Iodine, the Thyroid, and Radiation Protection

We have friends in Japan, living both north and south of the damaged reactors, and Shou-Ching asked me to do a post about how to protect against radiation.

The Concern

The radioactive substances released by the Chernobyl nuclear power plant meltdown are represented in this chart:

(Source. If you’re wondering what the other radioactive elements are, or why radioactive iodine is a byproduct of uranium fission, a possible place to start is Wikipedia, “Fission products by element” ).

Note first of all that the chart presents percentages of radioactive substances, not amounts. The amounts are highest on the first day and then decline rapidly. The great danger comes in the first few days.

During these dangerous first days, iodine-131 is, along with tellurium-132 and its decay product iodine-132, the dominant source of radioactivity. These radioactive iodine species account for over 50% of the radiation.

Not only its abundance, but also its effectiveness at causing biological damage make iodine far and away the greatest danger. Iodine radiation is highly effective at causing cellular damage:

Due to its mode of beta decay, iodine-131 is notable for causing mutation and death in cells which it penetrates, and other cells up to several millimeters away. [Source: Wikipedia, Iodine-131]

Worse, iodine is an important biological molecule that gets concentrated in the thyroid. So the dose of radiation becomes very high in the thyroid, and this leads to DNA damage producing a high risk for thyroid cancer.

Thyroid cancer is “the only unequivocal radiological effect of the Chernobyl accident on human health.” [1] Since Chernobyl released a great deal more radiation than the Japanese reactor meltdowns are likely to do, it’s likely that this will be the case in Japan also.

The rate of thyroid cancer after Chernobyl was higher the younger the age at time of exposure. Children and infants are at greatest risk:

It is now well documented that children and adolescents exposed to radioiodines from Chernobyl fallout have a sizeable dose-related increase in thyroid cancer, with the risk greatest in those youngest at exposure and with a suggestion that deficiency in stable iodine may increase the risk. [2]

The last point is crucial – iodine deficiency increases the risk.

Iodine deficiency and radiation risk

In iodine deficiency, the thyroid gland has difficulty generating enough thyroid hormone. T4 thyroid hormone, manufactured in the thyroid and so named because it has 4 iodine atoms, is 65.4% iodine by weight, so iodine is the key ingredient in thyroid hormone.

To compensate for an iodine deficiency, the body does two things:

  • The thyroid gland grows, so that it can more aggressively scan the blood for iodine. An enlarged thyroid is called a goiter.
  • The pituitary gland issues thyroid stimulating hormone (TSH), which induces the thyroid to aggressively scavenge iodine from the blood and turn it into thyroid hormone.

So in iodine deficiency the thyroid is aggressively scavenging all available iodine. This means that when a large dose of iodine-131 or iodine-132 arrives during radiation fallout, these radioactive iodine atoms are quickly picked up by the thyroid. There, they release their radiation and damage the thyroid.

On the other hand, in thyroid replete persons, the thyroid has all the iodine it needs and takes up little iodine from the blood. In this case, iodine that enters the body is distributed throughout the body, or excreted. Doses in any single cell are much lower. The danger to the thyroid is not much greater than that to other organs – which, the Chernobyl experience tells us, is not detectable to epidemiology. (There is even a theory that low-level radiation may be beneficial through hormesis.)

How can the thyroid be made replete with iodine?

The best way, which we recommend in our book, is to supplement with iodine and gradually build up the dose over a four to six month period. Start below 1 mg/day, take that for a month, then double the dose. After a month, double the dose again. Continue doubling until you reach your desired maintenance dose; we recommend at least 3 mg/day (a quarter Iodoral tablet), with 12.5 mg/day a reasonable dose. Some people taking as much as 50 mg/day.

At 12.5 mg/day, it can take a year or more to become replete with iodine in all tissues and to fully drive out other halogens, such as bromine, from the body. This has great benefits for immune function. So, it is best to get started!

