If you or anyone you love suffers from hypothyroidism, please read and share the below article on the benefits iodine has on normal thyroid function.
Iodine induces apoptosis and inhibits cells from forming cancer, esophageal varicose
Orthoiodosupplementation in a Primary Care PracticeJorge D. Flechas, M.D. This article will focus on my experience with
the use of inorganic non-radioactive iodine/iodide, thereafter referred to as iodine in a primary care practice. My medical
practice is situated in the Appalachian Mountains close to Asheville, North Carolina. This area is considered to be a
goiter belt. One of the major problems that we encounter in this location is a problem with hypothyroidism. Back in 1997
hypothyroidism involved 11.7% of the U.S. population. By 1994 severe iodine deficiency also involved 11.7% of the
population. Both of these studies were done at separate times by separate groups showing the exact number of 11.7%.
This reinforces what we were taught, that iodine deficiency goes hand in hand with the manifestation of hypothyroidism. I
have on a weekly basis at least one phone call from a healthcare practitioner questioning whether the intake of iodine
causes hypothyroidism and goiter. I often have to go back over the basics of thyroid physiology with these healthcare
practitioners, and explain to them that iodine is essential for normal thyroid functions and that it is the manmade organic
forms of iodine that are toxic (3).
My practice is family medicine with an integrative medicine twist. I have been using iodine supplementation in my
practice over the last four years in amounts needed for whole body sufficiency (orthoiodosupplementation).
Orthoiodosupplementation is the daily amount of iodine required for whole body sufficiency (3-5). Whole body sufficiency
for iodine is assessed by an iodine/iodide loading test (3). Prior to implementing orthoiodosupplementation, I perform a
complete history and physical examination. During a physical examination, I always check the patient’s thyroid. If
a mass is picked up on physical then another test that I order is an ultrasound of the thyroid. While undergoing
ultrasound to evaluate the mass I will have my technician measure the thyroid volume. Each lobe will have its length
measured in centimeters, width measured in centimeters and height measured in centimeters. All three measurements
are multiplied times each other and this gives the volume in cubic centimeters. Due to the non-spherical shape of each
lobe a correctional factor of 0.52 is used. The two lobe volumes are added together for the total thyroid size. A total
volume of 18 cc or more is considered a goiter (6). A volume size of 5 cc or less is suggestive of thyroid atrophy, another
manifestation of iodine deficiency.
Any solid mass that is picked up on ultrasound and shows itself to be greater in size than one centimeter by one
centimeter will require a radioactive I-123 uptake and scan. This test should be done previous to starting any patient on
iodine if a nodule is suspected. A nodule that does not pick up radioactive iodide is considered to be a cold nodule and
would suggest the presence of thyroid cancer. A needle biopsy of the cold nodule should be done by an E.N.T. doctor,
general surgeon or endocrinologist. If cancer is present the thyroid gland should be surgically removed. Thyroid
carcinoma is the most common malignancy of the endocrine system. Malignant tumors derived from the follicular
epithelium are classified according to histological features.
The incidence of thyroid cancer is approximately nine per 100,000 in the population per year and this usually increases
with age plateau after about age 50. Age is also an important prognostic factor. Thyroid cancer at a young age (less than
20) or in older people (greater than 65) is usually associated with a worse prognosis. Thyroid cancer is twice as common
in women as men but the prognosis is worse in men. Additional important risk factors include a history of childhood head
or neck irradiation, large nodule size greater than four centimeters, evidence for local tumor fixation or invasion into
lymph nodes, and the presence of metastasis. In my small practice of around 5,000 patients, I have found five thyroid
cancers in one year. If multiple nodules of the thyroid gland are found at the time of ultrasound then the diagnosis of
multinodular thyroid goiter is considered even if the gland is normal in size.
I request serum T4 (the main hormone produced by the thyroid), free T3 (the biologically active thyroid hormone at the
cellular level) and a thyroid stimulating hormone (TSH) level. The T3 level inside the cell correlates very well with the free
T3 that is in the serum. Following orthoiodosupplementation, serum T4 and TSH levels usually go down and free T3
stays steady. I have seen TSH sometimes go up rather than down while T4 and free T3 did not change or may have
gone up some. This does not mean that the patient was developing hypothyroidism but that the brain was stimulating the
body to make more sodium iodide symporters (NIS). The NIS are channels in the cell membrane that transport atoms
into a cell as compared to a calcium channel or a sodium channel or a chloride channel where the channel only admits
one atom to go through. The NIS transports sodium iodide into cells and has been found in all cell lines tested so far.
