Iodine All Boxed Up
As far as most of the medical community is concerned, iodine has been boxed up in its cylindrical Morton’s salt-box (with that cute umbrella girl on it) and shelved–as if there is nothing further to know or learn about it. Not so.
For iodine, I want you to be aware of three ideas:
1. Iodine deficiency is insidiously on the rise in developed countries and putting people, particularly women and children at HUGE risk. (Pregnant or pregnancy-eligible women need to take note.) Many US doctors are not aware yet of this re-emerging problem. We took care of “severe” iodine deficiency, and now years later, mild iodine deficiency is invisibly in our midst, wreaking its damage without our awareness.
2. It’s not just the thyroid that needs iodine, but brains, immune systems, prostates, and breasts, too. (Ahem, you got some of those, don’t you?) I know my knowledge-base had a huge gap here regarding iodine, and therefore, I assume other medical doctors (I’ve asked a few too) and people in general may be lacking information in this area as well.
3. There is a fear of iodine supplementation and excessive iodine intake because of the risk of hypothyroidism and hyperthyroidism. There are different camps of thought. Who is right? Who does know yet? Debatable. Regardless, many people aren’t even getting the bare minimum amount.
Could I be iodine deficient?
A resounding, “Yes.” Iodine deficiency was believed to be a resolved health issue in the US, but as I research, I see an insidious re-emergence of iodine deficiency in places such as the United States, Australia, and the United Kingdom. And I also see a lack of knowledge in standard health-care providers about the re-emerging deficiency. In pharmacy school and medical school we were taught that iodine deficiency was remedied in the United States by the implementation of iodizing salt back in the 1920s. Job accomplished! No more goiters! No more cretins (infants who are severely affected by iodine deficiency)! Celebrate and no more worries, right? Not so fast…
Apparently, somewhere in the realm of 38% of the world’s population is still deficient in iodine. Thirty-eight percent seems awful high to me, especially considering the nefarious effects on unborn fetuses. Looking at a few developed countries, the United States, Australia (New Zealand included in one of the citations), and the United Kingdom, each has pockets of iodine deficient populations (1, 2, 3, 4, 5). Increasingly, studies are showing iodine deficiency in modernized countries where iodine deficiency was presumed to be eradicated, yet I hear little hubbub about it, despite the potential gravity of the consequences! This bothers me. Apparently and quite sadly, iodine deficiency hasn’t yet made the consciousness of mainstream practicing medical doctors, like deficiencies of vitamin D and folate have. Why? I think because we rested on the laurels of “curing” severe iodine deficiency maladies. But laurels shrivel and decay, and the world changes and moves on. Changes in our food sources and practices greatly affect our iodine levels.
Why would a problem that we had “taken care of” 
be re-emerging?
Why is iodine deficiency re-emerging? As with almost all things, it’s due to multiple hits in our iodine intake. Take a look! Do any apply to you and your family?
1. Cutting down on salt use for health and also cutting down on other iodine-rich foods. People are following medical advice to cut down on salt, and therefore using less iodized salt. Also, egg yolks contain some iodine, but people have been told to cut down on those, too, due to cholesterol concerns. Seafood contains iodine, but we’re told to limit seafood due to mercury concerns.
2. We eat out lots more and we eat more processed foods–and iodized salt is not used in these foods. The commercial-grade salt used in processed foods and in restaurants is usually not iodized. I repeat: the salty foods you eat from a box or at a restaurant are (most likely) not iodized. So none of the salt in Ruffles potato chips or from McDonald’s French fries counts toward your necessary iodine intake.
3. Switching to sea salt and shunning iodized salt. Sea salt does not contain enough natural iodine to prevent iodine deficiency. It may have traces of iodine, but not nearly enough! Sea salt, unless specifically stated to be enhanced with iodine or seaweed, does not provide you with enough iodine. It is not a good source of iodine.
4. Iodine deprived soils. Some soils have always been low in iodine content (plants don’t need iodine to survive but they take it up if it’s in the soil), especially in areas away from the sea or under cover of mountain ranges. Some soils have become depleted of iodine with use and lack of iodine restoration. Plants grown in coastal areas should theoretically have more iodine in them, but lately there is a huge emphasis on eating locally so this could contribute to iodine deficiency, as well.