Risks of high-dose iodine supplementation

If a person’s thyroid gland is adapted for iodine scarcity and the person takes a large dose of (non-radioactive) iodine, the likely course of events is:

1.      Hyperthyroidism. The thyroid, aggressively scavenging for iodine to repair a deficiency of thyroid hormone, scoops up all the iodine and makes a large amount of thyroid hormone. The person develops symptoms of hyperthyroidism (too much thyroid hormone): anxiety, intolerance of heat, muscle aches, hyperactivity, irritability, hypoglycemia, elevated body temperature, palpitations, hair loss, difficulty sleeping.

2.      Wolff-Chaikoff effect. As thyroid hormone levels become too high, the body induces mechanisms for suppressing thyroid hormone production. Simply reducing TSH output is not effective to suppress thyroid hormone production if a very large iodine influx is received. Fortunately there is another mechanism for suppressing thyroid hormone formation, mediated by iodine itself: the formation of iodine-rich proteins (iodopeptides) in the thyroid that inhibt synthesis of the thyroid peroxidase (TPO) enzyme. Normally, this mechanism operates for a few days and wears off, restoring normal thyroid function. [3]

3.      Reactive hypothyroidism? Usually, everything will normally return to normal after a few days. But sometimes in previously iodine-deficient adults and more commonly in newborns and fetuses and some diseased persons, after very high doses of iodine the Wolff-Chaikoff effect can persist. In this case the early hyperthyroidism is followed by a period of hypothyroidism (too little thyroid hormone). This “hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks after iodide withdrawal, but transient T4 replacement therapy may be required in some patients.” [3]

4.      Risk for lasting hypothyroidism. People who develop a reactive hypothyroidism following a large dose of iodine are at high risk for later development of persistent hypothyroidism. [3]

So most people will experience transient hyperthyroid symptoms for a few days and then do fine. Some will develop a reactive hypothyroidism lasting a few weeks and then be OK, save for an elevated risk of hypothyroidism later which may or may not be due to the reactive episode.

Advice of the authorities to fallout victims

The advice from public health authorities is a compromise between the protective effects of high-dose iodine and the risk of messing up the thyroid.

A US Center for Disease Control (CDC) fact sheet explains the recommendations. A single large dose of iodine offers protection for about 24 hours. Recommended intakes are:

  • Adults should take 130 mg/day while exposure persists.
  • Children older than 3 and smaller than adults should take 65 mg/day while exposure persists.
  • Infants and toddlers aged 1 month to 3 years should take 32 mg/day.
  • Newborns should take 16 mg/day.

Our advice

The CDC dosage advice strikes us as very reasonable.

If you are not currently exposed to fallout, but think you may be exposed in the near future, you should consider beginning with small doses of iodine now – say, 3 mg/day. If that does not produce any symptoms, then try 6 mg/day; if it does, back off to half that dose. This will begin the adaptation process for your thyroid gland and help minimize hyperthyroid or hypothyroid reactions if you do have to take high doses.

Also, obtain your iodine tablets in advance. If fallout does occur, it may be hard to find iodine pills. NukePills.com says they are out of stock and have a large order backlog. I saw a story the other day that a 14-dose packet of potassium iodide was being sold at one site for $200, up from the normal $10 list price.

We recommend Iodoral 12.5 mg tablets. This is a good size for supplemental use; to reduce it to a 3 mg dose, cut the tablet in quarters with a razor blade. If fallout arrives, you can use ten Iodoral tablets to get a 125 mg adult dose.

For doses below 3 mg, smaller iodine tablets or liquid iodine solutions may be best; you can dilute liquid solutions to your desired dose. Some brands were recommended by readers in comments on our Supplement Recommendations page.

Conclusion

Outside of Japan, the risk is minimal, and even in Japan those who are replete with iodine are unlikely to develop thyroid cancer from exposure. After Chernobyl, thyroid cancer rates were high in Russia, the Ukraine, and Belarus which did not distribute iodine, but low in Poland which did. Fortunately, Japan has one of the highest iodine intakes in the world thanks to its high seaweed consumption. With that preparation plus proactive distribution of iodine tablets, we can expect and hope that the health effects of the reactor meltdowns will be minimal.

