Iodine and Thyroid Iodine and Thyroid FunctionFunction

A Question of BalanceA Question of Balance

Swiss Physician J.F. Coindet Swiss Physician J.F. Coindet 18121812

Had success treating goiter (extreme Had success treating goiter (extreme hypothyroidism) with seaweed and hypothyroidism) with seaweed and reasoned elemental iodine was the reasoned elemental iodine was the primary reason for his patient’s primary reason for his patient’s improvement. He tried tincture of improvement. He tried tincture of iodine at 250 mg per day with great iodine at 250 mg per day with great success in 150 goiter patients success in 150 goiter patients

French Physician Gene Lugol French Physician Gene Lugol 18291829

Devised his formula of 12.5 to 37.5 Devised his formula of 12.5 to 37.5 mg of iodine with potassium iodide in mg of iodine with potassium iodide in water as the most efficient and water as the most efficient and sufficient dose. Addition of potassium sufficient dose. Addition of potassium iodide increased the solubility of iodide increased the solubility of iodine sufficiently to be more iodine sufficiently to be more clinically valuable. clinically valuable.

IODINEIODINE Iodine is the one halogen the body requires for Iodine is the one halogen the body requires for

many biochemical processes. many biochemical processes. chlorine, bromine and fluorine are the others in order of chlorine, bromine and fluorine are the others in order of

increasing oxidizing potentialincreasing oxidizing potential 0.05 mg/day of iodine is necessary to prevent 0.05 mg/day of iodine is necessary to prevent

goiter but is not enough for optimal health goiter but is not enough for optimal health One gram of salt contains 77 mcg of iodine. One gram of salt contains 77 mcg of iodine.

Because of the high chloride content in table salt, Because of the high chloride content in table salt, some experts estimate that only about 10% of some experts estimate that only about 10% of the iodine in iodized salt is actually absorbed. the iodine in iodized salt is actually absorbed.

Even though the chloride in table salt is a Even though the chloride in table salt is a competing halide (chlorine - halogen) there is competing halide (chlorine - halogen) there is enough uptake of iodine in iodized salt from the enough uptake of iodine in iodized salt from the potassium iodide to prevent goiter.potassium iodide to prevent goiter.

The recommended daily allowance (RDA) of The recommended daily allowance (RDA) of iodine is 150 mcg iodine is 150 mcg somewhat higher for pregnant women and certain other somewhat higher for pregnant women and certain other

groups groups

Iodine Containing FoodsIodine Containing Foods Iodized salt, sea salt, and salty foodsIodized salt, sea salt, and salty foods All dairy products (milk, sour cream, cheese, cream, All dairy products (milk, sour cream, cheese, cream,

yogurt, butter, ice cream) yogurt, butter, ice cream) Margarine Margarine Egg yolks Egg yolks Seafood (fish, shellfish, seaweed, kelp) Seafood (fish, shellfish, seaweed, kelp) Foods that contain carrageen, agar-agar, algin, or Foods that contain carrageen, agar-agar, algin, or

alginate - all of these are made from seaweed alginate - all of these are made from seaweed Many prepared and/or cured meats (ham, bacon, Many prepared and/or cured meats (ham, bacon,

sausage, corned beef, etc) sausage, corned beef, etc) Fresh chicken or turkey with broth or additives injected Fresh chicken or turkey with broth or additives injected Dried fruit Dried fruit Canned vegetables Canned vegetables Commercial bakery products Commercial bakery products Chocolate Chocolate Molasses Molasses Soy products (soy sauce, soy milk, tofu) Soy products (soy sauce, soy milk, tofu) Any vitamins or supplements that contain iodine Any vitamins or supplements that contain iodine FD&C red dye #3 - this appears in many foods or pills FD&C red dye #3 - this appears in many foods or pills

that are red or brown, including colasthat are red or brown, including colas

Medications Containing IodineMedications Containing Iodine Amiodarone Amiodarone Cordarone® Cordarone® Pacerone®Pacerone® Iodoquinol Iodoquinol Yodoxin®Yodoxin® Vytone®Vytone® Potassium iodidePotassium iodide

