I'll grant you that processed foods may well not contain iodized salt. One additional common source of iodized salt I did not mention is restaurant food.

This focus on salt overlooks the fact that iodine is available elsewhere in our diet (i.e. fish and other seafood, dairy products, some vegetables). And it remains true that iodine deficiency is very rare in the U.S.

"In some parts of the world, iodine deficiency is common, but the addition of iodine to table salt has virtually eliminated this problem in the United States."

apollog: "Yes, Iodine is like sodium (and zinc, and copper, and iron, etc) ... essential at certain doses, and toxic if too much is consumed."

Given that people are extremely unlikely to have iodine deficiency and overdosage can be harmful (especially to thyroid function), would you now retract your suggestion that people who think they're hypothyroid start with iodine supplementation? Do you think that persons reading this thread who think they may be thyroid hormone-deficient should get checked by a physician to see if they're actually hypothyroid (and if so, to determine what the cause is i.e. autoimmune disease, drugs etc.) - or should they just start taking over the counter supplements to see what happens?

>> Given that people are extremely unlikely to have iodine deficiency and overdosage can be harmful (especially to thyroid function), would you now retract your suggestion that people who think they're hypothyroid start with iodine supplementation?

Again, you are presuming a number of things ... first, 99% of the entire population is already taking over the counter supplements of iodine, although usually at a much lower rate than was originally intended. Iodized salt is a supplement, although it is not consumed precisely or systematically, nor according to the original assumptions when the plan was formulated. So the question is not whether we supplement, but to what dosage we supplement. Nothing magical about supplementing via salt, and if one doesn't eat much iodized salt, then it is necessary to get iodine elsewhere.

The real rate of iodine deficiency is unknown; the average intake of iodine has dropped by 50% in the past two decades; were the original assumptions two times higher than needed, or is it likely that this drop in iodized salt intake resulted in more marginal deficiencies? Why are some doctors who study the problem calling for new laws to require that all food processors and restaurants use iodized salt?? If iodine deficiency is so rare (as you allege), then there is no reason... but the concerns are real.

You pointed out that fish and other seafood are a good source of iodine - quite right. Is it wrong to suggest that a person who feels a lack of energy might want to see if a few days of eating seafood or seaweed might improve their temperature, energy or mood? I don't think so. An overdosage is quite unlikely to occur unless one takes an unusually large dose. Many kelp tablets contain 100% of the RDA, and taking one of these a day for a short period is not going to cause the problems you are invoking. Eating sushi for lunch for a few days is not going to cause iodine toxicity. The costs of such an approach is low, the risks are low, and if it doesn't work and there is still suspicion of thyroid issues, then an appointment with a doctor is in order.

Any thyroid dysfunction should be considered a serious condition, one not to be mucked around with using home remedies, but one which requires the regular professional supervision of a doctor (or preferably an endocrinologist). If you take too much of a herb, or too much iodine, you're a prime candidate for tipping the thyroid in the other direction - and Graves' Disease (hyperthyroidism) is no laughing matter, believe me.

Hence, my advice is to use conventional treatments through your doctor. Hypothyroidism is very easily treated, and with regular blood tests your doctor can get your dosage Just Right to suit your individual needs. That's impossible to do with herbal alternatives.

Having said that, however, you might be interested in the following - but (at the risk of being repetitive)I urge caution and continuing medical supervision:

The following herbs will help to normalise thyroid activity: Pokeweed, Irish Moss, Kelp, Parsley, and Cayenne.

Eating raw Celery can help stimulate the thyroid and pituitary glands.

The following herbs help heal an underactive thyroid: Bayberry, Goldenseal, and Myrrh.

I see daisy has also covered the hazards of self-medicating for a presumed thyroid problem. What additionally bears repeating is that it doesn't make sense to go out and buy supplements to treat a disorder you may not have. The symptoms of thyroid deficiency such as lack of energy and depression are mimicked by numerous other disorders. While some of these may not require urgent, proper treatment, others are a different story. For example, if you actually have (instead of a thyroid problem) anemia secondary to chronic blood loss from a bleeding ulcer or tumor, or a hematological disorder, delays in diagnosis while you're trying a kelp supplement or other over-the-counter aids could have serious consequences.

"Why are some doctors who study the problem calling for new laws to require that all food processors and restaurants use iodized salt?? If iodine deficiency is so rare (as you allege), then there is no reason... but the concerns are real."

Who has shown that an iodine deficiency problem has developed in this country? Do you have any evidence for that (aside from speculation by fringe theorists)? And while I know you like to personalize disagreements by suggesting that it's only me who holds a particular view, let's remember that I've cited both the National Institutes of Health and the Mayo Clinic in this discussion in reference to the rarity of iodine deficiency causing thyroid problems in the United States.

>> Do you have any evidence for that (aside from speculation by fringe theorists)?

There you go again, Eric - using innuendo to imply that anyone who doesn't think like you must be a kook living in fantasy land. Why are you implying that the doctors cited above are fringe theorists? Why not have an honest discussion, free of your usual tactics?

Already cited is the 50% decrease in iodine consumption in the US, documented by the US Center for Disease Control - hardly fringy. You still haven't told us how that decrease is going to affect the iodine status of the population, and little research is being done, largely because so many are convinced the problem is solved.

Here's one clue: a paper from the University of Tennessee Medical Center in Memphis. It discusses the idea that iodine deficiencies have been eradicated in the US by showing 3 cases of young women with goiter and iodine deficiency, even though they live in a region where obvious goiter is considered eradicated ... taking iodine supplemented salt cleared up the problems. And it could be the tip of the iceberg, as "A high index of suspicion is needed to recognize these cases" ... too many doctors are like you, and naively assume as a matter of doctrine that the iodine problem only exists in history or in other countries - you have clearly stated your bias (no need to be on the look-out for such conditions, as they are oh-so rare). Except they aren't. The study also note that (even with the standard lab tests you cited), unless the clinician is considering the possibility of iodine deficiency, serious malpractice could occur: "unwarranted life-long thyroxine therapy." You should be involved in an honest discussion and educating people about this, eric, not blowing smoke and disinformation.

