Signs and Symptoms of Iodine

Iodine is one of the essential trace minerals that is required by the body for its optimum functioning. About 50 to 60 percent of the body’s iodine is stored in the thyroid gland; the rest is distributed throughout the body, especially in ovaries, breast and prostate tissue, muscles, and blood. It is required for making vital hormones like thyroid hormones Triiodothyronine (T3) and thyroxin (T4). Thyroid hormones control the body’s metabolic rate that can influence energy production and body temperature. They are also required for primary enzymatic reactions, protein synthesis, and hormonal regulation. Thyroid function influences the breakdown of fats and proteins, adrenal gland hormones, nerve conduction, muscle function, reproduction, hair health, skin, cellular oxygen use and bones.

Its role is not only limited to thyroid but also regulates the synthesis of all the major hormones in the body by its catalyst properties. In addition, iodine plays a pivotal role in bone health, regulation of immune response, development of the fetal brain, maintenance of cognitive functions and protecting against multiple infections.

Women require higher iodine amounts during periods of puberty and pregnancy. Insufficient iodine can lead to symptoms such as fatigue, dry skin, increased blood fats, brain fog, bowel irregularity, hoarseness, and delayed reflexes. It can also detoxify the body system by removing many heavy metals like lead, cadmium, mercury, and bromide. During pregnancy, if a woman is deficient in iodine, it can induce spontaneous abortion and interfere with normal fetal growth causing mental retardation and organ anomalies. Its deficiency is also associated with child deafness and its toxic levels can cause serious hyperthyroid symptoms. A normal concentration of iodine is crucial for achieving and sustaining finest levels of health.

Iodine has got both therapeutic and preventive qualities; prevents the body from disordered hormones, weakened immune system and has been proved useful in treatment of mammary dysplasia, atherosclerosis, ovarian diseases, and fibrocystic breast disease.

Iodine was discovered by Bernard Courtois in 1811 and he named it after a Greek work ‘iodes’ which means violet; raw iodine compound is violet in color. Iodine is most abundantly found in the ocean and is readily soluble in water. It is scarcely found in earth crust and solar system; being the 62^nd most common element in earth-crust. Naturally, iodine is found in two main forms; radioactive iodine and non-radioactive iodine. Radioactive iodine has diagnostic value and is used in diagnosing and treating thyroid disorders. Non-radioactive iodine is found in seaweed most abundantly and can be ingested to maintain normal quantities of this precious mineral.

How prevalent is iodine deficiency?

Unfortunately, iodine deficiency still remains a global health issue affecting more than 2 billion people worldwide of which 25 million are children of school-going age and 50 million have pronounced clinical symptoms of iodine deficiency like goiter. It affects the population of all age groups; growing children, pregnant and lactating mothers being the main victims. In US, NHANES (National Health and Nutrition Examination Survey) data about iodine levels have shown a fall of more than 50% over the last 40 years. Goiter has an average of 4.7% prevalence due to iodine deficiency; making it even higher in some states like Michigan.

Iodization programs have been running worldwide but they have given a cover to about 71% of the population only. It is important to note that the global campaign of iodized salt has also not been very successful in removing iodine deficiency. After a series of studies, it has been established that iodized salt alone is not the ultimate solution to overcome iodine deficiency. According to David Brownstein, the iodine guru, it is recommended to take unrefined (Himalayan or pink salt) in place of white refined salt as it has been processed which harmful chemicals and have lost all the important key minerals. World health organization (WHO) says that more than 20% of the world population is deficient in iodine intake.

How much iodine is required in a day?

On average, 150 micrograms of iodine is required for both males and females in a day. However, the RDA (recommended dietary allowance) for children and lactating mothers is higher than average adults. After research, the institute of medicine has set the RDAs of iodine for both males and females as:

Birth to 6 months of age: 110mcg
7 months to one year: 130mcg
Age 1 year to 8 years: 90mcg
Age 9 to 13 years: 120mcg
Age 14 years and older adults: 150mcg
Pregnant females: 220mcg
Lactating mothers: 290mcg

WHO and UNICEF have recommended a slightly higher level of 250mcg for pregnant ladies to rule out the possibility of iodine deficiency.