SSKI® (Lugol’s solution) SSKI® (Lugol’s solution) x-ray dyes x-ray dyes

CAT scans CAT scans IVP’s IVP’s arteriograms arteriograms Myelograms Myelograms

Medicated DouchesMedicated Douches Bet adine® Bet adine®

Medicated Douche Medicated Douche Massengil® Massengil®

Medicated Douce Medicated Douce povidone- iodine povidone- iodine

douches douches Iodine topical ointmentsIodine topical ointments

Povidone-Povidone- Betadine® ointment Betadine® ointment

KI Syrup® KI Syrup® Pediacof Syrup® Pediacof Syrup® Pima Syrup® Pima Syrup®

Kelp Kelp

IODIDE TRAPPINGIODIDE TRAPPING

The basil membrane of the thyroid The basil membrane of the thyroid cell has the specific ability to pump cell has the specific ability to pump iodine into the interior of the thyroid iodine into the interior of the thyroid cell. This is called cell. This is called Iodide TrappingIodide Trapping. .

In a normal gland the iodine pump In a normal gland the iodine pump concentrates the iodide to about 30 concentrates the iodide to about 30 times the concentration in blood. The times the concentration in blood. The rate of trapping is influenced by TSH rate of trapping is influenced by TSH in a negative feedback control in a negative feedback control method. (17) method. (17)

Sodium – Iodide Symporter Sodium – Iodide Symporter An integral membrane protein that resides in An integral membrane protein that resides in

the membrane of thyroid epithelial cellsthe membrane of thyroid epithelial cells Simultaneously transports both Na+ and I- ions Simultaneously transports both Na+ and I- ions

from extracellular fluid (i.e. blood) into the from extracellular fluid (i.e. blood) into the thyroid epithelial cell thyroid epithelial cell

Abnormalities in expression or function of the Abnormalities in expression or function of the symporter can lead to thyroid disease symporter can lead to thyroid disease

Most highly expressed in thyroid epithelial cells Most highly expressed in thyroid epithelial cells Lower levels of expression can be detected in Lower levels of expression can be detected in

mammary gland, mammary gland, salivary glandsalivary gland, stomach and , stomach and colon colon

None of these tissues is known to organify iodide None of these tissues is known to organify iodide Presence of the symporter in mammary gland leads Presence of the symporter in mammary gland leads

to secretion of iodine in milk, which is probably to secretion of iodine in milk, which is probably important for thyroid function in neonatal animals important for thyroid function in neonatal animals

Sodium – Iodide SymporterSodium – Iodide Symporter

One atom of iodine is transported into the cells for One atom of iodine is transported into the cells for every 2 atoms of sodium via the sodium/iodine every 2 atoms of sodium via the sodium/iodine symporter (NIS) symporter (NIS)

There is also a chloride/iodide symporter called There is also a chloride/iodide symporter called pendrin pendrin

Goitrogens can bind to the NIS receptor and Goitrogens can bind to the NIS receptor and damage it preventing iodine from entering the cell damage it preventing iodine from entering the cell

Normal saliva/serum iodide ratio is about 42. Less Normal saliva/serum iodide ratio is about 42. Less than 20 may be due to toxins or very high levels than 20 may be due to toxins or very high levels of bromine/fluorine binding to the symporter of bromine/fluorine binding to the symporter

The receptor can possibly be repaired with The receptor can possibly be repaired with vitamin C (3000 mg/day) and Celtic (unrefined) vitamin C (3000 mg/day) and Celtic (unrefined) sea salt. (16)sea salt. (16)

CHEMICAL GOITROGENSCHEMICAL GOITROGENS Bromine Bromine

from fruit fumigants and processed bakery productsfrom fruit fumigants and processed bakery products

