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Iodine Deficiency Holistic Medicine for the 21st Century David Brownstein, M.D. Center for Holistic Medicine 5821 W. Maple Rd. Ste. 192 West Bloomfield, MI 48322 248.851.1600 www.drbrownstein.com Leo Tolstoy “I know that most men, including those at ease with problems of the greatest complexity, can seldom accept even the simplest and most obvious truth if it would oblige them to admit to the falsity of conclusions they have delighted in explaining to their colleagues.” Medical Iodophobics Claim Iodine Causes…. • AIT • Hypothyroidism (IIH) • Hyperthyroidism • Brain Melting • Locusts, frogs, plague, darkness, and more • See Passover “Don’t Take Iodine!” Medical Iodophobia “Medical iodophobia is the unwarranted fear of using and recommending inorganic, non- radioactive iodine/iodide within the range known from the collective experience of three generations of clinicians to be the safest and most effective amounts for treating symptoms and signs of iodine/iodide deficiency (12.5- 50mg/day).” Dr. G. Abraham, 2004 Thyroid Nodules and Iodine • Both benign and malignant thyroid nodules have significantly less iodine than normal thyroid tissue Benign thyroid nodules contain 56% of the iodine content as compared to normal thyroid tissue Malignant thyroid nodules contain 3% of the iodine content as compared to normal thyroid tissue Analyst. March 1995, Vol. 120 Periodic Table History of Iodine • Discovered in 1811 • First used by Dr. William Prout (1816) in London for a patient with goiter J. Royal Soc. Of Med. 2011;104:15-18 History of Iodine • Birth of western medicine • Boussingault (1824) observed that goiter did not occur at many silver mining sites • The use of iodine for treating goiter was the first time that a single item (iodine) was used to treat a specific illness (goiter) RDA for Iodine Life Stage RDA Adult Male 150g/d Adult Female 150g/d Pregnancy 220g/d Lactation 290g/d National Health and Nutrition Survey • 1971-2012 NHANES showed iodine levels 35 declined 50% in the 30 United States µg/dl 25 20 NHANES I 1971-4 NHANES 2012 15 10 Urinary iodine levels levels iodine Urinary 5 0 1970 2012 http://www.cdc.gov/nutritionreport/pdf/Nutrition_Book_complete 508_final.pdf#zoom=100 National Health and Nutrition Survey • 1971-2012 NHANES showed iodine levels declined 50% in the United States • During this time, increased incidence of: • Thyroid illnesses (hypo, autoimmune, cancer) • Cancers of the breast, prostate, endometrium, pancreas, and ovaries • All of the above conditions can be caused by iodine deficiency. Severe Iodine Deficiency in U.S. From 1970-2006 14.00% % Population Severely Iodine Deficient 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% 1970 1990 2005 2006 2014??? NHANES CDC Thyroid 2011. Vol. 21. Number 4, 2011 Iodine Deficiency in UK • 737 14-15 year old girls in UK • Urinary samples 70% of samples below 100ug/L and 18% below 50ug/L. Presented at Society for Endocrinlogy BES 2011: April 11, 2011-14. Iodine Deficiency and Women of Childbearing Age: NHANES 2005-8 70 60 50 40 <150ug/L <100ug/L 30 <50ug/L <20ug/L 20 % Women Iodine % Women Deficient 10 0 Total Pregnant Nonpregnant Thyroid. Vol. 21 N. 4. 2011 The Importance of Ensuring Optimal Prenatal Iodine Intake (1) • Three groups of children • Group 1: Supplemented with KI (200ug/day) at 4-6 weeks gestational age. • Group 2: Supplemented with KI (200ug/day)at 12-14 weeks gestational age • Group 3: No iodine supplementation during gestation. Supplemented with 200ug/day after delivery All groups supplemented with KI until end of lactation. All children given a neurocognitive evaluation at 18 months of age Thyroid.Vol. 19. N. 5. 2009. 511-519 The Importance of Ensuring Optimal Prenatal Iodine Intake (2) 45 40 35 30 25 20 Group 3 Percentile of FT4 at term at FT4 of Percentile 15 10 5 0 <0.71 <0.71-0.82 <0.83-0.91 0.92-1.85 Thyroid.Vol. 19. N. 5. 2009. 511-519 The Importance of Ensuring Optimal Prenatal Iodine Intake (2) 100 90 80 70 60 50 Group 2 40 Percentile of FT4 at term at FT4 of Percentile 30 20 10 0 <0.71 <0.71-0.82 <0.83-0.91 0.92-1.85 Thyroid.Vol. 19. N. 5. 2009. 511-519 The Importance of Ensuring Optimal Prenatal Iodine Intake (2) 100 90 80 70 60 50 Group 1 40 Percentile of FT4 at term at FT4 of Percentile 30 20 10 0 <0.71 <0.71-0.82 <0.83-0.91 0.92-1.85 Thyroid.Vol. 19. N. 5. 2009. 511-519 Mean IQ 105 100 95 Group 3 IQ Group 2 90 Group 1 85 80 Delayed neurobehavioral performance was observed in 36% of children in group 3 and 25% of children in group 2 and none in group 1. “A delay in 6-10 weeks in iodine supplementation of hypothyroxinemic mothers at the beginning of gestation increases the risk of neurodevelopmental delay in the progeny.” Thyroid.Vol. 19. N. 5. 2009. 511-519 Pregnancy and Iodine • During pregnancy, before fetal thyroid gland becomes functional during 2nd trimester • Maternal T4 crosses placenta to promote normal embryonic development • Maternal iodine deficiency and hypothyroidism can result in adverse complications including: • Congenital hypothyroidism • Fetal loss • Placental abruption • Preeclampsia • Preterm delivery Thyroid. 