"Excess iodine is a known and well-studied cause of thyroid disease (both non and autoimmune), and this has been shown in test tubes studies , epidemiological studies , and interventional trials ," says Hoeffgen. Vulnerable patients with specific risk factors might have an increased risk of failing to adapt to the acute WolffChaikoff effect.7 Susceptible patients include those with autoimmune thyroid disease; a previous history of surgery, 131I or antithyroid drug therapy for Graves disease; subacute thyroiditis; postpartum thyroiditis; type 2 amiodarone-induced thyrotoxicosis (AIT); hemithyroidectomy; IFN therapy; and concomitant use of potential goitrogens, such as lithium. The hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks after iodide withdrawal, but transient T4 replacement therapy may be required in some patients. Symptoms of hyperthyroidism include: fast heart rate muscle weakness warm skin unexplained weight loss Increased incidence of thyrotoxicosis after iodine supplementation in an iodine sufficient area. Iodine Deficiency or Excess. 2012 Oct;19(5):414-9. doi: 10.1097/MED.0b013e3283565bb2. Dairy products (due to the use of iodophor cleaners for milk cans and teats), some breads (due to the use of iodate bread conditioners), seaweed and other seafood and iodized salt are the most common iodine-containing foods.30 In children from the USA aged 612 years, dairy intake is a particularly good source of adequate iodine, probably due to the abundance of dairy content in the diet of children in this age range.31 Australia introduced iodization of bread in 2009, which resulted in a modest increase in the median UIC of a small group of pregnant women.32 The amount of iodine that can be obtained from plant-based food is minimal and is dependent on the local environment (that is, iodine levels in the soil, groundwater used for irrigation, crop fertilizers and livestock feed).33, The many varieties of seaweed are a unique potential source of excess ingestion of iodine. Nauman J, Wolff J. Iodide prophylaxis in Poland after the Chernobyl reactor accident: benefits and risks. Dr. Jolene Brighten, NMD, is a womens hormone expert and prominent leader in womens medicine. Seaweed is a popular food item in many parts of the world, particularly in Japan34 and other Asian countries, where ingestion of seaweed soup is common in the everyday diet and is a frequent practice during the postpartum period.35 However, the iodine content of seaweed can vary widely.36 Cases of kelp-induced thyrotoxicosis have been widely reported, including one woman who drank kelp-containing tea for 4 weeks37 and another patient who had a long-standing history of using kelp-containing dietary supplements.38 In other reports, chronic seaweed ingestion has also been reported to be associated with a modest increase in serum levels of TSH without overt thyroid dysfunction.39,40. The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies) with anxiety and mood disorders in the community: a field of interest for public health in the future. In the eye of the storm: Iodinated contrast medium induced thyroid storm presenting as cardiopulmonary arrest. The site is secure. She too was asking if this could have caused harm! There are measures you can take to control symptoms and manage thyroid health effectively. I'm just hoping, maybe I'm taking too much Thyroid medication. 2022 Jun 21;14(13):2570. doi: 10.3390/nu14132570. The mechanism by which iodine can cause problems for those with hypothyroidism is well understood in medicine. This site is dedicated to providing you with the best information regarding optimal thyroid health and the possible complications that can occur with the thyroid gland. A significant amount of iodine is found in the thyroid gland and it is responsible for producing and regulating the thyroid hormones. Breastfeeding teens and women. Effects of chronic iodine excess in a cohort of long-term American workers in West Africa. Please enable it to take advantage of the complete set of features! Is iodine important? Online ahead of print. World Health Organization. Wow, so too much iodine can be a problem for ones thyroid. Diarrhea. Sea salt (or regular table salt if you wish to temporarily boost your iodine levels), black pepper, and parsley to taste. will also be available for a limited time. Iodine-induced thyroid dysfunction is a potential consequence in patients with nodular goiters and/or elderly patients.69,70 Guidelines from the Contrast Media Safety Committee of the European Society of Urogenital Radiology advocate that high-risk patients are monitored for thyroid dysfunction following iodinated contrast use.71 No guidelines are currently available for screening or follow-up of at-risk patients receiving iodinated contrast in the