The biomedicine approach is more about reductionism where importance lies in the analysis of a single molecule rather than a holistic format of looking at patterns, symptoms and constitutional types. 

This difference in thinking raised many flagbearers of Iodine like Guy Abraham, David Brownstein, Jorge Flechas who are advocators of using Iodine through food and supplementation in the most knowledgeable and factual way that is not fear-mongering us.

History of Iodine

“Iodine is the rarest of all things: a universal healing agent”

Long before thyroid, there existed Iodine an element dissolved in the dark waters of ancient Mother Ocean since antiquity.

As first forms of life ie algae or individual bacterium floating in the sea had basic molecule of chlorophyll, releasing oxygen which eventually created the earth we are inhabitants of. Since a surprise to many Oxygen is a highly unstable molecule which inserts itself into us giving us life yet deteriorating us slowing from inside. This oxidative damage had to be controlled by protective anti-oxidant and you guessed it right its Iodine to regulate this weathering/aging/burning effects of oxygen. So Iodine in the form of Thyroxine T4 is inseparable in every living being due to its important functions like protecting DNA & RNA proteins so that they can undertake their cellular work and reproduce, development of tissues esp connective tissue, apoptosis (cell death) of mutated cells so protecting against development of cancer. 

Definitely Iodine became a part of the evolution in the organisms even before it became a major part of the thyroid gland that created thermogenesis in us. Eventually birds and mammals developed the use of T3 and its receptors for thermogenic and metabolic purposes.

We contain around 15-20 mg of Iodine of which 30-40% is in the thyroid and of this 80% is stored in the thyroxine(T4) which means it has a function of spreading Iodine through the system and traveling outward from the thyroid to generate heat in the furnace of the cells. The remainder of Iodine is found in the blood, fluids and extracellular matrix (the spaces between the cells and tissues). 

Nutrients Required for the Uptake of Iodine 

1. Zinc – Helps in converting T4 to T3

2. Vitamin C – This vitamin improves cellular metabolism for iodine, making it an extremely important addition.

3. Selenium – De-iodinase enzymes use this to convert T4 to T3

4. Iron – If there is not enough of it, Iodine can be blocked from thyroid receptors

5. Magnesium – Helping in the assimilation of iodine

6. Vitamin B12 – Iodine is required for production of thyroxine and thyroxine is needed for the production of B12

Benefits of Iodine Sufficiency 

Just like in the Goldilocks story, we need Iodine in just the right amount so that there is neither excess nor deficiency of it creating side effects just as we need right amounts of hormones in our body.

• Feeling of well-being
• Prevents fibro-cystic breast disease as breast tissue contains hyaluronic acid, elastins and matrix polymers which are kept healthy by Iodine. Also its concentrated in tissues around the nipples to keep the milk secreted safe for consumption. Acc to Matthew Wood (renowned herbalist) Iodine with hyaluronins, elastin and other matrix polymers are a sacred breast tonic
• Mental clarity and lifting of brain fog. Achieving more in less time. Higher IQ measures at all ages
• Increased energy
• Feeling warmer in cold environments as it brings warmth and circulation
• Needing less sleep
• Disappearance of muscular aches and pains due to strengthening of connective tissues 
• Stronger immune system and resistance to microbial infections, including bacterial (gram-positive & gram negative), viral and protozoan pathogens 
• Improved skin complexion
• Regular bowel movement
• Iodine has been used to thin the mucus i.e. our Extracellular matrix (ECM) which is gunked up with matrix polymers and dead immune and bacterial cells. So ECM needs this constant self cleansing process to keep our cells healthy that are directed and regulated the ECM

Therefore what we see here are the impressive actions of Iodine being an:- 

1. Antioxidant – As iodine is a scavenger for free radicals that are slowing weathering away the cells stimulated by oxygen. Also an anti-oxidant to the extra-cellular matrix inside the body that is why its able to work through the infection, sepsis, oxidation and inflammation.
2. Antiseptic – safe use of Iodine externally has been confirmed by research but it also has been assured that internally it is effective as blood passes through the thyroid gland and Iodine is present there so it will cleanse the blood before it reaches the brain. This is just a Wow moment for me. 
3. Antibiotic – Its action of killing substances on skin has been well received but internally also it can be used similarly plus it does not create any resistance like many antibiotics.

