Wednesday, December 15, 2010

Iodine Deficiency Still Occurring

Why does hypothyroidism strike women to men at an 8:1 rate? Also, why do all autoimmune disorders attack women at a much higher rate (approximately from 8-10:1) as compared to men? I believe women are more susceptible to these illnesses due to a common nutritional deficit: iodine.

Women have a larger requirement for iodine as compared to men. It is well known that goiter strikes females (v. males) at a much higher rate. In fact, the difference in the gender rate of goiter becomes prominent at puberty. That is, girls begin having signs of goiter at puberty in much larger numbers as compared to boys. Why does this occur? The first sign of puberty in a girl is breast enlargement. The breasts are the second major site of glandular iodine storage next to the thyroid. Iodine is necessary to form the normal architecture and function of the breasts (as well as all the other glandular tissues). If there is iodine deficiency present, the different tissues of the body (e.g., thyroid, breasts, ovaries, etc.) will compete for iodine. The end result is that all of the tissue will have some form of iodine deficiency which can lead to iodine deficiency diseases. Iodine deficiency can lead to thyroid disorders including hypothyroidism, autoimmune thyroid disorders, and thyroid cancer. Furthermore, it can lead to autoimmune disorders as well as breast diseases such as fibrocystic breasts and cancer.

My clinical experience has shown that it is impossible to treat the above conditions without ensuring adequate iodine levels. I believe that inadequate iodine ingestion is responsible for the rapid rise in these illnesses. It is known that iodine levels have fallen over 50% during the last 30 years. As compared to men, women (due to having a larger amount of breast tissue) have a higher iodine requirement and suffer the consequences of iodine deficiency in larger numbers as compared to men.
However, there are other conditions that also exacerbate iodine deficiency. An article (Env. Health Persp. Vol. 115. N. 8. August 2007) pointed out that elevated pesticides in humans have resulted in lowered thyroid hormone levels. The authors of this study found that effects of the pesticides were stronger in women. Pesticides contain chlorine, fluorine, dioxins and other agents that interfere with iodine uptake and storage in the body. Therefore, the larger the exposure to pesticides, the more iodine is inhibited in the body.

So, what can you do? First, ensure adequate iodine supplementation. I believe we will not turn the tide against the rising rate of thyroid disorders and autoimmune disorders without correcting the epidemic rate of iodine deficiency that is currently present. My experience shows that in this toxic world we live in, the RDA is woefully inadequate. Therapeutic doses of iodine vary between 6-50mg/day. Those with chronic illnesses generally require larger amounts of iodine as compared to healthy people. Next, eat organic food that does not contain toxic pesticides. Finally, ingest an adequate amount of unrefined salt to help your body detoxify from these toxic chemicals. More information can be found in my books, Iodine: Why You Need It, Why You Can’t Live Without It, 4th Edition and Salt Your Way to Health, 2nd Edition.

Sunday, December 5, 2010

New Vitamin D Recommendations

Last week, the Institute of Medicine’s (IOM) Food and Nutrition Board released their recommendations on Vitamin D. The IOM is a non-governmental American organization founded in 1970 under the congressional charter of the U.S. National Academy of Sciences. The IOM provides U.S. citizens with advice on medicine and health.

The IOM raised the recommended supplementation dosages of vitamin D from 400IU/day to 600IU/day. For infants and children, the IOM recommended a dosage of 400IU/day.

What do I make of the IOM’s recommendations? Unfortunately, they cannot be given too much credence. How can you give the IOM’s recommendations any support when they recommend an eight pound child take a similar dose of vitamin D as a 200 pound adult? (Note: There is very little difference between 400IU and 600IU/day of vitamin D).

The IOM’s concerns about supplementing with higher levels of vitamin D seem to focus on the increased risk of kidney stones developing secondary to vitamin D supplementation. The IOM also states that very high levels of vitamin D (over 10,000IU/day) are “known to cause kidney and tissue damage”. The IOM makes this statement about kidney and tissue damage but they do not provide any research which shows that 10,000IU/day of vitamin D causes damage.

I have been checking vitamin D levels on my patients and recommending they take vitamin D supplements for over 18 years. My experience would clearly show that the vast majority of patients are very deficient in vitamin D. I can also assure you that supplementing with the IOM’s recommended dosages will do little to nothing to improve vitamin D levels in the vast majority of patients.

There are many studies which show that more than 600IU/day of vitamin D is necessary to treat illness as well as promote health. Studies have shown that 600IU/day will not raise vitamin D levels in pregnant or lactating women nor would it provide their babies with the needed amounts of vitamin D to optimize their health.

I have seen little problems with supplementing patients with 2,000-10,000U of vitamin D3/day. In fact, most report their health improves with vitamin D supplementation. In my career, I have seen one patient develop vitamin D toxicity. She is a 55 year old patient with multiple sclerosis who was having a MS flare and developed difficulty walking. Due to very low levels of vitamin D, I prescribed 10,000U/day of vitamin D3 daily for 30 days. At the end of thirty days, she was able to walk without a cane and go back to work (she was disabled due to MS problems). She continued to take 10,000U/day for three more months. I checked her calcium levels every two weeks. After taking 10,000U/day of vitamin D3 for a total of 120 days, her calcium level began to rise. At this point, I asked her to reduce her dosage to 10,000Units/week—my usual recommendations to my adult patients. She did not want to lower her dose since she was feeling so much better, but she followed my recommendations. Now, three years later, she is still doing well.

So what do we make of the IOM’s recommendations? I say not much. My advice is to enjoy the sun (where you can get natural Vitamin D) and have your vitamin D levels checked. If low, supplement with therapeutic doses—generally from 2,000-6,000IU/day of vitamin D3. It is best to work with a health care provider knowledgeable about vitamin D.

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