5. Changing from iodine based dough conditioners to bromine based dough conditioners. Iodine used to be used (specifically iodate) when making bread products. Now a form of bromine, bromate, is used, although its use is being discouraged. (6) Not only does this provide LESS iodine, but if you look at your periodic table, you’ll see that iodine and bromine are in the same group of the periodic table (halides). So bromine will actually compete with iodine in the body and “displace” iodine from necessary body reactions. I will try to explain this concept in more depth later because it is so intriguing. The same holds true for fluorine and iodine competition. (7)
6. The iodine amount in iodized salt is not uniform. The amount of iodine in a carton of iodized salt is not uniform. Sometimes the top of the carton of salt has less iodine than the bottom of the carton. Some brands do not contain as much iodine as others. The amount of iodine in a box may wane over time. These idiosyncrasies often have to do with the chemical properties of iodine which will allow it to “leach” out of the carton. (7)
7. Changing dairy-farming practices. Dairy is touted as a good source of iodine because the cows are frequently given iodine-supplemented feed and their teats are washed prior to milking with an iodine antiseptic to kill bacteria. However farming practices are changing and dairy cattle may or may not be receiving these interventions now. (When I bought milk and butter from the dairy farmer yesterday, I asked her about this. Her cattle are all grass-fed and she does not use an iodine-based cleanse for the teats. So I cannot imagine that the milk is rich in iodine that we personally buy, although it will be rich in vitamin K2 at the moment and butyric acid because it’s spring-grass eating time!)
8. Choosing organic milk over conventional milk. Organic milk usually has less iodine than conventional milk due to the cows being grass-fed. (9, 10)
Points to be eventually covered in Iodine Posts
Iodine is a big topic that I don’t want to undermine, so I will break it down into several posts. A few months ago, I thought iodine’s role was limited to prevention of goiter and keeping enough thyroid hormone around. That is all true, but there is so much more to iodine’s story, and some parts haven’t even been unraveled yet! Take home points that I will eventually cover in iodine posts, but probably not in this order. (If you are pregnant, able to be pregnant, or nursing, I urge you to start reading about iodine today, and don’t wait for my posts to roll out. Here is a simple article to get you started: Iodine Deficiency Common in Pregnancy, Docs Warn.):
- Do I need iodine? Absolutely. Can’t live without it. Function poorly with too little of it. “But what’s it do? What’s it for?” That is a bit challenging to answer. Kind of like, “What’s the sun for?” Is it for the trees? The flowers? Your vitamin D production? Your food production? Light? Energy? What aspect of our lives does the sun not touch? What aspect of our health does iodine not touch? Whether it is through the effect of thyroid hormone, which is composed of iodine, or direct effects we’re just now learning about, the body needs iodine. So it’s your job to make sure you know where you can get it. I will go over where to get iodine in future posts and “what it does.”
- Iodine deficiency is increasing for multiple reasons in developed countries, and I’ll bet money that you are affected by a couple or more of the reasons no matter what your health and food choices. No diet group is allowed to snicker here or stick their noses in the air. Many people are just not getting the iodine they need, and if they are, there’s a good chance that the body’s use of iodine is being interfered with by food and health choices they maybe haven’t even considered. I will go into food and environmental factors that may be interfering with your body’s use of iodine.
- Our childbearing women and their offspring for sure are hit VERY hard by an iodine deficiency. Women, did your obstetrician prescribe you a prenatal vitamin with iodine in it? If not, did your obstetrician ask you if the prenatal vitamin you chose has iodine in it? I will go over why women of childbearing age, their fetuses, and their children NEED adequate iodine. SADLY, these populations seem to be the most iodine deprived!
- Prostate, breast and immune health are starting to be linked to iodine. I will do my best to present some of this information. Much of it is newer, not well understood, and not well accepted.
- Iodine is important in brain health! Low IQs, increased ADHD, and apathy have been linked to iodine deficiency. We have studies to support this, and I will present those for your perusal.
- Iodized salt is not the devil. Iodine deficiency is a devil. I know so many of you treat processed, iodized salt like the plague. But there is a reason why The Morton Salt Company iodized their salt here in the States, and it helped immensely! I can’t underscore that enough. I guess I don’t really care if you shun iodized salt, I just want to make sure that no matter who or where you are, that you are aware of the body’s need for iodine and you take measures to get you and your family some good source of iodine. For many, the simple answer may just be adding iodized salt back into their diets. Others lean toward seaweed. Still others rely on supplements.
