There is a lot of controversy when it comes to iodine supplementation in thyroid and autoimmune thyroid conditions. When it comes to hyperthyroidism and Graves’ Disease, most endocrinologists will advise their patients to avoid iodine. On the other hand, while some natural healthcare professionals also recommend for their patients to avoid iodine, others advise their patients with hyperthyroidism to take iodine. What I’d like to do is use this post to answer some of the most common questions people have about iodine supplementation in those with hyperthyroidism.
Question: Since Iodine Is Involved In the Production Of Thyroid Hormone, And Hyperthyroidism Involves An Excess Of Thyroid Hormone, Isn’t It Wise For People With Hyperthyroidism To Avoid Iodine?
Answer: Although it’s true that iodine is necessary for the formation of thyroid hormone, this doesn’t mean that everyone with hyperthyroidism should avoid iodine. First of all, remember that most people with hyperthyroidism have Graves’ Disease. And although this condition involves an excessive production of thyroid hormone, the reason for this is due to the autoimmune component. It’s the TSH receptor antibodies which stimulate or attack the TSH receptors, which in turn results in the overproduction of thyroid hormone. Giving someone iodine doesn’t mean the thyroid gland will produce even more thyroid hormone. In fact, in the past, medical doctors actually recommended Lugol’s solution as a treatment for hyperthyroidism and Graves’ Disease.
Question: Can Taking Iodine Worsen One’s Hyperthyroid Condition?
Answer: It is possible, although in most cases iodine supplementation doesn’t cause problems in people with hyperthyroidism. However, if someone doesn’t take the proper precautions then there is a chance that iodine can exacerbate the autoimmune response in people with Graves’ Disease. I discussed this more in the article I wrote entitled “Can Taking Iodine Cause An Autoimmune Thyroid Condition?” During the formation of thyroid hormone an oxidation reaction takes place, and this is why antioxidants such as selenium and vitamin C are necessary to take. Plus, there does seem to be some people who just don’t do well when taking iodine. But just as is the case with everything else, it comes down to the risks and benefits. And if the proper precautions are taken then the benefits of iodine supplementation usually outweigh the risks.
Question: Can Taking Iodine Cause A Hyperthyroid Condition?
Answer: As I mentioned before, iodine can potentially exacerbate the autoimmune response if the proper precautions aren’t taken, and this in turn can worsen one’s condition. And it can also trigger an autoimmune response for those people who don’t have an autoimmune thyroid condition, thus potentially leading to the development of Graves’ Disease. In fact, I’ve spoken with a few people who think their condition might have been triggered by iodine supplementation, although I think it’s safe to say that most cases of Graves’ Disease aren’t caused by supplementing with iodine. And with regards to iodine directly causing hyperthyroidism, in most cases someone would have to take very large doses of iodine for this to happen.
With that being said, some euthyroid people do experience hyperthyroid symptoms upon supplementing with iodine, and sometimes this happens when low doses are taken. Plus, there have been a couple of publications which showed that kelp might have caused iodine-induced hyperthyroidism (1) (2). One of these reports involved a 39-year-old woman who already had multinodular goiter and drank kelp-containing tea, and developed hyperthyroid symptoms. The other situation involved a 72-year-old female who developed hyperthyroidism while consuming kelp supplements. However, in most cases when you read about iodine-induced hyperthyroidism in the literature, this is usually the result of taking organic forms of iodine-containing drugs (3).
Question: Should Everyone With Hyperthyroidism Take Iodine?
Answer: Those who have read past articles and posts that I’ve written on iodine know that I’m pro-iodine. However, this doesn’t mean that I recommend for everyone with hyperthyroidism and Graves’ Disease to take iodine. In fact, before I recommend iodine to my patients I think it’s a good idea to test for an iodine deficiency. And then if someone is deficient in iodine I recommend for them to start taking small doses of iodine, and to make sure they take antioxidants such as selenium and/or vitamin C, along with magnesium, and the B vitamins.
Question: What Form Of Iodine Do You Recommend?
Answer: Many healthcare professionals recommend Iodoral. I like Iodoral, but the smallest dose you can take is 12.5mg. I commonly recommend Prolamine Iodine to my patients, which comes in doses of 3mg. This is still well above the RDI, but approximately 1/4 of the dosage of iodoral. Lugol’s solution is another option. Lugol’s solution is a mixture of 5% iodine and 10% potassium iodide in water, and two drops of a 5% solution is equivalent to 12.5mg to iodine, and so this is why Iodoral was formulated to include 12.5mg per tablet. It was actually designed to help prevent gastric irritation and to eliminate the unpleasant taste associated with iodine. However, some people claim to get better results when taking Lugol’s solution. There are other variations of iodine as well.
Question: Can I Supplement With Kelp?
Answer: Even though I mentioned a few negative studies involving kelp, many people do fine when taking a kelp supplement. However, the downside of kelp is that 1) it can be more challenging to dose, and 2) heavy metals such as mercury and arsenic can be a factor. You can minimize your exposure to toxins by purchasing a higher quality, organic kelp supplement, although this doesn’t guarantee that the supplement will be free from toxins. The advantage of kelp is that it’s a natural food, and includes other trace minerals.