What are the rich sources of iodine?

Iodine is not made in the body so it’s mandatory to eat healthy amounts of this mineral for optimal functioning of its systems. Unlike most of the minerals, it is not readily available in foods. Iodine is rarely found in its elemental form and is present in salts like sodium iodide and potassium iodide. This iodide is absorbed from gut and taken by thyroid for its conversion to its active form. This is the reason that iodine has been added to table salt to get over its deficiency. Iodine is added in ‘iodinated salt’ as potassium iodide which amounts to 77ug/gram of salt.

Foods are still the most convenient and natural way to replenish iodine stores of the body. Adequate quantity of iodine is found in those foods that are based in iodine-rich environments like ocean. Some of the major food items with adequate amounts of iodine can be listed as follows:

Seaweed
Ready to eat cereals and grains (bread)
Fish (cod & tuna)
Dairy products (milk, yogurt, cheese)
Iodized salt
Kombu Kelp and Wakame (dried seaweed)
Shrimp
Prunes
Lima beans
Eggs
Poultry
Meat

Signs and Symptoms of Iodine Deficiency

Iodine is necessarily required by the thyroid gland to make thyroid hormones. In absence of adequate amounts of iodine, the functioning of thyroid glands is compromised culminating in lesser production of thyroids hormones. Less than normal levels of thyroid hormones lead to a group of unhealthy signs and symptoms known as hypothyroidism. Iodine deficiency can cause serious issues in pregnant ladies and their fetuses as it is required for brain formation and normal speed of growth. Its deficient quantities can render a child mentally retarded for life. The other major manifestations of iodine deficiency can be listed as:

Goiter or neck swelling (commonest): In iodine deficiency, the thyroid makes less hormone and brain receives the signal of this depressed level and releases the thyroid-stimulating hormone to induce the thyroid gland for more production. In absence of iodine, thyroid cannot meet the demands and keep on working at a fast pace resulting in swelling. If iodine is not supplemented, this vicious cycle of brain stimulation and overdoing by thyroid glands ensues. There comes an exhaustion point where thyroid loses its healthy tissues and gets destroyed causing even more serious deficiency of thyroid hormones in the body.
Weight gain: Deficiency of iodine causes deficient thyroid hormones which slow down the metabolic rates resulting in less energy utilization. The calories get accumulated in the form of fat leading to excessive weight gain.
Easy fatigability: A compromised metabolic rate cannot cope up with routine body processes and results in fatigue.
A consistent feeling of weakness: Low energy levels due to slowed biological cycles cause weakness and lethargy. The body fails to burn its fat and produce the required energy.
Hair loss: thyroid hormones play an important part in protein synthesis and hair requires those proteins for their strength and regeneration. Loss of proteins causes loss of hair.
Dry and scaly skin: Thyroid keeps on helping the skin to maintain its elasticity and moisture by replenishing its proteins which get lost in its absence leaving dry and flaky skin.
Cold intolerance: The slowed pace of metabolism produces less heat and body cells get more sensitive to cold.
Slow heart rate: Iodine causes slowing of heart rate causing lightheadedness and occasional fainting.
Brain degeneration and cognitive issues: Iodine is inevitable for a healthy brain and its lowered quantities damage the brain in the long term.
Disturbed menstrual cycle like heavy periods: Adrenal hormones are also disturbed by iodine deficiency which may cause heavy periods and other unpleasant changes in females’ monthly cycle.
Pregnancy issues like abortion and IUGR (intrauterine growth retardation): A pregnant lady needs a higher concentration of iodine as she also has to supplement her growing child. In iodine deficiency, natural enzymatic pathways are disturbed, hormones balance is lost and both the mother and baby are negatively affected.
Low IQ levels in school going children: Children need iodine for their proper growth and iodine deficiency interferes with their brain development and cognitive capacity.