- Do I need to take high doses of iodine? Not sure. That might fall into the “voodoo” realm. (Voodoo is my tongue-in-cheek word for food and health related things I see that I’m just not sure about. I used to call diet changes “voodoo.” I don’t anymore, but it took a lot of reading!) Tread cautiously. I will eventually talk about how some people use high doses of iodine and what the proposed benefits and risks of this are, particularly fibrocystic breast disease, prostate cancer, and a touch on the big topic of thyroid disease. The turf here is largely uncharted and uncertain.
Eat well to live well. Make sure you’re getting an iodine source. And lastly and importantly, my blog posts are never intended for use of diagnosis, evaluation, or treatment. Hopefully you’ll use them as stepping-stones to learn more about the topics I present and be able to have a conversation with your favorite healthcare provider.
~~Terri
1. Are Australian children iodine deficient? Results of the Australian National Iodine Nutrition Study. Li M1, Eastman CJ, Waite KV, et al. Med J Aust. 2008 Jun 2;188(11):674. (Abstract link.)
2. The Prevalence and Severity of Iodine Deficiency in Australia. December 2007. Prepared for the Population Health Development Principal Committee of the Australian Health Ministers Advisory Committee. (Full text link.)
3. Iodine deficiency in the U.K.: an overlooked cause of impaired neurodevelopment? Bath SC1, Rayman MP. Proc Nutr Soc. 2013 May;72(2):226-35. doi: 10.1017/S0029665113001006. (Abstract link.)
4. Iodine in Pregnancy: Is Salt Iodization Enough? Elizabeth N. Pearce. J Clin Endocrinol Metab. Jul 2008; 93(7): 2466–2468. doi: 10.1210/jc.2008-1009 (Full text link.)
5. http://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/
6. http://www.newsweek.com/five-controversial-food-additives-83551
7. Iodine Nutrition: Iodine Content of Iodized Salt in the United States. Dasgupta PK, Liu Y, Dyke JV. Environ. Sci. Technol. 2008, 42, 1315–1323. (Link to full text.)
8. Iodine concentration of organic and conventional milk: implications for iodine intake. Bath SC1, Button S, Rayman MP. Br J Nutr. 2012 Apr;107(7):935-40. doi: 10.1017/S0007114511003059. Epub 2011 Jul 5. (Link to abstract.)
9. Essential trace and toxic element concentrations in organic and conventional milk in NW Spain. Rey-Crespo F1, Miranda M, López-Alonso M. Food Chem Toxicol. 2013 May;55:513-8. doi: 10.1016/j.fct.2013.01.040. Epub 2013 Feb 4. (Link to abstract.)
10. http://www.sciencedaily.com/releases/2013/07/130704094630.htm
The HSD 
Also I’m curious if increasing your dietary iodine has helped with constipation at all (because that is a big issue for me as well)? Thank you!
With pregnancy, it has been too confusing of a ride for me to tell what’s what! Anecdotally, many people on the iodine forums report improvement in constipation, but I can’t say that I have or have not seen that. Just too confusing right now. With ALL the changes I’ve made the last two years, I have managed to keep regular every 1-2 days/max 3 with magnesium this pregnancy (except for a time around the end of the first trimester and beginning of the second when nothing worked). The other pregnancies I used Miralax daily with maybe weekly success. But, if iodine helps, it is more of a contribution than a turning point. Make sense? I’m still hoping when my hormones get back to baseline, that I’ll be able to once again eliminate daily magnesium like I had a just before pregnancy. Fingers crossed. ~~Terri
We think way too much alike. I was just researching this too. I am trying to figure out ways to get iodine. We don’t use salt-mainly because no one really cares for it here except in egg salad. I guess more sushi is in our future! 🙂 Thanks for researching!
I know you were implying “Great minds think alike” with your comment… 🙂 Ha! Ha!
Iodine just doesn’t seem to easy to get, does it? (Aside from seafood and seaweed. And we like sushi! But I have never made it.) We do like salt, and I have started using iodized salt in the house again because not all of my kids eat the seaweed and seafood reliably. After reading enough about iodine, I just felt we needed a source for every family member. Deficiency wasn’t worth the risk for them.
