Iodine and Hashimoto’s Thyroiditis, Part I

Mario Renato Iwakura is a Brazilian engineer and Hashimoto’s thyroiditis patient who is intimately familiar with the hypothyroidism literature. Mario has graciously agreed to do a guest series on the place of iodine and selenium supplementation in treatment of hypothyroid disorders. I’m very excited to have Mario’s thoughts, as he’s extremely smart and passionately engaged with the science. — Paul

Most doctors believe that iodine supplementation will aggravate autoimmune (Hashimoto’s) thyroiditis. This view is supported by observations that the incidence of Hashimoto’s hypothyroidism tends to increase in populations that increase their iodine intake. (The incidence of hyperthyroidism, on the other hand, increases as iodine intake decreases.). However not all epidemiological studies support this association [1][2][3][4].

Dr. Datis Kharrazian (“Dr. K”), whose 2010 book “Why Do I Still Have Thyroid Symptoms?”[5] is popular among Hashimoto’s patients, vehemently opposes the use of iodine in Hashimoto’s [5][6][7]. Chris Kresser of The Healthy Skeptic [8] has argued this point of view in his post “Iodine for hypothyroidism: like gasoline on a fire?”. And there’s little doubt that some patients have experienced bad consequences from high-dose iodine.

On the other side, doctors such as Dr. Guy E. Abraham [9], Dr. David Brownstein [10], Jorge D. Flechas [11] and Dr. David Derry [12] have claimed success prescribing high doses of iodine for Hashimoto’s and for breast and thyroid cancers.

Can these experiences by reconciled? What we will try to do is demonstrate that iodine acts synergistically with selenium, and that it is imbalances between the two that damage the thyroid.

First, Some Background

Thyroid peroxidase or thyroperoxidase (TPO) is an enzyme expressed mainly in the thyroid that liberates iodine for addition onto tyrosine residues on thyroglobulin (TG) for the production of the thyroid hormones thyroxine (T4) or triiodothyronine (T3).

The human body normally has low levels of auto-antibodies against both TG and TPO, which serve some physiological function. Autoimmune thyroiditis features high levels of these auto-antibodies, leading to immune attacks on the thyroid.

High levels of  thyroid auto-antibodies are positively associated with hypothyroidism symptoms [13][14]. TPO antibodies and TSH levels are strongly associated with progression of subclinical hypothyroidism to overt hypothyroidism [3], as can be see in Table 3 below:

Selenium Can Cure An Iodine Excess

Dr. K said in his book and site that “iodine stimulates the production and activity of the thyroid peroxidase (TPO) enzyme” [5][7]. Since TPO is a target of autoimmune attack in Hashimoto’s patients, this might worsen the disease [5][6][7]. In his book he also states that excessive iodine will shut down TPO activity [5], but he neither cites a reference nor states what level of iodine intake will cause this to happen.

In fact, excess iodine combined with selenium insufficiency will reduce (not increase, not shut down) TPO activity [15]. Let’s look at a study that had seven groups: normal iodine and lab-chow selenium only (NI), excess iodine and lab-chow selenium only (EI), and five groups with excess iodine and steadily increasing levels of selenium added to water (IS1 to IS5). TPO activity was reduced by excess iodine (EI), but returned to control levels (NI) with moderate selenium (IS1 and IS2). With excess iodine and excessive selenium (IS3 to IS5), TPO activity was also decreased, as we can see from table 2 below.

Some other studies have also demonstrated this reduced TPO activity at high iodine intakes [23][24].

This study [15] also showed a picture (fig. 1) of thyroid follicles from rats receiving normal iodine diet (NI), excessive iodine (EI) and excessive iodine plus 0.2 mg/L selenium (IS2). Thyroid follicles from the excessive iodine group (EI) are enlarged, a characteristic of goiter. But, there is virtually no difference between the first and last picture! If selenium and iodine are increased together, no goiter occurred.

Note that the IS2 level of selenium, which protects against iodine toxicity, corresponds in a person who drinks 1-2 liters per day to a selenium dose of 200 to 400 mcg per day – which happens to be the Perfect Health Diet “plateau range” for selenium.

Selenium Can Cure Autoimmunity

Another paper, also from China, looked at the effects of selenium in an animal model of iodine induced autoimmune thyroiditis [16].

There were three groups of mice, a healthy control group, and groups with iodine induced autoimmune thyroiditis without (AIT) and with (AIT+Se) selenium. The AIT+Se group was given high iodine (AIT only) for 8 weeks to induce the disease, and then, for 8 weeks more, they were given iodine plus selenium. After 8 weeks of selenium supplementation their thyroid follicles were almost fully recovered, as we can see below, even though high-dose iodine had continued:

The AIT group has enlarged cells characteristic of goiter and dead tissue; the AIT-Se group thyroid section resembles a normal thyroid. Thyroid weight doubled in the AIT group, proof of goiter, but returned to normal after selenium supplementation.

Before selenium was given to the AIT+Se group, serum TgAb antibodies were elevated, but they returned to normal after selenium supplementation:

An interesting aspect of this study was the changing population of immune cells. A specialized subpopulation of T cells, negative regulatory T cells or Tregs, helps establish and maintain self-tolerance by suppressing response to self-antigens and suppressing excessive immune responses deleterious to the host. Deficits in Treg cell numbers or function lead to autoimmune diseases [17].

In this study, CD4+CD25+Foxp3+ Treg Cells were reduced by high iodine, but returned much of the way toward normal after 8 weeks of selenium even though high iodine intake continued. The implication is that selenium-iodine balance may be needed to maintain proper Treg cell populations, and that selenium supplementation may restore normal regulation of autoimmunity.

The researchers concluded:

“In the present study, we observed that Se supplementation increased the frequency  of CD4+CD25+Foxp3+ T cells and enhanced expression of Foxp3 in vivo. These changes were accompanied by suppressed TgAb titers and reduced thyroiditis. Thus the benefit of Se treatment may be due to the increase of CD4+CD25+ regulatory T cells.”

Under What Circumstances Does Excess Iodine Induce Autoimmunity?

In the previous study high doses of iodine were used to induce autoimmune thyroiditis. Let’s look more closely into the circumstances in which that happens.

It’s often said that excessive iodine in Hashimoto’s triggers an immune response characterized by proliferation of T lymphocytes, a disrupted Th1/Th2 axis, and altered CD4/CD8 levels. Pathogenesis of autoimmune disease is believed to begin with the activation of T cell autoaggression (turning them into “allergized T cells”).

Our next study, also from China, showed that excess iodine can indeed cause such an autoimmune pathology, but only if there is a deficiency in selenium [18].

Mice in 5 groups were orally administrated different combinations of iodine and selenium for 30 days. Four groups had no selenium but varying amounts of iodine in their water:  0 μg/L (group I), 1500 μg/L (group II), 3000 μg/L (group III), and 6000 μg/L (group IV). The fifth group had 6000 μg/L iodine plus 0.3 mg/L selenium (group V).

In Group IV, high-dose iodine at 6000 μg/L caused a proliferation of lymphocytes. But this was completely abolished by the addition of selenium to water in Group V:

Normally there are relatively stable population of T cells and their subgroups in tissue till immune function is in disorder. As we can see from Fig. 1, increasing iodine increased T lymphocytic reproductive activity, and was clearly high in group IV. But group V, which also received selenium, had the same values as the control group (I).