2011;21(10):1081-1125 Pregnancy and Iodine “Even in the absence of congenital hypothyroidism, iodine deficiency during infancy may result in abnormal brain development and, consequently, impaired intellectual development .” Iodine and neuropsychological development. J Nutr. 2000;130(2S Suppl):493S- 495S J Nutr. 1996;126(9 Suppl):2427S-2434S …impaired intellectual development? Why Iodine? • Iodine deficiency is a worldwide problem • Mental impairment, reduced intellectual ability, ADD, autism • Goiter • Infertility • Increased risk of breast, prostate, endometrial, ovarian and other cancers Why Iodine? • 1.9 billion individuals world-wide estimated to have inadequate iodine nutrition • WHO claims iodine deficiency is the world’s greatest single cause of preventable mental retardation • WHO estimates that there are 300,000,000 school-aged children worldwide who are iodine deficient (36% of school aged children) • Over half of the population of Europe live in areas of iodine deficiency • 1/3 of the world’s population live in an iodine deficient area • 129 countries • Decreased childhood survival rate in iodine deficient areas • Neonatal mortality declines over 50% when iodine deficiency is rectified • 72% of world’s population is affected by iodine deficiency Lancet. 2003;362:1859-60 Lancet. Vol. 350. 9.13.97. p. 771-773 WHO J. Clin. Endocrinand Metabl. 2007;92:437-442 Anderson, M. 2007 Iodine deficiency in Europe: a continuing public health problem. Geneva: WHO. 2007. Gaaaaawly! Why Iodine? • Only 28% of prescription prenatal vitamins contain iodine • Average iodine content of I-prenatal vitamins was found to be below the RDA for I (119µg) • Of the prenatal vitamins that do contain iodine, only 15% have more than 150µg of iodine per daily dose This is a public health disaster that is unparalleled! FP News. 11.15.08 Thyroid Production Thyroid T4 T3 Effects On Body Low Iodine Postpartum and Thyroid Dysfunction • 149 women at 6 months postpartum and 98 controls followed for 12 years • Urinary iodine at 6 months postpartum and thyroid function at 12 years follow-up • Results: • Decreased UIC predicted hypothyroidism at 12 years follow-up • UIC <100ug/L and <50ug/L associated with significantly more hypothyroidism Clin. Endocrin. 2011.74:631-5 Low Iodine Postpartum and Thyroid Dysfunction 45 40 later 35 yrs 30 25 20 15 Hypothyroid 12 Hypothyroid 10 5 0 <50 50-100ug/L >100ug/L Clin. Endocrin. 2011.74:631-5 Why Iodine? • Elevates pH • Alkalinizing agent • Deficiency causes intellectual deficiency, goiter, hypothyroidism, autoimmune thyroid illness, thyroid cancer and other cancers • Production of thyroid hormone • T4, T3, T2, T1 • Necessary for the production of all the hormones of the body • Adrenals, ovaries, testicles, etc. • Iodine also responsible for formation of normal architecture of the glandular tissue • Breast • Thyroid • Ovary • Prostate? Iodine: Therapeutic Actions • Alkalinizing agent • Antibacterial • Anticancer • Antifungal • Antiparasitic • Antiviral • Detoxifying agent • Mucolytic agent “Great Scott! Maybe we should be using iodine!” Conditions Treated/Prevented With Iodine • ADD • H. pylori • Asthma • Hypertension • Atherosclerosis • Infections • Biofilms • Keloids • Breast Disease • Liver Diseases (Enterohepatic • Cancer Circulation) • Breast, ovaries, prostate, thyroid • Nephrotic Syndrome • Cerebral Palsy • Ovarian Cysts • COPD • Parotid Duct Stones • Cystoid Macular Edema • Peyronie’s • Dental caries • Pre-eclampsia • Diabetes • Retinitis Pigmentosa • Dry Eyes • Sebaceous Cysts • Dupuytren’s Contracture • Thyroid Disorders • Excess Mucous Production • (hypo, autoimmune and cancer) • Hemorrhoids Different Forms of Iodine • Iodine is not very soluble in water • Dr. Lugol (1829) found that when potassium iodide added to water increased the solubility of iodine • Lugol’s solution: 5% iodine and 10% potassium iodide in distilled water • 2 drops of Lugol’s solution contains 5mg of iodine and 7.5mg of iodide Lugol’s Solution • Widely available at most apothecaries • Recommended for almost any condition • Infection • Probably the most used medical item before patent medicine took hold RDA for Iodine Life Stage RDA Adult Male 150g/d Adult Female 150g/d Pregnancy 220g/d Lactation 290g/d Iodide and Iodine • Iodine is rare element • 62nd in abundance of the elements of the earth • Bottom third of elements in terms of abundance • Reduced form of iodine is known as iodide • Extra electron • Full complement of electrons Iodine/Iodide Bind to Different Areas of Body Iodine Iodide Breast Thyroid Prostate Salivary Glands Stomach Skin Where is Iodine Found in the Body? • Every cell in the body contains and utilizes iodine • WBC’s cannot effectively guard against infection without adequate amounts of iodine • Concentrated in the glandular system • Thyroid gland contains the largest concentration of iodine (50mg adult saturation) • Breasts, salivary glands, parotid glands, pancreas, cerebrospinal fluid, brain, stomach, skin, lacrimal glands, etc.
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