iodine why you need it (presentation)
TRANSCRIPT
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―Don’t Take Iodine!
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Medical Iodophobia
“Medical iodophobia is the unwarranted
fear of using and recommending
inorganic, non-radioactive iodine/iodidewithin the range known from the
collective experience of three generations
of clinicians to be the safest and mosteffective amounts for treating symptoms
and signs of iodine/iodide deficiency
(12.5-50mg/day).”
Dr. G. Abraham, 2004
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Edgar Cayce
“There are only four elements in the body:
water, salt, soda and iodine.”
―If we have adequate amounts of these four
elements in balance, the body is fully capable ofcreating all other elements in the universe.‖
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• Both benign and malignant thyroid
nodules have significantly less iodine than
normal thyroid tissue
Thyroid Nodules and Iodine
Analyst. March 1995, Vol. 12
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
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Periodic TablePeriodic Table
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Periodic TablePeriodic Table
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History of Iodine
• Discovered in 1811
• First used by Dr. William Prout (1816) inLondon
for a patient with goiter
J. Royal Soc. Of Med.
http://en.wikipedia.org/wiki/File:Prout_William_painting.jpg
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History of Iodine
• In 1820, Coindet (Geneva) reported efficacy
in treating goiter
•
Recommended iodine preoperatively to diminishgoiter size and vascularity
• He encountered stiff opposition with opponents
claiming iodine was poisonous
•
Coindet would not leave his house for fear of beingstoned in the street!
J. Royal Soc. Of Med.
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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)
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Life Stage RDA
Adult Male 150 g/d
Adult Female 150 g/d
Pregnancy 220 g/d
Lactation 290 g/d
RDA for Iodine
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National Health and Nutrition
Survey
• 1971-2000 NHANES
showed iodine levels
declined 50% in theUnited States
U r
i n a r y i o d i n e l e v e l s µ g / d l
1970 2000
CDC
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National Health and Nutrition
Survey
• 1971-2000 NHANES showed iodine levelsdeclined 50% in the United States
• During this time, increased incidence of:• Thyroid illnesses (hypo, autoimmune,
cancer)
• Cancers of the breast, prostate,
endometrium and ovaries
• All of the above conditions can be causedby iodine deficiency.
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National Health and Nutrition
Survey (2)
• The proportion of the U.S. population
with moderate to severe iodine deficiency
(
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Severe Iodine Deficiency in
U.S. From 1970-2006
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
1970 1990 2005 2006 2011???
% Population Severely Iodine Deficient
NHANES CDC
Thyroid 2011. Vol. 21. Number 4, 2011
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FP News.
11.13.08
―More than
70% of women
with access to
dietary iodine
may remain at
risk for
unrecognizediodine
deficiency
during
pregnancy.‖
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Pregnancy and Iodine
• 16.8% of U.S. women of childbearing age
had urinary iodine concentrations
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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 afterdelivery
Thyroid.Vol. 19. N. 5. 2009. 511-519
All children given a neurocognitive evaluation at 18 months
of age
All groups supplemented with KI until end of lactation.
The Importance of Ensuring
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The Importance of Ensuring
Optimal Prenatal Iodine Intake(2)
P e r c e n t i l e o f F T 4 a t t
e r m
Thyroid.Vol. 19. N. 5. 2009. 511-519
The Importance of Ensuring
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The Importance of Ensuring
Optimal Prenatal Iodine Intake(2)
P e r c e n t i l e o f F T 4 a t t
e r m
Thyroid.Vol. 19. N. 5. 2009. 511-519
The Importance of Ensuring
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The Importance of Ensuring
Optimal Prenatal Iodine Intake(2)
P e r c e n t i l e o f F T 4 a t t
e r m
Thyroid.Vol. 19. N. 5. 2009. 511-519
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Mean IQ
Thyroid.Vol. 19. N. 5. 2009. 511-519
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.‖
I
Q
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Iodine and IQ
• Meta-analysis of 18 studies
• Children and adolescents
• Found iodine deficiency associated with a
13.5 point lower IQ score in children and
adolescents
In Stanbury, JB (ed). The Damaged Brain of Iodine Deficiency. N.Y. 1994pp. 195-2000
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Iodine and Immunity
• Iodine:
• Has been shown to increase the movement of
granulocytes into areas of inflammation
• Improves the phagocytosis of bacteria by
granuloyctes
• Improves ability of granulocytes to kill bacteria
Med Hyppothesis. 1988;25:125-9
Iodine has a major physiologic role in the inflammatory
process
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Iodine and Immunity
• Iodine has been used in various infectious
illnesses including:• Leprosy
• Sporotrichosis
• Syphilis
• Mycosis
• Tubercular granulomatious
Minerva Med. 198677:805-9
The positive effect of iodine is not related to a direct effect onthe microorganism.