In Europe, approximately 50% of the population has a mild iodine deficiency - not surprising, it is much less common to take a supplement in their salt. And there are people in the US who don't take much iodized salt, either ... the message from health authorities has been to cut back on salt (good general advice) and some people have an emotional preference for 'natural' non-iodized salt (not necessarily good). What magic makes people in the US who don't use iodine supplemented salt different from the Europeans who don't take supplemented salt? There is no difference. Iodine levels are dropping - the evidence is that the average person is still ok, but an increasing number of people get far less than was intended when the supplementation started.

There is one country in Europe that has never had a history of iodine deficiency (Iceland), and they have never supplemented their salt with iodine. They have gotten all the iodine they need from seafood (true of the entire ocean system) and milk (limited to particular soils). Funny how most medical sources are recommending that people eat more seafood (for a variety of reasons), but Eric is opposed to someone with low energy...

"Why are you implying that the doctors cited above are fringe theorists?

You didn't cite any doctors, any websites or any research articles showing that that thyroid disease is increasing because of iodine deficiency. You still haven't. A report that several people were found to be iodine-deficient doesn't change the fact that such a deficiency is rare in this country. Additionally, the fact that a few want iodized salt added to processed foods doesn't do anything to demonstrate that there's a problem.

I have no idea why you're so hung up on iodine, seeing as how there's such a strong consensus among experts in the field that other factors are vastly more important in low thyroid function. In addition to NIH and Mayo, here are recently established guidelines by the American Association of Clinical Endocrinologists on diagnosing and treating thyroid disease. You'll note that in the section on hypothyroidism, the discussion on primary and secondary causes of the disease doesn't even mention low dietary thyroid intake...again, because it's so rare it falls far down the list of potential causes. Also, note that the AACE calls for careful evaluation of a potential thyroid problem by a qualified physician before establishing that someone has a thyroid problem (including that simple TSH test I mentioned earlier) - not guessing that a problem exists and sending someone out to the health food store for kelp tablets on a hunch.

I see you have no answers as to why people shouldn't get a simple blood test to screen for a thyroid problem (although the reason isn't hard to surmise given your well-known loathing for physicians). And where's your response to concern about missing a significant health problem by assuming thyroid disease and recommending an intervention that is highly unlikely do any good?

"Why not have an honest discussion, free of your usual tactics?...You should be involved in an honest discussion and educating people about this, eric, not blowing smoke and disinformation."

The irony. Oh yes, it's just me (pay no attention to all the good sources Eric quoted, it's just Eric's "misinformation" ;)size>

>> You didn't cite any doctors, any websites or any research articles showing that that thyroid disease is increasing because of iodine deficiency.

But that isn't the main question - the original post was about "sluggish thyroid", which may or may not be due to thyroid disease. Iodine deficiency can cause symptoms of lethargy and fatigue even the absence of clinical thyroid disease....my wife experienced profound symptoms long before her t3, t4 and TSH numbers indicated a problem.

>> I see you have no answers as to why people shouldn't get a simple blood test to screen for a thyroid problem (although the reason isn't hard to surmise given your well-known loathing for physicians).

Again, you are engaging in outright distortion and argumentum ad hominem. I didn't say that a person should not get a thyroid test - my statement was if a short term increase in iodine rich foods didn't result in noticeable improvement, such tests are in order. But you can't be honest about my position, can you?

In my opinion, if a person has a mild headache, an aspirin or tylenol may be in order as the first response. If a pattern of headaches emerges, or if the headache is severe, medical attention is needed. But one mild or moderate headache? You can get hysterical and argue that any headache could be a sign of a brain tumor or encephalitis, but such an approach is not credible. In theory, sure, any headache could be a sign of something serious. But real medical experts don't advise rushing to the doctor for the slightest ache or pain. The same is true of general malaise - reasonable lifestyle changes make sense as a first response. If that doesn't work, another approach is in order, including a physical exam.

>> I have no idea why you're so hung up on iodine,

I'm not - you are the one who insists on arguing about it. You said that bladderwack is sometimes used as an herbal source of iodine in some thyroid conditions (true) and went on to dismiss it due to the fact that salt is supplemented with iodine (though not to the degree you assume), while citing the 'fact' that canned and processed foods contain iodine supplements (often false). The truth is that the average intake of iodine is decreasing and it clear that some people don't get enough because the program is based on assumptions that don't hold true for many people. Pregnant and lactating mother, infants and children are at greatest risk of Iodine deficiency (about half of such women) - although in that case, the biggest concerns are permanent developmental disability of the young-uns. Others who don't consume much iodine (through whatever source) are also at risk of insufficiency, deficiency, inadequacy, or what ever you wish to call it.

The information you provide was not completely accurate, and you became argumentative when called on it. Then you distort, and finally retreat to the position that there is nothing that any person could possibly do on their own ......

"...you are engaging in...argumentum ad hominem"

The term ad hominem doesn't mean what you think it does. It refers to countering an argument by hurling insults at the opposing party (something you do frequently). Disproving and dismissing someone else's claims is not an ad hominem tactic; on the contrary it's a perfectly legitimate means of debate.

Your claims of "distortion" are similarly illegitimate. I do think people should get a simple TSH test to screen for thyroid problems before treating symptoms that may be due to something else entirely - you'd prefer that they try iodine supplementation for some unspecified length of time (a week? a month? six months?), despite the fact that you've given us zero evidence that iodine deficiency is anything but a rare cause of thyroid dysfunction, and thus extra iodine is highly unlikely to be helpful.

Speaking of distortion, I did not say that "there is nothing that any person could possibly do on their own". The sources I provided include information on drugs that may interfere with thyroid function, dietary factors that may be important and typical causes of low thyroid function (like a common autoimmune disease, Hashimoto's thyroiditis). This type of information may help guide people toward recognizing the cause of their symptoms, but ultimately if one has serious systemic complaints it only makes sense to get them diagnosed properly and treatment options explained. Then, fully informed, one can decide what course to follow on a rational basis.
Significant and prolonged symptoms of fatigue, lethargy, depression, weakness etc. (common to but certainly not exclusive to hypothyroidism) are not like having a "mild headache". If you want to draw a comparison, it's more like having an increasing incidence of prolonged and severe headaches. In such a case I'd disagree with someone who suggested the sufferer go try some feverfew, but instead would recommend they get checked out by a physician to make sure something more serious than migraine was not the problem.