References

[1] Thomas GA et al. Integrating Research on Thyroid Cancer after Chernobyl-The Chernobyl Tissue Bank. Clin Oncol (R Coll Radiol). 2011 Feb 22. [Epub ahead of print] http://pmid.us/21345659.

[2] Cardis E, Hatch M. The Chernobyl Accident-An Epidemiological Perspective. Clin Oncol (R Coll Radiol). 2011 Mar 9. [Epub ahead of print] http://pmid.us/21396807.

[3] Markou K et al. Iodine-Induced hypothyroidism. Thyroid. 2001 May;11(5):501-10. http://pmid.us/11396709.

Leave a comment ?

86 Comments.

  1. Hi Julie,

    Well, trigger and cause are two different things.

    Kelp consumption often causes acne, but kelp contains many things besides iodine.

    Iodine consumption often triggers bromine release from cells and high serum and urinary bromine. Bromine is a known cause of acne. However, sustained intake of iodine will eventually clear bromine from the body and end the acne. In some cases, this can take a year or more.

    Finally, iodine intake can amplify immune activity against pathogens, since the myeloperoxidase pathway is iodine-dependent. This can temporarily lead to an increase in inflammation at the site of infections – including acne lesions. But this is temporary.

    Often, therapies that are curative against infections lead to a flare of symptoms initially, due to higher immune activity. In many conditions, including acne, symptoms are due to immune activity, more than pathogen activity. Yet you need the immune activity to cure the infection.

    As far as Pubmed literature goes, there’s not a lot. This writer (http://www.ncbi.nlm.nih.gov/pubmed/17190637) concludes, “To summarize, there is no evidence to support iodides as a cause of comedonal acne.”

    I agree. An increase in iodine intake may trigger an acne eruption, but it is not worsening the disease and is not a cause of the acne.

    Best, Paul

  2. Paul,
    I continue to be amazed by your generosity towards your readers in the comments section of your posts. Thanks for doing what you do.

    Anyway…a quick question for a physicist

    I don’t know how concentrated iodine products are produced, but…when we talk about slightly (ultimately harmless) elevated levels of iodine in California milk, water, etc., does this mean we should be wary about iodine products coming out of that area in the month or so following a nuclear disaster in, say, Japan?

    I bought some California-produced iodine (iosol) two weeks after the disaster. I’m imagine there’s nothing to worry about given that it was probably made a few weeks before the sell date, but I was just curious–given the long half-life of iodine-131 (8 days) and its decay product (Xenon), can we be certain we’re getting a non-radioactive iodine product (i.e., not xenon) under these conditions?

  3. Oops. The idea of the mentioning that I didn’t know anything about the manufacturing process and the ‘harmless’ levels in California water was in case production of concentrated iodine involved simply distilling, say, iodine found in water—which could quickly make levels that are nothing to worry about more problematic. Doubt it’s produced this way, but I certainly have no real idea!

  4. Hi RW,

    Like you, I don’t know the manufacturing process for the iodine. But I think it’s highly unlikely they use a significantly contaminated source. The radioactive iodine would have landed as fallout primarily in the most recent 8 days. It would have been scattered over a wide surface area, on dust particles, on grass and diet and water.

    In ocean it would have diffused and been highly diluted, and they wouldn’t use fresh water as a source for iodine, so that wouldn’t be an issue.

    The largest doses would be concentrated by grazing animals, who get the fallout off the surface of grass and concentrate it in, say, milk. But I’ve seen measurements and the doses are currently very low in pastured cow milk.

    If you’re worried, let your Iosol sit for 8-16 days and over half will be gone.

    The xenon is not a concern, it’s harmless and the I-131 is a tiny, tiny fraction of the total iodine.

  5. Thanks Paul. I had an intuition that there wasn’t anything to worry about, but seeing it explained in full is more reassuring :).