Thyroid stimulating hormone, prolactin and oxytocin have been found to stimulate the making of NIS. While taking iodide,
one may see an elevated TSH but we have to recognize that this is not a bad thing. TSH has many actions outside the
thyroid that have been discovered. While taking iodine, the vast majority of patients lose fat and gain muscle weight. Very
rarely has weight gain occur. Often a check of the patient’s T4, free T3 and TSH shows the T4 to go down, free
T3 going down and TSH going up. Iodide is an essential nutrient that is absorbed by all cell lines. Its highest
concentration is seen in the thyroid.
The nutritional status of the patient will determine its response to orthoiodosupplementation (3). It is crucial that the
thyroid gland has plenty of antioxidants in its cells and many other nutrients. We have found that giving a multivitamin for
women with PMS (Optiviteâ ) improves the response to orthoiodosupplementation. One of my patient’s is a classic
example of the above scenario. She is a CNA who is 5’1″. At the time she started taking iodine, she experienced
an increase in appetite. Within a short period of time, six to eight weeks she gained about 15 pounds. She then was
started on this supplementation. Within six weeks the patient lost 15 pounds with a decrease in her appetite.
http://www.anaturalcure.com/mambo – ANaturalCure.com – Home of Alternative LivingPowered by Mambo Generated: 17 November, 2012, 20:50Breast tissue has an affinity for iodine. Iodine deficiency causes fibrocystic breast disease (FBD) with nodules, cyst
enlargement, pain and scar tissue. FBD can be characterized by a lumpy painful breast, generally in reproductive aged
women. Initially, this syndrome occurs in the premenstrual phase of a cycle or involves the whole cycle. These symptoms
can also occur in menopausal women on estrogen therapy. In 1928 an autopsy series reported a three percent incidence
of FBD, whereas in 1973 an autopsy report quoted an 89% incidence. A review by the American Academy of Pathology
gives a minimum incidence for FBD of 50% but suggests that 80% of North American women are afflicted with the
syndrome during their reproductive lifetime.
Ghent et al in 1993, presented data showing that iodine works great to reduce (FBD)(14). He was able to develop a
protocol and a scoring system that helps doctors assess how severe a woman’s FBD is. I would recommend that
this scoring system be utilized by physicians in their own medical practice. A precise method of recording the
patient’s data will help both physicians and patients see the improvement that occurs following
orthoiodosupplementation. This simple method numbers the quadrants of each breast one to four. The pathological
changes that can occur in FBD are noted as micronodularity, tenderness, fibrous tissue plaques, macrocysts and
turgidity. The presence or the absence of changes is recorded. For example if the micro nodularity of macrocysts disease
was present in the upper half of the breasts the numerical score would be one for micro nodularity and two for the two
breast quadrants scoring a total of three. If all five changes occurred in all quadrants in one breast the score would be 4
(all four breast quadrants) x5 (all five changes) equals 20 and for both breasts would be 40. Patients are also
encouraged to evaluate their own symptomology as expressed by a number of zero equals symptoms worse, one equals
symptoms unchanged, two equals less pain only premenstrual discomfort, three equals no pain unable to predict
menstruation. The subjective scoring system was employed and graded as follows. Zero equals no palpable
abnormalities normal, one equals is score of less than 7.2 and a score greater than 7 but less than the pretreatment
score and three equals a score greater than the pretreatment score (See Table I).
In my practice, I have over the last four years worked with some 200 women who have FDB. On average, patients come
to my office practice with a mean Ghent score of 15.7 and an average age of 41.4 years. On 12.5 mg of iodine, the score
after six months will drop from a mean of score 15 down to about 12.8. On 25 mg, the score will drop down to a mean of
score is 10.2. On 37.5 mg the score was 8.6. When we prescribe 50 mg of Iodoralâ
(4 tablets) for 3 to 6 months, the average patient will have a score of 7.6 with a p-value less than 0.001 compared to
baseline scores. After a full year at 50 mg iodine per day (4 tablets of Iodoralâ ), the patients mean score dropped to 3.8.