Subjects with Hashimoto’s also have a lower ratio of CD4+ to CD8+ lymphocytes than controls [19][20]. From fig. 2, we can see that iodine supplementation in groups II and III actually increased the CD4+ to CD8+ ratio, until the onset of autoimmune symptoms at very high doses in Group IV when the ratio decreased. However, group V, which had the highest iodine intake but with selenium as well, had the highest CD4+ to CD8+ ratio of all groups.  This suggests that high-dose iodine and selenium together may actually diminish the autoimmune syndrome compared to the low levels in the controls.

Another marker of autoimmune thyroiditis is the relative strength of the Th1 and Th2 responses, as indicated by the markers interferon-gamma and interleukin-4 (Th2). Th1(IFN-γ)/Th2(IL-4) ratios are increased in Hashimoto patients [21][22], and related with severity of Hashimoto’s disease [22].

As we can see from Fig. 3, the group with the highest iodine intake but no selenium (IV) was the only group that had clearly higher Th1/Th2 ratio. High iodine plus selenium in group V had similar Th1/Th2 ratios than control group (I).

The researchers concluded:

“The results revealed that there was no significant difference in the immunotoxicity between interventional group (group V) and control group (group I), indicating that adequate selenium has a favorable interventional effect on excessive iodine intake.”


Excess iodine intake can cause an autoimmune thyroiditis that bears all the characteristics of Hashimoto’s. However, in animal studies this occurs only if selenium is deficient or in excess. Similarly, in animal studies very high iodine intake can exacerbate a pre-existing autoimmune thyroiditis, but only if selenium is deficient or in excess.

With optimal selenium status, thyroid follicles are healthy, goiter is eliminated, and autoimmune markers like Th1/Th2 ratio and CD4+/CD8+ ratio are normalized over a wide range of iodine intake. It seems that optimizing selenium intake provides powerful protection against autoimmune thyroid disease, and provides tolerance of a wide range of iodine intakes.

In the next post in this series (Iodine and Hashimoto’s Thyroiditis, Part 2, May 26, 2011), we’ll transition from animals to humans. Does epidemiological evidence suggest that these animal findings are transferable to humans?


[1] F. Aghini-Lombardi et al. The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano Survey. J. Clin. Endocrinol. Metab. 84, 561–566 (1999).

[2] Marino MA et al. Urinary iodine in patients with auto-immune thyroid disorders in Santo André, SP, is comparable to normal controls and has been steady for the last 10 years. Arq Bras Endocrinol Metabol. 2009 Feb;53(1):55-63.

[3] Strieder TG et al. Prediction of progression to overt hypothyroidism or hyperthyroidism in female relatives of patients with autoimmune thyroid disease using the Thyroid Events Amsterdam (THEA) score. Arch Intern Med. 2008 Aug 11;168(15):1657-63.

[4] Stuckey BG et al. Low urinary iodine postpartum is associated with hypothyroid postpartum thyroid dysfunction and predicts long-term hypothyroidism. Clin Endocrinol (Oxf). 2011 May;74(5):631-5. doi: 10.1111/j.1365-2265.2011.03978.x.

[5] Dr. Datis  Kharrazian. Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal: A Revolutionary Breakthrough In Understanding Hashimoto’s Disease and Hypothyroidism.

[6] Dr. Datis  Kharrazian. Iodine and Autoimmune Thyroid — References.

[7] Dr. Datis  Kharrazian. Iodine and Hashimoto’s.

[8] Chris Kresser. Iodine for hypothyroidism: like gasoline on a fire?.

[9] Dr. Guy E. Abraham.

[10] Dr. Brownstein. Iodine, Why You Need It.

[11] Dr. Jorge D. Flechas.

[12] Dr. David Derry. Breast Cancer and Iodine : How to Prevent and How to Survive Breast Cancer.

[13] Ott J et al. Hashimoto’s thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case-control study in women undergoing thyroidectomy for benign goiter. Thyroid. 2011 Feb;21(2):161-7. Epub 2010 Dec 27.

[14] Díez JJ, Iglesias P. Relationship between thyrotropin and body mass index in euthyroid subjects. Exp Clin Endocrinol Diabetes. 2011 Mar;119(3):144-50. Epub 2010 Nov 17.

[15] Xu J et al. Supplemental Selenium Alleviates the Toxic Effects of Excessive Iodine on Thyroid. Biol Trace Elem Res. 2010 Jun 2.

[16] Xue H et al. Selenium upregulates CD4(+)CD25(+) regulatory T cells in iodine-induced autoimmune thyroiditis model of NOD.H-2(h4) mice. Endocr J. 2010 Jul 30;57(7):595-601. Epub 2010 Apr 27.

[17] Sakaguchi S et al. Foxp3+CD25+CD4+ natural regulatory T cells in dominant self-tolerance and autoimmune disease. Immunol Rev. 2006 Aug;212:8-27.

[18] Chen X et al. Effect of excessive iodine on immune function of lymphocytes and intervention with selenium. J Huazhong Univ Sci Technolog Med Sci. 2007 Aug;27(4):422-5.

[19] Gopalakrishnan S et al. The role of T-lymphocyte subsets and interleukin-5 blood levels among Indian subjects with autoimmune thyroid disease. Hormones (Athens). 2010 Jan-Mar;9(1):76-81.

[20] Zeppa P et al. Flow cytometry phenotypization of thyroidal lymphoid infiltrate and functional status in Hashimoto’s thyroiditis. Anal Quant Cytol Histol. 2006 Jun;28(3):148-56.

[21] Colin IM et al. Functional lymphocyte subset assessment of the Th1/Th2 profile in patients with autoimmune thyroiditis by flowcytometric analysis of peripheral lymphocytes. J Biol Regul Homeost Agents. 2004 Jan-Mar;18(1):72-6.

[22] Nanba T et al. Increases of the Th1/Th2 cell ratio in severe Hashimoto’s disease and in the proportion of Th17 cells in intractable Graves’ disease. Thyroid. 2009 May;19(5):495-501.

[23] Müller K et al. Effect of iodine on early stage thyroid autonomy. Genomics. 2011 Feb;97(2):94-100.

[24] Man N et al. Long-term effects of high iodine intake: inhibition of thyroid iodine uptake and organification in Wistar rats. Zhonghua Yi Xue Za Zhi. 2006 Dec 26;86(48):3420-4.

Leave a comment ?


  1. OH yes! I do all of that daily. thank you for clarifying!

  2. Carmen,
    There is a good website that has what u can eat to get your iodine.
    Carmen I have been on bio identical hormone ther. for 10 yrs because of a cruise we went on I picked up some nasty parasites that from the day we got off the ship I started having strange things happen. One of the problems I developed was hormone imbalance. 8 yrs later my body started to shut down because the parasites totally destroyed my immune system and the bacteria in my blood started to effect my heart. Went to a Bio Chemist specialist that does all natural and that is when I found out about the parasites. This started me on my way to healing myself. Do u know what it is that totally fixed my immune system and killed every parasite in the body….. I juiced for 30 days. That fixed everything in the body including my hormones. My pros. was low before and I took compounding cream for it and since the juicing I was due for retesting and my pros. was 2000 and it should be under 350 so the juicing fix it to where I should have not been on it anymore. It has made my test. alittle over because of to much pros. so now I am detox my liver to get the extra out and down to normal. The only thing I have to tk is Thyroid which will be lowered when the rest goes to normal. The juicing had brought me to normal. The other thing it did is out rid of my Eb. Barr and Mono that always shows up in my blood work and from the juicing it is no longer showing up. That is what causes the immune system to start attacking the thyroid. Totally fix the immune system fix the Hos.? My sister is going to do the juicing for the 30 days so we will see. Kill all the bad and build up the good to fix the body. So get your iodine from your food or take Kelp supplements which is a great source. Let me know if u want to do the juicing and I will tell u how I did it.

