just makes things easier, and if I had known, would have saved me a lot of grief in the early times.

For those considering ATDs, check out this article by Elaine Moore.
http://www.elaine-moore.com/MyArticles/GravesDisease/AntithyroidDrugs/tabid/137/Default.aspx

Quote from her article:
***According to a number of studies, the high iodine diet of individuals in the United States also accounts for the lower remission rate seen here. Iodine is a known trigger for autoimmune thyroid disease. Furthermore, ATDs work by inhibiting iodine absorption in the gut. With a high iodine diet, higher doses of ATDs are needed. And the higher the dose, the greater incidence of side effects, including rashes, hives, agranulocytosis (abnormal decrease in segmented neutrophilic white blood cells) and liver disease.***

But never fear.. we do not live a life of being deprived at all. It's simply about making educated choices. Here's a nice article of Elaine's on a healthy Graves' diet.
http://www.elaine-moore.com/MyArticles/AlternativeandComplementaryMedicine/DietinAutoimmuneDisease/tabid/202/Default.aspx

See ? Yummy stuff. :)

One graphic shown on the Google Doc I pasted in post #3, that you would need to do an independent search for.. show where we consume our daily sodium. Seventy five percent is in processed foods and meals away from home. Twelve and a half percent from the salt shaker, and the final twelve and a half percent is naturally found in foods.

Everything you ever wanted to know about salt here at The Salt Institute.
http://www.saltinstitute.org/

They even have a map of the North America showing where our naturally occurring salt is here:
http://www.saltinstitute.org/Production-industry/Production-locations

My personal favorite salt is the brand Real Salt.
http://www.realsalt.com/101/
They have some interesting information about salt included on their site.

Any natural sea salt is great. Natural sea salt will have a bit of color to it, and no anti-caking agents..

What are common sources of iodine in the U.S. diet?

http://www.hotthyroidology.com/editorial_176.html
This is not a list of what not to eat, but it's a good start to find where the iodine is, and perhaps have smaller portions, while increasing foods lower in iodine. We need adequate iodine, just not too much.

In searching for the elusive Boston study showing various brands of bread contain variations in iodine content to widely alter up-take scan results, I found this older British paper discussing , older reports showing the same type of thing.


It's a PDF file, so I think the best way to get around the software on this site is to have you Google:

Sachs BA, Siegel E, Horwitt BN 1972 Bread iodine content and thyroid radioiodine uptake: a tale of two cities. Br Med J 1:79-81.

It's an interesting discussion of how various factors can alter up-take scan results. Fortunately we have accurate antibody tests now, so the up-take scan is outdated, but you can see why they had trouble and errors were made.


The one I'm looking for from Boston was done in about 2002, if you happen to run across it.

Interesting look at iodine deficiency and sufficiency internationally..(and the cows)

International Counsel for Control of Iodine Deficiency Disorders

Newsletter , PDF file
http://www.iccidd.org/media/IDD%20Newsletter/1991-2006/v22n2_0506.pdf.

A short list of places high iodine might be hidden.

SEAWEED - #1 on the list - this includes kelp pills and soups with seaweed.

Iodized table salt (Morton's etc)

Dairy. All dairy, esp yogurt.. depends on the dairy. Popular yogurts are not cultured but thickened with seaweed based thickeners. Find a cultured product like Nancy's yogurt, and experiment. http://www.nancysyogurt.com/

Seafood, shellfish and mollusks

Red Dye #3

Betadine (iodine topical wound treatment)

Carageenan - food thickener made form seaweed (found in nearly all ice creams,
some salad dressings, sauces, some candies and soups, veggie meats - usually
found in creamy stuff - read labels)

Veggies and fruits grown in seaweed-enriched soil

Meats and byproducts from animals fed seaweed-enriched feeds

This is not a list of "forbidden" foods, just some more ideas to help find your sources.

The role of iodine in autoimmune thyroiditis.

http://www.ncbi.nlm.nih.gov/pubmed/9419438

If you are hyper, you obviously have enough iodine,since you are producing thyroid hormone.

If you are hypo, and the cause is low iodine, adding back iodine to the daily recommended amount, will help.
You should only take iodine if a lab test shows a deficiency. The skin patch test is a scam.

