The Effects of Iodine on Hashimoto’s

Introduction

Thyroid disease is in epidemic proportions with an estimated 200 million people worldwide suffering from thyroid disease with approximately 0.3-1.5 in 1000 people per year being diagnosed with Hashimoto’s Thyroiditis (HT). (Lee, Hashimoto Thyroiditis - Epidemiology, 2013)

Hashimoto’s Disease was first identified by Hakaru Hashimoto in 1912 and is a TH1 mediated, i.e. tissue-specific, Autoimmune Disease that attacks the thyroid tissues. (Syrenicz, 2013) HT is thought to be the cause of 90% of sufferers of hypothyroidism, the condition in which the thyroid slows down, slowing down all the metabolic processes in the body, including the rate at which our heart beats.

The thyroid is responsible for the rate at which many processes in our body take place. It has a direct effect on the speed of our metabolism, how well we metabolise glucose, protein and fats plus the ability of our heart and lungs to function optimally. (Morse, 2004) This list is not exhaustive but shows the major effect that the thyroid has on the everyday function of our body and why there are so many signs and symptoms attached to the under or over-functioning organ. In a hyperthyroid state, the thyroid is over-functioning and can be dangerous as it speeds up the heart rate. Hyperthyroidism is not left out of control for very long due to the dangers involved and often the thyroid is removed in this case. Hypothyroidism is less dangerous in the short term, however over many years if it is not well managed then it can lead to cardiovascular disease, heart attacks, strokes, and high cholesterol and if it is HT then the patient is at risk of other auto-immune diseases such as celiac disease, Rheumatoid Arthritis and Lupus.

The Nutrient Pathway for Healthy Thyroid Function

The nutrients required for the optimal functioning of the thyroid are iodine, Tyrosine, Selenium, zinc, Vitamin D, B Vitamins and Vitamin C predominantly. Although hypothyroidism is most commonly caused by a lack of iodine, the incidence of HT in demographics of appropriate iodine consumption is still the most common cause of hypothyroidism, which points to iodine deficiency not being a factor in the Autoimmune Disease. (Lee, Hashimoto's Thyroiditis, 2013)

Signs and Symptoms of Hashimoto’s Thyroiditis

The estimated number of signs and symptoms for HT run into the hundreds and are often general every day symptoms that both sufferers and the medical profession may not automatically attribute to thyroid disease. These include symptoms such as fatigue, hormonal issues including infertility and endometriosis, depression, outer 1/3 of eyebrows not growing, irritability, circulatory problems, poor memory, hair loss, early grey hair, dry skin, low blood pressure, generalised joint and muscle pain and constipation. It is due the generality of these symptoms that thyroid disease is not always suspected in the beginning with these patients. (Starr, 2011)

Significance of Reversing Hashimoto’s Thyroiditis

Health systems all over the world are struggling to keep up with the growing incidence of death and disease. Due to the enormous numbers of people suffering from HT and the risk factors associated with it, a large proportion of the patients putting a burden on the healthcare systems are linked to thyroid disease. Reversing HT would improve the outcomes and in turn take the burden off health sectors such as fertility, Oncology, dermatology, mental health, cardiology, neurology, immunology, Rheumatology, Orthapedics, Paediatrics, and endocrinology. A significant number of healthcare specialties that would have the numbers of patients reduced if HT was reversed.

Finding a cure for HT is vital if we are to stop the incidence of this disease rising. Allopathic medicine does not believe this condition or any autoimmune condition is curable or reversible and that patients suffering with it, will do so for life. (Sinkler, 2013)

The effect of Iodine on the Body

Iodine is a rare element, relative to the abundance of other trace elements on the planet, that is found primarily in the ocean and some sea creatures and sea vegetables. Iodine can be radioactive and non-radioactive and both are useful for different areas. Prolonged deficiency of iodine shows as a goitre. Iodine is the only trace element that exhibits any form of obvious deficiency symptom. (Venturi, 2003)

Iodine has a role to play in every cell and every hormone in the human body. It is one of our first lines of defence in the immune system due to its antibacterial, antiviral, anti-cancer and antiparasitic properties. Iodine also helps to elevate the pH level of the body and to remove excess mucous. Conditions currently treated with Iodine include Thyroid Disorders, Liver Disease, Prostate Disorders, Fibrocystic Breasts, Hypertension, Nephrotic Syndrome, Ovarian Disease, Atherosclerosis and ADD/ADHD. (Brownstein, 2009)

Many tissues in the human body possess a sodium/iodine symporter or pump such as the thyroid, breasts, stomach lining, salivary glands, ovaries, thymus gland, immune system, skin, choroid plexus, joints, arteries and bone. This pump allows for a steady uptake of iodine in all of these necessary tissues. Many diseases in these tissues are alleviated by improving the uptake of iodine. (Miller, 2011)

