Iodine excess and hyperthyroidism: pubmed.ncbi... - Thyroid UK

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Iodine excess and hyperthyroidism

ling profile image
ling
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pubmed.ncbi.nlm.nih.gov/113...

...

The presence of thyroid autoimmunity in patients residing in iodine-insufficient areas who develop iodine-induced hyperthyroidism has not been unanimously observed. In iodine-sufficient areas, iodine-induced hyperthyroidism has been reported in euthyroid patients with previous thyroid diseases.

Euthyroid patients previously treated with antithyroid drugs for Graves' disease are prone to develop iodine-induced hyperthyroidism.

As well, excess iodine in hyperthyroid Graves' disease patients may reduce the effectiveness of the antithyroid drugs.

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Buddy195 profile image
Buddy195Administrator

Thanks for posting ling; very interesting reading 👍

ling profile image
ling in reply toBuddy195

Hi Buddy, how are u doing?

Buddy195 profile image
Buddy195Administrator in reply toling

Hi ling, I’ve just started a trial of T3 as the TED specialist ophthalmologist thought it might help reduce some eye inflammation.....early days but will let you know if it helps! 😊

ling profile image
ling in reply toBuddy195

To what degree is the inflammation?

Buddy195 profile image
Buddy195Administrator in reply toling

CAS score is only 1 but swollen upper eyelids, photophobia and slight ache to left eye (slightly larger than right). He also said try ibuprofen x3 day for 3 months (with omeprazile to protect stomach) but I’ve stopped after I month as not finding any benefit. Still taking daily selenium and the lutein and zeazanthin you recommended. 👍Using HycoSan drops as needed for dry eye (worse in morning). Also prescription sunglasses and yellow over glasses for night vision driving (as finding lights of other cars problematic) How are things with you? 😊

ling profile image
ling in reply toBuddy195

Your TED seems to have persisted throughout?

Re omeprezole. Best not to take it for more than 7-14 days. This medicine, while it has its uses, can be very difficult to wean off without bad rebound effects.

Has the Hashimoto's management been smooth?

Am grappling with some issues. Thank u for asking : )

Buddy195 profile image
Buddy195Administrator in reply toling

I’ve stopped the ibuprofen and omeprazole combo as it didn’t appear do anything for me- tried for 1 month (not the 3 suggested by ophthalmologist).My eye swelling does fluctuate; some days are worse than others. I’ve only been taking T3 with Levo for a couple of weeks, so haven’t really seen any changes, but am introducing T3 very slowly, as recommended by other forum members.

Best wishes to you ling for a happy and healthy 2021 👍

ling profile image
ling in reply toBuddy195

Thanks for sharing.Wishing u the best for your health.

Bellazzurra profile image
Bellazzurra

Hello Ling, thank you for sharing this - it’s an interesting read. When it comes to iodine, it seems that the effects of excess and insufficient iodine are well understood. Yet, as someone with Graves’ Disease, I’m left confused about how to maintain a normal/optimal level of iodine.

The last time I tested for iodine, my levels were insufficient. However, my endocrinologist says to stay clear of iodine supplements as they could aggravate Graves’ Disease. I don’t understand why she isn’t more concerned about my insufficient levels - especially because of the many critical functions iodine is involved in.

ling profile image
ling in reply toBellazzurra

Your endo is spot on re iodine. Supplementing iodine when u have Graves is akin to taking poison. I can attest to that.

A few years back, over several weeks I ate seaweed quite frequently as a result of eating sushi.

On hindsight, the iodine from the seaweed triggered severe Graves symptoms. Note I was euthyroid at the time, and throughout that period, my blood tests continued to test normal?! But the symptoms were bad. Severe weight loss down to the bone, hair changes, thyroid eye disease flare, etc.

Of course, the iodine is but one trigger at the time but I believe it caused more severe symptoms and upped the symptoms severity.

Subsequently I have tested eating limited seaweed (minus the other triggers) to confirm its effects, and noted it does make me more hyper.

Where iodine is concerned, unless u are experiencing symptoms due to a low iodine level, as long as u are otherwise alright, just leave it be. When u have Graves, the body no longer processes iodine in the regular manner, and any additional iodine could just upset the Graves balance.