Chlorine Chlorine chloramine byproduct from drinking water chloramine byproduct from drinking water

chlorinationchlorination Ammonium perchlorate Ammonium perchlorate

rocket fuel found in tap waterrocket fuel found in tap water Fluorine Fluorine

naturally occurring in well water plus drinking water naturally occurring in well water plus drinking water fluoridationfluoridation

Thiocyanate Thiocyanate from cigarette smokefrom cigarette smoke

DIETARY GOITROGENSDIETARY GOITROGENS Cruciferous vegetables including: Cruciferous vegetables including:

Broccoli Broccoli Brussel sprouts Brussel sprouts Cabbage Cabbage Cauliflower Cauliflower Kale Kale Kohlrabi Kohlrabi Mustard Mustard Rutabaga Rutabaga Turnips Turnips

Other Foods Containing GoitrogensOther Foods Containing Goitrogens MilletMillet PeachesPeaches PeanutsPeanuts RadishesRadishes Soybean and soy products, including tofuSoybean and soy products, including tofu SpinachSpinach StrawberriesStrawberries

Dealing with Dietary GoitrogensDealing with Dietary Goitrogens The goal is not to eliminate goitrogenic foods from the meal plan, The goal is not to eliminate goitrogenic foods from the meal plan,

but to limit intake so that it falls into a reasonable range. but to limit intake so that it falls into a reasonable range. Limiting goitrogenic intake is often much more problematic with Limiting goitrogenic intake is often much more problematic with

soy foods than with cruciferous vegetables, since soy appears in soy foods than with cruciferous vegetables, since soy appears in so many combination and packaged food products in hidden form. so many combination and packaged food products in hidden form. Ingredients like textured vegetable protein (TVP) and isolated soy Ingredients like textured vegetable protein (TVP) and isolated soy concentrate may appear in foods that would rarely be expected to concentrate may appear in foods that would rarely be expected to contain soy.contain soy.

Isoflavones like genistein appear to reduce thyroid hormone output by Isoflavones like genistein appear to reduce thyroid hormone output by blocking activity of an enzyme called blocking activity of an enzyme called thyroid peroxidasethyroid peroxidase. This enzyme . This enzyme is responsible for adding iodine onto the thyroid hormones.is responsible for adding iodine onto the thyroid hormones.

A standard, one cup serving of cruciferous vegetables 2-3 times A standard, one cup serving of cruciferous vegetables 2-3 times per week, and a standard, 4-ounce serving of tofu twice a week is per week, and a standard, 4-ounce serving of tofu twice a week is likely to be tolerated by many individuals with thyroid hormone likely to be tolerated by many individuals with thyroid hormone deficiency. It's worth it to try and include these foods in a meal deficiency. It's worth it to try and include these foods in a meal plan because of their strong nutritional value and great track plan because of their strong nutritional value and great track record in preventing many kinds of health problems. record in preventing many kinds of health problems.

Cooking does appear to help inactivate the goitrogenic Cooking does appear to help inactivate the goitrogenic compounds found in food. Both isoflavones (found in soy foods) compounds found in food. Both isoflavones (found in soy foods) and isothiocyanates (found in cruciferous vegetables) appear to and isothiocyanates (found in cruciferous vegetables) appear to be heat-sensitive, and cooking appears to lower the availability of be heat-sensitive, and cooking appears to lower the availability of these substances. In the case of isothiocyanates in cruciferous these substances. In the case of isothiocyanates in cruciferous vegetables like broccoli, as much as one third of this goitrogenic vegetables like broccoli, as much as one third of this goitrogenic substance may be deactivated when broccoli is boiled in water. substance may be deactivated when broccoli is boiled in water.

Salivary, Urinary or Serum Iodine ?Salivary, Urinary or Serum Iodine ?

