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Megadose iodine: an idea whose time has gone.

Over the past 5 to 10 years, some practitioners have been recommending massive doses of oral iodine as a means of promoting better health. In addition, many people have been self-medicating with megadose iodine (which is readily available through the Internet and other over-the-counter channels). Typically, the amount of iodine being ingested is 80 to more than 300 times the Recommended Dietary Allowance, and 10 to 45 times higher than the Tolerable Upper Intake Level established by the Food and Nutrition Board of the Institute of Medicine. The theory that high-dose iodine is beneficial was put forth by Guy Abraham, MD, in several articles published in a non-peer-reviewed magazine and on his website. The theory was later repeated in a book by David Brownstein, MD.

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Five years ago, I wrote an editorial in the Townsend Letter questioning the validity of the claim that humans need iodine in amounts far greater than the amount present in a typical diet. I also pointed out that iodine is a known poison when administered in high doses, and that it can cause thyroid disease (including hypothyroidism, hyperthyroidism, and autoimmune thyroiditis), as well as acne, headaches, and other side effects. My editorial can be viewed on townsendletter.com by searching for "Iodine: A Lot to Swallow."

In the five years since it appeared, I have received numerous reports of adverse effects occurring in people who experimented with high-dose iodine. One previously healthy woman developed hyperthyroidism that could not be controlled by medication, necessitating thyroidectomy. A colleague told me that he had tried 6 mg per day of iodine with five patients, and that each of them had "terrible" side effects ranging from mood disorders to acne. The colleague himself tried 12 mg per day, and within two weeks he developed deep acne and had the worst coryza he had ever experienced.

In the August 2010 issue of Naturopathic Doctor & Review, Alan Christianson, NMD, wrote a review article on megadose iodine that supported the points made in my 2005 editorial. Over a period of several months, Dr. Christianson saw four patients who had developed thyroid disease (two with toxic multinodular goiter, one with Graves' disease, and one with hypothyroidism secondary to Hashimoto's thyroiditis) after starting high-dose iodine. Christianson presented this observation at a few medical conferences, and other practitioners at these conferences commented that they had seen similar adverse effects.

Christianson pointed out in his article (quoting directly from Abraham's writings) that Abraham's theory depends on the belief that the earth's topsoil was divinely created 6000 years ago with an extremely high iodine content, which was depleted by the flood of Noah, and that humans have had poorer health ever since. Abraham's theory also depends on the belief that academic views on iodine have been distorted by international foreign powers in order to make "zombies" out of "Christian America." (1) In addition, Christianson cited a 2009 report in Clinical Endocrinology, which provided evidence that the high incidence of thyroid disease in patients taking amiodarone (a drug that has a high iodine content) is due to the iodine released from the drug. (2) Abraham had previously claimed that amiodarone toxicity is not caused by iodine.

In my 2005 editorial, I pointed out that Abraham's iodine load test is not a valid indicator of iodine nutritional status. In this test, patients ingest 50,000 [micro]g of iodine and then collect their urine for 24 hours. Patients are considered to be iodine-deficient if less than 90% of the administered dose is excreted in the urine, on the premise that a deficient person will retain iodine in the tissues, rather than excrete it in the urine. More than 90% of patients who take the iodine load test are found to be iodine-deficient. However, the validity of the test depends on the undocumented and probably erroneous assumption that the average person can absorb at least 90% of a 50 mg dose. I challenged the proponents of megadose iodine to measure iodine in both urine and feces following an oral iodine load, in order to determine whether people are actually absorbing the iodine. While performing such measurements would be a simple way of confirming or refuting the validity of the iodine load test, to my knowledge none of the proponents of megadose iodine have conducted such studies.

The use of megadoses of nutrients is an important component of nutritional medicine. Many nutrients can be administered safely and effectively in large doses. However, certain trace minerals are dangerous and can even be fatal when given in very large amounts; these include selenium, copper, zinc, and iodine. It has clearly been shown that even moderately increasing iodine intake can cause thyroid abnormalities in a small proportion of the population. While many people seem to tolerate megadose iodine, some individuals develop major adverse effects. In lieu of any credible evidence that high-dose iodine is beneficial (other than for patients with fibrocystic breast changes or a few other clinical conditions), routine use of high-dose iodine should cease.

Practitioners who prescribe a potentially toxic substance based on an illogical theory are exposing themselves to malpractice suits, and companies that sell high-dose iodine to the public are exposing themselves to product-liability lawsuits.

Notes

(1.) Christianson A. Iodine's new paradigm: more or less? Naturopath Doct Rev. August 2010:8-10.

(2.) Han TS et al. Benzofuran derivatives and the thyroid. Clin Endocrinol. 2009;70:2-13.

Alan R. Gaby, MD
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Author:Gaby, Alan R.
Publication:Townsend Letter
Article Type:Editorial
Geographic Code:1USA
Date:Dec 1, 2010
Words:902
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