One last thing. I wasn't even supplementing the iodine, merely eating it through diet, and not even eating that much or for very long. But the after effects were potent.

I hope this sharing goes some way to help you understand more about iodine and Graves. I didn't read enough at the time and wasn't aware of how problematic it could be. I posted this article as I am presently looking for a multivitamin without iodine.

Best wishes.

Bellazzurra profile image
Bellazzurra in reply toling

I also avoid seaweed because it’s packed with iodine - even more so than many supplements I’ve seen - but hearing your story really does drive the message home. To think that your blood tests were normal the entire time, even while experiencing such severe symptoms!

The one thing I’ve noticed with Graves’ Disease is that my body lets me know very quickly when I’ve eaten or done something it doesn’t like. I start getting super anxious, nervous, jittery and depressed when I’ve eaten something that doesn’t agree with me or I’ll notice the bulge at the base of my neck get bigger if I’ve done too much exercise. I need to learn to listen to my body more and not waste any time thinking I’m just being paranoid.

I stopped the Ganoderma lucidum supplements for that reason because the anxiety of thinking that it could be aggravating my symptoms (even though it could have been the grapefruit juice alone) just wasn’t worth it. Whenever I’m feeling brave and balanced again, I may give the mushroom tablets another go just so I can rule them out completely but certainly no citrus fruits or iodine. Thank you, again, for sharing your experience.

ling profile image
ling in reply toBellazzurra

Yes, that's a good idea given you are recently diagnosed and still getting to know how this condition affects you, and how to live with and manage it.

What u say about physical exercise is also spot on. Physical exercise or exertions when u have Graves, and it isn't yet stabilised, causes the same bad effects as mental stress on the body.

Re normal blood tests. These being normal despite symptoms, clearly show one thing. Graves cannot be managed solely by medicating. Lifestyle changes, actively cutting down and managing stress, improving diet, all these go hand in hand in dealing with the Graves.

brighter84 profile image
brighter84

I wonder how this might work with someone who has had Graves but has had a (near total) thyroidectomy... is iodine still likely to be a problem? It's something I'm looking in to.

ling profile image
ling in reply tobrighter84

Near total - there's some thyroid left?

If there is, i'm inclined to think iodine could exert an effect, how great depending on the individual.

With Graves and iodine, its best to be careful and test out first how much your body can tolerate.

If you find out anything, i would be most interested to hear. Thank you!

helvella profile image
helvellaAdministrator in reply toling

It actually makes me wonder what happens in anyone without a thyroid (or only a tiny bit of remnant tissue).

In the healthy human with no thyroid issues, a major issue is how our bodies recycle iodine. We often think of it as a mechanism in place to take iodine from wherever there is any thyroid hormone deiodination, and from our digestive systems, to the thyroid. There to get recycled by being incorporated into new thyroid hormone.

What happens if there is no thyroid to take in the iodine?

Let's assume at least some gets excreted (in urine, seems likely). How is that process controlled?

in reply tohelvella

Some interesting ideas here:

misslizzyhealth.com/blogs/i...

helvella profile image
helvellaAdministrator in reply to

Interesting but, despite having lots of blocking on (as I usually do), the site plagued me with pop-ups trying to sell things. :-(

Let's accept that we need an intake of around 150 microgams of iodine a day when we have a thyroid.

That amount is required to replace what we lose, what we cannot recycle.

About 65% of levothyroxine by weight is iodine. Someone on, say, 150 micrograms as full replacement would be getting 100 micrograms of iodine a day.

Take an imaginary case - purely to enable discussion, it is obviously hyper-simplistic and certainly avoids detail:

Someone has a working thyroid.

They consume 150 micrograms of iodine a day in their diet.

They produce sufficient thyroid hormone.

They are not iodine deficient.

Next day, they have no thyroid.

They now take 150 micrograms a day of levothyroxine.

They still take in 150 micrograms of iodine a day from their diet.

A ttoal of 250 micrograms a day.