    • can you please tell me what you did to fix, I started Juicing but I need more of a plan

    • Hi Trista,

      Could you please email me at lorihaley1 at I would really like to ask you a few questions about your experience and it’s easier that way.

  3. Thanks Trista…I am taking Iodine already and have been a juicer for years. My case is pretty complex. 🙂 I appreciate your story and your input.

    • Hey Esme,
      The way I did my juicing is by watching FAt,Sick, and alsmost died which u can watch on Netflix or on the website Joe Cross is the one that did the video and it is his site. The site will give u what u need for juicing and recipes and ideas. It is the best thing u can do for yourself I promise. I juiced for a wk then I went to juicing for the day and had eat veggies for dinner like a organic sweet potato or a salad. Let me know if u need anymore help. Happy Juicing
      Trista 🙂

  4. “1 mg iodine . . . eliminates iodine deficiency, drives out other halides like bromine, and supports mucosal immunity.”

    I’d be curious to see data to support this. I’m not aware of any.

    In fact, the studies and clinical experience of the Iodine Project suggest that few, if any, people will achieve iodine sufficiency or bromine detoxification on such a low dose. One to two orders of magnitude higher doses seem necessary, in general at least.

    My own experience bears this out. It took me several years at 50 mg iodine/day, along with the rest of the Abraham iodine protocol, to achieve iodine sufficiency and to reduce high levels of bromine.

    By means of repeated iodine loading tests, it was easy to see how slow my progress was even at 50 mg/day. (And even that slow progress stopped, and even reversed, when I slacked off on the 1 tsp/day of Celtic salt recommended to promote urinary elimination of bromine driven out of tissues by the iodine.) My sense of well being closely tracked the results of the iodine loading tests.

    The doctors experienced with the Abraham iodine protocol believe that chronic exposure to toxic halides, especially bromine, has greatly increased the iodine requirements for good health well beyond what might have been necessary in premodern times. Considering the apparent hazards (e.g., hypothyroidism, hyperthyroidism, immune suppression, psychiatric problems, cardiac arrhythmias, various cancers) of insufficient tissue iodine and halide toxicity, it seems questionable to me to assume that 1 mg/day of iodine is sufficient in general, unless there’s data to support this I’m not aware of.

    • Hi Bill,

      Thanks. I didn’t mean sufficiency in the sense of getting all the benefits, but of avoiding clinical deficiency as expressed in iodine-deficiency hypothyroidism or cretinism in pregnancy.

      Any iodine will compete with bromine.

      It is interesting that you needed so much iodine to see benefits!

      In making recommendations I’m just balancing benefits against risks. If selenium is off or some other cofactor, or possibly if some infections are present, thyroiditis may result. I do still suggest high doses as a possible therapeutic strategy for cancer, hypothyroidism, and other conditions. It’s a judgment call.

      • “I didn’t mean sufficiency in the sense of getting all the benefits, but of avoiding clinical deficiency as expressed in iodine-deficiency hypothyroidism or cretinism in pregnancy.”

        Thanks, now I understand your argument better. But to me basing iodine requirements on the amount required to prevent goiter and cretinism, as conventional medicine does, is akin to basing Vitamin D requirements on the amount required to prevent rickets. As you know, both are required by tissues throughout the body, not just for bone or thyroid health.

        The body can be quite starved for Vitamin D but not *quite* starved enough to succumb to rickets. Similarly, the thyroid will take the iodine it needs and in so doing starve the rest of the body under deficiency conditions: so no goiter, but maybe fibrocystic breasts or breast cancer, arrhythmias, immune depression, poorly functioning insulin, thyroid, and other hormone receptors, etc., etc.

        “Any iodine will compete with bromine.”

        True, but the empirical question is how much iodine is needed for how long to clear bromine toxicity under current conditions. The question has been investigated by the Iodine Project and it appears to be on the order of 25-50 mg/day for most people, more for some, and even then it can take a year or more.

        “It is interesting that you needed so much iodine to see benefits!”

        Yup, it surprised me, too, but it does not appear to be unusual. Now that my bromine burden has been cleared, we will see over time how much I need to maintain iodine sufficiency and avoid bromine toxicity. I may try reducing to 25 mg/day and retest after some months to see if that’s enough. Or I may stay on 50 mg to keep my hard-won gains. Dr. Flechas will be consulting with my doc so we can learn from his experience.

        I don’t think thyroiditis has been seen much, if at all, by the docs using iodine at these dose levels, at least if the entire protocol, including selenium and unrefined salt, is followed. I have heard of docs seeing hypothyroidism with iodine, but my suspicion is that they haven’t used the complete Abraham protocol. The docs that do don’t report such problems, as far as I know. Also, some docs don’t realize that TSH can spike as iodine repletes, since it’s a signal to upregulate the iodine symporter. In that context, the high TSH is not a sign of hypothyroidism, but it can easily be misinterpreted as such since current medical orthodoxy simplistically regards TSH alone as a reliable marker of thyroid function.

        • Hi Bill,

          Is there a book for the Abraham protocol? Should this be done with a doctor? Sounds like tricky business.


        • imo, just guessing here, Paul is not really in a position to make “high” (by CW & rda) dose Iodine recommendations to the masses (& risk any adverse comeback).

          As you know yourself, getting Iodine sufficient requires adhering to a protocol of doses & ingredients (iodine, selenium, salt, others?). & preferably working with a supportive & knowledgeable Doctor in this area.

          So i do feel for Paul on subject. This is probably more something that people need to pursue for themselves to address their particular needs/situation.

          just thinking out loud…

          • Hi Darrin,

            Pretty much. In general I’m supportive of high iodine in theory, but in practice there are many ways it can go wrong. I’ve experienced a few hiccups myself. The likelihood of problems at 1 mg is much lower.

          • Darrin, I agree with you wholeheartedly that we must each decide what health moves to take our chances with, and that certainly includes the iodine protocol. I am not suggesting that Paul or anyone else tell the world to take >1mg doses of iodine.

            I was just saying that as far as I know it’s not supportable to claim that 1 mg/day of iodine is generally sufficient to reverse whole body iodine deficiency or bromine toxicity. To me the Iodine Project has pretty convincingly shown that isn’t true. My personal experience certainly accorded with that.

          • Hi Bill,

            I didn’t intend “drives out other halides” to imply that 1 mg iodine would necessarily eliminate them. Only that it would compete with them and increase their excretion rate compared to taking no iodine.

            The iodine dose required to reverse bromine toxicity within a given time is going to depend on bromine levels in the body and continuing exposure, plus other factors you mention like salt intake. So one couldn’t generalize about that.

            I find it pretty remarkable that such high doses are needed. Presumably this indicates that we have a lot more bromine in our environments than in evolutionary times.

  5. @Paul Jaminet
    “It is interesting that you needed so much iodine to see benefits!”

    Biochemical individuality; there is a bell-curve distribution of inherited need for each macro and micro nutrient.

    I personally find I have to be consciously making sure I’m getting iodine and sodium – and modulating my selenium intake – evey day, whereas I observe many others whose thyroids’ appear to be working just fine without them ever thinking about where they’re getting iodine from.

    • “I find it pretty remarkable that such high doses are needed. Presumably this indicates that we have a lot more bromine in our environments than in evolutionary times.”

      I found this remarkable, too, and hesitated to take so much. But the benefits have been clear enough, including, after several years, elimination of bromine toxicity and substantial reduction in my need for thyroid hormone for Hashimoto’s, which none of my docs has ever seen or heard of. I feel far better for it.

      Dr. Brownstein and the other docs using iodine seem to feel that indeed widespread toxic bromine exposure (among others) has greatly increased iodine requirements. I find this similar in some ways to how widespread exposure to refined carbohydrates has apparently increased Vitamin C requirements.

