Transcript Dr Sherri Tenpenny Power point presentation

AN UNDERUTILIZED
COMPONENT FOR HEALTH
The missing element:
IODINE
By Sherri Tenpenny, DO
OsteoMed II
7271 Engle Road, #115
Middleburg Heights, OH 44130
440-239-3438
www.osteomed2.com
www.DrTenpenny.com
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Review of Iodine Chemistry
Hg
2
Iodine Deficiency Disorders
 Iodine Deficiency Disorders
(IDD) refers to all ill-effects
due to iodine deficiency
 In 1990, WHO estimated that
28.9% of global population
was iodine deficient


11.2 million had overt
cretinism and
43 million at mental
impairment
Fetus
Abortions
Still births
Congenital anomalies
Perinatal mortaility
Endemic Cretinism
Neonate
Neonatal Goiter
Neonatal hypothyroidism
Mental retardation
Susceptibility to radiation
Child and
Adolescent
Goiter
Subclinical hypothyroid
Impaired mental function
Slowed physical
development
Susceptibility to radiation
Adult
Impaired mental function
Goiter
Hypothyroidism
Hyperthyroidism
 Therefore, IDD is the leading
cause of preventable mental
retardation in the world

Mastorakos: The Iodine
Deficiency Disorders Text
3
The Effect of Supraphysiologic
Levels of Iodine on Patients with
Cyclic Mastalgia.
The Breast Journal, Volume 10, Number 4, 2004 328–33. 2004.
Jack H. Kessler, PhD.
Symbollon
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Incidence of breast cancer
increases with age
A Woman’s Chances of Breast Cancer
Increases With Age
By age 30
1 out of 2,212
By age 40
1 out of 235
By age 50
1 out of 54
By age 60
1 out of 23
By age 70
1 out of 14
By age 80
1 out of 10
Ever
1 out of 8
Source: National Cancer Institute. 5-3-2002
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Despite nearly 100 years of
iodized salt, iodine deficiency
still exists in the US
6
 The First National Health and Nutrition Examination
Survey (NHANES I) took place between 1971 and
1974 found 2.6% of US citizens were iodine deficiency
 NHANES III, conducted between 1988 and 1994,
found 11.7% of all US citizens are iodine deficient

Journal of Clinical Endocrinology and Metabolism
1998;88:3401-3408
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Why is iodine
deficiency increasing?
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 Decrease in salt consumption—due to concerns




over sodium (hypertension, etc)
Decrease in egg consumption—due to concerns
over cholesterol
Decrease in fish consumption—due to concerns
over mercury
Minimal access to “sea vegetables”—seaweed,
kelp
Soil depletion: minerals are decreased by
accelerated deforestation and soil erosion


Food grown in iodine-deficient regions do not
provide enough iodine for the people and livestock
living there.
There are acute iodine deficiencies in the soils
around the globe, particularly in the Great Lakes
basin.
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What about all the salt
in processed food?
Availability of iodine in salt varies widely
due to the inconsistencies in the salt
manufacturing process….
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 Variability in the amount of iodine added
during the iodization process
 Loss of iodine due to salt impurities and
lack of chemical binding
 Uneven distribution of iodine within salt
batches and within individual packages
 Loss of iodine during cooking ranges from
50-70%
 Loss due to open containers sitting on the
kitchen counter ranges from 10-100%

Iodine Deficiency Diseases WHO manual
http://www.sph.emory.edu/PAMM/IDD/whomanual
/factors.pdf
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How much iodine do
we really need?
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Iodine “sufficiency”
A short history
 Iodine deficiency as a risk factor for goiter has
been known at least since 1820
 1916: Dr David Marine conducted a trial in Akron,
Ohio. Two groups of school girls were treated with
table salt with KI added.
 In the treated group, 2 people developed goiters
 In the control group, 250 people developed goiters
 1924: Iodized salt began to be used in the US—
first in Michigan
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Iodine “sufficiency”
A short history
 Several years later, an epidemiological study
concluded that if less than 5 percent of a population
where iodinized salt was used developed a goiter, the
amount of iodine was “sufficient” for the body.
 Since that time, only the impact of iodine (about
150ug/d) on the thyroid has been discussed
 IMPORTANT: Overt iodine deficiency is all that is
considered; the impact of mild to moderate iodine
deficiency is not even a consideration
TO DATE, NO RDA HAS EVER BEEN
DETERMINED FOR THE BODY
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How Iodine gets into tissues
 The Sodium-Iodine symporter (NIS) is a
membrane bound glycoprotein that transports
iodine into the follicular cells of the thyroid
 NIS has been found on many different tissues,
disproving the previously held view that it is a
thyroid-specific protein