We can't know here what exactly was involved in your wife's diagnosis and treatment (and I hope she is doing better), but experiencing "profound" symptoms in the face of completely normal thyroid function tests suggests that the problem lay elsewhere than in the thyroid.

Our exchanges on this subject have followed a a typically sorry pattern. Someone asks for suggestions for a medical problem. You promote some unproven or illogical remedy. I point out the defects in that remedy and emphasize the importance of making sure the condition has been accurately diagnosed and best treatment options explored, using links to information from experts in the field. You dredge up some tiny minority viewpoint from the remotest swamps of Google or PubMed to support your arguments, and pretend that the expert consensus I've summarized represents my views alone. Eventually, when I stick to the point and refuse to get sidetracked into...

I'm not as verbose as some here - I prefer to keep things simple - but consider these facts (provided by an endocrinologist):

1 teaspoon iodine, administered in early childhood, is enough iodine to last a person an entire (long) life-time.

Iodine is TOXIC to an over-active thyroid.

Nice and short, (although I don't think your body can hold on to Iodine that long) its good to know.

Put simply - nope, you can't give one childhood dose of iodine and have it last a lifetime. If it was that easy, we wouldn't need iodized salt or other food additives. Speaking of which, here's an interesting tidbit from the NIH:

"To avoid iodine deficiency in the United States, table salt is enriched with iodine ("iodized" salt), and iodine is added to cattle feed and used as a dough conditioner."

So - use table salt, eat beef and baked goods, consume shellfish, dairy products and certain vegetables, and you get the iodine you need in the vast majority of cases. Not too many people abstain from all those things.

I agree with daisy that iodine supplementation can be harmful in some thyroid conditions, including as mentioned earlier in the context of consumption of "health tonics" and seaweed to relieve supposed iodine deficiency.

Hi brendan!

I think what the doc who talked to daisy may have meant, is that the amount of iodine that fits into a teaspoonful of concentrate would be enough for lifetime needs - not that you could administer it that way.

"Your citation is sloppy and misleading. The source of information is not the National Institute of Health - it is from a compilation done by a company called Natural Standard. And the information itself is wrong - it is based on what was happening 50 years ago, not what is happening today."

Your critique is erroneous. The website is MedlinePlus, a service of the National Institutes of Health and its affiliate, the National Library of Medicine. The specific information they've approved for dissemination comes from a collaborative of physicians/scientists from such prestigious institutions as Harvard Medical School, Sloan-Kettering Cancer Center and Massachusetts General Hospital. It is not a "company". The website page was created in 2008, so it's a mystery why you think it's out of date.
This isn't the first time you've attempted to claim that information from an NIH website isn't really endorsed by the NIH - claims that lack any merit.

You have not, nor have any of your sources demonstrated that iodine deficiency is anything but a rarity in this country, and have not shown that there's any increase in thyroid disease from this cause. Quoting a salt industry trade group on the composition of "food salt" (this apparently is different from table salt, which is heavily iodized) doesn't do anything to contradict medical experts at the NIH, Mayo Clinic, American Association of Clinical Endocrinologists or the great majority of other knowledgeable practitioners who cite iodine deficiency as a rarity in the U.S. and a very unusual cause of thyroid dysfunction.

You continue to project an inaccurate definition of ad hominem. As a commonly recognized debate fallacy, this involves attacking the character of a person expressing an idea, rather than the idea itself. I have fully addressed the ideas you've presented here. Referring to "fringe" views is entirely accurate if, as is the case here, the views are unsupported by the great majority of experts in the field. I have clearly (and repeatedly) indicated why I think it is a bad idea, as you have suggested, to self-treat for a presumed thyroid problem before getting a simple blood test to determine if one has the problem in the first place. Your views have not been misrepresented. As to your motives, they are clear from your frequent denunciations of physicians and others involved in evidence-based medical care and in the context of many of your postings on a variety of subjects, and should help readers understand a basis for many of your recommendations.

Getting past the inevitable diversions, the take-home message from this thread is: The symptoms of thyroid disease can mimic those of numerous other conditions, and a "sluggish thyroid" can't be properly diagnosed without a proper physical exam and blood tests. Available supplements are of dubious benefit for treating a thyroid problem, and can actually be harmful in some circumstances. Knowing your options for treatments proven to...

There is a health program (might be WHO) which goes to some remote places like Tibet or Nepal, where iodine deficiency is rife. They administer teaspoons of iodine to the children there, and the research has found that it is sufficient to last them for their entire life-times. There was a documentary on TV about it a while back (here in Australia).

So (according to the research of this institution) - yes, the body can store iodine for long periods of time. And yes, the body only requires a teaspoon of iodine in a life-time.

daisy, the body does not indefinitely store all of the iodine it takes in from the diet. We lose some continually in the urine and from bile secretions. That's why we need continued daily intake.

Furthermore, the difference between the average daily intake and the upper limit for safe consumption isn't all that great - average intake is 100-150 micrograms a day, and ingesting over 1100 micrograms per day can cause health problems. The upper limit of safety is even less in children. So I don't see how you can properly give kids a great big dose intended to last a lifetime.

Can you cite any references showing that giving a teaspoon of iodine to kids meets their lifetime requirements?

Hmm... the World Health Organization recommends that pregnant women have an Iodine level from 150 to 249 ug, and in the US, that has dropped to an average of 139 (with many pregnant women under 50 ug!). So by all accounts, there is a real iodine deficiency at the most sensitive time (pre/perinatal development) ... and the conclusion is that iodized salt is an adequate strategy??

With a marginal deficiency in adults, the thyroid will not swell to the size of a tennis ball. It won't be noticed, unless a clinician is considering the possibility ... and (as we have seen here), most seem to think that there is still iodine added to bread, added to dairy and beef, added to processed food, added to canned food. Not true!

T3, T4, and TSH lab values can be of some use (especially for clear-cut cases), but are poorly related to basal temperature and other indications of thyroid activity. And the whole idea of 'normal' ranges of these hormones is rather arbitrary, and has changed over time.

We are right behind Australia and New Zealand - falling iodine intake, insufficiency. It's a classic U-shaped curve of concern. The problem is widespread, people recognize it and things improve, then the problem is ignored, and it rebounds.