USA. 11 Sources By Mary Shomon Iodine deficiency is a major health problem worldwide, but a new study points to the potential downsides of too much iodine. So the ideal situation would be to establish a balance. As a result of its high iodine content, use of amiodarone is associated with thyrotoxicosis in 9.6% of patients with low ambient iodine intake, and hypothyroidism in 22.0% of patients with normal ambient iodine intake.52 Overall, amiodarone-induced hyperthyroidism is more common in iodine-deficient areas, whilst amiodarone-induced hypothyroidism is more common in iodine-sufficient areas. This transport results in transient inhibition of TPO and a decrease in the synthesis of thyroid hormone. Careers, The publisher's final edited version of this article is available at, Vitamins (prenatal, labelled content per daily serving): 75200 g, Iodinated contrast (free iodine content, per CT scan): 13,500 g, Topical iodine (povidone iodine): variable, usually 15%, Expectorants, mouthwashes, vaginal douches: variable, Saturated solution of potassium iodide (per drop): 50,000 g, Recommendations for iodine intake in adults who are not pregnant or lactating are 150 g of iodine a day, Excess iodine exposure or ingestion can result in thyroid dysfunction in certain susceptible individuals, but is generally well-tolerated in most people, lodine-induced thyroid dysfunction might be subclinical or overt and either transient or permanent, Sources of iodine excess include iodine supplementation to prevent iodine deficiency at a population level, the diet, vitamins and supplements, medications, contrast media and topical iodine, Supraphysiologic doses of iodine are appropriate in certain specific medical indications, including its use in the treatment of severe hyperthyroidism before thyroid surgery and as potassium iodide following a nuclear accident. Ozkan S, et al. Started with one drop of Lugols and had energy, slowly increasing it, what happens should I decide to . "We summarized that adequate iodine nutrition of 150 mcg a day is essential for normal thyroid function but that an excessive intakebe it from a variety of sources (eg, fortified salt, supplements, seaweed, seafood)can have the reverse effect: too much iodine can cause hypothyroidism and hyperthyroidism and too little iodine low may lead to hypothyroidism," Dr. Leung says. eCollection 2022 Oct-Dec. Bego T, Meseldi N, Prnjavorac B, Prnjavorac L, Marjanovi D, Azevedo R, Pinto E, Duro M, Couto C, Almeida A. J Trace Elem Med Biol. We will provide helpful hints and highlight the best possible treatments available. Linder N, et al. Tomisti L, et al. One of the most rigorous studies that has examined the association between iodinated contrast use and thyroid dysfunction was a large casecontrol study that used medical records from two hospitals in Boston, USA, over a 20-year period.60 In this study, patients without pre-existing hypothyroidism or hyperthyroidism who received a single iodinated contrast dose had a 23-fold increased risk of developing either incident hyperthyroidism (including overt hyperthyroidism) or overt hypothyroidism at a median of 9 months following exposure, compared with patients who did not receive the high iodine load. Thyroid dysfunction due to excess iodine intake is usually mild and transient, but iodine-induced hyperthyroidism can be life-threatening in some individuals. Hyperthyroidism should never be taken lightly since it may adversely affect your ability to smell or taste things. Food and Nutrition Board, Institute of Medicine. Excessive iodine consumption can lead to similar symptoms as iodine deficiency, including thyroid dysfunction and goiter. Iodine overdose. Angela M. Leung, Division of Endocrinology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard (111D), Los Angeles, CA 90073, USA. During our visit, I had noticed her thyroid was boggy and so I sent her for a thyroid ultrasound. Iodine is a mineral found in iodized salt, seafood, eggs, dairy and . The Had she continued down that road of high dose iodine she would have found herself in a heap of trouble. During initial iodine exposure, excess iodine is transported into the thyroid gland by the sodiumiodide symporter. van der Molen AJ, Thomsen HS, Morcos SK Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR) Effect of iodinated contrast media on thyroid function in adults. Common Beauty Procedures That Are Compromising Your Health, 11 Strategies to Overcome Hashimotos Fatigue, Why Balancing Blood Sugar is Vital for Hashimotos Health, Hashimotos and Graves Remission after Helicobacter Pylori Eradication. Assessment of iodine status using dried blood spot thyroglobulin: development of reference material and establishment of an international reference range in iodine-sufficient