Reasons for Iodine Depletion

1. Soil depletion – This does not occur near the ocean, but can be due to desertification or erosion.
2. Highly Processed Food – It does contain some amount of Iodine therefore insufficient to create the optimum amount of Iodine in the body but just enough to prevent goiter.  
3. Halogens – Like Flouride in tap water, toothpaste compete with Iodine at the receptor level. Even Chlorine is another halogen which is used as water dis-infectant. Bromine was formerly not common, but now it is found in baked goods, soft drinks, plastic, pesticides, medications, and hot tub chemicals. 
4. Goitrogens – Such as grasses like millet, bamboo shoots are potent goitrogens even cruciferous family like canola oil, kale, cauliflower, brussel sprouts, rutabaga, cabbage, turnips, broccoli, milk, soy, tapioca etc but a myth busted here not all goitrogens are created equal so staying away from canola oil, tofu, milk can be a good idea but when cooked, steamed and fermented, these crucifers can be ingested.

Symptoms of Iodine Deficiency

• Cognitive decline, reduced intelligence, brain damage. A reduction of up to 13-20 IQ points in infants and children, even when no other symptoms are present. Sufficient iodine is essential during pregnancy and lactation. Iodine deficiency also affects adult intelligence (up to 15 IQ points) and brain function. This size of IQ decline is enough to prevent problem solving, inhibit the ability to learn and study, change the kind of job a person can do, and totally affect your productivity and quality of life. Depression is also considered as one of the signs of Iodine
• Fatigue – Iodine deficiency can cause abnormal pituitary-adrenal function as well as low thyroid function
• Fibromayalgia is caused primarily by an excess of fluorides and other goitrogens in the body
• Hashimotos and Graves could also be caused due to deficient or excess of Iodine*
• An increased incidence of anti-thyroid antibodies may lead to subclinical infections, gluten intolerance or food allergies
• Iodine is necessary for healthy breast and ovary tissue because of its effect on estrogens. Its deficiency can cause excessive estrogen and heavy periods, breast cancer, ovarian cysts, polycystic ovary syndrome and fibrocystic breast disease (painful breasts with nodules and cysts which are more symptomatic prior to menstrual periods). Fibrocystic diseases and ovarian cysts may reverse with sufficient iodine
• Infertility
• Hearing loss, including if the mother is deficient during pregnancy
• Aches and pains around the body, most noticeable in muscles and joints
• Infections – Ongoing subclinical infections from a compromised immune system. Iodine plays a role in protecting against bacteria, fungi and protozoa. Fungal infections such as candida/thrush, tinea, nail infections, bacterial and protozoan infections in the gut, and a variety of other chronic infections
• Build-up of fluorides, bromides and heavy metals (mercury, cadmium, lead). Iodine is one of a group of similar elements (halogens) including bromine, chlorine and fluorine. Halogens compete with each other in the body, particularly in the thyroid gland. Unfortunately bromine, chlorine and fluorine are toxic. When there is a deficiency of Iodine, the other halogens build up, causing hypothyroidism. Most of us are deficient in Iodine and in a constant state of halogen toxicity. The good news is that when sufficient iodine is present, the other halogens are excreted from the body, along with other toxic heavy metals such as mercury, cadmium and lead.
• Irregular mood or metabolism
• Indirectly, obesity and weight gain. Bromides make it difficult to lose weight once body fat starts to build up an accumulation of bromides, which are fat-soluble. Iodine displaces bromine, and having good iodine sufficiency makes it a lot easier to lose weight in this situation
• Cardiovascular diseases – Lipoprotein is a sticky substance as that produces arterial plaques from blood platelets, calcium and fibrin. Sufficient Iodine may reverse this lipoprotein build-up
• Cancer and prostate disease
• Hot flashes and other peri-menopausal symptoms
• Lung diseases – Iodine has been used successfully for treatment of asthma, bronchitis, viscous phlegm and other pulmonary ailments
• Weak digestion along with lack of stomach digestive acid production
• A tendency for cysts and skin tags
• Dry eyes, dry mouth, dry skin
• With severe deficiency of the essential trace element, it can causes goitre – a swelling of the thyroid gland. Long-term deficiency causes cretinism – stunted growth, mental retardation and many other health problems

Iodine Supplementation – A Goldilock Nutrient

The American FDA set the RDA (recommended daily allowance) for iodine consumption in 19xx at 150 mcg per day for adult men and women, 200 mcg for pregnant women, and 290 mcg for lactating women. Many credible researchers say that larger doses are needed for optimal health, functionality, longevity and protection.