      Many of our ancestors clearly got along well with low iodine and Vitamin C intake, but that does not prove that people today can. Another example to me of why simplistic evolutionary arguments aren’t sufficient and must be tested with empirical evidence from today, such as that from the Iodine Project.

  6. Bill please share any info you have on hashimotos and iodine? So many warnings against it. I disagree but struggle with dosing. The itching on one part of my shoulder wih iodine supplementing is torture. I have bromide rash as well on y hairline. I wonder if higher doses of iodine would crush me or help me.

    • Carmen, for an overview the simplest presentation is probably Dr. David Brownstein’s book, cited in a comment just above.

      As for bromine toxicity, I suffered from it, too. Keep in mind that if that happens the bromine was there already; the iodine only liberated it from tissues and moved the toxicity temporarily to detox organs such as skin. To me, bromine symptoms support the value of the iodine protocol since it does not seem healthy to bear such a toxic burden long term.

      The standard advice to take 1 tsp unrefined salt per day, which dates back to the original Abraham protocol, took care of the detox symptoms for me.

      For practical advice on troubleshooting the iodine protocol, the Yahoo iodine group is good (but they have doctrinaire views on how to treat thyroid problems that I would take with a grain of unrefined salt):

  7. I have brownsteins book and do the salt loading etc but he is very non specific about hashis. Basically in a nutshell “Some can take high doses and sone can’t”. I understand it is an individual decision…but I am trying to see if there is a larger amount of people who benefited from LARGE amounts of iodine that have hashis before I take a plunge. I don’t need more adrenal stress on top of what I already have so I am trying to make an educated decision. 🙂 Thank you for all your input. The yahoo group unfortunately rarely answered my questions and if I veered off topic in even one post bc of the connection to the thyroid they sent it off topic. I felt pretty unwelcome there. 🙁

  8. bill what was your total amount of iodine at one time?

    • “bill what was your total amount of iodine at one time?”

      50 mg Iodoral/day for several years, along with the rest of the Abraham iodine protocol (selenium, magnesium, Vitamin C, and unrefined salt).

  9. Hi Bill and Mario (if you are “listening”),
    Could i pester with a query regarding Selenium & Iodine.

    Is there a “dose” relationship between these two?
    ie. is there a need/requirement to increase selenium intake (food & supps) as one increases iodine intake (food & supps).

    ie. does the selenium requirement change between iodine intakes of say, 1mg, 10mg, 20mg, 50mg.

    thx guys

    • Darrin, all I really know is that the Abraham iodine protocol, which includes 200 mcg selenium per day, has been highly successful and safe in thousands of people with iodine doses ranging from 12.5 mg/day to well over 100 mg/day.

      Paul is worried about selenosis, but as far as I know it has not been seen with this protocol, even with thousands of patients under close physician supervision.

      I take 200 mcg selenium along with my 50 mg iodine and my PHD-ish diet, so I’d be very interested if there is believable evidence of selenosis risk.

      • Thanks Bill. that’s good to know.

        After “messing about” with my selenium & iodine supps.
        I seemed to have settled at supplementing with 200 mcg selenium every other day & 12.8 mg Iodine every day (currently from Iosol).

  10. Wow, just reading through the comments.

    Paul when you say bromine exposure, do you mean bromine like from Bleach?


  11. 7 Natural Treatments for Hypothyroidism - pingback on January 26, 2013 at 3:48 am
  12. Hi Paul

    Was wondering if you could help me understand some issues I’m having. I’v tried taking iodine at 225mcg but get this rash on my arms and other parts of my body which are itchy and come and go. I stopped iodine which made it better and started again but this time at 115mcg and after two weeks the rash has appeared again today. I had made the decision to stop iodine supplementation after that 225mcg experience but the reason I started again was because I got a throat pain off iodine for a few days which only goes away as soon as i take the iodine. I want to stop iodine now, but my throat becomes sore when I do after a week or so and I can only get rid of it with iodine, as if I’v been trapped with it.

    My TSH level was practically 1.0 whilst on Paleo/PHD and before any iodine supplementation although I still had cold hands and feet, dandruff (hypothyroid symptoms) Im not sure what to think of all of this. I could all just be bromine detox?

    Wouldnt have eggs, strawberries and a cup of yogurt daily give 150mcg minimum of iodine and avoid a deficiency? and have some extra seaweed and seafood for more iodine during the week. Iodine supplements just confuse me and how my body reacts to them makes me try to figure out whats going on wit my thyroid etc all the time. Im not sure if its bad or good or just bromine detox, or do i increase iodine or stop it or what?

    Hope your keeping well

    • Paul,
      You have a serious thyroid problem going on that is not letting your body use iodine that way it should be. Find a doctor that specializes in Bio Identical Hormone Therapy. All your problems are coming from hormones. Hormones effect the whole body and they run off our thyroid. You can not go to a reg. doctor for the hormones because they have no training in them in our country. You only want to do Bio Identical. You also need to get off of wheat completely which effects and can destroy your thyroid. Wheat is a wicked thing for the whole body. Get the book “Wheat Belly” that is written by a doctor that will help you out alot. You can get it from the libary or ebay. Hope this helps.

    • Abu, TSH alone isn’t a good indicator of what’s going on with your thyroid hormones, as TSH can change on a daily basis. You could be making plenty of T4 but not converting it to T3. Or, you could also have resistance to thyroid hormones at the cellular level. Or you could be making too much SHBG, which binds hormones. There are a lot of things that could be happening.

      Cold hands and feet, contrary to popular belief, are not always due to hypothyroidism. Adrenal issues can be a cause, as can low endothelial nitric oxide synthase (eNOS) production, which will def. cause cold extremities and also brain fog.

      Your best bet would be to see a functional medicine practitioner. I would check out some of the people at

  13. Hello Paul!

    I have been following the PHD for about 6 weeks now, although, to be fair, it has taken me a while to really hit my stride with it. During that time, though, I have only had wheat once, so I have been mostly gluten free. I am taking all supplements, and, as of the past few days, I think I am finally getting my macros in the right proportions and my fructose levels down to the right levels. Overall, I have been feeling great.

    I just added the iodine a few days ago, though: 225mcg. I have to say, that I have felt terrible every day since I began the iodine. Headaches have been nearly constant. I feel exhausted, and have had stomach cramps, constipation, and nausea. I did a google search and read that salt flushing can help with symptoms. I did one salt flush last night, and one this morning, and didn’t take my iodine this morning. I feel muuuuch better today. I am not sure what to do now. Should I chalk the symptoms up to bromine detox and keep trying to take the iodine? Should I lower the dose? Do I need to raise the dose (ie the Abraham protocol)?

    I am gathering from my searches and from these comments that iodine is a complex issue. I have no health insurance (although I am about to apply for the new low-income coverage in my county, so hopefully I will soon – yay Obamacare!) and have not seen a doctor in years because of that. I have never had my thyroid tested, but have long suspected hypo b/c my basal temps were VERY low when I was doing fertility tracking years ago, my energy levels are quite low, and I have trouble losing weight.

    Maybe I need to wait until I have some insurance and try to get TSH tested to get some better idea of what I am dealing with here. Are there other tests I should try to get once I am able to do do so?

    BTW, I am eating 3 brazil nuts and 3 pastured egg yolks daily, as well 1/4 pound lamb liver weekly and 1/2 pound beef 4 days a week (as per PHD recommendations).