  6. Hi Paul,

    I’m trying to address PHD supplementation requirements through whole foods as much as possible. Brazil nuts for selenium, salmon for DHA, organ meats for zinc/A, etc.

    I find iodine to be the biggest challenge. Do you think buying iodized sea salt to use at home and aiming for sea veggies once a week would go a long way to eliminating the need for supplementation?

    Thanks
    Greg

  7. Hi Greg,

    Iodized salt helps a bit. Sea vegetables and shellfish are the best iodine sources.

    I would try to find tasty seaweeds – some soup seaweeds are good, and dulse is OK – and eat a lot. Seaweed salads can be good. Maybe we’ll try a recipe for that one of these Sundays.

    Best, Paul

  8. Herbal teas with seaweed in them are something I’ve thought of as well, but I doubt they would be a significant source.

  9. Hi there — like others, I am grateful for your generosity in the comments! I have been supplementing with iodine for almost a year now. I take about 30mg a day as well as my kids and my husband (kids are 18 and 19 and gigantic so really adults). When they have reaction, it is acne. When I have reaction, it is flu-like symptoms. My understand is that this is the iodine pulling out the fluoride and bromide from my body — detox. I do salt loading (1/2 tsp real salt followed by 16 oz of water), sometimes more than once a day, and this relieves those symptoms. If I get the flu-like for a few days in a row, I back way off the iodine or quit for a few days.

    I started on iodine for hair loss — stopped the loss within 3 days and I have a lush field up there now! (Loss was due to serious hospital stay.) I am a huge fan — don’t think I’ll ever quit!

    I buy my Lugol’s solution (not a brand, it’s a formula) from a guy on ebay: http://myworld.ebay.com/the_full_orchestra. It’s $8 a bottle, I’ve been buying from him for about 6 months and no complaints. Lasts a long time, very reasonable.

    They say iodoral is better because it goes lower in the intestines, but I simply can’t afford it. I can’t take the Lugol’s on an empty stomach, it burns so I take after meals or in a smoothie. Tastes horrible… but I have hair!

    Thanks for all the info on the Japan fallout. I am much relieved and feel like we are doing the right things to protect ourselves. Your time is very much appreciated!

  10. Sally Oh, good to know that iodine solved your hair loss problem. I wish I could say the same thing, but after 9 months on Iodoral, there’s been no change. Following Paul’s advice have made a great improvement in other concerns like gas and bloating, so all in all, things are better on the PHD.

  11. A friend is recommending people purchase K103 which has a shelf life of 8-10 years and is to be used in the event of a nuclear disaster, comes in 85mg doses.

    I suggested iodine for everyday health and feel that, if there was an event close to me, I would already be protected. Am I on the right track with that thinking?

    Also, he says that the fallout living in the pastures and passed to milk products from cows and goats is a health concern. Wouldn’t iodine take care of those problems as well?

    Thank you.

  12. Hi Sally,

    Yes, you’d be highly protected compared to anyone not on supplemental iodine.

    Most people get about 100 mcg per day. The thyroid needs a fixed amount of iodine per day, and becomes more receptive to iodine the less there is in the blood. Roughly speaking, if you supplement 1 mg/day, your thyroid will pick up 1/10 as much of the radioactive iodine as an average person. If you supplement 10 mg/day, 1/100 as much. So that’s good protection.

    You can protect yourself further by increasing the dose during radiation exposure, say to 100 mg/day. Then, if the thyroid gland is picking up 100 mcg/day, and you are getting 1 mg/day radioactive iodine per day from fallout, raising supplemental iodine from 10 mg to 100 mg will reduce the radioactive iodine absorbed to about 1 mcg/day from 10 mcg/day.

    Iodine is protective against radioactive iodine from all sources.

  13. I have perhaps Lyme Hashimotos with possible Encephalitis. I have a weight gain of forty unbearable pounds. I run five miles daily, jump rope on my run or use and exercise band, run backwards, climb 2600 beach steps. I have participated in 5 marathon events. I cannot lose a pound.