children. Zimmermann MB, et al. Is Stevia Good or Bad for Hashimotos Disease? . Effect of Excess Iodine Intake from Iodized Salt and/or Groundwater Iodine on Thyroid Function in Nonpregnant and Pregnant Women, Infants, and Children: A Multicenter Study in East Africa. Transient hypothyroidism or persistent hyperthyrotropinemia in neonates born to mothers with excessive iodine intake. In those with Hashimoto's, it can cause a flare. PMC legacy view Both occur approximately three times more frequently in men than in women, which is in contrast to amiodarone-induced hypothyroidism.53 A comprehensive update on this topic was published in 2012.54 Type 1 AIT is a form of the JodBasedow phenomenon, in which excess iodine exposure results in thyroid autonomy as a result of altered thyroid function regulation. 2022 Oct 10;20(4):15593258221129777. doi: 10.1177/15593258221129777. Saberi M, Utiger RD. Hypothyroidism can lead to listlessness, increase in weight, flaky skin, irregular bowel syndrome, mental instability, a raspy voice, muscular aches and pains, unhealthy hair and nails and an increased awareness temperature change. Both too much and too little iodine can lead to goiter and other thyroid problems. The new PMC design is here! Too much iodine may lead to thyroiditis and thyroid papillary. Epub 2018 Aug 22. Iodine is the fuel it runs on. Iodine deficiency. 2022 Aug 10. doi: 10.1007/s00394-022-02960-6. 65% of T4 is iodine. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. For this reason, it is important to speak to a doctor before taking iodine supplements. Plus, consuming very high levels from foods high in iodine alone is very unlikely. Hyperthyroidism is caused by producing too much. Goyle A, Prakash S. Efficacy of multi-micronutrient fortified biscuits on urinary iodine levels of adolescent girls from Jaipur, India. McMonigal KA, et al. Our review describes the association between excess iodine intake and thyroid function. A deficiency or oversupply of iodine can cause thyroid nodules and goiter (an enlarged thyroid gland) and can cause them to grow. Fever. A.M. Leung would like to acknowledge the support of NIH grant 7K23HD06855204. Galofre JC, Fernandez-Calvet L, Rios M, Garcia-Mayor RV. Iodine-induced hyperthyroidism (the JodBasedow phenomenon) was first described in the early 1800s, when thyrotoxicosis was observed to be more common among patients with endemic goiter treated with iodine supplementation than in individuals without goiter.14 Iodine-induced hyperthyroidism might be transient or permanent, and risk factors include nontoxic or diffuse nodular goiter, latent Graves disease and long standing iodine deficiency.7 In addition, iodine-induced hyperthyroidism in euthyroid patients with nodular goiter in iodine-sufficient areas has also been reported when iodine supplementation is excessive.15, Globally, iodine supplementation has been the primary method over the past century to decrease iodine deficiency, which is the leading cause of preventable mental retardation.16 Iodine has been administrated as iodized oil orally and intramuscularly, introduced into the water supply, used in crop irrigation, incorporated into animal fodder and introduced into food through salt iodization, bread iodophors and other products.17 Fortified micronutrient biscuits have also been successfully used to raise the median UICs of schoolgirls (aged 1015 years) in India.18, Although iodine supplementation has decreased the number of people at risk of iodine deficiency and its associated sequelae, particularly in the past few decades, the use of iodine has also led to concerns of excessive iodine exposure in some individuals. Iodine is a mineral found in. 3. Konno N, Makita H, Iizuka N, Kawasaki K. Association between dietary iodine intake and prevalence of subclinical hypothyroidism in the coastal regions of Japan. There's a lot of controversy about iodine in thyroid health. Nat Rev Endocrinol. Escape from the acute WolffChaikoff effect is associated with a decrease in thyroid sodium/iodide symporter messenger ribonucleic acid and protein. Iodine in the thyroid gland is necessary for the formation of thyroid hormones . FOIA Published October 17, 2010. Blomberg M, Feldt-Rasmussen U, Andersen KK, Kjaer SK. I was inspired to give this live presentation after a returnpatient visit at my Portland clinic with Jenny. What is the iodine hypothyroidism connection? In general, the average person is probably going to do okay. Acquired Hypothyroidism in an Infant Related to Excessive Maternal Iodine Intake: Food for Thought. An official website of the United States government. People who consume either too little totoo much iodine are at an increased risk of developing hypothroidism. The thyroid, aggressively scavenging for iodine to repair a deficiency