Iodine Synergy (formerly I + 2 Iodine) is a high dose iodine formula composed of 2 types of iodine along with selenium. One scored tablet contains 15 mg of iodine as potassium iodide (76% iodine) and 10 mg of iodine as kelp (10% iodine). Certain organs of the body prefer iodine while some others have a greater need and preference for iodide which is why both forms are included in this product.

Symptoms of Iodine Deficiency:

• Low thyroid (hypothyroid)
• Goiter
• Cold hands & feet, fatigue, frequent crying, weight gain, dry eyes
• Polycystic Ovary Disease (POD)
• Fibrocystic breasts
• Irregular menstruation (amenorrhea)
• Infertility in females
• Urinary Tract Infections (UTI)
• Breast pain and premenstrual migraines
• Difficulty sweating even in hot weather
• ADHD, learning disabilities, and lower IQ in children born to mothers with low thyroid/ Iodine deficiency (especially first few weeks of pregnancy).
• Long term Iodine deficiency can lead to breast, ovarian, and thyroid cancers.

Iodine Insufficiency FAQ

How does iodine deficiency manifest itself?
Research work has shown that iodine deficiency in the thyroid presents as a thyroid goiter (enlargement of the thyroid). In those areas of the world where iodine deficiency is very high, such as in Switzerland and in certain areas of Asia and Africa, there are also higher incidents of thyroid cancer. Iodine is also concentrated by breast tissue, and a lack of iodine in the breasts manifests as fibrocystic breast disease (painful breasts with nodules and cysts and often more symptomatic prior to menstrual periods). 93% of American women have fibrocystic breast disease and the longer this disease exists, the higher the potential risk for development of breast cancer. 20% of all iodine in the human body is stored in the skin, specifically in the sweat glands. Lack of iodine in the sweat glands manifests as dry skin with a decreased ability to sweat. Iodine can also be concentrated in the stomach tissue, and the lack of iodine in the stomach manifests as achlorhydria (lack of digestive acid production). Iodine is used by the stomach cells, also known as parietal cells, to concentrate chloride which is necessary to produce hydrochloric acid (digestive acid). With the prolonged presence of achlorhydria, there is a much higher incidence of stomach cancer. Iodine is concentrated in the lacrymal glands of the eye, and a lack of iodine can cause dry eyes. Iodine can also be concentrated in the parotid and submandibular glands of the mouth, and iodine deficiency here can result in dry mouth. Iodine can be concentrated in the ovaries, and Russian studies done some years ago showed a relationship between iodine deficiency and the presence of cysts in the ovaries. The greater the iodine deficiency, the more ovarian cysts a woman produces. In its extreme form, this condition is known as polycystic ovarian disease.

Is there enough Iodine in our iodized salt?
When people go shopping for salt they will notice there is iodized salt verses regular salt. This is also true for sea salt that is plain sea salt verses sea salt with iodine. There is more iodine in iodized table salt that there is in plain sea salt, which contains very little iodine to start with. Quite frequently we see articles in the local press showing that there is a high amount of iodine in salt and we need to reduce the total amount of salt because of the potential damage from iodine. However, during the last National Nutritional Survey called the NHANES III from 1988 - 1994, the study revealed that 15% of the U>S> adult female population suffered from iodine insufficiency where this was defined as a urine iodine level 60 meq per liter. Another misconception that is out on the market is that high consumption of iodized salt helps prevent iodine deficiency. The fact is that iodized salt contains 74mcg of iodine per gram of salt. The purpose of iodization of salt was to prevent goiter and cretinism and was never meant for optimal iodine requirements by the human body. An example of this would be the ingestion of iodine in order to control fibrocystic breast disease that is a level of five milligrams of iodine per day. In this particular case one would need to consume 68 grams of salt. In Japan, the Japanese population has an intake of around 13.8 milligrams of iodine per day. Among the population of the Earth, the Japanese have the lowest prevalence and incidence of female reproductive organ cancer in their tissues.

Can I use seaweed purchased from the grocery store to supplement my body with iodine?
Seaweed sold in the United States has a tremendous variation in the amount of iodine content. In Japan, the average Japanese eats around 13.8 mg of iodine per day with the vast majority of that iodine coming from seaweed that has been specifically grown and cultured to maximize iodine trapping in the seaweed. To my knowledge, this particular type of seaweed is not being sold in the United States at the present time.