There is ample evidence of renal iodine clearance There is ample evidence of renal iodine clearance in the literature in Dr. Abraham’s references and in the literature in Dr. Abraham’s references and some evidence of salivary uptake from other some evidence of salivary uptake from other sources. sources.

According to Mr. Zareba under a NASA grant, the According to Mr. Zareba under a NASA grant, the mean correlation coefficient ( mean correlation coefficient ( r r ) between iodine ) between iodine elimination for blood/saliva was 0.99, for elimination for blood/saliva was 0.99, for blood/urine, 0.95, and for saliva/urine, 0.97. blood/urine, 0.95, and for saliva/urine, 0.97.

The absolute value of iodine concentrations in The absolute value of iodine concentrations in urine revealed marked variability, which was urine revealed marked variability, which was corrected by adjusting for creatinine levels. (15) corrected by adjusting for creatinine levels. (15)

With a normal symporter there is excellent With a normal symporter there is excellent correlation between the iodine concentration correlation between the iodine concentration increase in serum and saliva. However, the timing increase in serum and saliva. However, the timing is different. is different.

Salivary, Urinary or Serum Iodine ?Salivary, Urinary or Serum Iodine ?

From Bruger and Member, thyroxine was not From Bruger and Member, thyroxine was not concentrated from the blood to saliva but concentrated from the blood to saliva but elemental potassium iodide (KI) was from 5 to 7 elemental potassium iodide (KI) was from 5 to 7 times that of the blood. times that of the blood.

The maximal amount of iodine concentrated in The maximal amount of iodine concentrated in the saliva occurred 1 to 2 ½ hours after ingestion the saliva occurred 1 to 2 ½ hours after ingestion of KI peaking to 1200 times the initial salivary of KI peaking to 1200 times the initial salivary iodide. The salivary/blood iodine ratio in the iodide. The salivary/blood iodine ratio in the control period was 6 and reached a maximum of control period was 6 and reached a maximum of 28, 8 hours after ingestion of the iodide. (18) 28, 8 hours after ingestion of the iodide. (18)

Obviously measuring salivary iodide within Obviously measuring salivary iodide within several hours of supplementation will result in a several hours of supplementation will result in a very high unusable reading. This effect has been very high unusable reading. This effect has been verified by our own tests. verified by our own tests. Note that normal iodide trapping in the thyroid is about Note that normal iodide trapping in the thyroid is about

30 times that in the blood. 30 times that in the blood.

Salivary, Urinary or Serum Iodine ?Salivary, Urinary or Serum Iodine ?

The hypothesis is that since the salivary The hypothesis is that since the salivary iodide uptake from the interstitium and iodide uptake from the interstitium and thyroid trapping iodide from the blood is thyroid trapping iodide from the blood is approximately the same order over time, approximately the same order over time, the the saliva uptake can be a rough saliva uptake can be a rough indication of thyroid uptakeindication of thyroid uptake. .

If this is true then the If this is true then the saliva/urine ratio saliva/urine ratio can be a rough indication of thyroid can be a rough indication of thyroid iodide sufficiencyiodide sufficiency. . There is some anecdotal evidence from non-There is some anecdotal evidence from non-

traditional research to suggest this traditional research to suggest this relationship. relationship.

IODINE AND IODINE AND CHRONIC FATIGUECHRONIC FATIGUE

Dr. Brownstein writes: “The illnesses that Dr. Brownstein writes: “The illnesses that iodine/iodide has helped are many. These iodine/iodide has helped are many. These conditions include fibromyalgia, thyroid conditions include fibromyalgia, thyroid disorders, chronic fatigue immune disorders, chronic fatigue immune deficiency syndrome, autoimmune disorders deficiency syndrome, autoimmune disorders as well as cancer. Most patients who are as well as cancer. Most patients who are deficient in iodine will respond positively to deficient in iodine will respond positively to iodine supplementation. iodine supplementation.