• Mild iodine deficiency has re-emerged in Australia and New Zealand over the past decade and poses a significant health risk to future generations of these countries (9,10). Median urinary iodine excretion (UIE) levels in Australia have decreased from over 200 ug/l in 1990 to less than 100 ug/l by 1999 (9). Iodine deficiency has resurfaced after more than half a century of iodine sufficiency because of changes in work practices in the dairy industry and because consumers do not purchase iodised salt and the food industry does not use iodised salt in food preparation. The dramatic decline in iodine intake in the Australian population has been attributed to the major decrease in iodine concentrations in dairy milk (2,11). Since the early 1960s the major source of iodine in the Australian diet has been from iodine contamination of milk by iodophores used as sanitising agents in the dairy industry. These chemicals have been replaced by chlorine-based disinfectants. Because Australia has not had an ongoing iodine nutrition monitoring program (except for the island state of Tasmania), the problem of iodine deficiency has only come to light through the efforts of researchers interested in IDD (2). Health authorities have shown little or no interest in addressing the problem because mild iodine deficiency has not been seen as a threat to human health.

IODINE DEFICIENCY DISORDERS (IDD) IN THE ASIA PACIFIC REGION

Mild deficiency is not seen as a major threat to health! Sure, it may cause low body temperature, lack of energy, depression, reduce concentration, etc ... but is not a major threat according to most 'experts'!

Here's another gem from what passes as medical consensus - in Germany, 23% of the population...

None of this data mining from "THE ASIA PACIFIC REGION" etc. has anything to do with the bottom line in the U.S. - which is that thyroid dysfunction related to iodine deficiency is a rarity, and jumping to add iodine to the diet even before knowing if there is a thyroid problem 1) makes no sense, 2) is highly unlikely to have any beneficial effect, and 3) can aggravate thyroid problems in people with thyroid abnormalities.

"T3, T4, and TSH lab values can be of some use (especially for clear-cut cases), but are poorly related to basal temperature and other indications of thyroid activity. And the whole idea of 'normal' ranges of these hormones is rather arbitrary, and has changed over time."

This attempt to pooh-pooh a rational basis for diagnosis is inaccurate. Endocrinologists and others trained in diagnosing and treating thyroid disease use tests such as these routinely, because they work. The sensitive TSH test (which can detect abnormalities long before actual blood levels of active thyroid hormone levels fall) is critical to a proper diagnosis.* More on diagnosis here.

*This link to the American Association of Clinical Endocrinologists publication on guidelines for thyroid testing lists numerous tests that can be helpful in determine whether thyroid disease exists. Notably absent from this list is any suggestion to dose the patient with extra iodine and see what happens.

A rarity? No relation to what is seen in the US?

• However, the CDC researchers say those figures have since changed for the worse. The follow-up NHANES III survey, conducted between 1988 - 1994, found that 11.7% of Americans have iodine deficiency -- a fourfold increase over the past 20 years. (

source)

You're citing an 11-year-old report that references data up to 21 years old, which mentions that iodine deficiency "could resurface" in the U.S. This out-of-date citation also is about making sure that infants aren't born with birth defects - not about adults with "sluggish thyroids".

Contrast that "evidence" with up-to-date recommendations by the American Association of Clinical Endocrinologists (and other experts) which I've cited previously, which do not recognize iodine deficiency as a significant factor in thyroid disease among Americans, and which do not recommend rushing out to the health food store to dose with kelp tablets or tonics for presumed thyroid insufficiency.

Here's a good and current summary of valid testing for thyroid disease (with guidelines as to when people should get tested). Note also the number of conditions which can mimic thyroid disease and which also will not be helped by guesswork dosing with iodine.

"Advances in diagnostic methods now make it possible to detect hypothyroidism in almost all cases before severe symptoms develop. Doctors can diagnosis hypothyroidism after completing a history and physical exam of the patient and performing sensitive laboratory tests on the patient's blood."

>> You're citing an 11-year-old report that references data up to 21 years old

Yes, it compared data from ~10 years ago to previous research, and it concluded that iodine consumption had dropped by 50% in the decade they looked at, while iodine deficiency quadrupled, to 11%. Do you have more recent research that suggests that these trends have been reversed?

You have repeatedly made claims that were never true, or which were true 30 years ago, but which are not today (iodine is in restaurant salt, iodine is in processed foods, iodine is added to canned foods, iodine is added to bread, iodine in dairy, iodine in beef).

The program to ensure iodine sufficiency worked when people consumed lots of supplemented table salt, and when iodine was added to bread and milk. That program is no longer relevant to today's patterns of eating, and invoking 30 year old ideas that iodine deficiency is rare is not supported by the evidence.

Restaurants don't use table salt? Who knew? :)

As shown by various linked and reliable websites (including the NIH), iodine is in numerous foods as well as salt, forms a part of animal feed, and people eating a normal healthy diet do not have to fret about iodine deficiency (this seems to be a theme in our discussions - you try to convince us that the human body is terribly inadequate and needs all sorts of artificial supplementation, I reply (with evidence) that we typically do just fine eating a good diet).

Of course, nothing you're saying refutes what experts in the field of endocrinology/thyroid problems tell us - that iodine deficiency is only a rare cause of thyroid dysfunction, that a good diagnostic workup (including the sensitive TSH test) is necessary for making the diagnosis of hypothyroidism, and that self-dosing with iodine supplements is highly unlikely to do any good and may be hazardous to your health.

Keep up with the distractions and nitpicking if you want, but nothing you've posted changes any of the sensible and evidence-based recommendations of the folks who are knowledgeable about thyroid disease.

>> you try to convince us that the human body is terribly inadequate and needs all sorts of artificial supplementation,

Strange how you switch from the position that iodine supplementation of salt has made been successful and that certain forms of thyroid disease that were once common are now rare ... and then you question whether such supplementation is even necessary! If the human body is so immaculately 'adequate' as you think, shouldn't we eliminate all 'artificial' iodine in the food supply? Are you telling people it is a good idea to buy non-iodized salt? That positions dovetails nicely with the people who belief that 'artificial' is bad.

No, as you must realize I was referring to unneeded and potentially harmful dosing in the form of iodine-containing health tonics, seaweed tablets and the like. Also, while some vitamin fortification of foods and potentially multivitamin supplements are useful, megadosing with vitamins for fear of inadequate intake is mostly a bad idea. I (and others with a good understanding of human physiology) additionally don't believe in unnecessary supplements that supposedly are needed to make our blood alkaline (not), "cleanses" and other stuff that some think we must chug down because our poor inadequate bodies are incapable of homeostasis due to "toxins" and other imaginary evils.