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Iodine and Immunity
• Type 3 Deiodinase
• Catalyzes inactivation of T4 into rT3
• Releases an atom of I
• Expressed in granulocytes and
monocarboxylate transporter-8
•
Found at sites of inflammation
Endocrin. 2005;146:5128-34
J. Biol. Chem. 2003;278:40:128-35
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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
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Newborn Thyroid Gland
• Only holds a 24 hour reserve of iodine
• Fresh sources must be supplied in diet
Biochimie 1999, 81, 563-570
J. Pediat. Endocrin. Metabl. 2003, 16,521-28
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Breast Milk Iodine
• 47% of women sampled may be
providing insufficient iodine to meet
infants‟ requirements
J. Clin. Endocr. And Metab. 92: 1673-77
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Breast Milk and Iodine
• 13 breast feeding women
• Milk
• 12/13 (92%) had inadequate iodine inbreast milk
• 9/13 (69%) samples high in perchlorate
Env. Sci. and Tech. Vol. 42. No. 21. 2008
―…we were…dismayed to note that while little of the maternal
iodine (21%) finds its way to milk, the bulk of the perchlorate
intake ends up in milk.‖
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Milk and Iodine
• Between 1965 and 1980, U.S. milk iodine
content increased by 300-500%
• Changes in cattle feeds
• 1986, amount of organic iodine
ethylenediamine dihydroiodine (EDDI) in
cattle limited to 10mg/cow/day
J. Am. Vet. Med. Assoc. 176:1119-1121
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Iodine Content of U.S. Dairy
Whole Milk
• 1978: 602µg/L
• 1990: 155µg/L
• Recent Measurements:
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Rapeseed and iodine
• When rapeseed fed to cows resulted in an
increased thiocyanite level
• Milk iodine reduced by 17%
• Similar results have been shown in pigs
Br. J. of Nutr. 85:659-70. 2001
Nat. Inst. of Animal Science. Foulum, Denmark. 19
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Why Iodine?
• 1.9 billion individuals world-wide estimated to have inadquateiodine nutrition
• WHO claims iodine deficiency is the world‟s greatest single causeof preventable mental retardation
• WHO estimates that there are 300,000,000 school-aged childrenworldwide who are iodine deficient (36% of school aged children)
• Over half of the population of Europe live in areas of iodinedeficiency
• 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 iodinedeficiency Lancet. 2003;362:1859-60
WHO
J. Clin. Endocrinand Metabl. 2007;92:437-442Anderson, M. 2007 Iodine deficiency in
Europe: a continuing public health problem.
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Why Iodine?
• 100 consecutive healthy pregnant
Bostonians
• 50% found to be below the RDA 220 µg/day
• 9% below 50 µg/day
• WHO recognizes as severe iodine deficiency
Thyroid 2004;14:327-
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Iodine and Autism
• As similar to the U.S., a pattern of iodine
decline in a population and a
concomitant increase in autism has beenseen in other countries
• England, New Zealand, Australia, Italy
BMJ. 2004;328:227
Arch. Des. Child. Fetal Neonatal Ed. 2004. Sep;89(5):F436-9Med. J. Aust. 2003;178(4):159-162
Asia Pac. J. Clin. Nutr. 2003;12. Suppl. S15
BMJ Letters. 10.13.04. http://bmj.com/cgi/eletters/328/7433/226-c
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Iodine and ADD
• 16 women from iodine-deficient area of
Italy compared to 7 women from higher
iodine area• Pregnancy
• Women from iodine deficient area had:
• Reduced T4, decrease of FT4 with elevatedTSH in 50% of pregnant women
Clin. Endocr. 1995 APrl.;42(4):40
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“It is hypothesized that the imbalance of
maternal thyroid hormone homeostasis during
pregnancy as a consequence of endemic iodinedeficiency may be responsible for the impaired
psychoneurological development observed in
children from that area. Appropriate iodine
and/or thyroxine prophylaxis to women in thatregion may prevent the neurobehavioral,
cognitive and motor compromise of that
population.”
Iodine and ADD
Clin. Endocr. 1995 APrl.;42(4):40
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Iodine and ADD
• 16 Women living in a iodine-deficientarea versus 11 women living in an iodine-
sufficient area• 10 years follow-up
• ADHD diagnosed in 11/16 in iodine-deficient area versus 0/11 in iodine-sufficient area
• IQ lower in iodine-deficient area-- 88versus IQ of 99 in iodine-sufficient area
J. Clin. Endocr. 12/0
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CRETIN
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Iodine
Sufficient
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Iodine
Sufficient
Y th ANA
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