    I keep wondering what the real cause of this thyroid dysfunction is. Did it start when I took a blow to the head from a golf ball someone sliced while I was golfing. The ball hit right under my left temporal lobe. As I live on farmland is their flouride or bromine in the water. Or is it inherited from my father who died of Amyloidosis Lateral Sclerosis–my father was in New Mexico when the testing for the first Atomic Bomb exploded in the sky. How many children have suffered from thyroid disease whose parents were here and suffered radio active fallout. Most interesting as of late is the literature on thyroid function or lack of.
    The test was the culmination of three years’ planning and development within the super secret Manhattan Project headed by General Leslie R. Groves. Dr. J. Robert Oppenheimer directed the scientific team headquartered at Los Alamos, New Mexico. An isolated corner of the Alamogordo Bombing and Gunnery Range located 230 miles south of Los Alamos was selected for the test that was given the code-name “Trinity

  14. Paul,

    I am looking for a functional thyroid practitioner that can help treat my Hypothyroid symptoms in the greater Tokyo, Japan area.

    Any help?

    Best,

    Henry

  15. Hi Henry,

    Sorry, I don’t know of any. If any should read this, send me an email (pauljaminet@perfecthealthdiet.com) and I’ll forward it on to Henry.

    Best, Paul

  16. Hi Paul,
    I just found your book and really appreciate the information. I developed post partum thyroid-itis after having my first baby this year. I was hyper thyroid for ten months and am now in the “normal” range. The doctor said that it may stay there or go into hypo thryoidism.

    Should I take iodine? How much would you start with?

    Is it safe to take when we start trying for our 2nd?

    I have been gluten free for a week but I have been eating quinoa and buckwheat. Maybe I should cut that out too?

    Also, I have had toe-nail fungus on my big toe for years. Didn’t know if you had any thoughts about that. I am hoping it resolves with the new diet!

    Thanks again for all you do. It’s so hard to get this information.
    Sara

    • This is the best medicine to treat a toe nail fungus: Fungus Stop. Kill 99.9% of nail fungus. Anti fungal Nail Treatment. Toenails & Fingernails Treatment. by Zanne Helas. You can get it on Amazon, it send from Greece but comes pretty quick. It is all natural. I was able to get rid of the fungus that I had for long time.

      by ZANE HELLAS

  17. Hi Sara,

    I do think it’s good to take some iodine, and it is especially protective against hyperthyroidism.

    Start low, 225 mcg is a good amount. Some people even have trouble with that. Take a month to get adapted, and then try raising the dose a bit. Don’t increase dose any faster than one doubling per month.

    A good finishing dose is anywhere from 750 mcg to 3 mg. Higher doses might be therapeutic in some conditions.

    Quinoa and buckwheat are hard to judge, as we don’t have solid data on toxin content. Buckwheat is probably healthy, quinoa is more questionable but may be. If you like them, then it’s probably worth eating them. We focus on rice, and rice flour/potato starch/tapioca starch gluten-free products.

    Toe nail fungus – diet and topical treatments are the first step. Iodine, coconut oil, essential oils, and drugstore antifungal lotions can all help. Seth Roberts has had some posts lately about coconut oil.

    Best, Paul

  18. Wolfe & Chaikoff lied – http://www.optimox.com/pics/Iodine/IOD-04/IOD_04.html. Or at least, were badly mistaken.

  19. I have had a slow growing type of lymphoma for 5 years now. In the beginning my oncologist had me getting a CT scan with contrast (Iodine injected into veins) 4X’s a year. Now i am down to once per year. The lymphoma is currently in natural regression. How does the injected iodine for that test affect my thyroid and the rest of my body? I am being treated for hypothroid with armour thyroid. I have been taking kelp for about 4 months, doubling it once. Should i be concerned about too much iodine? or about destroying my throid?
    The perfect health diet fits very nicely with the foods i eat for not feeding the lymphoma cells as well as turning back on the mitochondria to cause the cancer cells to die back.

    • Hi Donna,

      I think a moderate amount of iodine is usually beneficial for hypothyroidism.