What about iodine and aging?
As most of us know, hypertension (high blood pressure) often becomes an issue as we age. Because of this, many are being told that they need to decrease the total amount of salt in their diet. However, we must realize that most people over age 60 are becoming depleted of iodine due to the lack of iodine in the diet and that this particular group of individuals is also the group with the highest occurrence of thyroid nodules and goiters. Also of interest is that 25% of the people in this age category will become senile as a result of low thyroid (hypothyroidism). Iodine supplementation may alleviate these iodine-related maladies, but iodine testing and thyroid studies such as a thyroid ultrasound and thyroid lab tests should be conducted prior to beginning iodine supplementation therapy.

Can Iodine be used while a woman is pregnant?
In Japan, the average Japanese woman is eating 13.8 mg of iodine per day while the average American woman consumes 100 times less iodine per day (approximately 0.138 mg per day). Iodine is very crucial in the first three years of life from the development of the fetus inside the womb until two years after birth. In the development of a child's IQ, it would be very advantageous for the mother to supplement her diet during pregnancy and, if she is nursing the child, for the first two years after pregnancy.

Does everyone need iodine supplementation?
Iodine supplementations should be prescribed only if indicated by the results of iodine testing. Iodine testing kits may be ordered from Dr. Flechas' office (1-877-900-5556) by individuals with a physician's order or by health care professionals. If ordered by an individual, test results will be returned to the ordering physician; if ordered by a health care provider, test results will be returned to the health care provider. A cost of $80 per kit covers the cost of the testing kit, testing services, and return postage (charges for additional postage will apply if mailed to location outside the U.S.). A urine iodine spot test was developed by the World Health Organization and looks for iodine sufficiency to prevent goiter. This test is now offered through our office for an additional ($30) thirty dollars making the total $110.

What happens to thyroid hormone production in the presence of iodine supplementation?
Iodine supplementations should be prescribed only when iodine testing indicates iodine deficiency. Iodine testing kits can be ordered from Dr. Flechas' office (828 684 3233) by individuals or by medical practitioners. Traditional medical literature indicates that patients who have thyroid nodules or thyroid goiter may have the potential to develop hyperthyroidism when supplementing with iodine. Hence, before commencing iodine supplementation, it would be advantageous for a person to have their primary care doctor order a thyroid ultrasound to rule out the possibility of pre-existing goiter or thyroid nodules. The primary care doctor should also order thyroid lab work (to be used as a baseline) before prescribing iodine therapy and this lab work should be repeated and followed at regular intervals during the patient's iodine therapy. For iodine therapy patients not also on thyroid hormone replacement therapy, adjustments to the iodine therapy should be made if signs of hyperthyroidism should occur. Should signs of hyperthyroidism occur in patients who are taking thyroid hormone replacement therapy as well as taking iodine supplementation, the physician should first recommend an adjustment in the thyroid hormone therapy rather than in the iodine supplementation. This adjustment in therapy is recommended because iodine is required not only by the thyroid but is required for the proper functioning of many other tissues. The presence of pre-existing thyroid nodules or goiter does not preclude the patient from iodine supplementation therapy. In fact, in the extensive research with iodine therapy done in my office, I have seen many case of pre-existing thyroid nodules and goiter shrink in the presence of iodine therapy.

More on Iodine

FAQ from Dr. Flechas Family Practice www.HelpMyThyroid.com

Q: How common is thyroid disease in primary care of patients?

A: Hypothyroidism is very common in the elderly. It occurs in about six percent of the individuals older than 60. Hypothyroidism is subclinical in about twenty percent of the elderly. Hyperthyroidism occurs in about two percent of adults but is subclinical in up to twelve percent of cases. Autoimmune thyroiditis, otherwise known as Hashimoto's thyroiditis occurs in about ten percent of adults and is four to five times more common in women than men. The incidence of thyroid nodules in the general population is estimated at four to nine percent but may be as high as fifty percent in the elderly.

Q: What test is sensitive enough to let us know if hypothyroidism is present?