In fact, I have come to the conclusion that In fact, I have come to the conclusion that iodine deficiency sets up the immune iodine deficiency sets up the immune system to malfunction which can lead to system to malfunction which can lead to many of the above disorders developing. many of the above disorders developing. Every patient could benefit from a thorough Every patient could benefit from a thorough evaluation of their iodine levels.” (2) evaluation of their iodine levels.” (2)

Iodine and Iodine and Fibrocystic Breast DiseaseFibrocystic Breast Disease

Mainland Japanese women have a very low Mainland Japanese women have a very low incidence and prevalence of FDB and breast incidence and prevalence of FDB and breast cancer. (13) Several investigators have proposed cancer. (13) Several investigators have proposed that the essential element I was the protective that the essential element I was the protective factor in mainland Japanese. (4 – 10) If indeed, factor in mainland Japanese. (4 – 10) If indeed, the essential element I is the postulated the essential element I is the postulated protective factor, the administration of I to protective factor, the administration of I to American women in amounts equivalent to that American women in amounts equivalent to that consumed by mainland Japanese women would consumed by mainland Japanese women would be expected to protect them from breast cancer be expected to protect them from breast cancer and improve FDB, as previously proposed by and improve FDB, as previously proposed by Stadel for breast cancer and confirmed for FDB by Stadel for breast cancer and confirmed for FDB by Ghent et al. (7) Ghent et al. (7)

Based on data supplied by the Japanese Ministry Based on data supplied by the Japanese Ministry of Health, the average daily I intake in mainland of Health, the average daily I intake in mainland Japanese is 13.8 mg. (6) Japanese is 13.8 mg. (6)

IODINE andIODINE andBREAST CANCERBREAST CANCER

The administration of thyroid hormones to I-deficient The administration of thyroid hormones to I-deficient women may increase further their risk for breast women may increase further their risk for breast cancer. cancer.

In a group of women undergoing mammography for In a group of women undergoing mammography for screening purposes (14) the incidence of breast screening purposes (14) the incidence of breast cancer was twice as high in women receiving thyroid cancer was twice as high in women receiving thyroid medications for hypothyroidism (most likely induced medications for hypothyroidism (most likely induced by I deficiency) than women not on thyroid by I deficiency) than women not on thyroid supplement. supplement.

The mean incidences were 6.2% in controls and The mean incidences were 6.2% in controls and 12.1% in women on thyroid hormones. 12.1% in women on thyroid hormones.

The incidence of breast cancer was twice as high in The incidence of breast cancer was twice as high in women on thyroid hormones for more than 15 years women on thyroid hormones for more than 15 years (19.5%) compared to those on thyroid hormones for 5 (19.5%) compared to those on thyroid hormones for 5 years (10%).years (10%).

Case ExamplesCase Examples

J was supplementing Iodoral® (7.5 mg KI + J was supplementing Iodoral® (7.5 mg KI + 5 mg Iodine per tab) at the rate of 50 5 mg Iodine per tab) at the rate of 50 mg/day for nine months (without adverse mg/day for nine months (without adverse effect) encouraged by the idea of clearing effect) encouraged by the idea of clearing mercury toxicity (a dental assistant) and mercury toxicity (a dental assistant) and tested at 25 PPM saliva and 60 PPM urine tested at 25 PPM saliva and 60 PPM urine iodide. One would expect that after nine iodide. One would expect that after nine months supplementation at this dosage, months supplementation at this dosage, iodine sufficiency would have been reached. iodine sufficiency would have been reached. The saliva/urine ratio ofThe saliva/urine ratio of

< 1 suggests this conclusion.< 1 suggests this conclusion.

Case ExamplesCase Examples

Dr. T supplementing for many years with an Dr. T supplementing for many years with an organic bound iodine in seaweed extract organic bound iodine in seaweed extract tested 17 PPM saliva and 15 PPM urine. The tested 17 PPM saliva and 15 PPM urine. The supplementation will continue but one would supplementation will continue but one would expect sufficiency with this long term expect sufficiency with this long term supplementation. Again the ratio approached supplementation. Again the ratio approached 1.1.

