Dear Friends and Patients:
One of the greatest pleasures in my medical practice is the interaction I have with our patients as we journey together to improve their health. I learn about their families, job situations, and outside interests. Most of our patients are proactive with their healthcare and many do research and reading on their own. Recently, one of my patients brought in an article from an alternative health newsletter on iodine sufficiency. She had a heart rhthym problem and wanted to know if taking iodine supplementation might help. So I told her I would review the article as I had never heard of taking iodine for atrial fibrillation. In this Newsletter I will continue the discussion of “Minerals and Human Health” which started in the December 2005 issue, but I’d like to discuss iodine in more detail.
In the early 1900's up until the 1960's, many physicians used Lugol (iodine/iodide) supplements in the treatment of thyroid and other problems. Today, due to misinformation or ignorance, most physicians avoid iodine therapy altogether as if it were a poison. Although there can be adverse reactions to iodine in some patients, it is an essential element for health.
According to a 1998 Journal of Clinical Endocrinology and Metabolism article, one-third of the world’s population lives in areas of iodine deficiency, which is the world’s leading cause of intellectual deficiency. Iodine is primarily utilized in the synthesis of thyroid hormone, and is detected in every organ and tissue in the body. It is found in high levels in the thyroid gland, lungs, liver, adrenal glands, heart, fat and muscle tissue. One article I reviewed stated iodine was depleted out of the thyroid gland and other tissues when thyroid hormone medications were taken. It also stated that some of the problems iodine therapy may help with include fibrocystic breast disease, polycystic ovary syndrome, hypo and hyperthyroidism, brain fog, constipation, obesity, diabetes, high blood pressure, goiter, and atrial fibrillation. I should also point out that selenium deficiency affects iodine deficiency, as selenium is required in the conversion of the thyroxine form of thyroid hormone (T4) into the more active form, tri-iodothyronine (T3).
The RDA for iodine is 2 micrograms/kilogram of weight, and somewhat more in children. An additional 25 to 50 micrograms per day may be needed during pregnancy and lactation. This is the amount needed to prevent goiter. But how much iodine is really needed to promote optimal health? And how do we test for this? To answer these 2 questions I dug out some of my old reference articles on iodine by Dr. Abraham, a former professor of Endocrinology and a physician who perhaps is the world’s foremost expert on iodine and the thyroid. I also researched a book by Dr. David Brownstein, “Iodine: Why You Need It, Why You Can’t Live Without It.”
In an article published in The Original Internist in September 2002, Guy E. Abraham, M.D. discussed what were optimal levels of iodine for our greatest physical and emotional health. Dr. Abraham pointed out that the Japanese have a very low incidence of fibrocystic breast disease and low mortality rates from cancer of the female reproductive organs. There is a large consumption of seaweeds in the Japanese diet which is estimated to provide 13.8mg of iodine a day. The daily US intake for many people may be as low as one hundredth this amount. Just using iodized salt is not enough. Dr. Abraham concluded the minimum effective daily dose of iodide is 13 mg, with no major side effects up to a dose of 150mg per day (100,000 times the RDA). Dr. Abraham also discovered that even patients with complete thyroidectomies (removal of the whole thyroid gland) benefitted from iodine therapy. In other words, it helped in areas outside the thyroid gland where thyroid hormone and iodine were active. He and other doctors in the Iodine Project also found that diabetes improved, hypertensive patients had more normal blood pressures, and goiters resolved. They also found that those taking thyroid medications could greatly reduce or eliminate these drugs.
One of the tests long promoted to see whether your body needs iodine or not is painting a 2" square of Tincture of Iodine from the drug store on the skin of your inner arm. If it disappears in less than 8 hours, you are severely iodine deficient. If it disappears in 24 hours, you still need iodine. I have concerns about the accuracy and reproducibility of this type of testing so I’ve never promoted it among my patients. After doing some research I came across an Iodine/Iodide urine loading test that can be run at Doctor’s Data lab in Chicago. This is the same lab we use for our heavy metal determinations in the urine, so I feel comfortable with the test’s accuracy and reproducibility. The test involves giving a loading dose of Iodoral (a prescription medicine that contains 12.5mg of Iodide/Iodine per tablet) and collecting urine for 24 hours. If there is low urine iodide excretion, your body is taking up the iodine and you need iodine supplementation. When 90% or more of the loading dose of iodide is excreted in the urine, your body stores have been replenished. We are now able to offer this test to our patients.
Who should have the Iodine/Iodide Loading Urine test?
• If you are taking thyroid medication or have hypo or hyperthyroidism.
• If you have a body temperature below 97.8 degrees.
• If you have fibrocystic breast disease, polycystic ovaries, or a strong family history of gynecological cancers.
• If you have diabetes, memory problems, obesity, chronic fatigue, atrial fibrillation, heavy metal toxicity, high blood pressure, prostate problems.
