Iodine deficiency is REAL

21. August 2009 William Davis (30)
Like many health-conscious people, Kurt avoids salt. In fact, he has assiduously avoided salt ever since his heart attack back in 1995.

Lately, Kurt had become tired, often for little or no reason. His thyroid panel:

TSH 4.2 mIU/L (0.27-4.20)
Free T3 1.74 pg/ml (2.50-4.30)
Free T4 1.05 ng/dl (0.9-1.7)

Kurt's TSH of 4.2 mIU/L is sufficient to increase LDL cholesterol by 20-30% and increase the (relative) risk for heart attack 3-fold.

Kurt's thyroid was also palpably enlarged. While it was just barely visible--just a minor bulge in the neck (in the shape of a bowtie), it could be clearly felt when I examined him.

I asked Kurt to add 500 mcg of iodine every day. Three months later, another thyroid panel showed:

TSH 0.14 mIU/L (0.27-4.20)
Free T3 2.50 pg/ml (2.50-4.30)
Free T4 1.1 ng/dl (0.9-1.7)

Kurt's thyroid function normalized to nearly ideal levels just with iodine replacement. (The free T3, while improved, remains low; an issue for another day!)

I see this response with some frequency: low-grade goiter and apparent hypothyroidism (low thyroid function) that responds, at least partially, to iodine replacement. In Kurt's case, iodine replacement alone normalized his thyroid measures completely.

With improved thyroid measures, Kurt also felt better with renewed energy and a 22 mg/dl reduction in LDL cholesterol.

Make no mistake: Iodine deficiency is real. While most of my colleagues have dismissed iodine deficiency as a relic of the early 20th century and third world countries, you can also find it in your neighborhood.
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Comments (30) -

  • Sabio Lantz

    8/21/2009 11:01:05 AM |

    What source do you recommend for iodine and what maintainance dose?

    I started my paleo diet/lifestyle on Jan 5, 2009 and got labs done TSH: 2.790 (0.270-4.200) Someone commented that I may need Free T3 & T4 for further eval.  I would like to try inc. my iodine since I don't use salt.

    Thank you  (my full labs are here -- I am also looking into the cholesterol)

  • Jenny

    8/21/2009 11:11:36 AM |

    Dr Davis,

    I was supplementing with kelp until I read about the arsenic levels found in kelp supplements. Arsenic is a known contributor to diabetes.

    I contacted the supplement company and they gave me a run around about the arsenic level. They wouldn't deny it but tried to make it sound like it wasn't anything to worry about.

    I wasn't at all happy about this, especially since so many supplements are contaminated with a lot of other substances since they aren't regulated.

    Is there any way to get iodine that doesn't expose us to unnecessary amounts of arsenic?

  • Dr. William Davis

    8/21/2009 11:57:30 AM |

    Hi, Jenny--

    There are many iodine supplements, such as potassium iodide drops, available widely in health food stores.

    Alternatively, of course, you could make a habit of eating kombu or wakame, rich seaweed sources of iodine widely consumed in Japan and available in Oriental food stores or even Whole Foods.

  • steve

    8/21/2009 3:04:48 PM |

    would be very interested in hearing your thoughts on Free T3 measurement.  Many doctors will measure Free t4, and only total free T3 saying there is not much difference between Free T3 and total T3 measurements.  Small protein binding or something to that effect.  Thanks.

  • Nameless

    8/21/2009 4:38:46 PM |

    Would the RDA levels of iodine in multivitamins be enough to defend against a deficiency?

    Are there absorption issues from this form?

  • Ross

    8/21/2009 9:49:06 PM |

    I bought some technical grade potassium iodide, some 99.9% metallic iodine and a dropper bottle and made some 50% strength Lugol's iodine.  The recipe is: 2.5g iodine, 5g potassium iodine, add water to total weight of 100g.  I found the full strength solution wasn't dissolving so went for half strength, which still took about a day to finish dissolving.

    This makes for about 3.25mg effective iodine per drop (which is quite a bit).  I add one drop of 50% Lugol's to the milk I use to take my vitamins at breakfast.  After three months of that, my dropper bottle is barely lower, but my thyroid panel is notably healthier (was at the bottom edge of "normal" T3/T4).

