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The Iodine Group | |
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The Debate
1. Iodine: A Lot to SwallowAlan R. Gaby, MD Townsend Letter for Doctors & Patients, August/September 2005
“Recently, a growing number of doctors have been using iodine supplements in fairly large doses in their practices. The treatment typically consists of 12 to 50 mg per day of a combination of iodine and iodide, which is 80 to 333 times the RDA of 150 mcg (0.15 mg) per day. Case reports suggest that iodine therapy can improve energy levels, overall well-being, sleep, digestive problems, and headaches. People with hypothyroidism who experienced only partial improvement with thyroid hormone therapy are said to do better when they start taking iodine. In addition, fibrocystic breast disease responds well to iodine therapy, an observation that has been documented previously. The reported beneficial effects of iodine suggest that some people have a higher-than-normal requirement for this mineral, or that it favorably influences certain types of metabolic dysfunction.
“While iodine therapy shows promise, I am concerned that two concepts being put forth could lead to overzealous prescribing of this potentially toxic mineral. First is the notion that the optimal dietary iodine intake for humans is around 13.8 mg per day, which is about 90 times the RDA and more than 13 times the "safe upper limit" of 1 mg per day established by the World Health Organization. Second is the claim that a newly developed iodine-load test can be used as a reliable tool to identify iodine deficiency.”
2. A Rebuttal of Dr. Gaby's Editorial on IodineGuy E. Abraham, MD and David Brownstein, MD Townsend Letter for Doctors & Patients, October 2005
“Our rebuttal will cover four topics:
“In the practice of medicine, we have seen very few natural therapies as safe and effective as orthoiodosupplementation. In the proper forms of iodine (inorganic non-radioactive forms), in daily amounts of iodine for whole body sufficiency and properly monitored, orthoiodosupplementation is not only safe, it is an effective tool for the clinician. Prior to the availability of assays for thyroid hormones and without any test for assessing whole body sufficiency for iodine, our medical predecessors recommended a range of daily iodine intake from Lugol solution (12.5-37.5 mg) exactly within the range required for achieving whole body sufficiency for iodine. Relying on clinical observation of the patient's overall wellbeing, our predecessors have given us useful information, which we have discarded in favor of preconceived opinions of self-appointed pseudoexperts. This has resulted in pandemic iodine deprivation. Iodine deficiency is misdiagnosed and treated with toxic drugs. Orthoiodosupplementation may be the simplest, safest, most effective and least expensive way to help solve the health care crisis crippling our nation.”
3. More on High-dose IodineAlan R. Gaby, MD Townsend Letter for Doctors & Patients, November 2005
“Although high-dose iodine therapy has a definite place in clinical medicine, I believe that some of their remarks warrant comment.
“First, it does not seem appropriate to use the term "orthoiodosupplementation" to describe the treatment they are recommending. That term is borrowed from Linus Pauling's "orthomolecular medicine," which refers to the concept of creating the optimal molecular environment in the body ("orthomolecular" means "the right molecules"). Defining the optimal dosage range as an amount that is 40 to 320 times the usual dietary intake obfuscates any debate about whether such a high intake is desirable or safe. Therefore, until iodine doses of 6.25-50 mg per day are proven to be optimal, it would be more logical to refer to these doses as "high-dose iodine therapy."
“High-dose iodine therapy is of great value in some circumstances. We should not forget, however, that this treatment was abandoned in the past, because it caused many deaths from heart failure, as well as a long list of other side effects. The doses used then were higher than those currently being advocated. However, it is premature to assert that more modest doses do not cause more modest side effects.”
4. Iodine Debate Continues: Rebuttal #2Guy E. Abraham, MD and David Brownstein, MD Townsend Letter, the Examiner of Alternative Medicine, April 2006
“On the Townsend Letter web site, (www.townsendletter.com), in December 2005, Alan R. Gaby, MD posted a sequel to his editorial on iodine. This time, Gaby did not defend his belief in evolution and the origin of man from the "iodine-rich" oceans. This time, he did not question the validity of our iodine/iodide loading test. This time, he did not debate the method we used to calculate the average daily intake of iodine by mainland Japanese. This time, Gaby concentrated his attention on the safety of iodine as used in the orthoiodosupplementation program.”
“The prefix "ortho" is not borrowed from Linus Pauling. The English dictionary contains hundreds of words starting with "ortho." For Gaby's erudition, the daily amount of iodine needed for whole body sufficiency was named orthoiodosupplementation from ortho = the right amount; iodo = for inorganic non radioactive iodine; and supplementation = for oral intake of this essential nutrient.”
“The endpoint in optimizing a nutritional program is the clinical response. The optimal amount of a nutrient is reached when it results in optimal mental and physical health. Having a test that confirms the optimal amount of a nutrient that achieves whole body sufficiency, concomitant with optimal physical and mental health in the absence of significant side effects, is what we strive to do. In fact, it is what all holistic physicians strive to achieve.”
5. Iodine Debate Continues: Gaby's Reply to Abraham & Brownstein's Rebuttal #2Alan R. Gaby, MD Townsend Letter, the Examiner of Alternative Medicine, April 2006
“Drs. Abraham and Brownstein argue that it is seaweed, not the iodine in it, that causes thyroid disorders. However, a main aspect of their iodine hypothesis is that Japanese people are healthy because they eat a lot of iodine, which in the Japanese diet comes mainly from seaweed. This seems like a contradiction.”
“What I said was, "Before one could confidently conclude that high-dose iodine is safe for 99% of the population (as stated by Abraham and Brownstein), it seems that a systematic toxicity study would be necessary." I suggested that such a study should include serial testing of all patients to identify the appearance of thyroid antibodies during treatment with iodine, since iodine supplementation has been reported to increase the incidence of thyroiditis. Thyroid-antibody measurements may not be necessary as a component of routine medical care, but they would seem to be necessary before one could confidently claim that high-dose iodine supplementation does not increase the incidence of autoimmune thyroiditis. I asked in my rebuttal how many of the iodine-treated patients had had thyroid-antibody tests, but Drs. Abraham and Brownstein did not answer my question.”
6. Iodine Debate Continues: Rebuttal #3Guy E. Abraham, MD and David Brownstein, MD Townsend Letter, the Examiner of Alternative Medicine, July 2006
"Gaby created
a contradiction where there was none by misquoting what we previously wrote:
"We proposed that, based on the concept of orthoiodosupplementation, only mainland Japanese consume adequate amounts of iodine and that 99% of the world population are deficient in inorganic, non-radioactive iodine; that is, they have not reached whole-body sufficiency for that essential element."
"Stable iodide
content of the thyroid gland measured by X-ray fluorescence scanning revealed
that autoimmune thyroiditis is associated with low stable iodide levels in the
thyroid....In Dr. Brownstein's practice, every patient placed on iodine therapy
had thyroid antibody levels tested before and after beginning iodine therapy.
Dr. Brownstein's experience has been consistent: the use of inorganic
nonradioactive iodine has not resulted in a higher incidence of autoimmune
thyroid disorders."
7. Iodine Debate Continues: Gaby's Response to Rebuttal #3Alan R. Gaby, MD Townsend Letter, the Examiner of Alternative Medicine, July 2006
"If Dr. Brownstein has done before-and-after thyroid antibody tests on all his patients, then his data might resolve the question of whether short-term treatment with high-dose iodine increases the incidence of thyroiditis. I urge him to publish his results. His data would not appear, however, to answer the question of whether long-term iodine therapy increases the incidence of thyroiditis, particularly since Dr. Brownstein only started using high-dose iodine routinely about three years ago."
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