• If you are a vegetarian or eat little seafood.
• If you want to know your iodine nutritional status.
Call the Center for further information or to schedule this test. Cost is $99 (includes the test kit, Iodoral, specimen shipping to lab and physician interpretation.). A repeat Iodine/Iodide loading test should be performed after three months of iodine therapy to monitor your status.
A word of caution. Iodine therapy can be a bit unpredictable and both slow thyroid function down or speed it up (this type of effect can occur when people living in iodine-deficient areas move to areas that are iodine-rich). So it is important to be monitored by a physician, and to go slowly when taking iodine supplements. Side effects among sensitive individuals include skin irritation, watery eyes or nose, nervousness, headache, racing heart, and increased saliva production
Minerals and Human Health – Part II
In the December 2005 Newsletter, I began an overview of “Minerals and Human Health.” We’ll pick up here where I left off and continue with additional minerals for discussion.
Iron is a mineral in the body with a narrow window of efficacy. Too much or too little will create health problems. Iron deficiency is one of the most common nutrient deficiencies throughout the world. Most iron in the body is found in the hemoglobin of our red blood cells. Hemoglobin carries oxygen to our tissues from the lungs. Myoglobin is a red pigment in our muscle tissues that stores and transports oxygen for use during muscle contraction. Myoglobin also contains iron. Myoglobin is also found in heart tissue. Small amounts of iron are found in enzymes essential to energy production. Iron deficiency may come about due to poor dietary intake, bleeding, parasitic infections, low stomach acid, malabsorption, and low vitamin A or vitamin C, which affects the transport and absorption of iron. Also, calcium either in supplements or foods may interfere with the absorption of iron and should be taken at different times.
The RDA for iron is 10-12mg for men and 15 mg for menstruating women. Foods such as flours that are enriched with iron where there are insufficient antioxidants in the diet can create free radicals that can cause damage to DNA. Iron supplements are not safe for individuals with iron storage disorders such as hemosiderosis, hemochromatosis or thalassemia. Caution is suggested in taking iron picolinate as a supplement, as the absorption is so efficient that it can lead to excessive iron levels. Iron supplements should be kept away from children who can inadvertently take an overdose of this mineral which can be fatal in a manner of hours.
Iron is a “growth-nutrient” for almost all forms of life – humans, tumor cells, lawn grass, bacteria, yeast. It is actually the unbound iron in humans that can create the problems. 99% of iron is bound to either hemoglobin, myoglobin, or transferrin. Acidification can cause an increase in unbound iron. Adults who are not vegetarians do not need supplemental iron in most instances.
Copper is involved in enzyme reactions, bone and connective tissue construction, and via ceruloplasmin, helps prevent the oxidation of fatty acids that can destroy DNA and cell membranes. It is also required to absorb, utilize and synthesize hemoglobin. It is also used to maintain the integrity of the myelin covering of nerves. Copper is needed by all tissues, but its highest concentration is in the liver where it contributes to energy and detoxification mechanisms.
Copper supplements have slowed tumor growth in animals. The RDA of copper is 1.5 - 3 mg/day and the best sources in the diet are organ meats, shellfish, and legumes. A prominent feature of copper deficiency is impaired iron absorption in the gut. A high ratio of copper to zinc can result from either a deficiency in zinc intake or excess copper intake. An inborn error of metabolism associated with the failure to eliminate copper from the body is known as Wilson’s disease. It can result in liver, kidney, and central nervous system damage.
Copper supplements should be approached with caution since copper is among the most powerful producers of free radicals. However, in proper balance with zinc, the two elements act as antioxidants by removing free radicals.
Manganese is an essential mineral co-factor in many enzyme reactions that are involved in protein, fat and energy metabolism. It plays a crucial role in the effectiveness of vitamin B1 (thiamin). It is also needed for bone growth and development, and reproduction. The best food sources of manganese are whole grains, nuts, and fruits grown in manganese-rich (= in the fertilizer) soils. Tea is very rich in manganese. Animal tissue contains very little manganese. The RDA for manganese is between 2-5 mg daily. Excessive manganese levels have been associated with certain forms of Parkinson’s disease and also a propensity for violence in humans. The excessive manganese may be due to a deficiency of calcium and/or an excess of other trace minerals such as copper, lead, and cadmium. There is also some evidence that an adequate intake of lithium and zinc may reduce the effect of excess manganese as it relates to violence.
Chromium is a mineral critical to controlling blood sugar levels. Deficiencies in chromium in humans typically lead to impaired glucose metabolism, elevated blood fats, and even peripheral neuropathy (tingling and numbness in the extremities). An estimated 50% of the American population do not consume the minimum recommended daily intake of 50 micrograms daily. Several studies have shown that taking chromium supplements lowers fasting blood sugar levels in healthy, normal individuals. There is also an association of chromium deficiency and heart disease and atherosclerosis in humans. In those patients with atherosclerotic plaque who died of heart disease, no detectable chromium was found in their tissue. Chromium can also lower cholesterol levels in individuals with elevated cholesterol.