We saw many patients with a score of zero, meaning no evidence of FBD. We often see patients’ breast pain
disappear in a 1 to 30 days at a dose of 50 mg. At lower doses, the pain persisted for a much longer time. The other
findings of micronodularity, tenderness, fibrous tissue plaques, macrocysts and turgidity will take almost a full year to fully
go away. Ghent felt that a score of seven or below was normal. We did not see any of the patients reach the score of
zero, meaning the absence of all of the pathological symptoms and physical findings of fibrocystic breast disease while
taking between 12.5 to 37.5 mg per day. Once FBD is gone, a patient may opt to drop iodine intake to 12.5 to 25 mg per
day. There is a chance that the cysts will return. Optimum amount for most patients for FBD is 50 mg (4 tablets) per day
continued indefinitely. Monitoring the patient’s serum TSH, T4 and free T3 is done every three to six months. We
did not see any major changes in serum T4, TSH and free T3 in these patients.
It was while treating a large 320-pound woman with insulin dependent diabetes that we learned a valuable lesson
regarding the role of iodine in hormone receptor function. This woman had come in via the emergency room with a very
high random blood sugar of 1,380 mg/dl. She was then started on insulin during her hospitalization and was instructed on
the use of a home glucometer. She was to use her glucometer two times per day. Two weeks later on her return office
visit for a checkup of her insulin dependent diabetes she was informed that during her hospital physical examination she
was noted to have FBD. She was recommended to start on 50 mg ofiodine(4 tablets) at that time. One week later she
called us requesting to lower the level of insulin due to having problems with hypoglycemia. She was told to continue to
drop her insulin levels as long as she was experiencing hypoglycemia and to monitor her blood sugars carefully with her
glucometer. Four weeks later during an office visit her glucometer was downloaded to my office computer, which showed
her to have an average random blood sugar of 98. I praised the patient for her diligent efforts to control her diet and her
good work at keeping her sugars under control with the insulin. She then informed me that she had come off her insulin
three weeks earlier and had not been taking any medications to lower her blood sugar. When asked what she felt the big
change was, she felt that her diabetes was under better control due to the use of iodine. Two years later and 70 pounds
lighter this patient continues to have excellent glucose control on iodine 50 mg per day. We since have done a study of
twelve diabetics and in six cases we were able to wean all of these patients off of medications for their diabetes and were
able to maintain a hemoglobin A1C of less than 5.8 with the average random blood sugar of less than 100. To this date
these patients continue to have excellent control of their Type II diabetes. The range of daily iodine intake was from 50
mg to 100 mg per day. All diabetic patients were able to lower the total amount of medications necessary to control their
diabetes. Two of the twelve patients were controlled with the use of iodine plus one medication. Two patients have
control of diabetes with iodine plus two medications. One patient had control of her diabetes with three medications plus
iodine 50 mg. The one insulin dependent diabetic was able to reduce the intake of Lantus insulin from 98 units to 44 units
per day within a period of a few weeks.
http://www.anaturalcure.com/mambo – ANaturalCure.com – Home of Alternative LivingPowered by Mambo Generated: 17 November, 2012, 20:50In the Type 1 diabetics that we have been following we have noted that if C-peptide is measurable, this would suggest
that the individual is making their own insulin. I have been able to help this group of patients to get off insulin or to greatly
reduce the amount they need for good glucose control with Iodoralâ at 4 tablets/day (50 mg). If C-peptide is absent then
we feel there is no insulin being produced and we have not been able to help this particular group of patients to get off
their insulin. We have been able to help these patients lower the total amount of insulin needed to control their glucose.
When patients take between 12.5 to 50 mg of iodine per day, it seems that the body becomes increasingly more
responsive to thyroid hormones (3-5). T3 and steroid hormones show the same family of receptors as hydrophobic small
molecules . Clur (17) has postulated that iodization of tyrosine residues in the hydrophobic portion of these receptors
normalize their response to the corresponding hormone. Optimal intake of iodine in amounts two orders of magnitude
greater than iodine levels needed for goiter control may be required for iodization of these receptors (4). Insulin
resistance is on the increase. The insulin receptor tyrosine kinase plays a major role in signal transduction distal to the
receptor as the primary event leads to subsequent phosphorylation of cytoplasmic proteins, called insulin receptors
substrate proteins (IRS). The IRS proteins are cytoplasmic proteins, with multiple tyrosine phosphorylation sites, and
phosphorylation of IRS proteins has been implicated as the first post receptor step in insulin signal transmission. The IRS
proteins have been referred to as the metabolic switch of the cell (18).