      High doses of iodine used in imaging studies can affect thyroid function. Usually the effect is transient, gone in 3-4 weeks, but once in a while there are lasting effects. I don’t think that is understood.

  20. Hi Paul,

    My girlfriend had a serious adverse reaction to a radio contrast dye injected for a CAT scan several years ago and has since avoided shellfish and most seafood at the behest of her doctors. We’re transitioning into the PHD now and I’m concerned that she might be iodine-deficient.

    Is it possible that such a reaction would be due to a sensitivity to iodine itself? Given that iodine is an essential micronutrient, it wouldn’t seem to make sense that such a sensitivity could exist.

    Jordan

    • Hi Jordan,

      It’s possible it was an iodine reaction. Also the radioactive iodine may have aggravated a thyroid condition making her more sensitive to iodine.

      The best way is to experiment, see if she becomes hyperthyroid after eating seaweed or shellfish. If she doesn’t, she can taste a small dose of iodine — cut one of the 225 mcg tablets into eighths and try just a fragment each day.

      If she has a negative reaction, just try to eat well for a year and then test iodine at low doses again, maybe the thyroid will have healed. Also, investigate any signs of chronic infection which might be behind a chronic thyroiditis.

  21. Gary Mullennix

    What does one do without a thyroid? My wife’s was removed surgically and then she was twice dosed with radioactive iodine flown in from France to destroy any thyroid tissue, possibly malignant which might have drifted from her original thyroid. My case was simpler. Years ago a Doc started me on synthetic thyroid to see if my enlarged thyroid might be malignant…it shrank and my wife and I take a daily dose of thyroid. Our annual physicals are generally within range with the metrics.

    But we don’t take any iodine supplements. We are in our early 70’s and both have thinning hair and older looking skin and we both take a steroidal cream for facial eczema. Any suggestions?

  22. Hi Paul,

    I’ve been reading your thyroid and iodine posts after some symptoms led me to believe I may be reacting to iodine.
    Since over a year now, following a miscarriage, antibiotics but then recurrent UTI type symptoms (now gone) I developed shaking episodes at night and couldn’t sleep. This started at the end of the antibiotics course. At the time it felt like adrenalin and I did have high cortisol at night in one adrenal test. These episodes reoccurred several times. One day I decided to stop all my supplements and I felt so much better! So I thought I must be reacting to something I was taking. Months later I had another episode at night where I could not fall asleep, had racing heart, my eyes wanted to stay wide open, and I felt the urge to walk around the house for a couple of hours before I was exhausted enough to drift off to sleep. Prior to this year of these strange night episodes I never had problems with sleep.
    It occurred to me that I may have reacted to seaweed I ate during that week (I couldn’t remember later if it was on the same day but it was that week so could have been). The last time I ate seaweed was on stopping my supplements. For years previously I was taking seagreens supplements which do have iodine so I doubt I was deficient.
    I am now wondering if post partum and with the infection (klebsiella oxytoca & pneumoniae both confirmed at different times) I developed a problem with my thyroid eg hashimotos. Some of the symptoms I had resemble hyperthyroidism as mentioned in this article.

    Since not taking any iodine or eating seaweed I have not had this problem again, since January. I am worried about eating seaweed again. What shall I do? Perhaps I should get my thyroid antibodies tested? I am scared to try seaweed or iodine again but wonder if I should try a tiny amount to see what happens. I haven’t noticed any effect after eating mussels or prawns… Any help in the right direction would be much appreciated.

    • Hi Claire,

      It sounds like you have hyperthyroidism, probably due to a nodule in your thyroid gone haywire. This will usually cure itself in a year or two but you have to minimize iodine until it is gone. I think you should go to a doctor and get evaluated.

      Best, Paul

      • Thanks so much for your quick reply. Last year when I was at my worst I did try to tell my GPs about it. They told me it was just anxiety! and refused to test thyroid antibodies. I think I will make another appointment to try again otherwise I’ll have to order tests privately.

