I recently was consulting with a patient who saw a different holistic doctor, and this doctor recommended for her to take 25mg of iodine right off the bat, without any testing. I personally don’t recommend for anyone to begin taking high dosages of iodine unless if they have been tested for an iodine deficiency. But it’s amazing how many patients I have spoken with who are told to take iodine without having had any testing at all. Plus, even if someone is deficient in iodine, I personally recommend starting with a low dosage, rather than 25 to 50 mg immediately. I start most of my patients who are iodine deficient with 3mg and then gradually increase the dosage. For some people I start with a lower dosage than this. And of course some people I don’t recommend iodine to at all.
There are numerous ways to test for an iodine deficiency, and below I will discuss four different methods of iodine testing:
Iodine Testing Method #1: One sample urine test. This is the urine test typically performed by most medical doctors to determine the levels of iodine. While this isn’t a completely useless test, it isn’t as accurate as the iodine loading test, which is described below.
Iodine Testing Method #2: Blood test. This seems to be an accurate way to test the iodine levels, but the problem is that most labs don’t do such testing.
Iodine Testing Method #3: Iodine Patch Test. This is a general test which can help determine whether someone is deficient in iodine. It involves drawing a 2 x 2 patch on your forearm using a 2% tincture of iodine. For someone who isn’t iodine deficient, the patch shouldn’t begin to fade until after 24 hours. Someone who is deficient in iodine will see the patch disappear in a shorter amount of time. Those with a severe iodine deficiency will see the patch begin to fade or disappear completely in 12 hours or less.
Once again, this isn’t the most accurate test (although it definitely is the least expensive of the four). Even though it isn’t accurate, it can help to give a general idea as to whether someone is deficient in iodine, and if they will need to supplement with iodine. However, I think 24 hours is a random number, and I feel that 12 to 14 hours is more accurate in determining how long the iodine should last before fading significantly. While someone can start off with this test, eventually it is recommended that they receive an iodine loading test to get a more specific reading.
Iodine Testing Method #4: Iodine Loading Test. This test measures the excretion of iodine over a 24-hour period. It admittedly isn’t the most convenient test, as you need to collect EVERY urine sample within a 24-hour period. Before this test you need to take a 50 mg tablet of iodine. Although taking such a high dosage on a regular basis without prior testing isn’t recommended, taking it one time shouldn’t cause problems with most people. This usually includes people with Hashimoto’s Thyroiditis. However, many people with Hashimoto’s Thyroiditis are still cautious about taking this test due to the ingestion of iodine, which is fine, as they can always choose one of the other tests if they’re really concerned about any negative effects of taking the iodine.
Ideally someone who has a sufficient amount of iodine should excrete at least 90% of the iodine over a 24-hour period. If it is less than this then the person has an iodine deficiency. The lower the excretion rate, the greater the iodine deficiency.
How Much Iodine Should One Take?
If it’s determined that someone is iodine deficient, then how much iodine should that person take? There are different opinions regarding this, but as I mentioned earlier, what I do is put someone on a low dosage of iodine (3mg), and then gradually increase the dosage each week, and will eventually retest. If the person begins with an iodine patch test, they of course can easily retest every 2 to 4 weeks, although one needs to keep in mind that it usually takes at least a few months to correct such a deficiency, and for someone with a moderate to a severe deficiency it can take a long time to accomplish this. For those who don’t obtain an Iodine Loading test right away, I definitely recommend obtaining this test after three to six months after beginning to supplement with iodine.
Different doctors will of course have different approaches, as some will recommend starting with large dosages of iodine, and others like myself will suggest taking it slowly. While many people have no problem taking large dosages of iodine immediately, others are not able to tolerate larger dosages. And there really is no way to predict how someone will respond, which is why I like to play it safe and start someone with a lower dosage.
In summary, before anyone supplements with iodine I recommend for them to obtain at least one of the above tests I mentioned. I also recommend that people begin with a low dosage of iodine, and then gradually increase the dosage. And when someone does begin an iodine supplementation program, it is important to retest after a few months in order to make sure they are taking a sufficient amount of iodine on a daily basis.