Can a high level of iodine harm the body?

Just like iodine deficiency, more than a certain level of iodine causes iodine toxicity that is also harmful to body. According to the Linus Pauling Institute, there should be intake of no more than 1100mcg of iodine in a day so it should be consulted with a doctor before going for iodine supplementation. A higher than normal intake of iodine will stimulate the thyroid to make extra quantities of thyroid hormones which can damage the gland itself in addition to harming multiple organ systems. Iodine poisoning, just like iodine deficiency, can also cause goiter as gland keeps on working at a faster pace and gets inflamed and burned out.

The side effects of iodine poisoning depend on the quantity of iodine and can range from being very mild to seriously grave. Such side effects can be summarized as:

Burning of mouth
Nausea and vomiting
Diarrhea
Flushing of face
Swelling and edema of airways
Palpitations
Vertigo
Coma

It is a medical emergency and medical assistance should be sought as earlier as possible to avoid the possible consequences.

How to check iodine levels in the body?

If there is a suspicion of the iodine deficiency of iodine toxicity, body should be tested to get an accurate or near accurate concentration of iodine. Here are the different methods of iodine testing to get an estimated amount of iodine in the body:

Iodine patch test:

This is an old, inexpensive and easy method of checking the body’s iodine status. Part of a body (usually arm) is painted with an iodine solution and its appearance is checked after 24 hours. If body contains normal amounts of iodine; the iodine mark does not fade away within 24 hours and can be seen after a time period of one day. However, if a body is deficient in iodine, it will absorb the painted iodine and mark will fade away within 24 hours. Although it’s a convenient way of testing iodine, it’s not the authentic one. Only 20% of the body’s iodine is present in skin and hence, its reaction cannot be labeled as whole body reserves.

Urine strip test:

This is a quick way of checking the presence of iodine in urine but it’s not the authentic one.

Iodine Blood test:

It is a more accurate method to check the concentrations of iodine in the blood that can give a close estimate to the whole body reserves of iodine.

Iodine loading test- 24-hour urine test:

This is the most authentic way to check iodine levels in the body and it was developed by dr. Abraham about 10 years ago. The person is given an iodine tablet of 50mg as the loading dose of iodine and its urine is collected for 24 hours and then checked for iodine concentrations. Since iodine is 95% removed by the kidneys in the urine, 24 hours collections of urine after loading dose of iodine will show the iodine status. If body is deficient in iodine, it will absorb more of the loading dose and less with appear in urinary collection. In contrast, if body is maintaining good levels of iodine, it will excrete the maximum of the loading dose in the urine. Anyhow, this test is a bit troublesome due to collection of urine for 24 hours.

What is the role of iodine-like elements on the body? How do other halides interact with iodine?

Iodine belongs to a group of elements that share the same chemical properties and form salt-like compounds with sodium, potassium and other metals. This group of non-metal elements is known as halides (iodide, bromide, chloride, fluoride) or halogens and includes bromine, fluorine, chlorine, astatine, and iodine. Iodine is the only mineral that is required by the body and all remaining halogens are toxic towards body tissues. There are numerous detrimental effects of halides in a number of body organs from iodine blockade to breast cancer.

The blockade of iodine: Since all the halogens are same in structure so they can compete for the receptor sites in the body. If iodine is deficient or any other halide is in excess quantities, the iodine receptors will be occupied by the toxic halide(bromide) and iodine will get blocked in spite of being there in the body. This is the more pronounced and clear toxic effect of these chemicals that can deprive iodine of its receptors and get attached to its place instead. When the receptor sites are blocked, enzymes will get down-regulated and all the biologic cycles involving iodine are disturbed. The only solution to avoid this issue is to maintain healthy levels of iodine and avoidance of remaining all halogens as possible. If there is some kind of toxicity by any halogen other than iodine, iodine should be supplemented in fair amounts to get back its receptor sites and normalize the metabolic processes.