of thyroid hormone, scoops up all the iodine and makes a large amount of thyroid hormone. Iodine. Thaker V, Levine B-S, Leung AM, Braverman LE. Clinical problem-solving. MeSH Nausea. Amiodarone administration may induce thyrotoxicosis. Note: If you have hypothyroidism you should also keep a journal of how you feel. Your levels should be monitored as we did with her over several months. The maximum recommended intake of iodine is 1,100 mcg per day for all adults, and 200 to 300 mcg per day for children up to the age of 8 years. Thyroid hormones control your metabolism. In order to make thyroid hormones, your thyroid gland needs iodine, an element found in food (most commonly, iodized table salt) and water. Located in your neck, your thyroid gland may swell during hypothyroidism, a condition called a goiter, from which goitrogens derive their name . Iodine is a mineral found in iodized salt, seafood, eggs, dairy and some breads. What kind of levels can help your thyroid? Perrine CG, Sullivan KM, Flores R, Caldwell KL, Grummer-Strawn LM. Color flow Dopploer sonography rapidly differentiates type I and type II amiodarone-induced thyrotoxicosis. Could SIBO Be Preventing Your Remission from Hashimotos? Several cases of congenital hypothyroidism caused by ingestion of excess maternal iodine tablets during pregnancy have been reported.47 Similarly, hypothyroidism in neonates born to mothers who ingested excessive amounts of seaweed or seaweed soup during both pregnancy48 and lactation have been reported.49,50 Given the risks of potential iodine-induced thyroid dysfunction, the American Thyroid Association recommends against ingestion of an iodine or kelp daily supplement containing >500 g iodine for all individuals, except for certain medical indications.51. Yes, taking iodine supplements can worsen hypothyroidism. And you better believe I am going to run a complete thyroid panel. Epub 2017 Jan 12. https://www.endocrinologyadvisor.com/home/topics/thyroid/thyroid-peroxidase-antibody-positivity-linked-to-reduced-live-birth-rate-in-recurrent-pregnancy-loss/. 365, 21232127 (2011). Jenny sought help and she got an answera diagnosis of hypothyroidism. The mechanism for the acute WolffChaikoff effect is not completely understood, but is thought to be at least partially explained by the generation of several inhibitory substances (such as intrathyroidal iodolactones, iodoaldehydes and/or iodolipids) on thyroid peroxidase activity.7 Reduced intrathyroidal deiodinase activity as a result of the increased iodine load might also contribute to decreased synthesis of thyroid hormones. The changing incidence of thyroid carcinoma in Shenyang, China before and after universal salt iodization. Ideally, you should consume between 150 and 299 micrograms of iodine daily, says the American Thyroid Association. Interestingly if you suffer from hyperthyroidism and you are being treated for this condition, then the treatment can result in hypothyroidism. Dasgupta PK, Liu Y, Dyke JV. The use of any information provided on this web site is solely at your own risk. Thus, iodine deficiency can lead to enlargement of the thyroid (goiter - see Goiter brochure ), hypothyroidism (see Hypothyroidism brochure) and to intellectual disabilities in infants and children whose mothers were iodine deficient during pregnancy. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. Top 10 Thyroid Tests and How to Interpret Them. We outline potential sources of excess iodine intake and the physiological responses and consequences of excess iodine intakes. Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100299 g/l: a UNICEF/ICCIDD study group report. When I checked Jenny's TPO antibodies they were well over a thousand. No wonder she felt bad! PMC sharing sensitive information, make sure youre on a federal Gordon CM, Rowitch DH, Mitchell ML, Kohane IS. Finally, individuals in the vicinity of a nuclear power plant can be directed to take potassium iodide in the event of a nuclear accident to prevent uptake of radioactive iodine into the thyroid, as was carried out in Poland following the Chernobyl nuclear accident.79. Treatment of amiodarone-induced thyrotoxicosis type 2: a randomized clinical trial. This usually happens when people take iodine supplements to improve their thyroid function. Eng PH, et al. For example, a 53-year-old woman in the USA developed thyroid storm and cardiopulmonary arrest immediately after undergoing an iodinated radiologic study.63 Two studies in Germany and the USA showed that a small proportion of patients who received either coronary angiography or an iodinated CT scan developed subclinical hypothyroidism ~1 week after the exam.64,65 A Turkish study of 101 patients who underwent coronary angiography found a small increased risk of subclinical