    • Hi Carmelite,

      Do you have a similar reaction to seafood? If you can eat seafood regularly, eg a few sheets of Nori seaweed with dinner every night and salmon/sardines once a week and shellfish once a week and some kind of seafood a third night, that will give some iodine. Then try cutting the 225 mcg tablets in half and trying them intermittently.

      Usually this will be one of several things:
      – Bromine toxicity. Take salt, water, and vitamin C to flush.
      – Hyperthyroidism. You have thyroid nodules and become hyperthyroid after taking iodine. If this is the case, lower the dose to minimize symptoms and take lithium supplements once a day. You can cut a 225 mcg tablet into quarters or eighths with a razor blade.
      – Reactive hypothyroidism. Supplement selenium once or twice a week and start the dose low and increase slowly.

      A thyroid panel would help tell the answer, but self-experimentation will probably be fine. Just lower the iodine dose, tend to nutrition, and test the flushing protocol.

      • Thank you for the reply, Paul!

        I have never noticed a reaction with seafood, but I don’t consume it very often. Salmon once a week is already a strain on my budget, so I don’t tend to do any more than that. I was eating a few seaweed snacks per day while waiting for my iodine to come in, and, now that you mention it, the same symptoms were starting to creep up on me even before I started the iodine. I was getting a sore throat, headaches, muscle aches, and stomach cramps. I hadn’t thought to associate it with the seaweed, but now that I am not taking iodine or eating seaweed, all of these symptoms are gone.

        I am already taking the lithium once/per day, and have been for several weeks now.

        I just got approved for county health insurance yesterday, and have an appointment in a couple of weeks. I think I am going to hold off on iodine until I can get my thyroid panel done. I need to get this straightened out one way or another for my long term health, I know. I am a single working mother, though, and also in school. Those symptoms were just too intense for me to be able to handle on a daily basis and keep up with my life. I will see what the thyroid panel says (I should do T3, T4, and TSH all, right?), and then go from there. Thanks!

        • Hi Carmelite,

          It’s good you’re seeing your doctor. I think T3, T4, and TSH would be good but consult with your doctor.

        • probably worth getting tested for Thyroid Antibodies as well if possible, if you never been tested.

          ask you doc about the Thyroid Antibodies test.
          It’s usually two tests from memory, TPOAb & TgAb.

  14. Hi Paul,

    I am curious what it means to you if one has normal T3 and T4 levels but the TSH is way high, meaning low thyroid? My Canadian number is 44, yet the T3 and T4 are normal.

    • Hi Lori,

      That generally indicates hypothyroidism. You may have an enlarged thyroid gland also. The TSH stimulates the thyroid to enlarge and produce more thyroid hormone, and this makes up for the destruction of hormone and tissue by antibodies.

      But symptoms are an important factor in completing the diagnosis.

      • Hi Paul,

        I am on a little stronger dose of meds now and now I am getting symptoms of high thyroid, yet my TSH is still suggesting low thyroid. My T3 and T4 levels are still normal. My ultrasound said my thyroid has inflammation. Is it possible to have normal thyroid but have the TSH out of whack? I am getting leg cramping etc that is normally due to low thyroid, or it could be from going on synthroid again. I don’t know. What do you think?

        • Hi Lori,

          It’s best to have a doctor evaluate this. Tests for anti-thyroid antibodies might be useful.

          Be sure to eat liver every week for vitamin A, as thyroid hormone needs vitamin A for proper activity.

          Leg cramping is more likely to be due to an electrolyte issue, low potassium or magnesium most likely. Try 200 mg magnesium/day plus tomatoes and potatoes.

          Best, Paul

          • What about organic carrots juiced for both vitamin A and potassium? Why only liver? It’s the meat issue with me.

          • Carrots are a nourishing food but they don’t have vitamin A, they have beta carotene which the body can convert to vitamin A. However, this conversion doesn’t always happen. Liver provides vitamin A itself along with a number of other very important nutrients that are hard to obtain elsewhere.

  15. Hi Paul,

    I have Hashimoto’s thyroiditis. I have started on low gluten diet and taking Iodoral 12.5mg per day along with selenium 500ug per day, megadose c, magnesium, and vit b complex since 3 months ago when my thyoid function is slightly below limits

    anti-thyroglobulin >1:6400x
    anti-microsomal Ab >1:6400x
    T3 5.88 (range 6.09~12.23)
    T4 65 (range 87-178)
    TSH 13 (range 0.34-5.6)

    three months later now, l was extremely fatigue with hair loss and the lab became

    anti-thyroglobulin 542 IU/mL(<4.11)
    anti-TPO 1646 IU/mL (100(range 0.34-5.6)

    Can you please explain the reason of the change if iodine suppl is the right way for Hashimoto’s?
    I reduce my selenium to 300ug and started taking Synthyroid now.

    What’s your suggestion? Will my thyroid function and antibodies return to normal finally if you keep my iodine suppl?

    Many thanks

    • My thyoid function now is
      T4 0.99
      T3 30
      TSH >100

    • Hi Steve,

      It’s generally a bad idea to start directly on high doses of iodine. You should start at 225 mcg and work up only very slowly to higher doses. Otherwise you are likely to get a reactive hypothyroidism.

      Also, 500 mcg/day selenium is way too much. Optimal intake is about 200 mcg/day and food probably provides 150 mcg/day, but food content is highly variable and in some parts of the country may provide much more.

      Excess selenium and excess iodine together kills thyroid cells and will create a severe hypothyroidism or possibly hyperthyroidism.

      My suggestion is:
      – Stop selenium, or take only 200 mcg selenium per week.
      – Reduce iodine immediately to 225 mcg/day and stay there.
      – Reduce vitamin C intake to 500 mg to 1 g/day.
      – Take vitamin B complex occasionally, not every day.

      Expect your thyroid to need 6-12 months at these supplementation doses to recover.

  16. Hey Steve,
    My sister has Hashimoto’s and when u have that u can not have a trace and I mean a trace of gluten. You need to find a doctor that specializes in Bio Identical Hormone Therapy. You need to get the gluten out of your system before you can get the right reading on your thyroid. The gluten is attacking the thyroid. This means wheat, barley, and rye. Check every ing. on the label and goggle to see if it has gluten. You will be shocked what has gluten in it. It has taken my sister over a year to get her thyroid at the right balance and she is the energize bunny. She is on a compound all natural thyroid medicine. You do NOT want to take any synthetic hormones. VERY dangerous and will case u more problems and it causes cancer. Your thyroid is still way to low and that is why u r fatigued and hair loss. U need to get the whole thyoid tested and only a doc who specializes in natural hormones will do this. Your body is not absorbing only thing u r taking because of the gluten still in your small intestine. U should not be taking anything until u get the gluten out because you r toxifiying yourself. Find the right doctor and they will get u on what u need at the right time. Get the book Wheat Belly that was written by a doctor and u will learn so much about gluten. This is a bk that our hormone doc tells everyone to get and read. Amazing book.

  17. How much selenium is needed per microgram of iodine approximately, to ensure that the autoimmunity does not flare?

    • Hi Withania,

      It is not proportional to iodine intake; rather you need neither too much nor too little selenium. Around 200 mcg/day from all sources including food is optimal. PHD food will probably deliver 150-200 mcg/day, so we recommend supplementing no more than 200 mcg/wk (= 30 mcg/day) to reduce the risk of an excess.

      • I find that if I have any supplements with iodine, even if it has selenium, my autoimmunity flares. A friend was put on iodine and selenium and she went from antibodies to full blown hashis. I’m still not confident to take even 200mcg of potassium iodide. Any advice/suggestions/thoughts?

        • How much iodine was your friend put on?

          Usually low doses are quite safe and beneficial for Hashi’s. They’ll generally reduce antibody titers.