The toxic effects of Bromine: Bromine has similar size and shape to iodine and can occupy its receptors on thyroid causing auto-immune thyroid diseases like Hashimoto’s thyroiditis and Graves’ disease making it an established goitrogen. Bromine is stable in its reduced form bromide so it’s used as a disinfectant in pools, spas, and hot tubs; hence an easy chance to get in contact with the bodies. It is also used as pesticide spray on crops thus increasing its concentration in those crops. In the past, it was also used in anti-epileptic drugs for seizures and has been greatly phased out from them because of its established harms. Unfortunately, it is also used in some bakery items as a dough conditioner and interior of the cars. Bromine toxicity (brominism) can cause tremors, arrhythmias, double vision, muscular cramps, mental retardation, schizophrenia, hallucination, dizziness, and apathy. It’s important to consider it as a toxin and should be avoided as far as possible.

The toxic effects of chlorine: Chlorine is another toxic halogen that is present in its halide form chloride in the extracellular fluid of the body. Chlorine is extensively used to disinfect municipal water supplies. Chlorine can enter the body through drinking or absorption of this chloride water. Being a strong anti-microbial agent, it can kill and disturb the gut bacteria. One of the byproducts of chlorine is dioxin which is a toxic carcinogen associated with birth defects, reproductive issues like stillbirth, immune disruption, and cancer. Try to filter this chlorinated water to avoid its contact with the body.

The toxic effects of fluorine: You might have seen a large number of commercials advocating the importance of fluoride (halide of fluorine) in dental carries and teeth cavities. Well, news flash. There is no authentic data to prove this claim. Anyhow, studies have shown its association with thyroid cancer. It binds the iodine receptors on thyroid and interferes with its ability to concentrate on the thyroid gland leading to hypothyroidism, higher levels of TSH and increased risk for thyroid cancer. Fluorine toxicity can cause discoloration of teeth (dental fluorosis), low IQ, kidney toxicity, hip fractures, weak immune system, and weak bones.

The epidemiological studies have concurred the fact that bromide and fluoride levels were higher while iodine levels were lower in breast cancer. Bromide levels were found to be significantly high in females with breast cancer in comparison with healthy women. Hence, iodine should be supplemented and other halides should be avoided to decrease the risk of breast cancer.

Different kinds of iodine:

In order to achieve the maximum benefits of iodine, it has been prepared and used in different forms. Different parts of body have different kinds of receptors for iodine forms so it’s understandable that different types or combinations of iodine will give best results. For example, thyroid uses iodide form while breast uses iodine form. If only one form of iodine is used, it will not give maximum results. Hence, multiples forms of iodine have been prepared and the prominent ones include:

Sodium iodide
Potassium iodide
Lugol’s iodine

Sodium iodide and potassium iodide are used for iodine supplementation to make up the iodine deficiency and enhance the thyroid function at its best. Lugol’s iodine was created by Dr. Lugol in 1829 by mixing 5%iodine with 10% potassium iodide. This amazing combination has been very effective in addressing multiples issues with the same solution.

Medical Uses of Iodine

Due to its anti-microbial and anti-fungal qualities, iodine has been traditionally used on skin and nails to cure different kinds of infections. It’s available in Lugol’s solution form that can be applied topically to gets its benefits. Here are a few medical uses of iodine:

Detoxification: Iodide has the ability to bind and excrete excess amounts of heavy metals like mercury and lead along with toxic halides like bromide and chloride. The only requisite is its adequate concentration in the body.

Minor cuts and abrasions: Being an effective anti-bacterial, it can disinfect and treat minor cuts. Tincture of iodine is still used after circumcisions and superficial wounds.

Foot ulcer and cracked heels in diabetics: diabetics who have lost pain sensations in feet and are susceptible to foot injuries and ulcers can get benefit from iodine. It will prevent it from being infected. However, it should be cared not to use it in deep wounds.