Please chime in on anything you’ve seen or read in the posts to come! The information is vast and not always in agreement! ~~Terri
Reblogged this on lethargicsmiles and commented:
I have been wanting to post about iodine for some time now. “Why?” you ask. Well, as a POTSie, I used to think I didn’t need to worry about iodine. After all, I eat SO MUCH salt to keep my blood volume up; how could I ever be short? Even after I heard about iodine deficiency, I didn’t worry too much about using sea salt (which doesn’t cut it for iodine) instead of good old fashioned iodized Morton sea salt because of how much sodium I get from my broths I figured I was covered. Even if you don’t have POTS and are the average American, you probably think you are covered too. You likely are more concerned about how much sodium you are consuming and being mindful of how much salt you add to food than you are about iodine. You think you don’t need to worry about iodine because you get plenty of sodium and basic salt is iodized in the US. Am I right? Then read on.
Guess what? The food industry does not care about your iodine intake! They will get the cheapest salt they can and it is not iodized. So, if you don’t eat iodine rich foods and do not use iodized salt, you have a problem. Most people do not even know to think about iodine since iodine deficiency tends to be thought of us an “eradicated” issue and also as an issue producing extreme symptoms (goiter). Neither of this facts are completely true.
If this isn’t enough (I hope it isn’t) and you are saying, “You’ve got me, I want to know more,” please visit a medical doctor/fellow blogger’s blog post on iodine deficiency (complete with citations) which I have reblogged. She is very much an anti-“voodoo” type doctor and sticks to the facts. Her post is informative and is the first post of a series she will be writing on iodine!
Thanks, Jackie. There are just so many “hits” to our iodine intake/regulation–probably different hits for each person depending on their diets (dairy-free, no processed salt, excess processed food, excess bromine in wheat products and some sodas, fluoride, vegan, just don’t like seafood, etc). I didn’t realize how many and that we were on such a fragile balance in our modern society, particularly child-bearing age/pregnant/lactating women. Of course, for every pro there is a con and supplementation can bring about its own issues, which I hope to address. Take care. ~Terri
I just stick to seaweed chips because I’m scared to supplement! 😊 I can’t wait to learn more because I read a bit, added in seaweed — sometimes Morton, and washed my hands of it! There was so much conflicting information.
Looming questions I have about iodine that maybe I will learn answers to with your series:
1) Does the iodine skin test people use at home to check for deficiency actually work?
2) What nutrients (if there are any in particular) does the body need to use iodine best?
3) They say animal milk (especially cows milk) has iodine because the cow feed is sometimes supplemented with it. Sometimes? How would one ever know the cow farm their milk is from have cows iodine and the amounts in their milk products? Do/can organic or grass-fed type farmers supplement their cows with it?
1) Skeptical. Subject to interpretation. And besides that, there’s the chemistry of it. It can evaporate from the skin differently in different temperatures. (Same is true of the iodine in iodized salt.) It can be reduced to iodide and change colors. However, iodine is known to be absorbed form the skin so nothing inaccurate there. The 24 hour loading test is generally accepted.
2) Selenium for sure for starters–but I will write on that and get sources and more information of what’s out there.
3) Most don’t know the cows/dairies their milk come from, and each dairy’s practices will be different. So I don’t think you can reliably know. Upon collection at the dairy, all the milk gets pooled together in bulk and so there will be a mix of milk higher in iodine and lower, depending on the cows’ grass iodine content, cows’ feed supplement, and cows’ teat management. I don’t know for sure about the organic/grass-fed farmers and supplements. I have looked to no avail yet.
Here is an abstract regarding iodine getting in milk from feed and teat treatment: http://www.ncbi.nlm.nih.gov/pubmed/22192200. (Although we have pockets of iodine deficiency, I think the dairy industry worries about having too much iodine in products, as too much iodine makes people worry, too.)
Iodine is a really confusing topic to be sure. Just seems to be a mixed bag.
Wow, you’re timing is unbelievable. Just started investigating this and was hoping to find something on your site (cause I love getting you’re thoughts on these kinds of things) and before I could even look I see an email update with this! I really appreciate you taking on this topic and hope to glean any insights you may have regarding the whole thyroid issue as well which seems overwhelmingly confusing with such huge differences between what mainstream medicine recognizes and recommends and what alternative practitioners recommend (which is in itself a whole other spectrum).