B supplementing 6 months 12.5 mg/day B supplementing 6 months 12.5 mg/day Iodoral® tested 9 PPM saliva and 6 PPM urine Iodoral® tested 9 PPM saliva and 6 PPM urine suggesting a higher dosage could be used to suggesting a higher dosage could be used to approach higher residual levels and a lower approach higher residual levels and a lower ratio suggesting sufficiency as not reached. ratio suggesting sufficiency as not reached. The 24 urine iodine loading test would be The 24 urine iodine loading test would be

appropriate.appropriate.

Case ExamplesCase Examples B supplementing 6 months 12.5 mg/day Iodoral® tested 9 B supplementing 6 months 12.5 mg/day Iodoral® tested 9

PPM saliva and 6 PPM urine suggesting a higher dosage PPM saliva and 6 PPM urine suggesting a higher dosage could be used to approach higher residual levels and a could be used to approach higher residual levels and a lower ratio suggesting sufficiency is not reached. lower ratio suggesting sufficiency is not reached. The 24 urine iodine loading test would be appropriate.The 24 urine iodine loading test would be appropriate.

M was not supplementing but ate substantial amounts of M was not supplementing but ate substantial amounts of seafood and mostly Mexican foods but very little US seafood and mostly Mexican foods but very little US produced processed foods. M’s saliva tested 17 PPM and produced processed foods. M’s saliva tested 17 PPM and urine 15 PPM.urine 15 PPM.

20 other subjects were tested who were not supplementing 20 other subjects were tested who were not supplementing except for iodized salt and multivitamin tabs with iodine in except for iodized salt and multivitamin tabs with iodine in the 100 ug range. None were consuming substantial ocean the 100 ug range. None were consuming substantial ocean dwelling foods. Usual tests were 1 PPM saliva and 0.1 PPM dwelling foods. Usual tests were 1 PPM saliva and 0.1 PPM urine. The absolute values are very low and the ratio is 10. urine. The absolute values are very low and the ratio is 10. A 24 hour urine loading tests would probably support A 24 hour urine loading tests would probably support

this conclusion.this conclusion. Testing was performed in the morning with no fast Testing was performed in the morning with no fast

required. It is recommended that a 12 hour fast, 8:00 PM to required. It is recommended that a 12 hour fast, 8:00 PM to 8:00 AM for example, be required in order to minimize the 8:00 AM for example, be required in order to minimize the effects of hydration.effects of hydration.