Have you dug up any authoritative findings from endocrinology experts yet that say we are in dire peril of succumbing to iodine-deficiency hypothyroidism, and that dosing ourselves with iodine-containing supplements is the way to go if we suspect our thyroids may be malfunctioning?

Yes, when researchers actually look to see if things are completely rosy as some believe, there is evidence that it is not - that iodine levels are dropping, and that these low levels have negative effects in spite of some people's optimism.

Here's a 2009 study that found that in Germany (a country that 'doesn't have an iodine problem'), 2/3 of the population has thyroid nodules - this is double the number using older technology to scan for nodules. Conclusion? The "... study underlines the clinical significance of iodine deficiency and should renew the discussion on routine iodine supplementation."

Of course, since so many 'scientists' are convinced the iodine issue is not a problem and can't be a problem, this will be ignored for at least a decade. Calls to 'renew the discussion' will be met with dismissals of that evidence as irrelevant or fringe, and more references to outdated, inaccurate beliefs.

Here is a link that might be useful: Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination.

Leaving off the obvious (that having thyroid nodules doesn't mean you're hypothyroid, since nodules have a variety of causes):

It is even more blatantly obvious that if you're using more sensitive imaging devices, you will find more abnormalities. Another example is the increase in presumed abnormalities found on breast MRI as opposed to routine mammography (as an aside, I find in my practice that while MRI sometimes does find significant abnormalities that mammography misses, it also leads to biopsies of lots of things that are completely benign).

So those researchers who are using better (or at least more sensitive) equipment to find more nodules would need to explain their iodine theory. It would've been more convincing had they compared nodule incidence with years past using the exact same scanning equipment, and correlated that with actual thyroid function testing. Speaking of which, did those German researchers recommend self-dosing with iodine supplements for feeling "sluggish" before one even knows if a thyroid problem is to blame? I didn't see that, nor have I heard of any reputable physician or researcher make that suggestion.

This hyper-need to beat the drum for iodine supplements makes me wonder how often overdoing the iodine leads to hyperthyroidism. ;)

Another factoid - having thyroid nodules (the vast majority of which are benign), even in instances where they are formed by the thyroid gland to compensate for low hormone levels, mostly relate to problems that have nothing to do with iodine in the diet. For instance, there are intrinsic synthetic defects that hamper thyroid hormone production, so the gland gets bigger to pump out the adequate level of hormones (this is an example of why most people with thyroid nodules are not deficient in hormone production - the gland has compensated to maintain a normal (euthyroid) state). Or you could have nodules due to an inflammatory/autoimmune process (Hashimoto's thyroiditis is a common autoimmune disease with causes and treatment not related to iodine intake).

It is incorrect to assume that nodules = hypothyroid = need for more iodine, and especially so in the United States and other developed countries.

thanks daisy, for you help. I was only asking for suggestions. I had a thyroid test done after my first pregnancy, it was normal- although I was exhibiting signs of hypothyroidism, and it runs in my family, I let it go.
I'm still experiencing the problems. It could possibly be something else, but God only knows the tests I'd have to go through and if they could even give me an answer without throwing the latest drug sample at me.
Irish moss is good for ya, so is kelp and parsley. Nothing wrong with adding these to my diet in moderation.
It could be hormonal, it could be glandular, it could be alot of things but I'd have to go to a very good doctor and trust him to run specific tests for my specific symptoms. It could even be anemia. See, the problem is that my husband has been laid of for months, and we already have some medical bills totaling $600. Puh-lease. Can't afford anything else.
There are alot of health issues we have ignored because we can't afford the bills. Dental, eyes, a few other things.
So, unless you know a good doctor in a nearby larger city that donates his time and skillls to really helping people get well, then I'm outta luck.
Eric oh and apollog, you guys just love to debate!

? Is a diet including fish considered to have adequate iodine, for the average individual ?
A lot of people are on their cardiologist's salt restricted diets.

Here's a relevant study on hypothyroidism in upper middle-aged and elderly adults. Researchers who found low thyroid function in the study participants investigated a variety of potential causes for the problem. Here's what they found.

Results. The causes of hypothyroidism were as follows: autoimmune thyroiditis, 308 (47.0%); postoperative hypothyroidism, 175 (26.7%); therapy for previous thyrotoxicosis, 63 (9.6%); thyrotropin deficiency, 15 (2.3%); iodine excess, 6 (0.9%); subacute thyroiditis, 2 (0.3%); and unknown etiology, 86 (13.1%) patients.

Notice that iodine deficiency doesn't even make the list, even though a percentage of these older patients are likely to be on low-salt diets.

What this demonstrates is again that 1) the vast majority of cases of low thyroid function are due to non-iodine-related causes, and 2) iodine excess can cause the very problem that enthusiasts for iodine supplementation think it cures.

It's odd that novice who started this thread, now thanks daisyduckworth for her advice, though novice is evidently ignoring it by not seeking a medical diagnosis and instead choosing supplementation (even though previous testing found she didn't have a thyroid problem). She probably should be thanking apollog instead, as he's the self-diagnosis/self-treatment advocate in this thread.

>> It's odd that novice who started this thread, now thanks daisyduckworth for her advice, though novice is evidently ignoring it by not seeking a medical diagnosis and instead choosing supplementation (even though previous testing found she didn't have a thyroid problem). She probably should be thanking apollog instead, as he's the self-diagnosis/self-treatment advocate in this thread.

You expressed a note of concern when I mentioned my wife's thyroid condition, but you dodged the reason I mentioned her ... she was having clear symptoms of thyroid issues long before her lab tests indicated a problem! Those tests can often be useful, but they have their limits. In a case where diagnostics have already be run and found to be 'normal', taking ~100% of the daily value of iodine for a short period is one approach that might have benefit.

The reference ranges or ideas of what is 'normal' for the thyroid hormones are imperfect and arbitrary. They have changed over time. While a person outside of the ranges almost certainly needs medical attention, it is quite possible that a person with 'normal' values may in fact not have optimal thyroid function.

"You expressed a note of concern when I mentioned my wife's thyroid condition, but you dodged the reason I mentioned her ... she was having clear symptoms of thyroid issues long before her lab tests indicated a problem!"