I think of myself as pretty well educated regarding the food/nutrient stuff but I realize after reading this that (mostly because I don’t like seaweed and don’t have easy access at the moment to healthy sources of seafood like fish and shellfish) we have very little in our diet that could provide iodine. I’m gettin’ on that right away (I may be buying my first box of iodized salt in over 7 years!).
This really makes me wonder about older people as well. My mother-in-law has followed a severely restricted diet (not in the good way) after having a heart attack 15 years ago. She hasn’t had another heart attack since which, to her, is proof the diet is working but otherwise her health is just ruined (oral and throat cancer and horrible oral thrush, lichens planus, neuropathy, multiple hospitalizations for c. dif infections, hearing loss, emotional/cognitive problems . . . and on and on). She consumes no salt, very little fat (mostly of the veggie oil variety) and relies almost entirely on “heart healthy” packaged foods and some turkey bacon here and there (the package says it doesn’t need to be refrigerated! something is very, very wrong there). I wonder how many older Americans following this advice have seen a similar pattern?
Can’t wait to read more, thanks again!
Oh, my. What can one say? We tell cardiac patients to cut down on fats and salt. They do. But what do they replace it with? Processed foods. Processed oils. And now even mainstream media is coming out with stories about the saturated fat theory being inaccurate. But do patients get this information? There is just so much misinformation out there and so much junk, processed foods not fit for us to be eating, yet so habit-forming and so labeled as “heart healthy.” If I could do nothing else but get people off of processed foods–and that includes junky bread processed with bromine and with two or three preservatives and who knows what else– I’d feel better.
With regards to iodine, it is a huge topic and like you mention, there is a huge disparity between conventional medicine and natural/alternative medicine regarding it (and thyroid). I hope to present both sides so that why the disparity exists can be seen.
Didn’t it feel a little strange to buy that ioidized salt–or have plans to buy it? My husband and kids looked at it and said, “Wow. Why is it SO white!?” Ugh.
Thanks for your kind words, and I’ll get to reading and writing more. Terri
So I have been researching magnesium recently and now it looks like I need to pay more attention to iodine too. Do you supplement? I use sea salt and pink salt as my main salt choices. I will eat some seaweed but that’s not all the time. (I use them as wraps for deli meat.) You know my family eats very little processed food and I eat less than 2%. Apparently this is something that I should worry about.
I supplement on the lower end of the dose. My kids get iodized salt, dulse crumbled in chicken soup, curries, or casseroles when I remember, eggs, and seafood once or twice a week. I think iodine is very important for childbearing age women for sure, and for other people it may play a role in certain problems they have-such as fibrocystic breast disease, thyroid issues, prostate–such that they may want to know any research that’s out there. (Which I’ll slowly try to cover.) At least being “Paleo,” (Paleo-ish), are we not ahead of the game on magnesium? (Let me know!)With iodine, we are ahead of the game in some areas (since we will have less bromine exposure from breads), and behind in the dairy and iodized salt category. If our vegetables come from iodine rich soil, presumably along the coasts, we get that edge. But it’s too unpredictable.
Best post ever! Iodine is one of the best and most important things we can supplement with, along with dropping fluoridated water, IMHO 🙂 I’m so glad you are onto it, and sharing what you find out. There is so much to know and understand. I love your baby steps posts that breaks it down for us non medical types 🙂
Thanks. There is a lot to read about and consider regarding iodine! I waver back and forth on some of its issues, so I’ll keep sifting and try to present why such a dilemma. Definitely we need some and many are not getting it, but how much? With what? What for? From what? The smaller posts make for more posts, but I think it’s easier to not get bogged down in all the information that way and keep the key points at the forefront. And you know it’s important for me that people know WHY! Hope you and your family are great! We are headed into summer and loving it!
So interesting! I can’t wait to read your other posts about this. I am pretty sure i am iodine deficient (i do eat a lot of seafood, but probably not enough, and I never use iodized salt), and look forward to seeing what the options are. 🙂
Thank you for covering these topics! You mention egg yolks, sea food and iodized salt, how else can I ensure I’m getting adequate iodine intake?!