Adequate iodine is essential to blocking fluoride, Chloride & Bromide from entering the cells. Flouride cells are mutagenic allowing the growth of cancer cells and also cumulative in the body over time. Flouride affects the thyroid by slowing the process of iodine attaching to tyrosine. The thyroid stimulating hormone (TSH) output is inhibited by fluoride. Fluoride competes with the TSH receptors on the thyroid gland, reducing the amount of hormone getting to the thyroid and in turn producing more. (Durrant-Peatfield, 2011)

Iodine and Hashimoto’s Thyroiditis

Most allopathic practitioners advise against Iodine use with HT arguing that it will cause flare-ups of the condition. This is verified by the higher incidence of HT in populations with higher intake of iodine. In other studies, allopathic Doctors have had success with high dosing of iodine in HT. This could be due to the ability of the thyroid to swing between Hyperthyroidism and Hypothyroidism in the case of Hashimoto’s Disease.

In some cases, it is theorised that not just lack of iodine, but excess iodine can also cause Auto-immune induced thyroiditis. A study completed on 102 Peace Corps workers in West Africa concluded that excess iodine, (which was in their water as a purifier) indeed caused an autoimmune reaction and in doing so raised the TSH levels of the volunteers and causing goitre’s in many of them. (Pearce, et al., 2013) There are a few issues with this study however. One is the method in which the testing was conducted. As there was no access to ultrasounds, all testing was done via manual manipulation and palpation of the thyroid to decide on the presence of a goitre. In 5 of these cases, different opinions were reached by different case takers, leaving the results in question With regard to testing, no long term follow up was conducted as opposed to the testing soon after they arrived back in their country of origin. It is possible that even if their levels had normalised once home and the excess iodine removed, that long term could find many of them with autoimmune thyroiditis anyway due to genetically.

Another issue with this study is the lack of thorough questioning of the volunteers to ascertain both their family history and past health status which may have predisposed them to developing an Autoimmune thyroid condition anyway and also the lack of questioning around other changes to their diet besides the iodine filtered drinking water. It is possible that the new environment they found themselves in was higher in toxic heavy metals, or the new foods they were consuming were high in goitrogens and gluten. So while this study does show a possible link between high doses of iodine and the onset of autoimmune thyroid disease, it cannot be used as definitive proof.

That said, it was demonstrated in one study from China that excess Iodine could only bring about an autoimmune reaction if Selenium was deficient in the subject. A worsening of symptoms was also evident when there was a high level of selenium but insufficient iodine. It went on to show that in animal subjects as long as the selenium was at correct levels then the thyroid would remain healthy and goitre non-existent. (Iwakura, 2011)

Another possible explanation for the variances of high iodine causing HT could be the level of toxic metals such as mercury contained in seaweeds that are unknowingly ingested in high amounts for the benefit of thyroid health. (Wilson, 2013) Information is readily available as to the dangers of ingesting too much fish due to the mercury content, however seaweed is still seen as a superfood with no thought to the evidence that it too contains an extremely high level of mercury. Mercury binds to thyroid cells and can inhibit the uptake of minerals needed by the thyroid for correct functioning. Mercury can also inhibit the conversion of T4 to T3. (Osansky, 2012)

Iodine in our Daily Diet

The Recommended Daily Allowance (RDA) of Iodine in Adults is 150ug. Just 1 teaspoon of iodised salt yields 266% of our RDA and 100g fish gives almost 100% of our daily diet (See Appendix A). Much of the populations’ iodine intake is added to processed foods such as iodised salt and fortified breads and cereals. Iodine deficiency disorders, along with iodine-induced disorders, occur all over the world (See Appendix B) with very few countries exhibiting an optimal level of iodine in its population. (Byrd-Bredbenner, Moe, Beshgetoor, & Berning, 2009)

Current Trends

Allopathic Treatment of Hashimoto’s Thyroiditis

Most thyroid patients are not tested for auto-immune thyroiditis as allopathic treatment is the same regardless of the cause. The use of replacement hormone is the first line of treatment and the thyroid function will be monitored via blood tests to ascertain the amount of hormone replacement required. The blood tests most routinely ordered are TSH, Free T3 and Free T4. Once the appropriate amount of hormone replacement is reached and has stabilised for the individual, then usually yearly blood tests are routine, to keep the blood levels in the accepted range.

