Iodine is a controversial subject for hypothyroid patients. One of the most classic signs of iodine deficiency is an enlarged thyroid gland and goitre: on the other hand, people with Hashimoto’s disease often develop a goitre that can be aggravated by supplementing with additional iodine, especially in large doses.
What is Iodine?
Iodine is a trace mineral element found in food, that combines with the amino acid tyrosine in the body to produce thryroxine (T4) and triiodothyronine (T3). These are the key thyroid hormones.
Isn’t the Hashimoto’s Treatment an Iodine-based Drug?
Levothyroxine – the standard treatment for Hashimoto’s disease – is a synthetic version of thyroxine (T4). This hormone is made in the body itself, by the thyroid, from a synthesis of iodine and tyrosine. When you take Levothyroxine, you are absorbing the hormone (the already-synthesized tyrosine and iodine combination). You are not taking iodine.
Treatment for Hashimoto’s consists of taking thyroxine (marketed as Synthroid, Levoxyl, Levothroid, Unithroid, etc), which will convert to the active hormone –T3 – within the body, to boost the metabolic system. In Hashimoto's patients the drug also slows the auto-immune attack, alleviates symptoms, and shrinks any goitre.
Why Isn't my Thyroxine Working?
Isn’t Iodine Good for Hypothyroid Conditions?
Hashimoto’s thyroiditis is an auto-immune disease that ultimately leads to a condition of hypothyroidism, among other things – it manifests in many different ways. The disease is not caused by a lack of iodine, but by a case of mistaken identity within the immune system. In Hashimoto's the body recognizes the thyroid antigens as foreign, and sets off a chronic immune reaction, resulting in lymphocytic infiltration of the gland and progressive destruction of the thyroid tissue. As the thyroid is destroyed, Hashimoto’s patients become hypothyroid. But they may have Hashimoto's disease for many years without being hypothyroid – this condition only occurs when the auto-immune attack sets about destroying the thyroid itself.
Hashimoto's is not due to iodine deficiency, and supplementing with iodine is most likely to make matters worse, by aggravating the already weakened thyroid gland. During the progression of the disease, nodules form in the thyroid, and these can either be "hot", and take up iodine more rapidly than normal, or "cold" and not take up iodine at all. Any nodules are usually identified first by ultrasound, and then by a radioactive uptake scan. This determines their type and uptake, and will help identify any potentially cancerous nodules.
What Happens if a Hashimoto’s Patient Takes Iodine Supplements?
Some people find that they have an “iodine crash”, where the thyroid enlarges (becomes “angry”), is extremely tender, and the whole body becomes shaky and exhausted for several days. Luckily the reaction is normally so severe – and obvious – that you would be unlikely to repeat the experiment. If you ever find yourself having a strong reaction to a supplement, check whether it contains iodine – often included in the form of a seaweed such as dulse or kelp. Some multivitamins include iodine.
Can I Eat Seaweed?
In small amounts. The occasional sushi is not a problem. Iodine is found in seaweed, shellfish, white deep-water fish and certain vegetables, including garlic, chard, spinach, and mustard and turnip greens, lima beans, sesame seeds, and soybeans. The iodine ingredient in food does not seem to aggravate a Hashimoto’s thyroid in the same way as it does when administered in supplements, but it is still a good idea not to overdo it in the diet.
Links
The Truth About Hashimoto's Disease
The Marshall Protocol – a Cure for Hashimoto's?
References
1 Mary Shomon, http://thyroid.about.com/cs/vitaminsupplement/a/iodine.htm
2 Duygu Yazgan Aksoy, et. al. "Effects of Prophylactic Thyroid Hormone Replacement in Euthyroid Hashimoto's Thyroiditis" Endocr J (Japan) Vol. 52: 337-343, (2005).
3 Levothyroxine sodium (Levothyroxine Sodium) tablet information, Lannett Company, Inc.
Sarah Tomley - Sarah is an editor and writer who has been working in the UK publishing industry for over 18 years. She has an honours degree in ...
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