Conjunctivitis: Studies suggested the fact that iodine solutions (povidone-iodine) are superior to silver nitrate to treat conjunctivitis.

Fungal infections: iodine is also very effective in stopping the growth of fungus in skin and nails. Light concentrations are good enough to heal it. It may take some time to heal but worth trying it.

Before using topical iodine, any chances of allergic reactions should be ruled out. The practice of using iodine as a topical drug has been minimized to avoid the possible risk of iodine toxicity as iodine can get absorbed from the tissue into blood to cause harmful effects. In addition, cherry angioma, breast pain, soreness of mouth and large breast has been shown to be linked with iodine deficiency and bromide toxicity. Iodine supplementation in this regard will also cure the given symptoms.

While taking iodine; don’t forget to take selenium – The concomitant effects of iodine and selenium:

Selenium is a wonder element with powerful antioxidant qualities. Just like iodine, selenium is another trace element that is essential for better health due to its role in thyroid regulation and iodine metabolism. It cannot be manufactured in the body and should be supplemented by food at the RDA (recommended daily allowance) of 55ug per day. Selenium deficiency may occur because of its inability to get absorbed in gastrointestinal issues like Crohn’s disease and surgical resection of gut. Its deficient levels have been linked with arthritis, HIV progression, cardiomyopathies and death from lungs or colon cancer. The exact mechanism of this association is not known yet and it is thought that loss of antioxidant role of selenium might be the underlying reason. Selenium helps to tackle a lot of toxic load via an enzyme called glutathione peroxidase.

Here are the selenium-rich foods to minimize the risk of selenium deficiency:

Brazil nuts
Tuna
Beef
Cod
Turkey
Whole wheat bread

Meat and whole-grain bread are the common sources of selenium for the American population. However, it should be taken care to avoid excessive intake of selenium that is more than 400ug in a day. At this toxic dose, selenium can cause irritability, nerve damage, hair loss, and garlic breath. Selenium levels can be checked by hair and nails to ensure the normal range of concentrations.

Why is selenium so important for iodine?

Selenium controls more than ten vital enzymes and reactions; those are not possible in its absence. Two of these important enzymes include:

Glutathione peroxidase
Iodothyronine deiodinases

Glutathione peroxidase removes the free radicals and oxidants by reducing the harmful hydrogen peroxide to water. This conversion is not possible without selenium.

Iodothyronine deiodinases are another group of enzymes that can activate and deactivate thyroid hormones by removing or inserting an iodine molecule. For example, they can activate the inactive T4 from thyroid to active T3 in blood. Selenium and selenoenzymes catalyze this conversion and hence it performs a concomitant role in thyroid regulation. In absence of selenium, iodine is of no use as thyroid hormones cannot be activated to their activated form. Hence, don’t forget to think about selenium when you plan to supplement your iodine for a better functioning thyroid gland.
Iodine and the Celtic salt:

Celtic salt is the naturally occurring sea salt in the clay ponds near the shores. It is a grey colored substance that has not been processed and is purely natural. It is said that Celtic salt contains more than 85 trace minerals including iodine, magnesium, zinc, potassium, and manganese. Due to its natural ingredients, Celtic salt can help in digestion and improve enzymatic activity of the body.
However, it is not a rich source of iodine and you can’t rely on Celtic salt solely to achieve the RDA of 1500mcg per day.

References:

https://ods.od.nih.gov/factsheets/Iodine-Consumer/#h4

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284174/

https://www.thyroid.org/hypothyroidism/

https://www.sciencedirect.com/science/article/pii/S1021949814000155

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691155

http://www.jstor.org/stable/10.1086/345361

https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/#h3

https://lpi.oregonstate.edu/mic/minerals/iodine

http://nutritiondata.self.com/facts/dairy-and-egg-products/111/2

http://www.umm.edu/health/medical/altmed/supplement/iodine

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976240/