The Sodium/Iodide Symporter (NIS): Characterization, Regulation, and
Medical Significance Endocrine Reviews 24 (1): 48-77
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Iodine and the rest of the body
 The NIS mediates active iodine transport into
tissues:

Pancreas, liver, gastric, small, and large intestine mucosa
Nasopharynx, lacrimal glands, choroid plexus and the ciliary body of
the eye (DRY EYES)
Skin
mammary glands

salivary glands



 NIS activity increases in the presence of TSH,
leading to increased iodine uptake
 Sodium/iodide Symporter (NIS): characterization, regulation,
and medical significance. Endocr Rev. Feb;24(1):48-77. 2003
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Physiological formation of thyroxine
inside the thyroid gland
Occurs inside of THYROID gland, in THYROGLOBULIN CELLS
polypeptide matrix in follicular lumen of thyroid cells
Triiodothyronine
T3
Iodine deficiency shunts
pathw ay GREATLY tow ards
T3, and decreases TSH
1 Na+
TPO
Iodinatoin
Na-I
Symporte r
DIT ca n b e "recycl ed " to
form u p to 8 T 4 a nd T 4
[1 Iodide + Tyrosine]
[3,MIT* + iodide]
TPO^
Iodinatoin
TPO
Iodinatoin
[3,5 DIT** + 3.5 DIT]
TPO
COUPLING
- Alanine
TSH
TetraIodo
thyronine
T4
*MIT = mono-iodothyronine
**DIT = di-iodothyronine
^ Thryroperoxidase
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What is the relationship
between low iodine and
breast pathology?
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Low iodine:
Cause of breast pathology
 1967: An iodine deficiency in rat causes tissue
hyperplasia and atypia in mammary tissue.
Eskin B, Mammary gland dysplasia in iodine deficiency.
JAMA 1967; 200:115–19.
 Strum J. Site of iodination in rat mammary gland.
Anat Rec 1978;192:235–44.

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Low iodine:
Cause of breast pathology
 1976: Epidemiologic data suggest a
relationship between regions of known endemic
goiter —known to be related to low iodine—and
increased breast disease.


Stadel B. Dietary iodine and risk of breast, endometrial, and
ovarian cancer. Lancet 1976; 1(7965):890–91.
Cann SA.. Hypothesis: iodine, selenium and the development
of breast cancer. Cancer Causes Control 2000; 11:121–27.
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Low iodine:
Cause of breast pathology
1979: Iodine deficiency in estradiol-treated rats leads to
pathological changes in breast tissue including cyctic
changes, periductal fibrosis and lobular hyperplasia.
Strum, JM. Virshows Arch B Cell Pathol Incl Mol Pathol. 1979; 30:209
1975 to1989: Ghent and Eskin treated more than 1300
patients with a variety of breast pathology and observed
that iodine lead to an improvement rate of 40–70% in
subjective (pain) and objective (fibrosis) symptoms.
Ghent W, Eskin B. Iodine replacement in fibrocystic
disease of
the breast. Can J Surg 1993; 36:453–60.
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Low iodine:
Cause of breast pathology
 1995: The histological changes can be reversed by
reintroduction of iodine.

Eskin, B. Biol Trace Element Res. 1995;39:9-18
 1996: Rat studies have demonstrated that iodine
suppresses the formation of breast tumors.

Funahashi, H. J. Surg. Oncology 1996;61:209-13
 1997: Iodine absorption and organification occurs in the
same ductal epithelium where the majority of breast
cancers occur.

Russo, J. Differentiation and breast cancer. Medicina.
1997;57:Suppl 2:81-91
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How much iodine is needed
to have healthy breasts?
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Iodine and healthy breast
 Breast tissue is a “sponge” for iodine
 Studies have shown that the minimum amount of
iodine to protect the breast from fibrocystic disease
and cancer is 20-40 times more than is needed to
prevent goiter
In other words, breasts need 3-4 mg/day of
iodine to be healthy

Ghent, W. Iodine replacement in fibrocystic disease of the
breast. Can. J. Surg. 36:453-460, 1993.
NOTE: THE RDA FOR THE THYROID IS 150ug/day!
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Iodine and diseased breast tissue
 Incidence of fibrocystic breast changes among
women is reported to be >60%

Approx. 5% of fibrocystic conditions have changes
that would be considered risk factors for developing
breast cancer
 These changes respond and reverse in the
presence of 3-6mg/day of iodine for 3-4
months.