Another organ that can concentrate iodine is the liver. An enterohepatic circulation of iodine has been reported recently
19. I have one patient with liver fatty infiltration who had varicosities of the esophagus with bleeding. Once she started on
iodine for FDB we noticed that her GI bleeding stopped and the varicose veins of her stomach and esophagus
Iodine deficiency may cause the ovaries to develop cysts , nodules and scar tissue. At its worse this ovarian pathology is
very similar to that of polycystic ovarian syndrome (PCOS). As of the writing of this article I have five PCOS patients. The
patients have successfully been brought under control with the use of 50 mg of iodine per day. Control with these
patients meaning cysts are gone, periods every 28 days and type 2 diabetes mellitus under control.
Ideally, all patients should have an iodine loading test prior to orthoiodosupplementation. This test is one in which 50 mg
of iodine is given after discard of the first morning void. All urine is collected for the next 24 hours including the first
morning urine void the next day. The urine sample is then sent to my laboratory, FFP Laboratory for testing (21). The lab
is a CLIA approved high complexity testing laboratory in the state of North Carolina. The testing that is done is using the
method as described in previous articles . To date we have done over 3,000 loading tests. Iodine therapy is then
instituted using 50 mg/day. The body becomes iodine sufficient in about three months. Please be aware of the difference
between micrograms (mcg) and milligrams (mg). One milligram is equal to 1,000 micrograms. The majority of the loading
tests that are performed at FFP Lab are on women ages 31 – 70 years old. In 667 patients analyzed, the mean
level of excretion was about 18 mg for all age groups no patient achieved whole body sufficiency prior to
orthoiodosupplementation. The mean excretion drops, as the population gets older (See Fig. 1-6). This suggests that of a
total 50 mg of iodine given, the patients on the average retained a mean of 32 mg into their body on the first go around.
We have received many comments over the last two years. Following orthoiodosupplementation, patients have described
vivid dreams, dissipated depression, no more cold extremities, more energy and less fatigue.
Patients have noticed an overall feeling of well-being. Patients have noticed a loss of weight. One patient after taking four
pills of iodine lost eight pounds of fluid weight in 24 hours. We have had patients note better bowel function. Patients who
have been constipated for over ten years have now noted daily bowel movements. We have also had patients noted
relief from leg cramps at night. In less than 1% of all the patients treated with I, have we seen an allergic reaction. More
often than not, the allergic reaction is hives. After treating over 1,000 patients with iodine, I have at no time seen the
Iodine induces apoptosis and inhibits cells from forming cancer. The absence of iodine in the thyroid causes goiter(3,4).
Goiter is associated with breast cancer, stomach cancer, esophageal cancer, ovarian cancer and endometrial cancer . It
is felt by many researchers that the absence of iodine is a promoter of cancer. I feel that those patients with the lowest
excretion rates and the highest absorption of iodine on the iodine loading test are the ones with the highest risk for
development of cancer. From literally hundreds of phone interviews with patients over the last two years, the levels of
iodine excretion that seem to raise the highest alarm are those in which the excretion is somewhere around 10 mg or
less per 24 hours in patients age 35 and up. My observations at this point show that there is a definite increase in the
incidence of breast cancer, stomach cancer, ovarian cancer or thyroid cancer. If a patient has the iodine loading test and
has an iodine excretion of 10 mg or less in a 24-hour period, I initiate a cancer workup. In 1976, a JAMA article showed
that 6% of the female population was at risk for breast cancer (25)). Women who received thyroid supplementation
doubled their risk of breast cancer to 12%. The age groups we used to separate the patients in Figures 1-6 were based
on this article. As women get older, the risk of breast cancer increases. In Figures 2-6 the iodine/iodide loading test
shows that the older the women are, the lower the rate of iodine excretion.
Shomon MJ. Epilogue: Critical Hypothyroidism Issues for the Twenty-First Century. Living Well With Hypothyroidism.
http://www.anaturalcure.com/mambo – ANaturalCure.com – Home of Alternative LivingPowered by Mambo Generated: 17 November, 2012, 20:50New York: Quill, 2000: 251-276.