1. Seaweeds are the best sources for iodine supplementation but vary according to different species :-

a. Bladderwrack (Fucus Vesiculosis, Fucus spp) – It contains di- iodotyrosine (DIT), an immediate precursor of the thyroid hormones Thyroxine T4 and Tri-iodothyronine T3. Indeed, Fucus seems particularly effective in treating early stage hypothyroidism where women were on low thyroid medications and often forget to take medications without significant symptoms, therefore in such cases may completely resolve hypothyroidism. (How do I know this? empirical experiment)

Small pieces can be eaten with food or in encapsulated powdered form but around 3-5 grams should be sufficient. Also its helpful with sore achy muscles and cartilage growth as well prevent further inflammation of the prostate gland. 

b. Kelp & Kombu – They are the richest sources of iodine as  they contain 1500-2500 mcg/gm of dried seaweed but there are others that you can be mindful of when to use which one. Other sea veggies include like Hijiki  which contains 629 mcg/gm, Dulse 72 mcg/gm, Wakame 32 mcg/gm and Nori 16 mcg/gm can be useful when your main source of iodine is through food.

2. Iodine-Rich Food – Though culturally people also consume fish heads as they contain thyroid gland as well blood pudding, blood sausages from animals free of pesticides and hormones as it provides small but significant amount of iodine alongwith other nutrients. Eggs, fish, milk are also some of the sources.

3. **Lugol’s Solution – The most oldest Iodine founded by Jean Lugol in 1829, the solution contained 1 part Iodide and 3 parts potassium iodide which makes Iodine freely available. It has a total Iodine content of 126.5 mcg/ml. Which is round about 6.5 mcg per drop. So this widespread medicine claiming many successes suddenly got a bad reputation when medical industry started advertising cheaper medicine which discredited how miraculous this liquid Iodine can be. 

Can be used in cases where mucus is a complication like emphysema, bronchial asthma and bronchitis.

Topically it can be used for skin blemishes, keratosis, moles and other skin blemishes applied very cautiously. Use it at night before bed because the brown patches can remain for several hours.

****Note – When using internally go low and slow with 1 drop in a glass of water for few weeks and if you feel there is no effect then increase it gradually for eg 10 drops for people who are non-obese but suffering from serious Iodine deficiency at least for 3 months so that the body can reach Iodine sufficiency. People who are obese or have a poor ability to absorb iodine might need it for a year. 

4. **Nascent Iodine – It in liquid form and more bioavailable than the previous one because it holds electromagnetic charge when consumed. If using Nascent Iodine similar dosages are recommended.

**Please work with a healthcare who is Iodine literate so that there is no issue of over-dosing with Iodine liquid doses. It should not typically be used during pregnancy or breastfeeding. 

Iodine & Selenium Synergy 

If you are trying to have Iodine sufficiency, make sure to supplement or eat selenium rich foods like brazil nuts atleast 4-5 because when there is high Iodine in the body, thyroid conversion from T4 to T3 will create hydrogen peroxide which is a free radical and needs selenium to neutralize it. So if you daily intake of iodine is around 200 mcg but you have exceeded that limit then its always prudential to take 600 mg of selenium to combat that oxidative damage.

Tests for Iodine Levels

1. Iodine patch test – This is a quick, rough, simple, inexpensive test. Paint a 5 cm (2 inch) square of iodine tincture (such as Lugol’s solution) onto your inner arm or thigh. If the stain disappears or almost disappears:

• In less than 5 hours, then you are almost certainly extremely deficient.
• In less than 10 hours, then you are probably deficient.
• In less than 24 hours, then you may be deficient.
• remains or only slightly lightens after 24 hours then your levels are considered normal.

You can repeat this test every couple of weeks to see when your iodine dose can be reduced.

2. Iodine urine test – Take 4 iodine tablets (12.5 mg each) or 8 drops of Lugol’s solution in half a glass of water. You will need a laboratory or test kit to monitor the iodine in your urine during the next 24 hours. If you have sufficient iodine, 90% of the 50 mg dose will be excreted during the next 24 hours. If iodine is lacking the body retains most of it with little appearing in the urine. 