Jack H. Kessler, PhD. The Effect of Supraphysiologic
Levels of Iodine on Patients with Cyclic Mastalgia. The
Breast Journal, Volume 10, Number 4, 2004 328–33. 2004
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Importance of Selenium
 Selenium deficiency may have a profound effect on
thyroid hormone metabolism and possibly on the
thyroid gland itself
 Type I deiodinase, a selenium-dependent enzyme,
plays a major role in converting T4 to T3 in peripheral
tissues
 If both iodine and selenium are deficient, adding only
selenium decreases serum T4


The enzyme increases transport of T4 into the cells
Lack of iodine reduce the product on T4
 PEARL: if treat a patient with selenium and their
symptoms and lab tests get worse, it is because they
are iodine deficient.
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Iodine and Selenium Deficiency
 Elevated TSH, in the absence of iodine supplementation,
indicates an insufficient saturation of the T3 in the
receptors in the brain


T3 in the brain is produced locally, not derived from circulating T3
Therefore, a normal T3 and elevated TSH indicates iodine
deficiency in brain tissue
 In moderate and severe iodine deficiency:
 T4 is low but T3 can be variable; It can also be high
 This is due to preferential production of T3, considered a
“protective” for the rest of the body

Endocrinology 103 :1196-1207. 1978.
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Iodine and Selenium Deficiency
 Prolonged selenium deficiency coupled with iodine deficiency may
lead to tissue hypothyroidism and impaired brain function.

Eur J Endocrinol. 1997 Mar;136(3):316-23.
 Selenium deficiency lowers concentrations of the enzyme, glutathione
peroxidase.


Glutathione peroxidase is important for T4 synthesis and for
detoxification of H2O2 from the thyroid gland.
When a person is also iodine deficient, accumulation of H2O2
may lead to thyroid cell death.
 PEARL: This is why mild selenium deficiency
can contribute to the development and
maintenance of autoimmune thyroid diseases
(Hashimoto disease)

Selenium and thyroiditis. J Endocrinol. Jul;190(1):151-6. 2006
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Iodine and Salivary Glands
 The Na/I symporter found on the thyroid as been found to
salivary glands
 Iodine concentrations in salivary glands can reach 30 to 40
times that seen in plasma
 Fluoride and bromide inhibit iodide transport into saliva
 Thiocyanate inhibit iodide transport and utilization
Thiocyanate: mostly from cigarette smoke
 Also found in cabbage, broccoli, almond, horseradish, corn
 Food sources found to be insignificant contributors



Specificity of salivary thiocyanate as marker of cigarette smoking
is not affected by alimentary sources. PMID: 8990245
Selenium decreases thyroid peroxidase antibodies
concentrations. J Clin Endocrinol Metab. 2002 Apr;87(4):1687-91.
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Concerns about excess
iodine…
….are they real?
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Concerns about
supra-physiological doses of iodine
 1948: Wolff and Chaikoff reported that organic
binding of iodine in the rat thyroid in vivo was
blocked when iodide plasma levels reached some
“critical high threshold”, a phenomenon known as
the acute Wolff-Chaikoff effect.

Wolff J, Chaikoff IL. Plasma inorganic iodide as a homeostatic
regulator of thyroid function. J Biol Chem 174:555–564. 1948.
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Not commonly known about the
Wolff-Chaikoff effect
 1949: The maximum duration of the inhibitory
effect that iodine had on the thyroid was 50 hours
 Within 2 days, an escape or adaptation occurs,
so that normal hormone biosynthesis resumes

Wolff J, Chaikoff IL, Goldberg RC, Meier JC. The temporary
nature of the inhibitory action of excess iodide on organic iodide
synthesis in the normal thyroid. Endocrinology 45:504. 1949.
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Not commonly recognized about the
Wolff-Chaikoff effect
 1963: The Wolff-Chaikoff effect is an auto-regulatory
system to protect the thyroid from iodide overload
 The amount of thyroid inhibition is determined by the
level of depletion in the person.

The more depleted, the more the thyroid shuts down during
initial loading
 Since the amount of depletion is often unknown, when
replacement is started, the effects are highly individualized.

Braverman LE, Ingbar SH. Changes in thyroidal function during
adaptation to large doses of iodide. J Clin Invest 42:1216–1231,
1963.
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How much
iodine is safe?
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Testing for Iodine Deficiency
 No consensus exists about the best way to
measure for iodine deficiency.





Blood: not possible
Skin spot iodine: qualitative, at best
Spot urine iodine: an estimate
24 hr urine: inconvenient but really a measurement
of dietary intake
24 hr urine with challenge: several problems
 Loading
molecule issue
 Fat absorption in breasts/body
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How much iodine is safe?
 There is considerable controversy about the maximum
safe iodine dose and duration of use when ingested in
excess of the RDA.
 Problem: Thyroid chemistry is complex and a clear,
linear dose-response relationship between iodine intake
and thyroid function does not exist.

Backer, Howard. Use of Iodine for Water Disinfection: Iodine
Toxicity and Maximum Recommended Dose. Environmental
Health Perspectives, Vol.108, No.8 August 2000.
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Braverman et al. showed that almost
ALL people remain euthyroid in the
face of large amounts of iodine.