Many patients however report that all though blood tests are in the accepted range many of their symptoms are still present such as the weight gain & difficulty in losing it, fatigue, dry skin and hair and foggy brain. So all that is being managed in these cases is the Thyroid Stimulating Hormone. The most recent test available is the Reverse T3 and it is understood that this acts like a brake on thyroid function. When all the tests come back normal but progress is not made with symptoms, finding an allopathic doctor that will have your Reverse T3 and antibodies tested would be of value to the patient.

Natural Treatment of Hashimoto’s Thyroiditis

In natural medicine circles, HT is treated with a multi-pronged approach working with the understanding that HT is experienced differently by all sufferers. Treatment will most likely start with increasing nutrient levels (particularly those in which are required by the thyroid feedback loop) such as zinc, selenium, iodine, B Vitamins, Vitamin C and Vitamin D. The natural practitioner in this case though will also look at modulating the immune system, with various herbs such as Astragalus, healing leaky gut if present, addressing adrenal fatigue if relevant and looking at sugar levels.

Diet plays a major role in treating HT from the natural perspective. Gluten is always removed due to its chemical similarity to the thyroid, which then causes the body to wage an autoimmune attack on the thyroid each time gluten is consumed. Dairy and Soy is often removed as well due to their inflammatory effect on the body. All thyroid diseases are inflammatory diseases so the removal of inflammatory foods is a priority.

Goitrogens are also removed from the diet in most cases. Goitrogens are foods that in large amounts can cause goitre due to their ability of being able to block iodine in the thyroid. Some practitioners advise that their patients can cook these vegetables which include Broccoli, Cabbage, Cauliflower, Turnip, Brussel Sprouts, kale, cassava, linseeds, soy, millet and sweet potato to remove the goitrogenic properties although this is still a topic of debate and some practitioners advise their patients to avoid them altogether. (Zimmermann MD & Eastman MD, 2014)

Implementation

Implementation in Clinical Practice

Using Iodine as a supplement in the treatment of HT has merit. When a client presents with diagnosed HT and is shown to be Iodine deficient by way of a iodine loading test or skin patch test, iodine supplementation alongside selenium supplementation is appropriate. A Hair Mineral Analysis Test would also be appropriate to first ascertain the levels of selenium.

Iodine Loading Test

Urinary testing is the most accurate form available for iodine in the body. Urine is collected over 24 hours and the iodine content measured. The body excretes 90% of ingested iodine so the more that is excreted from the body, the more the initial intake of iodine. The amount of Iodine is measured by ug/L of urine.

Iodine Skin Patch Test

A less time-consuming or inconvenient way of testing iodine levels in the body is through a skin patch test using liquid potassium Iodide. The skin is painted with the iodide to about the size of a 50c piece. The skin is then monitored on an hourly basis until the iodide is no longer evident on the skin. If the Iodide lasts longer than 8 hours then iodine levels are appropriate in the body. If the Iodide wears off in less than 4 hours then severe deficiency is evident and supplementation is required.

Basal Temperature Testing

According to Dr Brodha Barnes who dedicated his life to the study of thyroid disease, Basal Temperature Testing is the only truly accurate way of assessing thyroid function as it measures how much energy in generated by the cells (evident in the heat level of the body) as opposed to the blood tests that only measure the pituitary hormone levels (Thyroid Stimulating Hormone) and T3 (Liothyronine) hormone levels in the blood. A healthy functioning adult with a healthy thyroid will exhibit a temperature of 36.6°c and 36.8°c. The best time to check this is both first thing in the morning before getting out of bed and then again at mid-afternoon under the arm for a minimum of 5 consecutive days to get an accurate reading.

Conclusion

Iodine is useful in the treatment of HT when the patient has low iodine levels confirmed by skin patch testing or iodine loading tests. In Australia, our soils have a mild Iodine deficiency (See Appendix B), so it would be a standard part of any consultation with Hashimoto’s Thyroiditis or any thyroid disease to check iodine status before beginning treatment of any kind. It seems appropriate however that in this case, optimum doses of Selenium must be given along side of the iodine to counter any adverse affects such as goitre. Continuous testing of selenium and iodine levels would be necessary for continued success.

The iodine and selenium should be used in conjunction with appropriate dietary guidelines for Hashimoto’s Thyroiditis along with the individual clients needs in mind. It is evident that all cases need to be reviewed individually and understood that not one treatment process is a failsafe in all patients with Hashimoto’s Thyroiditis.

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APPENDIX A

IODINE CONTENT OF FOOD

Disclaimer: The information provided in this article is for educational purposes only and is not intended to diagnose, treat, or cure any medical condition. Always consult with a qualified healthcare professional before making any changes to your diet, lifestyle, or treatment plan. Individual needs may vary, and what works for one person may not be suitable for another.