    Also, this stuff is CHEAP!  The $30 worth of iodine/potassium iodide that I bought (100g I2, 200g KI) will make about 4 liters of 50% Lugol's (~80,000 drops).  I've got enough to give myself and my wife a drop a day for the rest of our lives, and have enough left over to make a few dozen 10-day anti-radiation KI courses (130mg/day or 1.3g/course).

    I2 is picky about the container (teflon or glass with an airtight seal) but dry KI just needs to be kept dry and cool in a small tupperware container and it's shelf life is "indefinite".

  • Dr. William Davis

    8/21/2009 11:45:48 PM |

    Steve--

    Free T3 deficiency will, I believe, prove to be among the most important factors acting as a coronary risk factor.

    Plenty more on this issue to come in future.

  • ChloeJ

    8/22/2009 4:40:51 AM |

    Taking your ideas to heart about iodine deficiency, I thought I would try seaweed snacks (now I wish I remember where I read about them) and ordered from Amazon based on reviews...Long story short:  Love them.

    So much I love them, I just signed up for the 5 box (24 in a box)monthly automatic delivery (2 of the boxes go to my household assistant who has a number of foreign exchange students over the years as part of the church ministry she belongs to, and one student from Korea introducted her to these dried, salted seaweed called nori or kim).  We did a taste test by buying from a local asian/Korean grocery and I was dismayed to find all 5 kinds we bought had corn oil listed as an ingredient, so we are sticking with the Amazon delivery as it is nori, sesame oil, and sea salt. Low carb, low calorie, I think low sodium (60 mg) for whatever floats your diet boat.  

    Still I will look into Lugol's or pharmaceutical grade potassium iodine.  One concern:  An upper limit to iodine intake?  I have not seen any data. Thanks.

  • JD

    8/22/2009 12:17:21 PM |

    Off topic but wonder if you have seen this study?

    http://www.sciencedaily.com/releases/2009/08/090820124038.htm

    Type 1 Diabetes Linked To Immune Response To Wheat

  • Dr. William Davis

    8/22/2009 3:54:04 PM |

    The upper range of dosing for iodine is a hotly-contested question.

    For example, take a look at what Dr. David Brownstein (put his name in Google) says. He uses doses of 50 mg (50,000 mcg) or more.

  • TedHutchinson

    8/22/2009 4:24:03 PM |

    Organic versus Inorganic Arsenic in Herbal Kelp Supplements
    Although the report has several methodologic shortcomings, the most serious flaw is the authors’ failure to recognize that the arsenic most commonly found in seaweed and seafood products is relatively nontoxic.
    This is in contrast to inorganic arsenic, which has well-documented acute and chronic toxicity.
    Amster et al. (2007) did not discuss the possibility that the arsenic measured in the kelp supplement was in the organic form, nor did they address the great variability in toxicity among arsenic compounds.
    These two oversights lead to the unsupported conclusion that the arsenic found in kelp is responsible for the unique set of medical conditions observed in their patient.

    The full text is online and it is worth reading.

  • TedHutchinson

    8/22/2009 4:51:49 PM |

    Sorry I meant to add
    this is the form of kelp I use $3.76 and code WAB666 would save you $5 if you ordered something else as well.
    How about being really extravagant and ordering a years 360 X 5000iu Vitamin D3 olive-oil based gelcaps for $14.98
    2 years supply of iodine + 1yrs vitamin d3 for less than $20.
    UK readers may be interested to know the cheapo German supermarket Lidl does iodised salt for 15p pack, it's probably worth decanting it into a airtight container as kitchens can be humid and iodine in salt will not be stable over time so Salt Pigs are possibly not the best way to retain the iodine in iodised salt.

  • Nameless

    8/22/2009 6:13:17 PM |

    I'm going to ask my doctor for a script for an iodine test next time I see him. I think a 24 hour, urine test is the only way to measure it properly. Serum isn't so accurate, if I remember right, although it certainly would be less of a hassle.

    Anyone know what is the optimal level of iodine status? Top of normal range, or anywhere in range?