PTPT thyroithyroidd

volumvolumee

TSHTSH MIU/LMIU/L T4T4 Mcg/Mcg/dldl

FT4FT4 Ng/dlNg/dl FT3FT3 Pg/dlPg/dl

prepre postpost prepre postpost prepre postpost prepre postpost prepre postpost

11 4.354.35 3.63.6 7.87.8 1.41.4 9.29.2 7.97.9 0.850.85 1.31.3 2.92.9 2.52.5

22 5.55.5 5.55.5 2.02.0 2.22.2 10.710.7 8.98.9 1.11.1 1.11.1 2.52.5 2.52.5

33 4.74.7 5.65.6 3.43.4 5.15.1 9.69.6 6.46.4 1.11.1 1.11.1 2.72.7 2.82.8

44 5.95.9 1212 2.72.7 6.16.1 8.78.7 8.08.0 1.21.2 1.21.2 3.03.0 3.23.2

55 5.75.7 8.98.9 1.41.4 1.11.1 6.36.3 6.36.3 1.01.0 1.21.2 2.92.9 2.92.9

66 11.611.6 9.59.5 1.01.0 0.340.34 7.57.5 6.96.9 1.21.2 1.11.1 2.92.9 2.72.7

77 7.07.0 6.16.1 1.41.4 2.32.3 8.28.2 66 1.01.0 0.840.84 2.92.9 2.72.7

88 6.76.7 7.57.5 2.32.3 1.31.3 9.49.4 7.47.4 1.01.0 1.151.15 2.72.7 3.13.1

99 15.815.8 14.714.7 0.760.76 0.530.53 9.79.7 88 1.21.2 1.31.3 3.13.1 3.43.4

1010 9.29.2 7.77.7 21.521.5 11.911.9 8.38.3 5.45.4 1.21.2 0.90.9 2.82.8 2.62.6

MEAMEANN

7.77.7 8.18.1 4.44.4 3.23.2 8.88.8 7.17.1 1.11.1 1.11.1 2.82.8 2.82.8

SDSD 3.63.6 3.33.3 6.346.34 3.63.6 1.31.3 1.11.1 0.120.12 0.160.16 0.170.17 0.310.31

pp 0.290.29 0.180.18 <.01<.01 0.340.34 0.500.50Effect of Iodide Supplementation in daily amount of 12.5 mg for3 consecutive months on thyroid volume and thyroid function tests

IODINE OR NO IODINEIODINE OR NO IODINE

Iodine increases thyroid function if Iodine increases thyroid function if the individual is iodine deficientthe individual is iodine deficient

Iodine decreases thyroid function if Iodine decreases thyroid function if the individual is sufficientthe individual is sufficient

We don’t know the optimal dose or We don’t know the optimal dose or what individual factors affect what individual factors affect outcomeoutcome

Thyrodine Quantitative Fluid Analyzer for Iodide

An instrument that precisely measures iodide concentrations in body fluids. The analyzer will very accurately report these parameters:Iodine in saliva as an indirect measurement of the interstitial iodine concentration level.Iodine in whole blood as an indirect measurement of the sodium/iodine symporter efficency.Iodine in urine as an indicator of the body’s iodine sufficiency

Future Studies The Thyrodine Device does not purport to provide The Thyrodine Device does not purport to provide

sensitivities less than 0.1 mg/L (PPM) but is sensitive sensitivities less than 0.1 mg/L (PPM) but is sensitive enough to measure the uptake effects of iodine enough to measure the uptake effects of iodine supplementation whether in Lugol’s formula (as Iodoral® supplementation whether in Lugol’s formula (as Iodoral® of 7.5 mg potassium iodide and 5 mg elemental iodine) or of 7.5 mg potassium iodide and 5 mg elemental iodine) or other organic form such as kelp, dulse or seaweed extract.other organic form such as kelp, dulse or seaweed extract.

The hypothesis of measuring the ratios of saliva vs urine The hypothesis of measuring the ratios of saliva vs urine iodine as a measure of sufficiency and blood vs. urine as iodine as a measure of sufficiency and blood vs. urine as an indicator of availability of iodine for the tissues (iodine an indicator of availability of iodine for the tissues (iodine symporter) is unproven except from anecdotal information. symporter) is unproven except from anecdotal information.

We have started a clinical trial to evaluate iodine We have started a clinical trial to evaluate iodine supplementation and thyroid function. We will see what supplementation and thyroid function. We will see what levels of bromide, chloride and fluoride are in the urine as levels of bromide, chloride and fluoride are in the urine as well as iodine and hope to find out if there is some well as iodine and hope to find out if there is some competition between halides and if iodide supplementation competition between halides and if iodide supplementation above sufficiency levels cause thyroid dysfunction.above sufficiency levels cause thyroid dysfunction.

ReferencesReferences 1. Hintze, G., Emrich, D., Kobberling, J., Treatment of endemic goitre due to 1. Hintze, G., Emrich, D., Kobberling, J., Treatment of endemic goitre due to

iodine deficiency with iodine, levothyroxine or both: results of a multicentre iodine deficiency with iodine, levothyroxine or both: results of a multicentre trial. European Journal of Clinical Investigation, 19:527-534, 1989.trial. European Journal of Clinical Investigation, 19:527-534, 1989.