Chromium is stripped out of most foods in the refining processes. Chromium is found in whole grains and beans, but unless chromium is added to the fertilizer, these foods may be low in this essential mineral.
Selenium, up until the 1960's, was considered a toxic mineral for humans by the FDA. In places like South Dakota and Montana, there is so much selenium in the soil that animals grazing on the grass can develop selenium toxicity resulting in nerve and behavior problems. In humans, selenium toxicity may begin as low as 1000mcg daily, but it is much more common at about 65,000 micrograms daily. We now know, however, that small amounts of selenium are critical for our immune systems and detoxification pathways. The RDA is 70 micrograms. In Finland, where the selenium-deficient soil leads to a high incidence of cancer and heart disease, wheat flour is enriched with selenium just like we add iron to our white flour. Wheat germ, seafood, and Brazil nuts are the best sources of selenium. In a recent prospective double-blind human intervention study, supplements providing 200 micrograms of selenium were able to reduce the incidence of various cancers by up to 60%. Vitamin E enhances the action of selenium. There is evidence in elderly people, several hundred micrograms of selenium along with 400 IU of vitamin E improve their mental status while decreasing their anxiety, depression, poor appetite and fatigue. As previously noted, selenium is critical for thyroid function. It is also a potent anti-oxidant.
Molybdenum is an essential mineral for the detoxification pathways. I often see patients with heavy metal toxicity due to mercury, arsenic, or lead have low hair molybdenum levels. There is no RDA for molybdenum, but levels of 75-250 micrograms have been recommended by the Food and Nutrition Board. This is an extremely non-toxic mineral. Beans and organ meats are the best sources of molybdenum, but again, content is dependent upon the soils the plants are grown in or the animals graze on. We use a plant-chelated form of molybdenum at the Center for patients who are low in this mineral.
Is Your Water Safe to Drink?
Clean drinking water is one of the world’s most precious resources and is something we don’t usually think about in this country. Most of us just go to our tap or refrigerator, or pull out a bottle of water and drink it without thinking about what is in it. Water can be contaminated with parasites, bacteria, chemicals, viruses , organic matter, and even radiation from uranium deposits under the ground. Take a moment to consider the following questions about your drinking water.
• Do you depend on ground water for your drinking water, either from a public source or private well?
Ninety percent of disease outbreaks reported to the CDC (Center for Disease Control) in 2001-2002 were ground water-related. Our home in the country had a water system installed and serviced by a nationally known water company. I made the mistake of assuming that our treated water was of good quality because this national company was well-known. Their service people would come out to add salt to our water softener or change the filters in the reverse osmosis systems and we just assumed they were experts in their field and everything was alright. After the 2004 hurricanes, I had a comprehensive analysis of our well and drinking water done by National Testing Labs, which also tests water for governments and industry. This company tested for bacteria, heavy metals, minerals, inorganic and organic chemicals and pesticides. We discovered that the equipment from the well-known water company was not doing the job. After weeks of research, I called Walter Zukowski of Best Water Solutions. Our experience with him was wonderful. He looked at the water analysis data from National Testing Labs and custom designed a water treatment system using ozonation, filtration, and reverse osmosis. We found him to very knowledgeable and I highly recommend his company (he can be reached at 352-372-8962).
If you use well water as a drinking or cooking source, I suggest you have the well water analyzed each year through an independent lab such as National Testing Labs.
• Is your source of water from a city or municipality?
We forget that cities get their water from somewhere, and that somewhere is ultimately a well into the aquifer, or a lake or river. Contact your water utility and ask for a copy of their Consumer Confidence Report (also called a water quality report). This report tells you what substances have been found in the water your are drinking. Although some municipalities use ozonation to sterilize drinking water, most municipalities use chlorination to kill bacteria and viruses that are in the water. Chlorine reacts with organic matter in the water to form by products called THM’s (trihalomethanes). In high concentrations THM’s have been shown to cause cancer in humans. Low levels of chlorine remain in the distribution system to keep it sterile, and there are some studies that indicate drinking chlorinated water for 35 or more years can increase the risk of cancer of the bladder and colon. I highly recommend activated carbon filters which remove chlorine from both drinking water and shower water. Shower water chlorine is absorbed through the skin and contributes to much greater amounts of chlorine than drinking a glass of tap water. A number of different companies make water filters that remove chlorine. The Amway Corporation makes an under the counter carbon filter integrated with an ultraviolet light system to kill bacteria and viruses, and filter out contaminants including toxic metal, parasites and their cysts (we can order this for you at our cost).