> As an example, here is an old abstract talking about thyroglobulin binding with iodine in Hashi's vs. controls.
>
> <http://www.ncbi.nlm.nih.gov/pubmed/6895564>
>
> Then there is the fact that Hashis cycles. Iodine just might give a temporary improvement, but then you are back to an attack.
>
> Here is another very old abstract that does indeed indicate that Hashi's patients have a defect in iodine metabolism. It doesn't bind to thyroglobulin as efficiently as it ought.
> <http://jcem.endojournals.org/cgi/content/abstract/21/7/806>
>
> So an argument can be made that Hashi's may need more iodine than other people, but then you are back to hormone production= attack on the thyroid.
>
> Here is yet another study that shows a connection between excess iodine intake and hypothyroidism. Other studies specifically show a connection to the development of Hashis.
>
> <http://www.eje.org/cgi/content/abstract/159/3/293>
>

<http://www.sciencedirect.com/science/article/pii/S1568997201000167>
"Like most autoimmune diseases of humans, chronic lymphocytic (Hashimoto's) thyroiditis results from the combination of a genetic predisposition and an environmental trigger. A body of clinical and epidemiologic evidence points to excessive ingestion of iodine as an environmental agent. In genetically determined thyroiditis in animals, iodine enrichment has been shown to increase the incidence and severity of disease. Its mechanism of action is still uncertain."

<http://74.125.155.132/scholar?q=cache:mgGpNyJeyLQJ:scholar.google.com/+iodine+hashimoto%27s&hl=en&as_sdt=1,44&as_ylo=2008>
"In conclusion, the excessive nutritional iodine intake (from 1998 to 2004) may be considered an environmental factor conducive to a high prevalence of both Hashimoto's thyroiditis and iodine-induced hyperthyroidism, as recently received by Papanastasiou and cols. (10)."

<http://www.bprcem.com/article/S1521-690X(09)00102-X/abstract>
".More recent studies suggest that chronic high iodine intake furthers classical thyroid autoimmunity (hypothyroidism and thyroiditis) and that iodine-induced hyperthyroidism may also have an autoimmune pathogenesis."

<http://www.bprcem.com/article/S1521-690X(09)00100-6/abstract>
"On the other hand, epidemiological studies have shown that hypothyroidism is more prevalent in populations with a high iodine intake. Probably, this is also a complication to thyroid adaptation to iodine intake. Many thyroid processes are inhibited when iodine intake becomes high, and the frequency of apoptosis of follicular cells becomes higher. Abnormal inhibition of thyroid function by high levels of iodine is especially common in people affected by thyroid autoimmunity (Hashimoto's thyroiditis)."

<http://thailand.digitaljournals.org/index.php/SMJ/article/view/3633>
"When the diet of humans is greatly deficient in iodine , goiter almost in variably ensues, sometimes accompanied by hypothyroidism. More surprising is that exposure to excess iodine sometimes leads to the development of thyroid disease. These abnormal responses are based on the intrathyroid pathways of iodine metabolism . The manifestations may be iodine-induced hypothyroidism and hyperthyroidism. These disorders are not rare and should be considered because many forms of diet and medications are iodine-containing compounds."

http://jcem.endojournals.org/content/76/2/466.abstract
"This disease can be diagnosed from laboratory tests, but thyroid biopsy is also a useful tool to differentiate this condition from other diseases causing hypothyroidism. Not only clinicians, but also pathologists, must pay attention to this type of hypothyroidism, because thyroid function may revert to normal by iodine restriction alone."

The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto's thyroiditis.

http://www.ncbi.nlm.nih.gov/pubmed/12728462

Quote:
In conclusion, 78.3% of patients with hypothyroidism due to Hashimoto's thyroiditis regained an euthyroid state iodine restriction alone. Both a low initial serum TSH and a high initial urinary iodine concentration can be predictable factors for a recovery from hypothyroidism due to Hashimoto's thyroiditis after restricting their iodine intake

Wolff-Chaikoff effect (high iodine intake suppresses thyroid ). This was used before they had other treatments. The problem is this does not help Graves' antibodies, but can cause an increase ( see links above). This suppression can last weeks, months or more..but eventually the thyroid will "escape" putting the patient in a dangerous position.

Unfortunately some non-medical licensed providers prescribe this, not understanding our autoimmune disease, only thinking it is simple thyroid. Not so !. The problem here is they are not allowed to write prescriptions. Don't be fooled.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268376/figure/F1/

http://en.wikipedia.org/wiki/Wolff%E2%80%93Chaikoff_effect

This Wolff-Chaikoff effect is very useful when preparing a patient for thyroid surgery or if one is hospitalized in ICU with a thyroid storm.