          Try eating some seafood. Even a small amount of seafood will have 200 mcg iodine.

          Then, try the tablets, but cut them in quarters with a razor blade, so they have 56 mcg. Try that for a while. If you don’t notice anything, try 112 mcg and then the 225 mcg.

  18. I’m learning alot from everyone’s comments. I need to find another bioidentical hormone doctor since mine recently passed away and my conventional doc put me back on all the “old stuff” that I’m hearing most say to not take. You are right, most docs are not trained on any of this in med school. They get very little info on bioidenticals and most feel that ones who practice it are quacks. Awful. Trista, I am interested in how you juice. I have to “eat” most of my foods via the blender, juicer or just soft foods due to my jaw issue/swallowing issue/no bite because of the jaw being crooked right now (maybe metal toxicities, too), some say I should chelate but stil having metals in my face, I’m not sure it would do much good. Thoughts? Trista, my email is Thank you and everyone else for your tips on getting healthy and balanced. Appreciate it. I’ll keep reading…

  19. Paul,

    I am also trying to understand about iodized salt and iodine? Is it the same thing, or should one avoid iodized salt whether they are low or high thyroid?

    • Iodized salt is fine to take but the iodine dose is fairly small. I would favor using sea salt and iodine supplements or seafood/seaweed, the sea salt provides more minerals than table salt and specific iodine salts (maybe only on days when you don’t eat seafood) provide a better level of iodine intake. 225 mcg/day on non-seafood days is good.

      • Thanks Paul. This is really helpful and explains why there is so many high rates of hypothyrodism here. Apparently immigrants do not have problems with hypothyrodism until they come to North America. Do you know anything about that?

        • Hypothyroidism is usually caused by gut dysbiosis / small intestinal bacterial growth so it is promoted by sugar and omega-6 fat diets. Low iodine intake increases risk further. I’m not surprised immigrants would have more hypothyroidism here.

          • Hello Paul,

            When you say “hypothyroidism is caused by…” I thought it was mainly created from Hashimoto’s? And that the main trigger was gluten? Ive read that an estimated 90% of all cases. If that is so, are you stating that gut dysbiosis is what is triggering the immune system to flare/attack? Also, how does one get rid of dysbiosis? Probiotics/no sugar?

  20. I was diagnosed with Hashi’s by my naturopath in 2011…I have been GF and followered her No Iodine and low dose selenium methos. Within 4 months My Thyroid anitbosies have normalized so no need for supplimental thryoid treatment. I also have PCOS and am on Metformin to regualte my cycle. I have been seeing a RE and am persuing fertility treatments. The problem is in the mean time I moved to Florida where homeopathy is frowned upon and not understood. I want to find the right prenatal suppliment, but they all say they have Iodine and a baby needs you to take it. Since the doctor’s here don’t understand I am hesitant to follow what they reccoment. Any thoughts on which direction I should go?

    • Hi Jessie,

      Well, on the one hand I don’t think you should take a prenatal supplement, they have too much of many things and I think it does more harm than good. On the other hand I think you should take a low dose of iodine, it is crucial for baby health and also should help against PCOS and Hashi’s. The selenium probably did you good but if you eat a seafood-and-red-meat focused diet like PHD then you probably won’t need it. I would suggest reading our book for guidance on prenatal nutrition — the main thing you need is increased consumption of liver and egg yolks and seafood.

      • Paul, Thanks for the tip….so keep my regular vitamin routine then? I can’t eat seafood. I have eggs about 3-4 times a week, but my cholesterol is high so I don’t have everyday. All other days I have a homemade kale/grean leafy/carrot and fruit smooth with flax seed powder (mill myself). I will check our your book though.

    • Hi Jessie,

      Did you follow a gluten free diet (if that’s what you meant by GF)?

      Also, you didn’t take Iodine?

      Can you please email me at lorihaley1 at

  21. Hey Jessie,
    I live here in FL and have a great homeopath in Brandon. I also have a OBGYN who has del. over 10,000 babies and he does the bio identical hormone therapy for the last 20 yrs. and he is top of his field on this. He is for all natural so he would be great to go to for what u need. It depends on where u live. Dr. Hall is in Ocala. If u r interested in either one let me know. My whole family and my husbands family go to both for yrs. and I do not recommend anyone I have not been going to for a long time and know they r good at what they do. My sister also has Hashi’s and found out 2 yrs. ago and started going to Dr. Hall for her hormones and ofcourse she had to go serious gluten free and she is just on compound tyroid now and she is doing amazing. He deals in all of it and being a baby doc. is what u need. He does not del. babies anymore but can do everything else for u. Let me know if I can help.
    Trista : )

    • Trista,

      Thanks I am in Palm Coast and work in Daytona. I am already with Mayo doctors in St. Augustine and a good RE. I just keep getting conflicting information, because my labs now are so much better then 1.5 years ago they all say you don’t have thyroid or PCOS….WTH??

  22. Hi Paul, Thanks for all your great info and your amazing book.

    I have hypothyroid symptoms (cold hands/feet, etc) and I’m using all your rec supplements plus I’m taking some natural thyroid meds as well.

    I’m would like to know if you think swimming daily or every second day in cold-ish sea water (60*F-71*F) would effect my situation positively or negatively?

    I thought the cold water would stimulate the thyroid and other glands, but maybe it would just make me feel colder.

    Any thoughts appreciated! Sharon =)

    • Hi Sharon,

      Alternating between cold and hot may help. Get in the sea and then come out to a hot shower. Go to a sauna and alternate with a cold shower. Cold showers in summer, hot showers in winter are good.

      I think 70 F should be fairly comfortable, we swim often in that temperature at Cape Cod in the summer. 60 F is frigid, I won’t go in there!

  23. Wow, thank you so much for this! This might be the most detailed, scientifically referenced article on iodine supplementation and Hashimoto’s that I’ve seen. I’m trying to eat more food with iodine. What is your opinion on kelp supplements? Kelp also has selenium and seems to solve the “balance” issue you speak of, but can also contain metal toxins.

  24. Trista,
    I live in Brandon too and would love to hear your doctor recommendations. Thanks!

  25. Good Day Paul, well I thought I was doing very well on PHD with the added iodine for breast health and energy.I have been doing this for 9 months now. But the last 2wks I started having symptom of hypothyroidism so I went to the doctor and had tests. I have a nodule .6 on my thyroid. My question is why? I was taking 25mg iodine and I’d eat a brazil nut. I am incredibly tired. The doctor wants to take a needle biopsy but I want to wait and try upping my selenium for a few weeks and then have it measured again. thank you for any advice.

    • Hi cris,

      25 mg is too much iodine. Selenium content of food is too uncertain to be sure of hitting the safe zone. We stopped recommending iodine over 1 mg last year, except in rare therapeutic cases. We now recommend 225 mcg iodine daily, or when seafood is not eaten.

      Stop the iodine, wait a month, and then test a low dose of iodine. Cut a 225 mcg tablet into quarters to get a low dose. If your nodule is producing thyroid hormone in unregulated fashion, you may react in hyperthyroid fashion to even small amounts of iodine.

      The nodules will generally go away / heal with time and the likelihood is you’ll be back to normal in a year. I would eat bone/joint stock soup for extracellular matrix, supplement zinc and optimize copper, maybe supplement mixed tocopherols/tocotrienols. Eat liver, egg yolks, seafood, other nourishing foods.

      The doctor presumably wants to check to make sure it is not cancerous. That is unlikely, but I don’t know what the odds are.

      • Paul, I am just curious as to why this would happen to me. With iodine I was seeing improvements in small cysts around my eyes and I felt more energy. I am stopping the iodine but will continue the brazil nuts. thank you once again.

