We discussed a lot about iodine in our first blog – Iodine: Why You Need It And Why You’ll Love It! and it’s vitally important that you read that blog first, to gain an understanding of what we discuss below.
Where Do We Find Iodine?
We can get iodine by eating iodine-rich foods and taking iodine supplements. Foods containing iodine include:
ocean seafood (such as fish especially baked cod shrimps and seaweed),
potatoes,
lima beans,
corn,
cranberries,
strawberries,
prunes,
plums,
bananas,
iodised salt
unique types of salt (Celtic Sea salt and Himalayan pink crystal salt)
pasture-raised organic eggs
traditionally produced dairy (milk, yogurt, and cheese in raw organic form)
Based upon micrograms per serving and daily value (DV) of iodine, the top food sources of iodine include: 36
Seaweed — Whole or 1 sheet: 16 to 2,984 micrograms (11 percent to 1,989 percent)
Iodized salt usually contains potassium iodide in the range of 76mcg per ¼ teaspoon of salt, as well as 580mg of sodium 36. However, because table salt carries health concerns, I recommend Himalayan crystal salt, which has variable levels of iodine, which is not added unnaturally like we see with iodized salt. Click here to learn more about which salt is better for you.
There are two types of salt that are available—refined salt and unrefined salt. Refined salt is the thin white table salt that’s pretty much in every restaurant. Refined salt is made by food companies because it has a longer shelf life then unrefined salt. Just as manufacturers refine flour to take out natural ingredients that will decay and go bad with time, they refine salt to extend its shelf life. It contains sodium and chloride plus toxic ingredients that shouldn’t be in salts such as ferrocyanide and aluminium silicate.
Unrefined salt has a full complement of minerals from wherever it is mined. Celtic Sea Salt and Himalayan Salt contain over 80 minerals. Refined salt creates an acidic pH environment in the body while the minerals in unrefined salt, helps alkalize tissues. If we eat many refined foods, we can become too acidic which can lead to degenerative problems in the body.
While thyroid function is easily measured, there is no specific blood test to determine how much iodine is circulating in your body. Doctors can conduct blood tests for levels of thyroid hormone and thyroid-stimulating antibody immunoglobulin (TSI) levels. An iodine deficiency is suspected when thyroid hormones fall below a normal range. The appearance of a goitre also indicates either a deficiency or overabundance of iodine. A review of your usual diet, supplement use, and use of iodized table can help health professionals get a ballpark sense of your intake. This kind of assessment is qualitative, and it can help you understand if you’re a risk of inadequate iodine intake.
Iodine patch test – an iodine skin patch test is another way to assess an iodine deficiency. Problem is, this has never been validated and there aren’t any clinical trials to support this. It goes like this. Buy an iodine tincture (2% iodine), rub some on your skin (which will turn brown). The iodine patch will fade. It always does.
The thinking is however that if it fades quickly, your body has absorbed it quickly (within 4 to 12 hours) because you’re deficient. Your body sucked it up like a dry sponge does water. If it fades slowly (still medium brown 24 hrs later), you’re not deficient because your body isn’t as ‘thirsty’ for iodine. As a compound, iodine is very volatile and evaporates easily. Not just from the skin, but from iodized salt which is why iodized table salt can be unreliable. From all accounts the skin test is not an accurate way to test for iodine deficiency.
Urinary iodine test – can be done. More than 90% of ingested iodine is excreted in your urine within 24-48 hours. Therefore, your daily iodine intakes can be measured based on how much you’re peeing out. This is more accurate than a diet recall, but it can support a diet recall which is used to screen those at risk.
The iodine loading test is more specific again where you take 50 milligrams of iodine at time zero, collect 24 hours of urine after that, and measure how much iodine comes out in the urine over the 24 hours. When you take iodine orally, 98% or so is excreted in the urine. You can measure the amount in and the amount out, subtract the numbers, and know how much the body has hung on to. Generally, when the body hangs on to more iodine, it’s more deficient. So once people get iodine sufficient, they have enough iodine in their body and they take 50 milligrams, they’ll pee out about 45 milligrams or 90%. They’ll hang on to 5% of it or so. That’s iodine sufficiency. If a person pees out only 50% of the iodine they are holding on to 50% because they are very deficient, and their body needs iodine.
How Much Iodine Should I Take?
Below are the guidelines for iodine developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies.37 The Recommended Dietary Allowance (RDA) is listed in micrograms (mcg). Note that if you have a thyroid condition, whether hypothyroidism or hyperthyroidism, your healthcare provider’s specific recommendations for iodine intake may vary from these standard recommendations.
Iodine Doses for The Upper Tolerable Intake Level, UL
Adults 19 years and over 150 mcg and should avoid prolonged use of doses higher than 1100 mcg per day without proper medical advice.
Pregnant women should ideally take 220 mcg
Breastfeeding women 290 mcg
In children:
Doses should not exceed 200 mcg per day for 1 to 3 years old children,
300 mcg per day for children 4 to 8 years old,
600 mcg per day for children 9 to 13 years old,
900 mcg per day for adolescents.