hyperthyroidism at up to 8 weeks after the iodine exposure.66 However, one small study showed that intravenous administration of an iodine contrast agent during pregnancy did not result in a notably increased incidence of fetal thyroid dysfunction.67 Finally, we have reported the occurrence of iodine-induced hypothyroidism in three neonates who received intravenous contrast agents to evaluate congenital cardiac defects.68. What Does It Feel Like to Have Thyroid Disease? Rhee SS, Braverman LE, Pino S, He X, Pearce EN. This web site offers health, wellness, fitness and nutritional information and is provided for informational purposes only. In her story, she shared how she wasn't sleeping, wasn't eating and felt like she had no one to talk to. We got her stable and then brought in nutrients and herbs to support her thyroid and Omega Plus, which helps support a healthy immune system. Careers. Nothing stated or posted on this web site or available through any services offered by Dr. Jolene Brighten, ND and Brighten Wellness, LLC, are intended to be, and must not be taken to be, the practice of medicine. The visible lump will move up and down when you swallow, said the national health service (NHS). Iodine is essential for thyroid hormone synthesis. In some susceptible individuals, the use of these iodine-containing substances can result in thyroid dysfunction as a result of the high iodine load. For example, a 4-ounce serving of cod has approximately 132 mcg of iodine, while a 4-ounce serving of salmon will have 32 mcg of iodine (3). Endocrinology Advisor. The effect of iodine supplements can vary by person, causing the thyroid to produce either too much or too little hormone. When she was watching the news, she found that the media reported that the incidence of thyroid disease was on the rise in many areas of China . In a US study published in 2009, iodine (as potassium iodide or kelp) was a labelled ingredient in only 51% of 223 prenatal nonprescription and prescription multivitamins.46 However, among the 25 brands containing iodine derived from kelp, measured values (33610 g per daily dose) were frequently discordant with the labelled values (75300 g per daily dose), including 13 brands with a >50% discrepancy between the measured and labelled values. For Jenny, she had developed hypothyroidism after the loss of a close family member. This starter pack is exactly what every woman needs to bring her hormones back into balance! Iodine-induced thyrotoxicosis after ingestion of kelp-containing tea. Bogazzi F, et al. Seaweed and soy: companion foods in Asian cuisine and their effects on thyroid function in American women. . In most individuals, the decreased production of thyroid hormones is only transient and resumes after adaptation to the acute WolffChaikoff effect.7 In rats, this adaptation is associated with a marked decrease in expression of the sodiumiodide symporter (NIS) that is present on the basolateral membrane of thyroid follicular cells.8 NIS is a 13-transmembrane glycoprotein that mediates the active transport of iodine from the circulation into the thyroid.9 The decrease in expression of the NIS occurs by 24 h after exposure to excess iodine and results in reduced intrathyroidal iodine concentrations. In turn, the reduced iodine levels lead to a decrease in levels of the iodinated substances that inhibit synthesis of thyroid hormones, which results in the resumption of normal production of thyroid hormone (Figure 1). Foods that have iodine are yogurt, eggs, meat, fish and other seafood, radish, parsley, potatoes, oatmeal and bananas. High intakes of iodine among women during pregnancy and the postpartum period has no adverse effect on thyroid function. 2022 Dec;74:127055. doi: 10.1016/j.jtemb.2022.127055. 100 - 300 micrograms is ideal. Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100-299 g/L: a UNICEF/ICCIDD study group report. In my experience, every woman has a unique history with different contributing factors that must be addressed. Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Minelli R, Gardini E, Bianconi L, Salvi M, Roti E. Subclinical hypothyroidism, overt thyrotoxicosis and subclinical hypothyroidism: the subsequent phases of thyroid function in a patient chronically treated with amiodarone. US Food and Drug Administrations Total Diet Study: dietary intake of perchlorate and iodine. J. Med. Your thyroid gland traps iodine and transforms it into thyroid hormones. Michikawa T, et al. Emder PJ, Jack MM. Federal government websites often end in .gov or .mil. The effect of small increases in dietary iodine on thyroid function in euthyroid subjects. By contrast, type 2 AIT is characterized by parts of the thyroid gland being destroyed, which results in thyroid hormones leaking into the circulation.