A: The third generation thyroid stimulation hormone TSH assay is extremely sensitive and relatively inexpensive. Over and subclinical hypothyroidism can be detected by an elevated TSH and subclinical and over hyperthyroidism can be detected by suppressed TSH.

Q: What type of test can be done to detect autoimmune thyroid thyroiditis?

A: Anit-thyroglobulin (ATA) or anti-thyroid peroxidase (ATPO) antibodies are elevated in patients with Hashimoto's chronic thyroiditis. In patients with Graves' disease we will typically see an elevated thyroid-stimulating immunoglobulin.

Q: In patients who have had thyroid cancer and been treated with the use of radioactive iodine, what would be the most sensitive test to let them know that there may still be some thyroid tissue left?

A: We follow patients with thyroglobulin levels. If there is any thyroid tissue available in the body that tissue will try to make thyroglobulin. We would like to see the thyroglobulin levels down at zero post ablative I-131 therapy.

Q: What types of tests can be used to look at the thyroid?

A: Visualization tests such as the I-123 scan and ultrasound are helpful in structural abnormalities of the thyroid. In Graves' disease we see diffuse enlargement of the thyroid. In a toxic adenoma we see a hyperfunctioning nodule. In multnodular toxic goiter we see multiple hyperfunctioning nodules. In sub acute thyroiditis we see a decreased I-123 uptake and spotty scan.

Q: What populations should be screened for thyroid disease?

A: TSH serum levels for all adults over 60+ every five years. Some would suggest starting this process at age 35 for some patients where there are symptoms and signs of thyroid disease. For patients with other autoimmune disorders such as type 1 Diabetes, collagen Vascular Diseases or a reversed-degree relative with thyroid disease. Other diseases to look at where low thyroid disease is associated with illness is vitiligo, Addison's Disease, pernicious anemia and premature ovarian failure. Thyroid screening should be done in patients who have had history of prior radiation therapy to the neck. Thyroid screening should be done in patients with history of hypercholesterolemia otherwise known as elevated cholesterol and thyroid screen should be done in patients who have abnormal fast cardiac rhythms otherwise known as cardiac tachyarrhythmias.

Q: What are the most common signs and symptoms of thyroid disease?

A: In patients with hypothyroidism we see fatigue and weakness in 99% of the patients. Dry and coarse skin 97%. Slow speech 91%. Cold intolerance 89%. Thick tongue 82%. Facial edema 79%. Coarse hair 76% Memory impairment 66%. Constipation 61%. Weight gain 59%. Hair Loss 57%. Hoarseness 52%. Menorrhalgia (excessive menstrual bleeding) 32%. Decreased hearing 30%. Retarded mentation. Bradycardia. Hypothermia. Eyelid edema. Periorbital puffiness. Thinning of the lateral eyebrows. Prolonged relaxation and deep tendon reflexes. Diastolic hypertension. Distal heart sounds. Signs of pericardial effusion. Depression. Ataxia. Hyperlipidemia. Impaired fertility. Muscle aches and pains.

In patients with hyperthyroidism we see patients having problems with tachycardia or fast heart rate 88% of the time. The tachycardia is usually defined as a heart rate of 100+ per minute. Weight loss is 70%, Fatigue 71%. Heat Intolerance 67%. Polydipsia (constant thirst) 64%, Thyroid bruit 63%. Emotional disturbance 61% Sweatiness 44%. Tremors 41%.. Proximal muscle weakness 32%. Eye changes such as eye irritation, stare, proptosis, diplopia, and photophobia occur in about 32%. Pedal edema 29%. Frequent bowel movements 28%. Pruritus (itchy skin) 27%. Increased appetite 13%. Atrial fibrillation 10%. Gynecomastia 10%, Splenomegaly 10%. Weight gain 5% Pretibial myxedema, which is usually associated with Graves disease 4% and insomnia. Other things that have noted in patients with hyperthyroidism include irritability, nervousness, thyroid enlargement, decreased menstrual cycle, goiter, shortness of breath, lymph node enlargement and clubbing otherwise known as thyroid acropathy.

In patients who are developing problems with autoimmune thyroiditis otherwise known as Hashimoto's thyroiditis, patients will frequently complain of feeling of fullness in the throat and painless thyroid enlargement.