No, I said this: "We can't know here what exactly was involved in your wife's diagnosis and treatment (and I hope she is doing better), but experiencing "profound" symptoms in the face of completely normal thyroid function tests suggests that the problem lay elsewhere than in the thyroid."

If initial testing doesn't indicate thyroid dysfunction but clinical symptoms and other testing still suggest the possibility of a thyroid problem, other tests (mentioned in link(s) above) can be done, but no responsible practitioner would recommend iodine supplementation (which can be hazardous) without diagnosing hypothyroidism and ruling out other, potentially serious causes of symptoms.

"The reference ranges or ideas of what is 'normal' for the thyroid hormones are imperfect and arbitrary."

No, they are not arbitrary - they have been developed through considerable study and clinical experience. For a person to experience "profound" symptoms and have thyroid hormone values in the normal range suggests strongly that the problem lies elsewhere (as noted, the senstitive TSH test experts recommend as a thyroid function screen, typically becomes abnormal long before hormone levels fall and thus would predate the development of "profound" symptoms.

Did you notice that study I linked to showing that while iodine excess was found to cause low thyroid function in a small percentage of patients, iodine deficiency didn't show up as a cause at all? And one again, a request for you to define what you consider to be a "short period" to go without proper evaluation in order to self-dose with iodine? A week? A month? Six months? Longer?

Most doctors prescribe medication as soon as the condition is noted, starting with very low doses, and increasing to a certain amount which in most cases normalises thyroid function. Hence the need for regular monitoring. Dosages may go up or down depending on thyroid function tests (blood tests).

The patient can usually tell if the dosage isn't right at a given time, and see a doctor for confirmation of suspicions and dosage adjustment.

The reason most doctors go this road, is that once the thyroid begins to dysfunction, it's pretty much a guarantee that it will continue to do so. Once you've 'got it', you've got it for good, and you'll needs meds for the rest of your life to keep things nicely balanced. The thyroid does not heal itself. Mind you, with hypERthyroidism, a patient can go into remission, but inevitably the thyroid will return to over-drive - usually with a vengeance.

There is a risk of over-dosing on the meds, which can lead to Graves' Disease (hypERthyroid) - and once that happens there's no going back. Another reason for regular check-ups.

Thyroid nodules, BTW, are very common with hyperthyroidism, and they can become cancerous (though rarely).

What a lot of people don't know, is that thyroid problems (especially hypERthyroidism) can lead to many other serious conditions, not least of which is diabetes Type 2. Meds for that can cause weight gain. Also with hypERthyroidism, during a crisis (called a 'Thyroid Storm'), steroids are used, and they are notorious for causing rapid weight gain. Such things are not required with hypOthyroidism, which doesn't need quite such aggressive treatments.

To clarify some things:

I should mention that it remains controversial whether to treat low thyroid hormone levels that are asymptomatic. One setting in which this could be problematic is if the patient is pregnant, in which case it's important to have adequate thyroid function to prevent birth defects.

With some types of thyroid hyperfunction the condition can normalize over time and does not inevitably return. If a person has Graves' disease (an autoimmune disorder that's one cause of hyperthyroidism), that typically doesn't improve without treatment.

There is some association between thyroid problems and diabetes (autoimmune disorders can affect multiple organs); if there is thyroid disease in persons with type II diabetes, it usually involves hypothyroidism. More info here.

I am considered to be Euthryroid based on tests but my doctors have found when I do not take thyroid medicene I exhibit most of the problems associated with hypothyroid patients. This includes sleeping over 18 hours a day and still being tired.

Other than a couple of foods I do not salt my food or regularly eat fish because of objections to depleting the oceans. You must keep in mind that not all fish come from the ocean. When I notice a sign that I am low in thyroid I will eat a bit of dried seaweed that I keep on hand.

Many of the food advertisements currently available mention that the food is prepared with sea salt. There is almost always a comment that it lacks the iodine that supposedly gives food an off flavor. I have never noticed the off flavor but the adds seem to mention it. If it is true, but I see no reason that sea salt would not have iodine, people are receiving less iodine and we could as they are now finding out about children being low in Vita D developing more of a low iodine entake.

There have been some interesting links that I will explore so thank all of you.

Well, that link just takes us back to the same anonymous article. More on that in a moment.

If your mother has "sluggishness" and weight gain unexplained by other factors, she might have a symptomatic thyroid problem. If she's not satisfied with the medical workup and recommendations she's gotten, maybe another physician would be more helpful. I'd consider that option first before trying diets proposed by anonymous authors on the Internet.

I don't see any actual research listed on the website you linked to. The supplement dealer who is linked to in the article praises several people for supposedly being researchers on coconut oil. One of them (Bruce Fife) is a naturopath and I can find no articles by him on that or any other subject listed in the PubMed database of scientific research. Another, Gabriel Cousens (supposedly an MD), claims that coconut oil can "cure" diabetes, which is news to the rest of the profession and qualified diabetes researchers.

I'm wary of stuff promoted as a "superfood" when there's such an overwhelming lack of good evidence to show it prevents/treats disease, and convincing evidence that it's loaded with calories and saturated fat.

>> I'm wary of stuff promoted as a "superfood" when there's such an overwhelming lack of good evidence to show it prevents/treats disease, and convincing evidence that it's loaded with calories and saturated fat.

And what's the latest research? Here's a recent study that looked at overweight women put on a low calorie diet and exercise program: one group was given a supplement of soy oil, the other was given a supplement of coconut oil. The soy group saw their total cholesterol go up while their HDL ('good') cholesterol went down. The coconut group saw their HDL go up, and they were the only group to see a reduction in waist size.

The dogma that all saturated fats are bad is not supported by the research. Yet most doctors continue to ignore the research and tell their patients to avoid coconut oil, while they encourage people to consume 'healthy' soy oil.

Here is a link that might be useful: Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity.

Back to your familiar themes, I see - the current state of knowledge (backed by extensive research and clinical experience) is "dogma", "most doctors" are wrong, and a tiny foreign study for someone's masters' thesis proves the point, no further questions need be asked.