I think that is why iodine is so tough for us. If produce is grown in iodine sufficient soil, you drink dairy from cows who get feed supplement and udder cleansed with iodine, you eat commercial bread with iodate dough conditioner, and take some iodized salt–some would say that is way enough–perhaps too much for some. On the other hand, if your produce is from iodine poor soil (not uncommon), you don’t eat dairy or use organic milk which may not have much iodine, skip iodized salt, skip grains or eat bread with bromine dough conditioners, you could easily fall on the low spectrum. And we have no great test for levels. We use 24 hour urine for iodine (yeah, like when did you ever order that?) or assess the thyroid complete panel–which some would argue is not good at indicating iodine. Rather than look at individuals, our medical community relies on spot urinary iodine excretion and puts it together as a whole (because spot levels are SUPER variable) population to try to decide if we are iodine sufficient. Long answer. Sorry. I would presume if you eat commercial dairy (or know how your organic milk cows are regarding iodine), use iodized salt, eat eggs with yolks, good amount of produce, and some seafood, your iodine shod be sufficient. Could/should it be higher is a debate. Sources for iodine really are very variable and hard to come by naturally in foods. Some gardener about kelp on their gardens. Sorry such a windy answer!
Fascinating article! While I have given up processed foods entirely, I had no idea that commercial-grade salt did not contain iodine—that doesn’t make any sense to me at all!
Elemental Iodine: The Natural Remedy
Supplemental Method for Whole Body Fitness
The day-to-day intake of the indispensable element iodine used in entire body sufficiency is identified as orthoiodosupplementation. Whole body sufficiency of iodine will be evaluated by an iodine to iodide load testing. The test consists of taking one 50 mg tablet form of Lugols iodine solution. Next iodide levels are calculated during the subsequent twenty-four hour sample collection. The iodine to iodide loading test is centered on the concept that the typically functioning human system includes a process to help keep consumed iodine until eventually total body iodine sufficiency is truly realized. During orthoiodosupplementation an adverse feedback system may be induced that progressively changes the excretion of iodine and stabilize the absorption. As the body iodine level goes up, the percent of the iodine retained lessens with a simultaneous boost for the rate of iodide excreted in the twenty-four hour urine collection. When full body sufficiency of iodine is reached the uptake iodide and iodine is removed as iodide in the urine. Inside these united States populace the percent of iodine removed in the twenty four hour sample collection prior to orthoiodosupplementation averages forty percent in loading tests carried out by Dr. Flechas.
Soon after several months of supplementation with 50 mg Iodoral every day many non- obese subjects not exposed to excessive goitrogens realize total body iodine equilibrium arbitrarily identified as ninety percent or more of the iodine elimated in the 24 hr sample collections. Patients maintained about one-and-a-half g of iodine once they reach sufficiency. A repeat loading test following several months on orthoiodosupplementation is ideal.
The purpose of orthoiodosupplementation is not the treatment of disorders but the provision of optimum quantities of a crucial component towards total body sufficiency and towards ideal mental and physical potential. Total body sufficiency for iodine correlates well with all-around health and wellbeing and a number of individuals could recognize when they reached sufficiency before being made aware of the results of the test. Iodine sufficiency is associated to a feeling of overall health, mental clarity, feeling more comfortable in colder conditions, boosted energy, needing a lesser amount of rest, accomplishing more in less time, having ordinary bowel movements as well as better skin tone.
Sample Procedure
The sample kit is made up of one 50 mg tablet, a 3 liter orange urine sample bottle, two vials, 16 ounce collection cup, and shipping material including one pre-paid return mailing label and a zip lock bag with absorption materials to be wrapped about each specimen vial before shipment).
General 24 hr evaluation routine:
1. Dispose of the first morning void
2. Take one tablet Iodoral fifty mg
3. Initiate collection of urine following instructions included within the kit
4. The earliest void during the following morning should be included for the urine collection
5. If complete urine volume is above three liters use instructions supplied with the kit.
Bromide evaluation
In addition to Iodine test we additionally offer bromide evaluation to determine if this hazardous goitrogen exists inside the body. Unwanted bromide concentrations can bring about diminished thyroid function and general body fatigue.
https://www.drbethanybarnes.com/elemental-iodine-impact-environmental-hazards.jsp
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