Hollowell JG, Staehling NW, Hannon WH, et al. Iodine Nutrition in the United States. Trends and Public Health
Implications: Iodine Excretion Data from National Health and Nutrition Examination Surverys I and III (1971-1974 and
1988-1994). J of Clin Endocr & Metab 1998; 83:3401-3408.
Abraham, G.E., The safe and effective implementation of orthoiodosupplementation in medical practice. The Original
Internist, 11:17-36, 2004.
Abraham, G.E., Flechas, J.D., Hakala, J.C., Orthoiodosupplementation: Iodine sufficiency of the whole human body. The
Original Internist, 9:30-41, 2002.
Abraham GE. The Concept of Orthoiodosupplementation and Its Clinical Implications. The Original Internist 2004;
Abraham GE, Flechas JD, Hakala JC. Optimum Levels of Iodine for Greatest Mental and Physical Health. The Original
Internist 2002; 9:5-20.
Larsen PR, Ingbar SH. The Thyroid Gland. In: Wilson JD, Foster DW, editors. Williams Textbook of Endocrinology.
Philadelphia: W. B. Saunders Company, 1992: 357-487.
Cho JY, Leveille R, Kao R, Rousset B, Jhiang SMPAF, Burak WE et al. Hormonal regulation of radioiodide uptake
activity and Na /I symporter expression in mammary glands. J Clin Endocr Metab 2000; 85(8):2936-2948.
Eskin BA. Iodine Metabolism and Breast Cancer. Trans New York Acad of Sciences 1970; 32:911-947.
Eskin BA, Bartuska DG, Dunn MRea. Mammary Gland Dysplasia in Iodine Deficiency. JAMA 1967; 200:115-119.
Eskin BA, Parker JA, Bassett JG, et al. Human Breast Uptake of Radioactive Iodine. OB-GYN 1974; 44:398-402.
Eskin BA. Iodine and Mammary Cancer. Adv Exp Med Biol 1977; 91:293-304.
Eskin BA, Grotkowski CECCP, et al. Different Tissue Responses for Iodine and Iodide in Rat Thyroid and Mammary
Glands. Biological Trace element Research 1995; 49:9-19.
Ghent WR, Eskin BA, Low DA, et al. Iodine Replacement in Fibrocystic Disease of the Breast. Can J Surg 1993; 36:453-
Hutter RVP. Consensus meeting: Is fibrocystic disease of the breast precancerus? Arch Pathol Lab Med 1986; 110:171-
Evans RM. The steroid and thyroid hormone receptor superfamily. Science 1988; 240:889.
Clur, A., DI-Iodothyronine as Part of the Oestradiol and Catechol Oestrogen Receptor – The Role of Iodine,
Thyroid Hormones and Melatonin in the Aetiology of Breast Cancer. Medical Hypotheses, 27:303-311, 1988.
Cefalu WT. Insulin Resistance. In: Leahy JL, Clark NG, Cefalu WT, editors. Medical Management of Diabetes Mellitus.
New York: Marcel Dekker, Inc., 2000; 57-75.
Abraham, G.E., Serum inorganic iodide levels following ingestion of a tablet form of Lugol solution: Evidence for an
enterohepatic circulation of iodine. The Original Internist, 11(3):29-34, 2004.
Vishnyakova VV, Murav’yeva NI. On the Treatment of Dyshormonal Hyperplasia of Mammary Glands. Vestn Akad Med
Nauk SSSR 1966; 21:19-22.
Abraham GE, Flechas JD, Hakala JC. Measurement of urinary iodide levels by ion-selective electrode: Improved
sensitivity and specificity by chromatography on anion-exchange resin. The Original Internist 2004; 11(4):19-32.
Stadel BV. Dietary Iodine and Risk of Breast, Endometrial, and Ovarian Cancer. Lancet 1976; 1:890-891.
Talamini R, Franceschi S, Favero A, et al. Selected medical conditions and risk of breast cancer. British J of Cancer
Venturi S, Donati FM, Venturi M, et al. Role of Iodine in Evolution and Carcinogenesis of Thyroid, Breast, and Stomach.
Adv Clin Path 2000; 4:11-17.
Kapdi CC, Wolfe JN. Relationship to thyroid supplement for hypothyroidsim. JAMA 1976; 236(10):1124-1127.
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