Question: If It’s Determined That Iodine Supplementation Is Beneficial, How Much Should I Take?
Answer: This does depend on the person. If someone has a mild deficiency, then they will require less iodine when compared to someone who has a moderate to severe iodine deficiency. I usually will start someone with 3mg of iodine, and then slowly increase the dosage. But for some people even 3mg is too much. And how much iodine someone will build up to depends on how deficient the person is. When I was diagnosed with Graves’ Disease I began with 3mg of iodine and took as much as 24mg of iodine per day.
Hopefully this provides you with some valuable information about iodine supplementation. But I still didn’t answer the main question in the headline, “Is iodine safe to take for people with hyperthyroidism?” If someone has a deficiency in iodine and takes the proper precautions (which includes working with a competent natural healthcare professional) then in most cases taking iodine is safe. There are still some people who will react to iodine even if they are deficient and take the proper precautions. But in my experience it is rare for people to have a negative reaction to iodine supplementation, although due to the controversy involving iodine you will be sure to hear any “negative cases” with regards to iodine, and the truth is that while some people don’t do well when taking an iodine supplement, some people have negative reactions to other supplements as well.
Dr. Eric, Can you explain what some of the reactions to iodine might be? Is it just a worsening of hyperthyroid symptoms?
Hi Christine,
This depends on the person, as if someone has hyperthyroidism and has a negative reaction to iodine then they very well might have an increase in hyperthyroid symptoms. On the other hand, many won’t experience an increase in hyperthyroid symptoms, but might have other symptoms such as a rash, or perhaps have some headaches.
I was diagnosed as being severely deficient in iodine. I was prescribed one drop of Lugol’s solution 3x weekly. I measured my thyroid antibodies monthly and watched the anti-TPO climb over 6 months from 175 to 285 and the Anti-Tg climb from 9 to 19.96. Seeing the trend, my G.P. reduced my dose of iodine to 1 drop weekly, then advised me to stop it as my TSH rose from 3.14 to 4.73 in the same period. I was taking selenium in the form of 2-3 Brazil nuts/day and zinc and magnesium tablets. I took a bottle of selenium tablets over a month to ensure I was getting a measured amount of selenium when the antibodies started to trend up. Apparently there’s a facebook group on Hashis 401, I think or allied to STTM that uses a strict protocol of iodine and other supplements and report no adverse effects.
Hi Honora,
Thank you for sharing your experience with us. It’s great that you monitored the thyroid antibodies while taking the Lugol’s solution. Of course there could be other factors which could have resulted in the increase in the thyroid antibodies, but it of course is possible that the iodine was responsible for this. And this admittedly is a challenge when supplementing with iodine, as sometimes a person will feel fine, and perhaps even have an improvement in symptoms, yet the thyroid antibodies will increase. I wasn’t aware that STTM had a facebook page which discusses iodine protocols in people with Hashimoto’s Thyroiditis. Thank you for letting us know.
Forgot to say I’ve got subclinical Hashimoto’s!
Does living next to the ocean have any effect?I can smell the seaweed really strong some days.Is sprinkling a teaspoon of dried organic seaweed okay for those who have a bit of hyperthyroidism?
Hi Linda,
I’m pretty sure that living next to the ocean shouldn’t cause problems. As for whether sprinkling a tsp of dried organic seaweed is okay, I would still take the precautions that I discussed in the post. This is especially true if you plan on doing this on a regular basis.
Hi DR
however my query may not related to Subject but need some recommendation:
my daughter have Hashimotio’s for 2 years now however here TSH FT3 and FT4 are normal she always have:
1- Anxiety
2- crash in the evening
3- Muscle pain
any idea , all the other blood test also are ok as:
1- B12
2- VIT D
3- Iron level
4- Calcium and magnesium
do you have any cases like that, and what we need to do to got consultation from you side
thanks
Hi Ashraf,
It’s great that the TSH and thyroid hormone levels were normal, along with the vitamin/mineral levels you listed. But of course there could be other factors to look into, such as the adrenals, gut problems (leaky gut syndrome is common in autoimmune thyroid conditions), imbalances of the sex hormones, toxins, etc. And so I do think it’s a good idea to work with a natural healthcare professional, as while blood testing can be valuable, it doesn’t tell the entire story. Plus, also keep in mind that when evaluating blood tests, you can’t always rely on the reference ranges provided by the labs.
Hello Dr. Eric,
I have been diagnosed with Hypothyroidism with Hashimoto’s and taking natural thyroid medication (Naturethroid), however I am not feeling better and there might be underlying factors causing my fatigue, hair thinning/loss, dry skin, constipation and not forget weight gain. Based what I am reading, is there a link between H. pylori and Hypothyroidism.
I had additional tests today (10/24/13), TSH=5.84, T3=283, and T4=0.93, its seems TSH levels are dropping from previous test (TSH=7.7), since I started natural thyroid medication. Also, H.pylori test along with pancreatic tests are negative. So far, I been screened for gall bladder, pancreas and stomach issues resulting in all tests are negative. Why am I feeling so crummy?