  • David

    8/22/2009 7:49:25 PM |

    I take a couple drops per day of an iodine supplement called "Iosol," and I really like it. It's only 12 bucks a bottle (1,830 mcg per drop, 610 drops per bottle). You can find it here: http://www.iherb.com/TPCS-Iosol

    It's not potassium iodide, but rather a combination of iodine (extracted from kelp as unbound iodine) and ammonium iodide. Some think this is better than potassium iodide. You can read why here: http://www.byronrichards.com/index.php/thyroid_leptin/entry/what_is_iosol_iodine/

  • billye

    8/22/2009 8:20:10 PM |

    Hi Jenny,

    I supplement with 325 mcg Kelp caps from Now.  Amster et al. 2007 reports that the arsenic most commonly found in seaweed and seaweed products is relatively non-toxic. For example,the level of concern for total arsenic in crustaceans is 86 ppm,a concentration 10 times higher than  the amount found in kelp supplements.  I had diabetes type 2 for 20 years.  My last 3 A1c tests indicated levels of 4.7, 4.8 and 5.0.  So much for contribution to diabetes.

  • Daniel

    8/23/2009 6:59:47 AM |

    Thank you for making light of this!

    Iodine & Vitamin D supplementation is making a dramatic difference in the way I feel. Mood and concentration have improved, not to mention my blood pressure has normalised (especially around meal time).

    Get your levels tested and if in doubt!

  • Dr. William Davis

    8/23/2009 2:30:19 PM |

    Thanks, Ted. Great summary of the evidence.

    Also, the Japanese include kombu, wakame, and other seaweeds in their daily diet in quantities that far exceed a kelp tablet or two without arsenic toxicity.

  • David Gillespie

    8/24/2009 1:42:57 AM |

    you might be interested in this article on the relationship between increased fructose consumption and iodine deficiency: http://www.raisin-hell.com/2009/06/why-iodine-is-being-added-to-your-daily.html

  • Gloria Ives

    8/24/2009 3:22:59 AM |

    Can you address sea salt use? I've steered completely away from table salt and into sea salt. Some sea salt, such as the pink Himalayan variety, boasts something like 80 some odd minerals present in it. Is there adequate iodine in sea salts, if any?

  • steve

    8/24/2009 1:35:55 PM |

    would be interested in hearing from Chole J which of the healthy seaweed snacks she gets from Amazon

  • homertobias

    8/25/2009 1:16:15 AM |

    My take on Nori:  It is basically a potatoe chip from the sea.  So it has iodine in it, so the arsenic may not be harmful.  So.....what oil did they use?  Sesame oil is not that good for you.  Did they keep the oil below it's smoke point?  How often do they change it?  Where did the seaweed come from?  Downstream from the Chinese Drywall factory? Even sushi grade Nori smells rancid to me.  No thanks, I just don't think it is a health food.

  • Sabio Lantz

    8/25/2009 2:10:54 AM |

    This site info is great !  Thanx all.  In case you plan to make your own mixture (I do, eventually), people may think you are actually a trouble maker and not a health nut:  I learned that Iodine is use illegally to make d-methamphetamine.  Here is a govt site telling of that issue.   Who'd have guessed !
    Smile.

  • Anna

    8/25/2009 4:21:39 PM |

    You can buy "wild crafted" seaweed from domestic sources in remote California or Maine sources if you want to avoid unknown sources from overseas.

    I have a variety of hand harvested and naturally dried seaweed products from Mendocino Sea Veggetable Company (www.seaweed.net).   They sell a small booklet with recipes, too.  

    We especially love the Mendocino Miracle Mix (ground mixed seaweeds) sprinkled over our morning eggs.  I put MMM in everything from homemade condiments (mayonnaise, ketchup, mustard and salsa) to soups.  MMM is also great mixed 30/30/30% with coarse Mendocino or Atlantic sea salt  and sesame seeds for a great seasoning shake.

    There is another company I haven't yet tried, but it is also recommended by a Mendocino friend, Ocean Harvest Sea Vegetable Company http://www.ohsv.net/ .