Some healthcare experts, recommend higher servings than described here and suggest that these recommendations are insufficient to provide all the iodine the body requires. However, as with everything, there is an upper limit to how much iodine you should consume.
Most doctors have been trained to believe that iodine is toxic to the thyroid gland. They believe that iodine will precipitate a thyroid problem or if one already has a thyroid problem, iodine will make it worse. This is where some of the controversy lies as more and more holistic doctors are trialling iodine usage with patients who have thyroid autoimmune issues, and they are seeing significant results. Dr Bronstein, Medical Director of the Centre for Holistic Medicine in West Bloomfield, Michigan says that,38
“The NHANES and other data clearly show iodine levels have been falling over the last 30-40 years and thyroid illnesses have been increasing. If iodine were a toxic agent to the thyroid, we would see hypothyroidism and autoimmune thyroid disorders such as Graves’ and Hashimoto’s disease falling during this time period, not rising.”
“Animal studies show that you cannot cause Hashimoto’s disease in an animal unless they are iodine deficient, and they are given a goitrogen. That is what is happening to our human population; we are iodine deficient, and we are exposed to an ever-increasing amount of goitrogens like bromide and fluoride.”
Brownstein is the author of Iodine: Why You Need It. Why You Can’t Live Without It. 5th Edition and believes that the current RDA for iodine is inadequate to supply the body’s need for iodine.
“When you couple in the increasing exposure to toxic halides such as bromine, fluoride, and chlorine derivatives, our iodine requirements have markedly increased over the years. My experience has shown that iodine in doses ranging from 6-50 mg/day (i.e., 6000 – 50,000 mcg) is adequate to provide iodine for the vast majority of the population. Finally, it is important to use the right kind of salt: unrefined salt.”
This dosage far exceeds the RDA for iodine however if you wish to explore this further Brownstein has several books that he has written on these topics. There are also a number of other integrative doctors and endocrinologists who reiterate similar observations in their books or research papers including Dr. Eric Osansky in his books, “Natural Treatment Solutions for Hyperthyroidism and Graves’ Disease” and “Hashimoto’s Triggers.”
I encourage you to explore their observations further.
Types of Iodine in Supplements.
Iodine supplementation may be needed if you don’t get enough iodine in your diet. Iodine is found in many multivitamins with minerals and multi-mineral formulas and as stand-alone iodine supplements. To learn about the available types of Iodine in supplements and what you need to know about iodine if you’re on medications click here.
Lugol’s iodine
A popular supplement in the natural health world. It is a solution of elemental iodine (5%) and potassium iodide (KI, 10%) together with distilled water. Each drop has 6.25 mg of iodine (6250 mcg) – 2.5 mg iodine and 3.75 potassium iodide. Patients are often prescribed take 2 drops per dose providing about 12.50 mg or 12, 500 mcg of iodine.
Nascent iodine
“Nascent iodine” was once used as simply another name for sodium iodide (an iodide atom bound to sodium). However, when this free form of iodide is exposed to a positively charged ion, such as sodium or potassium, as it would be in a liquid supplement, it will bind with these to form sodium iodide or potassium iodide. Therefore, if you are buying a supplement promoted as “nascent iodine”, it is most likely sodium iodide or potassium iodine
Potassium iodine
Common salt of iodine found in many supplements, either in a multivitamin and minerals or as a stand-alone iodine supplement. Doses typically range from 200 to 800 mcg per dose.
Multivitamins with minerals and multi-minerals
Typically contain different forms of iodine. Common salts include sodium or potassium iodide, potassium iodate, potassium iodide, or sodium iodide. Doses in most multis range from 50 to 220 mcg for prenatal formulas.
Povidone iodine/Betadine
Also known as iodopovidone and goes by the brand name Betadine. It is an antiseptic used for skin disinfection before and after surgery. It can also be used to disinfect minor wounds. Interestingly – it can be used to purify water (camping etc) in which case you would consume some iodine if you drank the water, but it’s not recommended to use povidone iodine as an iodine supplement. As a disinfectant, it contains far more iodine than is needed for human health.
Side Effects of Iodine Ingestion.
Although iodine side effects are rare, some people report minor concerns including a metallic taste in the mouth, burning, nausea, headache, or diarrhea. When taking higher doses of potassium iodide immediately after radiation exposure, people have reported skin rashes, swelling of the salivary glands, or in more severe cases, difficulty breathing.
If you have dermatitis herpetiformis, an itchy skin rash often caused by gluten intolerance or autoimmune disease, iodine may worsen the condition. Iodine may interact with certain medications, especially thyroid medication. Mild interactions may occur with medications that contain lithium, medications for high blood pressure, diuretic water pills, and iodine-containing products for heart conditions.