Aside from the limited number of patients studied (20 in each group) and the short duration of the study (12 weeks), there's the question of exactly what the participants did (they were "instructed" to follow a low calorie diet - no evidence as to what they actually ate). Also there's no information provided as to their lifestyles - in such small groups, such factors can make a big difference in the outcome.
And what happens when people follow their usual eating habits, only substituting high-calorie, high-fat coconut oil for their usual cooking oils? Will there be wonderful results for the supermarket magazines to announce and for supplement companies to trumpet (as they're already doing in the case of the study you cited)?

It'd be really interesting to see a large-scale well-conducted trial in the U.S., not funded by the coconut oil industry, where people ate their accustomed diet, only using coconut oil instead of less expensive and better characterized heart and weight-friendly oils.

By the way, here's what a "holistic" coconut oil skeptic thinks about health claims made for this product.

Here is a link that might be useful: Monkeying with coconut oil

More FUD from e-oh, as usual. We saw the same thing when low carb diets came out - a dogmatic rejection of them as unhealthy since they contain saturated fat. But a low carb diet can be better for weight loss and blood lipids than the standard diet that is low-fat but which has lots of n-6 oils.

Since this is a thread on the thyroid, thought I would direct your attention to another relevant article (this one from those 'foreigners' in Canada) which reviews the literature on medium chain triglycerides. Bottom line: MCTs and coconut oil can increase energy expenditure / metabolic rate. I'm not sure that it even affects the thyroid hormones per se, but if that type of fat is better absorbed into cells and burned to give a higher energy expenditure, that itself might be good for some with thyroid conditions.

They also found that MCTs were better than other fats to improve satiety or switch off hunger, and are associated with a decrease in food consumption and a tendency towards losing weight.

Here is a link that might be useful: Physiological Effects of Medium-Chain Triglycerides: Potential Agents in the Prevention of Obesity

It's good to see you at least partially returning to the subject of thyroid function, but as you yourself admit, the latest link you've posted presents no evidence that coconut oil has any beneficial effect on thyroid function.

This connect-the - d o t s stuff has a certain entertainment value, but the bottom line is that we know the harm that saturated fats do, coconut oil is an expensive source of high levels of saturated fats, and jumping on this bandwagon makes even less sense than promoting iodine supplements for people who think they might possibly have a thyroid problem.

>> This connect-the - d o t s stuff has a certain entertainment value, but the bottom line is that we know the harm that saturated fats do, coconut oil is an expensive source of high levels of saturated fats, and jumping on this bandwagon makes even less sense than promoting iodine supplements for people who think they might possibly have a thyroid problem.

My wife's autoimmune thyroid problem is intermittent - there are days when she is quite cold and miserable. She is not to the point where she is on prescription thyroid hormone. She finds that seaweed, tyrosine, and coconut oil help her feel better. For you to poo-poo it, or to split hairs about whether coconut oil actually affects thyroid function (versus 'merely' improving her metabolic rate) strikes me as snooty. You have taken things to the nth degree of abstraction - the one where people no longer exist or matter.

You object to the expense? At a few pennies a tablespoon, it costs no more than olive oil (although it is somewhat more expensive than corn oil or motor oil). It is less expensive than eating almonds or drinking pomegranate juice to round out the diet. I think that the cost is a red herring.

And we don't know that all saturated fats are equal in their effect (in fact, the evidence points the opposite direction). It wasn't long ago that all cholesterol was seen as bad. Today we are a little more nuanced - many people are trying to increase their 'good' HDL cholesterol.

Here is a link that might be useful: Kurt's Response to Iodine

Your buddy, "Kurt", sure has his fingers in a lot of pies.
His blog identifies him as a cardiologist, but there he is giving advice on thyroid problems using a testimonial and undocumented speculation about iodine (which flies in the face of good evidence and recommendations by leading experts in endocrinology). "Kurt" also promotes "bioidentical hormones" for women's hormone replacement therapy (as we've seen elsewhere, this is a poorly regulated field with false promotion of lower risk than standard hormone replacement treatment). And "Kurt" apparently also has an interest in a home blood test kit company which he thinks you should use to test thyroid hormone function, rather than getting proven testing in a laboratory that utilizes up-to-date technology and good quality assurance programs.

Just take a spin around the web and see what supplement dealers are selling coconut oil for, particularly the "virgin" oil that supposed to be ever so much better. You can wind up paying a lot for all that saturated fat.

From your earlier description, it had appeared your wife's reported thyroid problem was due to low iodine - now it seems that it's from one of the common causes described earlier, autoimmune disease. Testimonials aside, there's no evidence or good reason for iodine to help such a condition - in fact excess iodine could be harmful.

"For you to poo-poo it, or to split hairs about whether coconut oil actually affects thyroid function (versus 'merely' improving her metabolic rate) strikes me as snooty."

We don't know that her "metabolic rate" has been affected by the oil at all.
And it strikes me as unfortunate that when your beliefs are challenged and you have no good comeback, your response is once again to descend into personal insults.

So let's get this straight now - for anyone reading this thread who feels "sluggish" and thinks their thyroid might be to blame, your recommendation is to take iodine supplements (wuseless in the vast majority of cases of thyroid disease and actually harmful in some thyroid ailments) and coconut oil (expensive with potentially damaging cardiovascular implications), rather than getting an accurate diagnosis from a qualified physician and ruling out other potential causes of fatigue?

> Your buddy, "Kurt", sure has his fingers in a lot of pies. His blog identifies him as a cardiologist ...

It's clear that you can't read for comprehension, and that you are fogging up the details a bit, Mr. Magoo. That website is written by a cardiologist, but Kurt is a patient in that case study.

> We don't know that her "metabolic rate" has been affected by the oil at all.

Actually, we do. Metabolic rate and temperature are closely related - it is something she can feel, and which can be measured with a device known as a thermometer.

> Just take a spin around the web and see what supplement dealers are selling coconut oil for, particularly the "virgin" oil that supposed to be ever so much better.

I would not be surprised if someone somewhere on the internet was peddling coconut oil at a price higher than gold ... and so what? Coconut oil generally retails at a price that is on par with olive oil. There are some people pushing estate olive oils that are quite pricey (one sells for $180 a liter)- that is quite irrelevant to the idea that olive oil has desirable qualities, or that it usually sells for a much lower price. Lots of people recommend consuming more olive oil - are they all shills for the $180 a bottle stuff?

>> From your earlier description, it had appeared your wife's reported thyroid problem was due to low iodine - now it seems that it's from one of the common causes described earlier, autoimmune disease.