  26. I have been taking levothyroxine since 2001.Never had any changes in the dosage,except for once. After having the baby had to reduce to 25 mcg then within a few months was back at 50mcg.The past 5 yrs the doctors recommended Fish oil and Vitamin D,B12,so started taking them with my usual multi vitamin and levo.During this my thyroid levels had been normal.My folate levels were high and the AST levels were like 7-11.I was not feeling good so I stopped the fish oil,B12,vitamins after which I got floaters,thoracic low back shoulder pain and fatigue.I started regular cardio exercise with strength training,I started feeling dry throat,with BP in the 90/60’s range with pulse at 55 to 60 accompanied with dizziness.Checked the levels Tsh was high so the dosage was increased to 75mcg I was asked to take a multivitamin and 2000iu Vitamin D keep up my workouts.I felt worse with night flashes,high pulse and higher BP.When the levels were checked the TSH was low so reduced the dose to 25mcg which was low so back on 50mcg with multi vitamin and VIt D.

    When I was on 75mcg I took melatonin couple of days because of not able to sleep and anxiety.Since then I have a pain near my pituitary on the left side with tension kind of head aches.I also started feeling weakness on my right leg from the hip like near the sciatica.This weakness has not gone away and keeps coming often with tremors and anxiety.I have reduced my workouts since then to a minimum but still feel like some blood circulation problems.During this period had thyroid ultrasound and all neurological and cardiology tests are fine.I get easily bruised for no reason my BP is on the lower side of 90’s,pulse in the 58-63 range with dizziness.

    I also developed non pitting edema on only my ankle no feet,its bilateral but more prominent on the left side.I still get weakness on the right side,tremors some time.I started juicing for breakfast and dinner with some solids for lunch,the dry throat has started again with more weakness and greenish yellow bruising out of no where.Will juicing affect my thyroid,should I stop my multivitamins during this time.

    I also used to gargle with warm salt water at the first sign of soar throat which always helps wonderfully but notice strange things happen near my thyroid.I have always use iodised salt.Even though it clears up my cold and soar throat.I get a very dry throat after gargling could this have also messed up my levels.

    Before this gargling never had problems with my levels or weakness as long as I took levo with multivitamin.Why does the levels change when vitamins are not taken and why do I have this dry throat and and strange feeling in my throat if I want to take my vitamins naturally through juicing.How can I eliminate the edema.I am being shuffled between doctors without any improvement.

  27. L'hypothyroïdie « AltheaProvence - pingback on September 2, 2013 at 3:14 am
  28. I did a little research and it’s not just bromine but also chlorine and fluorides (felllow halides of bromine) that can cause Hashimoto’s. So if you do a lot of swimming in pools, like I do, and/or your water is fluoridated or you use fluoride toothpaste, you could still have problems, even if you had no contact with bromine. Iodine would help with those, as well. No wonder people could need high doses.

  29. Hello Paul !

    OMG i feel as if my brain is gonna explode. I have done so much reading the last couple of days. SO MUCH input… so much confusion. Now i m here.

    i try to keep it short : i turned 80 10 10 raw vegan about 1 year ago. Before that my TSH levels were always about 1.30 …. after half a yea of being mainly raw vegan (no salt, no seaweed) my TSH levels were 2,5 and now they r 3,6 . I have problems losing weight, i have dandruff, i have itchy scalp, a few weeks ago my legs were really itchy while sleeping. Its getting less now. I have a slow digestion, i have more premenstrual pain and swelling in my breasts for 4-6 months. I feel my ovulation more than i used on the “sad diet”. I have started to take a german product now. We only seem to have supplements with Potassium-Iodide here. (Kaliumjodid) i could NOWHERE find anything with iodine (Jod?). I took my temperature as well a few mornings after waking up in bed and it was 36,2 °Celsius. Below 36,4 indicates hypothyroid issues i ve read somewhere. Also i m feeling usually cold in a room with 21°C. Hands and feets r usually cold but i believe i always had that. I dont feel energetic as most ppl do on this lifestyle.
    I am eating 1-2 brazil-nut per day . Which should provide about 200 mcg of Selenium . Is that too much or too low or not reliable since its a nut ? I ve also bought selenium supplement made of “Beer-yeast” ..sorry i dont knwo the english word but i believe it causes me bloating PLUS when i “burp” it tastes really horrible like yeast.
    I feel a bit different since i m taking those 200 mcg of Potassium-Iodide. A bit like Coffee-detox withdrawal. Light headache, feeling a bit dizzy, brain fogged. But usually only the fist 1/2 of the day. I take the supplement after breakfast in the early morning.

    Someone told me now that i have to take MUCH higher doses and that PotassiumIodide alone doesnt work. That i also have to take Iodine (BUT I DONT find it here in germany!) and actually recommendations for Potassiumiodide itself r max. 500 micrograms per day. How can some take 50 milligramm here :O i am so confused.

    Do u think i m doing fine with my Pot. IOdide 200mcg per day? do i have to search for Iodine? How much would i have to take of that? R my detox-symptomes already showing that 200mcg is a good dosage or already too much?
    Do i have to replace Brazil-Nuts with another supplement? What is this salt-loading / salt flush ? I always got taught on this diet that salt is so bad. But should i consider doing that too? what exactly is that?

    THanx so much already !

    best regards

    Stephy from germany 🙂

    • Hi Stephy,

      First, have you changed your diet to PHD from the raw vegan? It is not a good diet. That is the main thing you need to change.

      Hypothyroidism generally originates with a gut infection and in your case probably arose due to suppressed immunity (lack of vitamins A and D, zinc and iodine).

      Potassium iodide is the correct form. Iodine is reactive so you get it as salts. Potassium iodide is stable and safe.

      The best source of selenium is beef, lamb, and seafood. On PHD you shouldn’t need to supplement it.

      You don’t need much iodine. 200 mcg is good as a daily supplemental dose. Eat seafood (fish, shellfish, and seaweed) for more iodine.

      So you are doing OK with your current supplement. But you should switch your diet to PHD.

      Best, Paul

  30. I disagree that a raw vegan lifestyle would be harmful to the thyroid. I know of a few who have improved their condition drastically by being raw vegan.

    Stephy just needs to eat seaweed (raw nori) kelp. I am surprised you cannot get iodine in Germany.


    • Hi Lori 🙂

      Yes i dont think the raw veganism itself is the cause of my issue. Its just the fact that i didnt use iodized salt at all and no seaweed. Since ppl were always anti-seaweed (coz of the heavy metals and stuff).

      I dont lack in any other vitamins that he mentiond. I m supplementing with Vitamin D since here in germany is obviously not a lot of sun most of the year. And i m getting vitamin b12 shots. Other vitamins mentiond r plenty in my diet. Never having a minus on cronometer where i track my micros and macros. I ve orderd Iodoral online now because i seriously couldnt find iodine supplements here. Only iodide stuff. Its 12,5 mg though. I hesitate to take such a high dose. High dose compared to german recommendations which r like 300 or 400 microgramms maximum. (only Potassiiumiodide). I ll probably break them in half or not take it every day first.

  31. Hi Paul,

    When you say the best source of selenium is beef, lamb and seafood, are you saying that it is better absorbed then nuts or seeds?

    Have you seen this article?