If you recently moved from an iodine-deficient region, like eastern Europe or Africa, your body might overcompensate for increased iodine in your diet. According to the American Thyroid Association, people in iodine-deficient areas have adapted to functioning with extremely minute amounts of iodine, and a sudden increase in iodine may cause symptoms of a thyroid disorder.17
People have a wide variance in how much iodine their bodies can tolerate before expressing symptoms of overdose, and further, that a person’s thyroid adapts to high amounts of iodine in a biological feedback loop that allows the body to maintain its healthy functioning (this even has a name: the Wolff-Chaikoff effect).39 People with autoimmune diseases, particularly those affecting the thyroid, are most at risk of experiencing negative health issues from consuming higher servings of iodine. When Dr Bronstein was asked “If it’s fine for people with Hashimoto’s Thyroiditis to take iodine, then why do some people feel bad when supplementing with iodine?”
He replied, “Iodine can cause a detoxification reaction whereby the body releases bromide. I believe this is where many of the adverse effects are coming from. I explain this in my books. My experience has clearly shown that vast majority of patients with autoimmune thyroid disorders improve with iodine when it is used as part of a holistic treatment regimen. Do some react negatively to iodine? Yes. Iodine is not for everyone, but my clinical experience has clearly shown adverse effects to iodine are rare when it is used appropriately.”38
If you are wanting to explore higher doses of iodine it makes sense to work with a holistic, integrative health practitioner.
Iodine and Medications.
Iodine supplements can interact or interfere with medicines that you take. Click here for several examples 40:
Iodine supplements might interact with anti-thyroid medications such as methimazole (Tapazole®), used to treat hyperthyroidism. Taking high doses of iodine with anti-thyroid medications could cause your body to produce too little thyroid hormone.
Taking potassium iodide with medicines for high blood pressure known as ACE inhibitors could raise the amount of potassium in your blood to an unsafe level. ACE inhibitors include benazepril (Lotensin®), lisinopril (Prinivil® and Zestril®), and fosinopril (Monopril®).
The amount of potassium in your blood can also get too high if you take potassium iodide with potassium-sparing diuretics, such as spironolactone (Aldactone®) and amiloride (Midamor®).
How Do We Use Iodine as a Family?
As a family we have always used iodine topically on cuts, wounds, and infections, as an anti-septic (see Types of Iodine in Supplements). As an example, when one of us has a sore gum, we drop some iodine onto the tooth and gum and using a toothbrush, give it a good clean. We repeat this a couple of times and find the iodine helps the immune system fight off infection.
From personal experience when I decided to increase my iodine intake to help recover from a period of sustained stress, I focused on dietary sources of iodine and selenium and daily use of Lugol’s iodine. I used it topically on my face and neck each day for a few weeks and I genuinely felt it fortify my weary endocrine system. I didn’t use an iodine supplement, nor a multivitamin containing iodine, just a few drops of Lugol’s iodine solution mixed every night with a clean organic moisturiser on my face and neck.
It was like someone took me off the roller coaster and sat me down and held my swirling head. I felt clearer and sturdier than I had in a long time. I used it daily for a few weeks and then backed it off to a few times a week. Every few days I also mixed some into my toothpaste. Now I use it on my skin once a week and I wouldn’t go without including it in my weekly routine. I also focus on making sure I’m eating iodine rich foods. I do take a premium glutathione supplement Cellgevity that contains selenium however, it’s one of two supplements that I take daily, (and because I will get emails asking what supplements I take) the other daily supplement is magnesium. I also take activated B’s and probiotics a few times a week.
In Closing
We’ve covered a lot in these two blogs, and as we finish up this discussion on iodine let me be clear, our ultimate goal from these insights should be to consistently support and strengthen our thyroid gland and our entire endocrine system.
It is therefore imperative that we minimize our stress levels as stress creates a hormone response that negatively impacts our thyroid function.41Exercise is a natural and extremely effective way to combat stress and can also help stimulate the secretion of thyroid hormones.42Getting enough sleep also helps support a healthy thyroid and these hormones can directly impact our sleep quality. Avoiding toxins like plastics (BPA), pesticides and halides (fluoride, chlorine, bromine) are a smart strategy as well they can have a detrimental effect on thyroid function.
Following a clean, low tox diet is also one of the easiest ways to support your thyroid. Eat selenium-rich foods, as well as iodine-rich foods, as you now know – both are necessary for the synthesis of thyroid hormones. When considering your diet, incorporate gluten-free grains since gluten has been associated with autoimmune thyroid diseases.43 Finally, don’t forget to take care of your liver as this helps with vitamin A conversion and uptake. A healthy liver supports thyroid function.43 For a greater understanding on what else you can do to look after your thyroid please see our related blog, What Role Do Halides, Perchlorates and other Chemicals Play in Iodine Deficiency, Thyroid Disorders, Fertility Issues and Cancer?
Yours in health,
Jennifer Barham-Floreani,
Bach. Chiropractic, Bach. App Clinical Science
Registered internationally, no longer practicing as a chiropractor in Australia.
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