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Is Iodine Safe To Take In People With Hyperthyroidism?

There is a lot of controversy when it comes to iodine supplementation in thyroid and autoimmune thyroid conditions.  When it comes to hyperthyroidism and Graves’ Disease, most endocrinologists will advise their patients to avoid iodine.  On the other hand, while some natural healthcare professionals also recommend for their patients to avoid iodine, others advise their patients with hyperthyroidism to take iodine.  What I’d like to do is use this post to answer some of the most common questions people have about iodine supplementation in those with hyperthyroidism.

Question: Since Iodine Is Involved In the Production Of Thyroid Hormone, And Hyperthyroidism Involves An Excess Of Thyroid Hormone, Isn’t It Wise For People With Hyperthyroidism To Avoid Iodine?

Answer: Although it’s true that iodine is necessary for the formation of thyroid hormone, this doesn’t mean that everyone with hyperthyroidism should avoid iodine.  First of all, remember that most people with hyperthyroidism have Graves’ Disease.  And although this condition involves an excessive production of thyroid hormone, the reason for this is due to the autoimmune component.  It’s the TSH receptor antibodies which stimulate or attack the TSH receptors, which in turn results in the overproduction of thyroid hormone.  Giving someone iodine doesn’t mean the thyroid gland will produce even more thyroid hormone.  In fact, in the past, medical doctors actually recommended Lugol’s solution as a treatment for hyperthyroidism and Graves’ Disease.

Question: Can Taking Iodine Worsen One’s Hyperthyroid Condition?

Answer: It is possible, although in most cases iodine supplementation doesn’t cause problems in people with hyperthyroidism.  However, if someone doesn’t take the proper precautions then there is a chance that iodine can exacerbate the autoimmune response in people with Graves’ Disease.  I discussed this more in the article I wrote entitled “Can Taking Iodine Cause An Autoimmune Thyroid Condition? [1]”  During the formation of thyroid hormone an oxidation reaction takes place, and this is why antioxidants such as selenium and vitamin C are necessary to take.  Plus, there does seem to be some people who just don’t do well when taking iodine.  But just as is the case with everything else, it comes down to the risks and benefits.  And if the proper precautions are taken then the benefits of iodine supplementation usually outweigh the risks.

Question: Can Taking Iodine Cause A Hyperthyroid Condition?

Answer: As I mentioned before, iodine can potentially exacerbate the autoimmune response if the proper precautions aren’t taken, and this in turn can worsen one’s condition.  And it can also trigger an autoimmune response for those people who don’t have an autoimmune thyroid condition, thus potentially leading to the development of Graves’ Disease.  In fact, I’ve spoken with a few people who think their condition might have been triggered by iodine supplementation, although I think it’s safe to say that most cases of Graves’ Disease aren’t caused by supplementing with iodine.  And with regards to iodine directly causing hyperthyroidism, in most cases someone would have to take very large doses of iodine for this to happen.

With that being said, some euthyroid people do experience hyperthyroid symptoms upon supplementing with iodine, and sometimes this happens when low doses are taken.  Plus, there have been a couple of publications which showed that kelp might have caused iodine-induced hyperthyroidism (1) [2] (2) [3].  One of these reports involved a 39-year-old woman who already had multinodular goiter and drank kelp-containing tea, and developed hyperthyroid symptoms.  The other situation involved a 72-year-old female who developed hyperthyroidism while consuming kelp supplements.  However, in most cases when you read about iodine-induced hyperthyroidism in the literature, this is usually the result of taking organic forms of iodine-containing drugs (3) [4].

Question: Should Everyone With Hyperthyroidism Take Iodine?

Answer: Those who have read past articles and posts that I’ve written on iodine know that I’m pro-iodine.  However, this doesn’t mean that I recommend for everyone with hyperthyroidism and Graves’ Disease to take iodine.  In fact, before I recommend iodine to my patients I think it’s a good idea to test for an iodine deficiency.  And then if someone is deficient in iodine I recommend for them to start taking small doses of iodine, and to make sure they take antioxidants such as selenium and/or vitamin C, along with magnesium, and the B vitamins.

Question: What Form Of Iodine Do You Recommend?

Answer: Many healthcare professionals recommend Iodoral.  I like Iodoral, but the smallest dose you can take is 12.5mg.  I commonly recommend Prolamine Iodine to my patients, which comes in doses of 3mg.  This is still well above the RDI, but approximately 1/4 of the dosage of iodoral.  Lugol’s solution is another option.  Lugol’s solution is a mixture of 5% iodine and 10% potassium iodide in water, and two drops of a 5% solution is equivalent to 12.5mg to iodine, and so this is why Iodoral was formulated to include 12.5mg per tablet.  It was actually designed to help prevent gastric irritation and to eliminate the unpleasant taste associated with iodine.  However, some people claim to get better results when taking Lugol’s solution.    There are other variations of iodine as well.

Question: Can I Supplement With Kelp?

Answer: Even though I mentioned a few negative studies involving kelp, many people do fine when taking a kelp supplement.  However, the downside of kelp is that 1) it can be more challenging to dose, and 2) heavy metals such as mercury and arsenic can be a factor.  You can minimize your exposure to toxins by purchasing a higher quality, organic kelp supplement, although this doesn’t guarantee that the supplement will be free from toxins.  The advantage of kelp is that it’s a natural food, and includes other trace minerals.

Question: If It’s Determined That Iodine Supplementation Is Beneficial, How Much Should I Take?

Answer: This does depend on the person.  If someone has a mild deficiency, then they will require less iodine when compared to someone who has a moderate to severe iodine deficiency.  I usually will start someone with 3mg of iodine, and then slowly increase the dosage.  But for some people even 3mg is too much.  And how much iodine someone will build up to depends on how deficient the person is.  When I was diagnosed with Graves’ Disease I began with 3mg of iodine and took as much as 24mg of iodine per day.

Hopefully this provides you with some valuable information about iodine supplementation.  But I still didn’t answer the main question in the headline, “Is iodine safe to take for people with hyperthyroidism?”  If someone has a deficiency in iodine and takes the proper precautions (which includes working with a competent natural healthcare professional) then in most cases taking iodine is safe.  There are still some people who will react to iodine even if they are deficient and take the proper precautions.  But in my experience it is rare for people to have a negative reaction to iodine supplementation, although due to the controversy involving iodine you will be sure to hear any “negative cases” with regards to iodine, and the truth is that while some people don’t do well when taking an iodine supplement, some people have negative reactions to other supplements as well.