2. Brownstein, D., Clinical experience with inorganic, non-radioactive 2. Brownstein, D., Clinical experience with inorganic, non-radioactive iodine/iodide. The Original Internist, 12(3):105-108, 2005iodine/iodide. The Original Internist, 12(3):105-108, 2005

3. Eskin B., Bartuska D., Dunn M., Jacob G., Dratman M., Mammary Gland 3. Eskin B., Bartuska D., Dunn M., Jacob G., Dratman M., Mammary Gland Dysplasia in Iodine Deficiency, JAMA, 200:115-119, 1967.Dysplasia in Iodine Deficiency, JAMA, 200:115-119, 1967.

4. Eskin, B., Iodine Metabolism and Breast Cancer. Trans. New York, Acad. of 4. Eskin, B., Iodine Metabolism and Breast Cancer. Trans. New York, Acad. of Sciences, 32:911-947, 1970.Sciences, 32:911-947, 1970.

5. Funahashi, H., Imaj, T., Tanaka, Y., et al, Suppressive Effect of Iodine on 5. Funahashi, H., Imaj, T., Tanaka, Y., et al, Suppressive Effect of Iodine on DMBA-Induced Breast Tumor Growth in the Rat. Journal of Surgical DMBA-Induced Breast Tumor Growth in the Rat. Journal of Surgical Oncology, 61:209-213, 1996.Oncology, 61:209-213, 1996.

6. Ghent, W., Eskin, B., Low, D., Hill, L., Iodine Replacement in Fibrocystic 6. Ghent, W., Eskin, B., Low, D., Hill, L., Iodine Replacement in Fibrocystic Disease of the Breast, Can. J. Surg., 36:453-460, 1993. 7. Derry, D., Breast Disease of the Breast, Can. J. Surg., 36:453-460, 1993. 7. Derry, D., Breast Cancer and Iodine, Trafford Publishing, Victoria B.C., 92, 2001.Cancer and Iodine, Trafford Publishing, Victoria B.C., 92, 2001.

8. Vishnyakova, V.V., Murav’yeva, N.L., On the Treatment of Dyshormonal 8. Vishnyakova, V.V., Murav’yeva, N.L., On the Treatment of Dyshormonal Hyperplasia of Mammary Glands, Vestn Akad Med Navk SSSR, 21:19-22, Hyperplasia of Mammary Glands, Vestn Akad Med Navk SSSR, 21:19-22, 1966.1966.

9. Cann S., Netten J., Netten C., Hypothesis: Iodine, selenium and the 9. Cann S., Netten J., Netten C., Hypothesis: Iodine, selenium and the development of breast cancer, Cancer Causes and Control 11:121-127, 2000.development of breast cancer, Cancer Causes and Control 11:121-127, 2000.

10. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to 10. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976. 11. Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976. 11. Epstein, S.S., Steinman, D., Breast Cancer Prevention Program. Macmillan, Epstein, S.S., Steinman, D., Breast Cancer Prevention Program. Macmillan, NY, 1998, pg 5. NY, 1998, pg 5.

12. Waterhouse, J., Shanmvgakatnam, K., et al, Cancer incidence in five 12. Waterhouse, J., Shanmvgakatnam, K., et al, Cancer incidence in five continents. LARC Scientific Publications, International Agency for Research continents. LARC Scientific Publications, International Agency for Research on Cancer, Lyon, France, 1982.on Cancer, Lyon, France, 1982.

ReferencesReferences 13. Stadel B., Dietary Iodine and Risk of Breast, Endometrial, and Ovarian 13. Stadel B., Dietary Iodine and Risk of Breast, Endometrial, and Ovarian

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to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976.to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976. 15. Grazyna Zareba, Elsa Cernichiari, Lowell A. Goldsmith, and Thomas W. 15. Grazyna Zareba, Elsa Cernichiari, Lowell A. Goldsmith, and Thomas W.

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