In patients with subacute thyroiditis it is not unusual for us to find patients having problems with exhaustion, neck pain mistaken for a sore throat and low grade fevers. For patients with thyroid nodules we typically see neck swelling and thyroid tenderness.

Q: When a patient presents with evidence of high thyroid output such as thyrotoxicosis, what types of illness should be considered?

A: One should look for exogenous administration of thyroid hormone. We look for autoimmune diseases such as Graves' disease, toxic multiple nodule goiter, atoxic adenoma otherwise known as Plummer's disease which is where a person has a solitary nodule of the thyroid which is putting out a lot of thyroid hormone. There is such a thing call Hashitoxicosis. We also look for the de-Quervain sub acute thyroiditis. These patients usually have an elevated thyroid T4 in the blood stream, elevated thyroid binding globulin that is usually very high with increased sedimentation rate. We also see problems with silent thyroiditis, thyrotropinona of the pituitary. We see problems with thyrophoblastic thyroid hormone resistance and struma ovarii, which is a special case where we find that ovarian tissue has the ability to make thyroid hormone, which then can give problems with thyrotoxicosis.

When one sees a patient with hypothyroidism we start considering things such as chronic lymphocytic thyroiditis otherwise known as Hashimoto’s thyroiditis, radiation and surgically induced hypothyroidism, sub-acute thyroiditis, post-partum thyroiditis, secondary and tertiary hypothyroidism due to pituitary insufficiency. Treatment for the above conditions has to be tailor made to each individual so that a patient having symptoms of hyperthyroidism or hypothyroidism should be working with their endocrinologist or primary care physician to resolve the source of the problem.

Q: What types of foods is known to inhibit thyroid function and cause goiters?
A: These foods include such things as turnips, cabbage, mustard, cassava root, soybeans, the skin of peanuts, pine nuts and millets. Prescription drugs that are known to depress thyroid function include lithium bromide, tricyclic and moamine oxidase inhibitors, anti-depressants, dopamine and adenosine. Environmental contaminants include dioxin and PCBs can also inhibit thyroid function.

Iodine Product Change Explanation

The new product name is Iodine Synergy. The dose of iodine changed from 25 mg to 10 mg. The selenium, a key ingredient in this formula, increased from 25 mcg to 40 mcg.

Iodine sources in the industry include kelp and potassium iodide. Our past product contained both. Our new product contains iodine from only potassium iodide. Since kelp comes from the ocean, it is very difficult to control the varying mineral and metal levels from batch to batch and each batch can contain a different amount of iodine concentration based on sea conditions at the time of harvesting. Designs for Health is concerned that into the future as water pollution worsens, metal content may become more difficult to control as well.

Potassium iodide is a potassium salt of iodine and therefore supplies both iodine and iodide, which was the goal of the original formula. Not only does this form provide consistent levels of iodine, but potassium is also required for thyroid hormone uptake into cells.

The selenium level was doubled to ensure a high enough dose to potentially reduce antibodies in individuals with autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Grave’s disease. It is not unusual for Hashimoto’s thyroiditis to coincide with one of the following: nodular goiter with euthyroidism, subclinical hypothyroidism, or permanent hypothyroidism. Multiple studies clearly show selenium given to animals by mouth reduces thyroid inflammatory activity. The researchers see a decrease in thyroid peroxidase antibodies [TPOAb(+)] which reflects an improvement in autoimmune thyroiditis. Selenium also raises glutathione levels, an important antioxidant for thyroid protection. Selenium is a coenzyme for converting T4 (thyroxine) into the active T3 (triiodothyronine) hormone. Research also shows selenium is cancer-protective. With this synergistic blend of ingredients Iodine Synergy seemed to be an appropriate name for this product.

As for the dose of this product. We feel that the 10 mg iodine dose is better for slowly dosing individuals up to higher doses sometimes desired by practitioners (typically 20-50 mg per day in individuals carefully selected for high-dose iodine therapy based on clinical and laboratory criteria) and for slowly weaning them back down as their iodine tests improve. The lower dose also allows for a small capsule as opposed to a large tablet which was required for the old formula. The 10 mg capsule may make an excellent maintenance dose for some individuals overcoming, or at high risk for, selected hormone related diseases, such as thyroid diseases, and fibrocystic breast disease.