    I add some kombu to my homemade bone broths and often add crunchy dried seaweed to salads instead of croutons.  Some seaweeds can be soaked  a few minutes to plump back up and tossed into a salad.  When I make sashimi I also serve a salad of just seaweed with a ginger-(wheat-free) raw tamari vinaigrette.   Once you get over the unfamiliarity with sea vegetable it becomes quite ordinary and not much different to eat than land vegetables.

  • Melissa

    9/1/2009 8:16:38 PM |

    I ended up with hypotension from cutting out salt in my paleo diet and it was not fun. I now eat seaweed, but you have to be careful with that too. A seaweed-loving friend of mine now has hyperthyroidism!

  • Sabio Lantz

    9/1/2009 9:56:15 PM |

    Yeah, thanx Melissa -- everyone is tempted to recommend a "one-size-fits-all" diet but I bet it is more complicated than that.
    All this feedback is very helpful.  
    One person says take tons of iodine, the next says it can cause thyroid disorders, we must be very careful when taking advice on the internet (or anywhere else, for that matter).

  • trinkwasser

    9/10/2009 3:04:27 PM |

    Thanks for the reminder, I've been trying various seaweeds and sea vegetables but ran out while the local samphire was in season (I think it was a previous post by Anna that turned me on to these), I just put them on tomorrow's shopping list.

  • kris

    11/2/2009 11:52:41 PM |

    Dr. Davis,
    I dont know where to put this article, which is  helpfull in the times of H1N1. I am just going to copy it here and leave it for you to decide the place for this please.
    Vitamin D is also is major immune system booster.
    http://www.starfireresearch.com/health/topics/swineflu.html

    Iodine: the Forgotten Weapon
    Against Influenza Viruses


    David Derry, MD, PhD
    332 – 425 Simcoe Street
    Victoria BC V8V 4T3

    Correspondence: Dr. David Derry dderry@shaw.ca


    Background: After the 1918 Influenza Pandemic which killed an estimated 30 million people, governments financed research on the Pandemic’s causes. Over 25 years, influenza viruses were isolated and methods for killing them with various agents discovered. Iodine was the most effective agent for killing viruses, especially influenza viruses. Aerosol iodine was found to kill viruses in sprayed mists, and solutions of iodine were equally effective. In 1945, Burnet and Stone found that putting iodine on mice snouts prevented the mice from being infected with live influenza virus in mists. They suggested that impregnating masks with iodine would help stop viral spread. They also recommended that medical personnel have iodine-aerosol-treated rooms for examination and treatment of highly infected patients. Current methods of dealing with influenza infection are isolation, hand washing, antiviral drugs, and vaccinations. All of these methods can be improved by incorporating iodine into them. When impregnated with iodine, masks become much more effective, and hand washing is more effect when done with mild iodine solutions. Isolation techniques coupled with aerosol iodine would make them safer for patients, medical personnel, and all persons working with the public. Public health authorities could organize the distribution of iodine and at the same time educate the public in the effective use of iodine. Oral iodine might also boost body defense mechanisms in the upper oral and respiratory mucus. Conclusion: Iodine incorporated into masks, solutions, aerosols, and oral preparations could help to kill influenza viruses and fight off an H1N1 Pandemic.

    Keywords. H1N1 • Influenza virus • iodine • aerosols • immunization • isolations • masks • prevention

    Derry, D.: Iodine: the Forgotten Weapon Against Influenza Viruses.

  • A C

    5/18/2010 5:21:46 PM |

    I wonder if eliminating gluten would clean up that T3 issue. Yesterday I read that Celiac Disease can cause hypothyroidism.

  • buy jeans

    11/3/2010 12:23:22 PM |

    Kurt's thyroid function normalized to nearly ideal levels just with iodine replacement. (The free T3, while improved, remains low; an issue for another day!)

  • Katie

    8/4/2011 8:45:17 PM |

    Jenny!
    I just started the NOW kelp w/ dulse caps, 325mcg iodine.  How do they work for you?  The supplement world is soooo confusing and overwhelming!!  I'm wondering if I can take two of these a day, one in am and one in pm?
    Thanks for any insight you can provide!
    Katie

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