        After reading some more comments on your blog I’m wondering if it could be a seaweed toxin reaction or allergy….apparently some allergic reactions could resemble hyperthyroid attacks?..
        But thank you, I’ll try my best to look into my thyroid more with my GP (my last TSH was about 2 which is why they refused to look further, but the previous TSH was 4.5, when I was pregnant)

        • If you have a nodule that overproduces thyroid hormone in the presence of iodine, then you might see TSH of 2 when iodine is deficient but then TSH of 0 after you take iodine. The fall in TSH from 4.5 to 2 could be a result of a nodule forming (or healing, but it doesn’t sound like you healed).

          • Thank you. Very interesting. So to help me approach the GP, and for my own understanding, is it a scan and/or antibody test I would need, apart from standard thyroid blood tests like TSH?

          • Hi Paul.
            I haven’t eaten any seaweed since January and been feeling completely fine since 🙂
            I did a thyroid panel very recently and these are my results:
            TSH: 1.32, FT4:14.8, T4:71, FT3:4.3, FT4:FT3 ratio: 3.4, rT3:0.28, autoantibodies: TG <20, TPO <10.

            I was told they are perfect, but I'm still worried about not eating seaweed and not getting enough iodine. Not sure when I should try seaweed again or possibly iodine supplement.

          • It seems like hormone levels are still high so you need to give the thyroid more time to heal. Get lots of wound healing supports, e.g. extracellular matrix, vitamin C, and gut supports. As you get better try reintroducing a quarter nori sheet per day, then a half, then one, then build up to four. After adding seaweed wait a month before you try another increase.

          • Thanks so much for you reply Paul. I’ll keep going with the PHD protocol with the stuff you suggest.
            The thing is without seaweed I feel fine. I did get some palpitations last night though and I wonder if it was due to eating fish roe and duck yolks this week, particularly yesterday. I think they have some iodine in them. Or perhaps it was something else.

            You say my hormone levels are high. Which reading are you referring to? They are all in range according to Genova lab ( but I realise some ranges can be too broad) but T4 is on the low side apparently indicating low iodine levels, which would make sense since I’ve eliminated seaweed.

          • Hi Paul, I would appreciate it if you could let me know which of my thyroid readings indicate high hormones. I can’t work it out. Thank you

  23. Dear Paul —

    I’m experiencing distinct persistent symptoms of hypothyroidism but my lab tests are normal (TSH 1.02) and I do not have Hashimoto’s. I do however have low serum iodine (51 mcg/L) and very small cystic nodules on my thyroid; I have been using non-iodized sea salt exclusively for about a year, and ate seaweed very inconsistently until…

    A month or two ago I realized that my hypo symptoms seemed to get worse after eating sushi. I tested supplementing 1/4 of potassium iodide 225mcg pill which exacerbated symptoms. About 3 weeks later, I tried 1/8th of a pill, I felt good during the day, but I had trouble going to bed for about 3 hours and didn’t feel very well.

    You’ve mentioned that one should start small and increase slowly — is it possible that that small dose might need to be as low as 1/16 of a 225mcg dose, and gradually increased? Would I begin feeling the benefits relatively soon or would those only come when I eventually reached higher levels of iodine?

    Best,
    Hannah F.

    • Hi Hannah,

      You are mildly hyperthyroid. The thyroid nodules overproduce thyroid hormone in response to iodine, that is why they have depleted serum iodine. When you take in iodine from food or supplements, you become transiently hyperthyroid and that is the source of your negative symptoms. When you are iodine deficient, you have normal levels of thyroid hormone and feel more normal; or in more severely deficient states you become hypothyroid. Usually when there is enough thyroid injury to generate the nodules, the rest of the thyroid gland is also damaged and underproduces thyroid hormone. So when you cure the nodules, you can expect to transition to overt hypothyroidism and TSH will rise.

      I would focus on good gut health and wound healing. Eating extracellular matrix and taking extra vitamin C will help the thyroid heal. Manage iodine to minimize symptoms.

      Best, Paul

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