    Brazil nuts and sunflower seeds are also a great source of selenium. 🙂


  32. Hi Paul,

    I’m very impressed with your knowledge. I have Hashimoto Dx, very low DHEA,low progesterone and high Testosterone, came back very reactive to Gluten, low iodine,low Vit.D,low K, my T3 was very low normal and my T4 was normal lower rangeDr. said my Adrenal are shot. I’m exhausted, unmotivated and 20 lbs overweight with being mostly on a Paleo type diet most of my life- less red meats and maybe 800 to 1200 calories a day(before popular). This new Dr.put me on the following 10/25/2013: Spironolactin 25 mgs,Still taking Levothyroxine 50 mcgs, Cytomel 10 mcgs, Progesterone/DHEA compound cream(at night), iodine-2 drops 150mcg each(potassium iodide and kelp),D3,Adrenal supports(with Siberian Rhodiola root extract120mg,Holy Basil+supercriticalextract and 50mg,and a blend of Ashwagandha + 350mg)-2 a day and DIM…I have added today some selenium, Coq10 and B12 on my own. I alternate protein shakes with Almond or coconut milk and make most of my meals. I’m more tired on this new formula- I just learned Ashwaganda is a nightshade herb- could this be doing it and is citrus(lemons and lime,or Pomograntes and grains(GF))bad for me. I have been very strict and have access weight around my core or upper body- this has not gone done at all. Very Frustrating…What do you think? I would appreciate any help you…Thanks..


  33. U only ate 800 to 1200 calories ???????????? for years ? or did i get it wrong? wow thats super little…..u can also ruin ur metabolism with such little amounts of food. U shouldnt go underneath ur BMR … which (i dont know ur weight and size) but for me 5,6 / 168 and about 65 kg its about 1400 calories minimum per day.. mini mini minimum. I eat 2000 without gaining and i dont do any sports at the moment.

  34. interesting article…also might want to read is on iodine, hashimoto’s and fertility or pregnancy, for which the iodine requirements appear to be based article

  35. Hello,
    My thyroid was irradited 2004 for Basedow diagnosis (back then I did not know better..).I´m currently on Armour (3 months) after a year of Liothyronin (T3), and before that 9yrs on Thyroxine (with poor results).
    My question is, is it possible for the thyroid gland to ever recover with proper nutrition and iodine, selenium ect? After seeing this Paul´s article, it occurred to me, that what if the thyroid meds (ie hormones) just suppress the thyroid from recovering as the body gets the hormones in an easy pill-form, instead of letting the thyroid, and the whole HPA-system, try to manage to stabilize things and the production by them selves?
    Do you think this is possible? Has anyone heard of recovered thyroid?
    The thing is, that one just has to stop taking the pills, and that might not be wise.. But I´m not fine at all WITH the pills, so if my body is trying to tell me something.. With iodine I got my normal temperature back, but all the tiredness persists despite of what the pill is..
    Thank you so much 🙂

  36. My question is simple. Does the lack of iodine effect the impact that selenium will have on TPOab and Tgab. You illustrated that T4 is effected by selenium in that it declines when selenium is supplemented alone but I think one of the true keys to understanding this whole picture is whether or not selenium without iodine will change the effect selenium will have on thyroid antibodies. Maybe you mentioned something and I missed it but any thoughts on this idea?

  37. Selenium and Thyroid More Good News - Jeffrey Dach MD - pingback on January 1, 2014 at 10:44 am
  38. Hi Paul. Great article! I have two questions please for anyone. Can healthy thyroid tissue that has been destroyed by autoimmune destruction ever grow back again? Or is it, once the tissue is gone, it’s gone? Also, can a substantially smaller thyroid (resulting from autoimmune destruction) produce a normal amount of hormone? Or is the size of the thyroid directly related to it’s ability to secrete hormone, given all else is equal? Thx! Wayne

    • Hi Wayne – I had the same questions and found this article:

      Chronic autoimmune thyroiditis. Conventional wisdom has it that ‘once hypothyroid means always hypothyroid’. Indeed, the vast majority of patients with hypothyroidism due to chronic autoimmune thyroiditis require life-long thyroxine replacement therapy, but spontaneous recovery does occur in about 5% 1 . Return to the euthyroid state is apparently more frequent in countries like Japan, where – at a high ambient iodine intake – restriction of dietary iodine alone may induce a remission 2 .Conditions that increase the likelihood of spontaneous recovery are the presence of a goiter, a relatively high thyroidal radioiodine uptake, and a preserved increase of T3 after the administration of TRH during thyroxine treatment 3,4,5 .The spontaneous evolution from hypothyroidism back to euthyroidism has been related to the disappearance of TSH receptor blocking antibodies 6 . Changes in the titers of co-existing TSH receptor blocking and stimulating antibodies explain the sometimes observed alternating course of hypothyroidism and hyperthyroidism in the same subject 7 .

  39. THEORETICALLY, everything positive that was said about Iodine is true. However, I utilize (and have for many years) a master Kinesiologist to assist in the treatment of my Hashimoto’s dis-ease. Currently, when testing to the innate intelligence of my body – my body has responded with a very strong “NO!” to taking iodine. It’s disconcerting and yet, I have worked with this person long enough to know that what he is accessing is my own body’s wisdom. I will take it when my body is ready. Thank you.

  40. Hi Paul, Thanks for all the info. It would be interesting if you could do a post on heavy metal toxicity. Thyroids are just the canaries in the coal mine. Check out the work of Dr. Chris Shade and Quicksilver Scientific.

  41. Hi Paul,

    I am curious what you think about taking organic sulfur on a daily basis to improve low thyroid? I read on the internet that it can actually make the thyroid worst, but I have a friend who took it and it really assisted her in losing the thyroid weight as well she could cut back on her meds. I am going to buy some soon so if you had an answer for me that would be great. 🙂 😛

  42. Just to be clear apparently it’s supposed to help because it aids in removing toxins, thus allowing the thyroid to heal even if partly. What do you think?

    • Lori, it’s a case of the hip bone is connected to the thigh bone… Sulfur is very beneficial to the body and helps with detox. Many people are benefited by supplementing with it and eating foods high in sulfur. If you follow the breadcrumbs as to the ‘why’ behind your thyroid issues, it might lead you to gut issues (leaky gut, SIBO, etc.). Those with gut issues often have difficulty with sulfur metabolism. Molybdenum and N acetyl glucosamine can help with sulfur metabolism but a closer look might be needed if that doesn’t help. Don’t take any sulfur if you suspect you have issues with it. You first need to re-establish your sulfur metabolism. Yup, it starts with the thyroid and then we find ourselves staring at our thigh bone saying ‘how did you get involved?!’

  43. Iodine for Thyroid Problems: Helpful or Harmful? - pingback on February 20, 2014 at 3:50 pm
  44. Thanks for this overview and discussion, Paul.

    I am trying to figure out why I have just had a huge TPO antibody spike. I have Hashimoto’s, with avg TPO antibodies around 200-300.

    Two months ago, after starting selenium supplementation (200 mcg/day), I started taking iodine, starting with one 12.5 iodoral tablet, and increasing by one table each week, until I hit 3 tablets/day, generally following Brownstein’s iodine protocol.

    I just got my labs back, and see a huge spike in my TPO antibodies, up to 1300.

    I am concerned–is it possible that I did not supplement selenium enough, and have caused an autoimmune flare up? The thing is, I feel really good. No symptoms, etc.

    I suppose it could also be accidental gluten exposure or the fact that I recently reintroduced eggs…

    Any input on this?

    • Hi Erin,

      I think that’s too much selenium and too much iodine.

      It’s much safer to supplement just 225 mcg iodine and eat some seaweed and seafood.

      Also, you shouldn’t need to supplement selenium at all if you eating beef/lamb and seafood as your main meats, as PHD recommends.

      Excess selenium and iodine is one of the causes of thyroid injury and autoimmunity.

      So I would cut back heavily on the supplementation.

      Best, Paul

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