Braverman LE, Ingbar SH. Changes in thyroidal function
during adaptation to large doses of iodide. J Clin Invest
42:1216–1231. 1963
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Potential Side Effects
from taking iodine
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Side effects from taking Iodine
 Iodism:


A mildly toxic syndrome resulting from use of iodine
Characterized by skin rashes, acne, stomatitis,
unpleasant metallic taste, gastritis, nausea, frontal
headache, hyper-salivation, fatigue, coryza,
sneezing, conjunctivitis, laryngitis, bronchitis

Delange, FM. Iodine Deficiency. The Thyroid.
Lippencott Williams, Wilkens, 2000. p. 295-329
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What about iodine allergy?

Ioderma: a rash and called an iodide "sensitivity"
 reactions
are possibly cell-mediated immune reactions
 usually dose-dependent; but can occur low doses
There are no reported anaphylactic reactions
known to iodides alone
 There are no in vitro tests that can reliably
document intolerances to iodides


From “Ask the Expert” column of the AAAAI website.
Authored by Dr. Burton Zweiman of the University of Pennsylvania
http://www.aaaai.org/aadmc/ate/drugallergy.html
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Working Theory by “me”:

Iodism may REALLY be cellular
displacement of bromine,
fluorine and chlorine by
replenishing iodine
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 Bromine toxicity: Skin rashes, severe
acne, appetite loss, fatigue, metallic taste

Bromine inhibits both, T4 and T3 production
and can lead to hypothyroidism
Sources: PBDE is a bromine-based fire retardants used in carpets,
mattresses, upholstery, furniture and various electronic equipment. Hot
tubs use bromine instead of chlorine.
Medications: Atrovent Inhaler, Atrovent Nasal Spray, Pro-Banthine (for
ulcers), anesthesia
Foods: All bakery products have bromine. Brominated vegetable oil is
vegetable oil that has had atoms of the element bromine bonded to it.
Brominated vegetable oil is used as an emulsifier in citrus-flavored soft
drinks such as Mountain Dew, Gatorade, Sun Drop, Squirt and Fresca to
help fat-soluble citrus flavors stay suspended in the drink and to
produce a cloudy appearance.
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 Fluoride toxicity: Skin rashes, acne,
gastritis, migraine-like headaches;
stomatitis
Medications: 5-Fluorouracil, Anesthesia, Flonase, Flovent, Paxil, Prozac
and other SSRI anti-depressants
Removed from market: Baycol, Fen-Phen, Omniflox, Posicor, Propulsid
Others: Fluoride dental tablets, public Drinking water, tooth paste
Chloride toxicity: headache, sinus inflammation,
taste disturbances
Sources: public drinking water, Splenda (Sucralose), hot tubs, propellants in
spray cans, swimming pools
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Recommended Iodine Dosages
 Doses of 250mcg-50mg can produce symptoms of
hypothyroidism even if the gland is normal
 The optimal daily intake for iodine is 3mg to 6 mg

New research from Kessler shows minimal thyroid
suppression in large population at 3mg/day
 Adding iodine can increase the TSH level

Not a concern unless hypothyroid symptoms, then
manage appropriately!
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Iodine support recommendations
 Be sure that the patient is loaded with selenium for at least
6-8 weeks before starting iodine. Include L-tyrosine and
magnesium.
 Start slowly; remember the worse side effects occur in
those who are the most deficient
 If the patient demonstrates any signs of hypothyroidism,
including elevated TSH and suppressed T4:

Stop the iodine for 1 week and restart at a lower dose




Symptoms of resolve within 48-72 hours of stopping iodine
Give chlorophyll tablets 3 TID from the health food store
Can add Armorthyroid 0.5-1 gr daily or Synthroid 0.01ug
Support detoxification of bromine, fluorine and chlorine, known
carcinogens.
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A short word about
activism…
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What can you do?…
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Get involved…
There are issues now
that really are about life
& death
Mandatory “poisons”
being promoted as
“protection” are upon us
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Stay informed…
Please go to http://sayingnotovaccines.blogspot.com/ for daily
vaccine updates and http://drsherri.wordpress.com for daily
updates on breast health and thermography.
Get involved: We are getting short on time…
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You still have the right
to
JUST SAY NO…
but maybe not for long
"When we give
government the power
to make medical
decisions for us, we, in
essence, accept that
the state owns our
bodies."
~U.S.Representative Ron Paul, MD
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Spread the word…
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Thank you …
Safe Travels…
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OsteoMed II
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W-440-239-3438
F-440-239-3440
www.OsteoMed2.com
New Medical Awareness Seminars
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BOOKS-DVDS-MORE!
Sherri J. Tenpenny, D.O.
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www.SayingNoToVaccines.blogspot.com
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www.DrSherri.wordpress.com
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All Rights Reserved
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