Symptoms of Excess Iodine 

When Hashimotos patients consume excess Iodine, initially it can make them feel good but later they crash and feel worse because Iodine makes thyroid produce a lot of hormones initially but without selenium and antioxidants it can harm the thyroid tissue and destroy it.

Some of the side-effects, contraindications and symptoms of excess iodine include:-

• Unpleasant brassy taste.
• Increased salivation and sneezing
• Headaches in the frontal sinus.
• Acne-like skin lesions.
• Reduced sex drive / libido.
• Insomnia in the form of an irritable excess energy. This only affects a few people. Some actually sleep better. Try not to take the iodine at night, rather, take the biggest part of the daily dose in the morning, and the remainder in the afternoon.
• A faster pulse than normal, with atrial fibrillation in the worst case. Iodine is a heart stimulant so if you are using thyroid medication or other stimulant drugs then that may be too much stimulation and heart palpitations may develop. In this case reduce the stimulants sufficiently to rectify the problem.
• Heat intolerance, increased body temperature without having a fever, excessive sweating.
• Cloudy urine and body odour are temporary effects as halogens are excreted from your body. In severe cases, the chelation of halogens, aluminium and heavy metals can make you feel ill. In this case, lower the dose.
• In rare cases, often related to breast disease / cancer, breast milk can turn yellow as accumulated bromides are excreted too quickly.
• Gut biome – Daily supplementation with orally-taken Iodine for a period of weeks or longer will probably damage the gut microbiome, because iodine is a potent antibiotic.

My Final Thoughts 

I wanted to bring Iodine into the limelight because there is so much of fear mongering around this subject from many practitioners and many iodophobics who are on the far end of the spectrum demonizing iodine which had to be demystified. I am at neither side of the spectrum rather I keep an open mind which is also the reason why I was keen on writing this blog about this God given mineral that we all can’t live without. 

There are many instances where clients suffering from Hashimotos do try high doses of Iodine out of desperation, thats like putting gasoline on fire because of too much oxidative stress on the thyroid gland, therefore it is recommended to stay away from Iodine supplementation in various multivitamins, in drop doses etc, but then again you can always go low and slow with food like quantities sprinkling sea veggies over stews and soups and blood sausages as for me Food as Medicine comes first than anything else.

With so much love for this subject, in the end I had to put forth the positives and negatives of Iodine to give back the power in your hands and to use your own your discernment that how judiciously would you use Iodine in your daily life. 

Listen to your body and take cues from it. It knows everything!

References:-

https://pubmed.ncbi.nlm.nih.gov/26361258/

https://pubmed.ncbi.nlm.nih.gov/28290237/

http://www.ncbi.nlm.nih.gov/pubmed/19772817

http://www.ncbi.nlm.nih.gov/pubmed/24742364

Iodine, The Universal Nutrient. Guy E. Abraham., 2007

 Iodine Replacement in Fibrocystic Disease of the Breast. Ghent, W.R., Eskin, B.A., Low., D.A., et al., Can. J. Surg., 36:453-460, 1993

Orthoiodosupplementation: Iodine Sufficiency Of The Whole Human Body. Abraham, G.E., Flechas, J.D., Hakala, J.C., The Original Internist, 9:30-41, 2002

Optimum Levels of Iodine for Greatest Mental and Physical Health. Abraham, G.E., Flechas, J.D., Hakala, J.C., The Original Internist, 9:5-20, 2002

Bernecker C. Intermittent therapy with potassium iodide in chronic obstructive diseases of the airways. A review of 10 years experience. Acta Allergol. 1969 Sep;24(3):216-25

Iodine Supplementation Markedly Increases Urinary Excretion of Fluoride and Bromide.Abraham, G.E., Townsend Letter, 238:108-109, 2003

Orthoiodosupplementation in a primary care practice. Flechas, J.D., The Original Internist, 12(2):89-96, 2005

Iodine in Medicine and Pharmacy Since its Discovery – 1811-1961. Kelly, Francis C., Proc R Soc Med 54:831-836, 1961

Iodine Deficiency and Therapeutic Considerations. Patrick, Lyn., Alternative Medicine Review, Vol 13, No. 2, 2008

Books – Iodine: Why You Need It, Why You Can’t Live Without It by David Brownstein

The Iodine Crisis by Lynn Farrow