I never said that and never meant to imply that. I have mentioned the fact that she has hashimoto's disease in previous threads. I said "my wife experienced profound symptoms long before her t3, t4 and TSH numbers indicated a problem" which is absolutely true - she was told that her numbers were normal even as they were slipping and she felt profound symptoms. My point was that these tests (while often useful) are limited and often are not as sensitive as how a person feels.

Great followup on "Kurt" - except it doesn't address any of the relevant points I raised. The doc in question is a cardiologist, not an endocrinologist, makes inaccurate statements about hormonal therapy, uses testimonials instead of hard evidence and promotes a form of home lab testing in which he apparently has a financial interest, and which sounds highly dubious as to accuracy of results. Or did you miss those concerns when first mentioned?

"Metabolic rate and temperature are closely related - it is something she can feel, and which can be measured with a device known as a thermometer."

Nope, we don't know that coconut oil had any effect in this regard. Beyond the unreliability of testimonial evidence in general, there are so many factors affecting body temperature (time of day taken, level of physical activity, other physical conditions and medications, infection and so on) that you couldn't possibly attribute any changes to coconut oil based on random measurements in this setting. And body temperature and level of thyroid function are not synonymous - if they were, diagnosing a thyroid problem could be undertaken via a thermometer - and it cannot.

" would not be surprised if someone somewhere on the internet was peddling coconut oil at a price higher than gold ... and so what? "

It's relevant if the product is being touted for undemonstrated health benefits and carries risks associated with high saturated fat content - as is the case with coconut oil.

"My point was that these (thyroid function) tests (while often useful) are limited and often are not as sensitive as how a person feels.

It remains true that taking iodine supplements is not the way to treat Hashimoto's thyroiditis - and could even be harmful.
No lab tests are perfect - but thyroid function testing is the gold standard for diagnosing hypothyroidism. Making guesses about someone's condition over the Internet and promoting supplements to treat them is a really bad idea.

By the way - after hearing abundant comments from you in this and other threads about how "most doctors don't know this" and "doctors are wrong about that", one wonders: who diagnosed and is taking care of your wife's thyroid problem? A physician or another type of practitioner?

And how did the Hashimoto's thyroiditis get diagnosed? Was it one of those "limited" lab tests, or was some other means involved?

> Great followup on "Kurt" - except it doesn't address any of the relevant points I raised. The doc in question is a cardiologist, makes inaccurate statements about hormonal therapy, uses testimonials instead of hard evidence and promotes a form of home lab testing in which he apparently has a financial interest, and which sounds highly dubious as to accuracy of results ...

You are welcome to look at a clinical experience backed up by lab results as mere 'testimonials' - I think that there is a demonstrated link between low T3/T4 and elevated cholesterol, and I think that in many people, correcting an iodine deficiency is enough to restore the T3 and TSH levels to normal.... which is why I posted a link to that.

As to his financial interests in the products he advocates, I don't know and don't pretend to know. On the radio yesterday, there was a discussion about doctors who make hundreds of thousands of dollars referring their patients to imaging clinics they own ... that type of possible conflict of interest seems to be rather common, and the medical boards don't seem interested in taking any action to stop it. I would not be surprised if "Kurt" actually does believe that levels of hormones like T3 and vitamin D and testosterone can be important in the development of heart disease, and that the testing is an accurate, cost-effective way to identify whether or not there might be a problem with any of these. But you would have to ask him.

>> It remains true that taking iodine supplements is not the way to treat Hashimoto's thyroiditis - and could even be harmful.

We have already established that large amounts of iodine can have negative effects - there is no dispute there. Where we have not agreed is related to smaller doses - it is my position that iodine deficiency can make any form of hypothyroidism worse, and reasonable amounts of iodine may be useful for some with hypothyroidism.

Nope, we don't know that coconut oil had any effect in this regard. Beyond the unreliability of testimonial evidence in general ...

Look, Magoo, the literature review I linked to above is not 'testimonials' - it was put together from dozens of studies related to MCTs and coconut oil - it found these compounds can in fact increase metabolic rate ... the shorter chain compounds enter cells without need for transport, and they burn faster and hotter than other fats. That word 'testimonial' seems to hold magical import in your psyche - you apparently think that calling any argument you disagree with a 'testimonial' proves that it is untrue (even when it is not even a testimonial)!

This has nothing to do with the unreliability of testimonies - it is about an individual patient adjusting their lifestyle to feel better - a big difference, but something you can't understand since it is all so abstract and by the book for you. You deny that the patient can be aware of their own condition, or do anything constructive about their...

"You are welcome to look at a clinical experience backed up by lab results as mere 'testimonials'...This has nothing to do with the unreliability of testimonies - it is about an individual patient adjusting their lifestyle to feel better...you are an abstract semi-entity in cyberspace"

With that last remark you unwittingly demonstrate a big part of the problem with testimonials. We have no adequate way of verifying the personal information you or any other anonymous message board poster might give us. What we can do is check out reliable sources available online. The ones you have given us do not provide backing for the idea of self-diagnosis and experimental supplementation with iodine, coconut oil, or other Perfect Food/cure-all for fatigue that may or may not be of thyroid origin.

Neither your word nor mine, nor that of anyone whose stories we claim to tell can be considered reliable. Testimonials are not enough.

Coconut oil will probably heat you up if cold is the problem, I have found that bacon is the best way to stay warm in the frigid Alaskan winters. Fixing heat does not mean fixing sluggishness however, and certainly not fixing weight gain.

I seem to remember Huckabee saying something recently on his radio program about high fat diets making mice lazy, but that is neither here nor there.

So if your cat is getting on in years, you need to leave out high-fat mouse snacks?

The site the above poster is spamming for contains an expanded version of what has come to be known as the "quack Miranda warning":

"...we are required to inform you that there is no intention, implied or otherwise that represents or infers that our product be used in the cure, mitigation, treatment, or prevention of any disease.

Please be aware that we are unable to "discuss" treatment of medical conditions or compare our product to pharmaceutical drugs. We make no health claims nor can we provide any guarantee that our products will work for your intended purpose. You use our products and information provided here completely at your own risk."

It doesn't sound like they're very confident that what they're selling has any value.

Anyone read Prescription for Nutritional Healing by James E Balch and Phyllis A. Balch?
They have some good advice.