Their iodine intake has just shot up by about 66%. Yet they are, it is claimed, now expected to take an iodine supplement on top of that?

in reply tohelvella

It’s probably nonsense. How can you take seriously anything said by Miss Lizzy?

Sorry about the ‘pop ups’ ☹️

helvella profile image
helvellaAdministrator in reply to

Can be very useful, sometimes, to have something concrete to act as a target for thought and dicsussion! :-)

in reply tohelvella

🤗.

brighter84 profile image
brighter84 in reply tohelvella

And what if a high level of iodine in the diet/other was causing the thyroid dysfunction in the first place? Means you'd have an even higher level.

I used an iodine calculator that said my total daily intake is likely between 223 and 273 mcg. (thyroidlabanalyzer.com/iodi...

Talking about testing, Dr. Christianson says "The amount we absorb is fairly equal to the amount we eliminate. Because of that, the amount that we ingest is similar to the amount that we excrete."

But... I'm confused. Do we assume that whatever iodine doesn't get absorbed by a (non-existent) thyroid simply gets excreted?

My plan is to try a low-iodine diet for a few weeks to see if it improves any of my symptoms.

ling profile image
ling in reply tobrighter84

brighter84

helvella

Maybe you've seen this article? Some iodine info in relation to what's being discussed.

Iodine and thyroid function

ncbi.nlm.nih.gov/pmc/articl...

Role of iodine in thyroid physiology

Iodine is a trace element in soil and water that is ingested in several chemical forms. Most forms of iodine are reduced to iodide in the gut3). Iodide is nearly completely absorbed in the stomach and duodenum3,5). Iodine is cleared from the circulation primarily by the thyroid and kidney. Under normal circumstances, plasma iodine has a half-life of approximately 10 hours, but this is shortened if the thyroid is overactive, as in iodine deficiency or hyperthyroidism. The mean daily turnover of iodine by the thyroid is approximately 60-95 µg in adults in iodine-sufficient areas. The body of a healthy adult contains from 15 to 20 mg of iodine, 70%-80% of which is in the thyroid. In the basolateral membrane of the thyroid cell, the sodium/iodine symporter (NIS) transfers iodide into the thyroid across a concentration gradient 20-50 times that of plasma by active transport3,6).

Degradation of T4 and T3 in the periphery releases iodine that re-enters the plasma iodine pool7). Most ingested iodine is eventually excreted in the urine. Only a small amount appears in the feces.

The mammary gland concentrates iodine and secretes it into breast milk to provide for the newborn8). The salivary glands, gastric mucosa, and choroid plexus also take up small amounts of iodine. The NIS9,10) and pendrin9) have been reported in trophoblasts, and the placental iodine content is approximately 3% that of the thyroid11).

...

Because 90% of ingested iodine is excreted through kidney within 24-48 hours21), ...

helvella profile image
helvellaAdministrator in reply toling

I have read that excess iodine in the kidneys and bladder can cause problems. But need to check that up.

brighter84 profile image
brighter84 in reply toling

Yes, they left a little bit of my thyroid in apparently! I have no idea how much or whether it does anything... which is rather odd.

I had a very negative reaction to iodine prescribed by the doctor (supposedly to calm my thyroid down!) before I had the thyroidectomy. I ended up in A&E with extremely high levels. So perhaps high iodine was fueling the fire for my Graves disease all along.

ling profile image
ling in reply tobrighter84

The endo prescribed it?

Why would iodine be prescribed to a Graves patient who needs thyroidectomy, which basically mean your thyroid hormone levels are not well controlled by medications?

Definitely can't be to calm the thyroid down, unless some mistake during the preparation process had been made prior to the thyroidectomy?

Were you eating a lot of dietary iodine when you had Graves?

bantam12 profile image
bantam12 in reply toling

It's prescribed pre op to reduce vascularity and bleeding during op.

brighter84 profile image
brighter84 in reply toling

This was approx 20 years ago so it's hard to remember the specifics. It might have been the GP who prescribed it come to think of it. And it definitely wasn't for pre-op reasons. But it most definitely sent me to A&E!

I used to have a diet fairly high in dairy and eggs pre-thyroidectomy, yes.

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