Hi Norma,
I’m glad that the H. Pylori test came out negative. Keep in mind that there can be many different factors which can trigger an autoimmune response. I know you said you have been screened for stomach issues, but has a leaky gut been ruled out? Other factors could include food allergens, pathogens other than H. Pylori, adrenal problems, imbalances of the sex hormones, etc. So while the naturethroid is helping to lower the TSH, it of course isn’t doing anything for the underlying cause of the condition, and so I would recommend working with a local natural healthcare professional who will try to detect, and then correct the cause of the problem.
I stopped taking my hyperthyroidism meds as it makes me feel sick all the time. I’m now taking 3 x 1000mg omega3 daily and 1mg zopax for the tremors but have decided to gradually stop using it and rather take a beta blocker.
Is it safe for me to take Kelp as a supplement and what dosage? The Omega3 definitely works better than the other meds as except for some tremors I feel fine.
Thanks
Elize
Hi Elize,
Some people who have problems with supplements such as Iodoral do fine with kelp, but not everyone. Dr. Larry Wilson has an interesting article on iodine, and talks about kelp as well:
http://drlwilson.com/Articles/IODINE.htm
Hi Dr
Ross here from South Africa. I have Graves disease as well as Myasthenia Gravis. I do a lot of thorough research and its difficult to find meaningful articles concerning Graves disease and iodine. So thank you for the article above, it is useful for me on my journey. I would like to understand the process of the conversion of T4 to T3 and how iodine is involved in that conversion? Could a deficiency in iodine show elevated levels of T4 that aren’t being converted to T3?
I will look at your linked article above, but if you could recommend any other articles concerning hyperthyroidism or Graves disease and iodine that would be great.
Thank you
Ross
Please Help!
My sister in law is into a lot of “natural medicine”, and there is nothing wrong with that, as long as your information comes from valid sites. Currently, she is taking Lugols daily. She is waiting to get extra doses of Selenium and Vitamin B12. Apparently, the Vitamin Shoppendid not have the doses she wanted.
She DOES NOT have any history of thyroid disease. What are her potential side effects beside developing autoimmune disease? My SIL is 64 and a smoker. She is trying to get my MIL, who is 83, to do the same.
Further, any proof that iodine defiency causes either Thyroid Cancer or Breast Cancer
Thx
FDdoc
Hi Cynthia,
The main concern with taking large doses of iodine is that it potentially can trigger thyroid autoimmunity. There is no solid evidence that I know of that an iodine deficiency can cause thyroid cancer or breast cancer, but of course this doesn’t mean it can’t be a factor. This is especially true with regards to breast cancer, as there is some “suggestive evidence” that iodine might play a preventative role:
http://www.ncbi.nlm.nih.gov/pubmed/10710195
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC314438/
Is the amount of iodine in a multivitamin ok when you have graves? Also, is the soy in the multivitamin ok as well?
Hi, are there any concerns with taking iodine during pregnancy? I’ve had a hyperthyroid for while now, but haven’t had any symptoms in years. The only reason my ob found it was through a blood test. She prescribed me ptu which has a long list of side effects and warnings and I’m not comfortable with taking it.
Is the amount of iodine in a multivitamin ok when you have graves? Also, is the soy in the multivitamin ok as well?
i was initially hpothyroid and was prescribed synthyroid. My tsh got suppressed to .01 and doctor had to stop synthyroid. amtibodies were tested and they were negative.the tsh level after 1 month of stopping medicine is .03. I also stopped my prenatal multivitamins which contain 220 mcg of iodine thinking it kight aggravate the hyperthyroidism
Please suggest if i can take iodine
I was treated with radioactive iodine in 1995 I was told to avoid all fish. When I came home if I went near a radio or tv for about a month they would not work! If I have a medical and cross my legs and a doctor hits the leg with a hammer I do not react – this is apparently common.
Hi and thanks for this very helpful website. Briefly this is my story.
10 years now since diagnosed with Graves Disease. Originally given 20 mg Neo Mercazole twice daily. After 6 months I was taken off all meds. One year later and doing fine, suddenly I get ill with GD symptoms again and am put back on Meds again. Couldn’t work out why I redeveloped GD until it was made known that the Oz government made it compulsory to bake read with added iodine in it. This coincided perfectly with me relapsing again. So for the next 8 or so years I travel well on only one 10mg a day of Neo Mercazole and supplements including Spiralina, Flaxseed oil, zinc, and selenium via Brazil nuts, AND avoiding foods hi in iodine. That was until a week ago where I binged on iodine food while camping with friends. Heaps of eggs, prawns, fish scallops and butter fish.Now suddenly I cannot sleep more than 2 hours a nite (usually 6-7), feel like my whole body especially chest is over heating, and heart beat skipping a beat every two beats.Feels like Adrenalin. Been 4 days now… could this be thyroid storm? Looks like I am one of those rare guys to be adversely affected by iodine. I am now 67 yo
I have graves hyperthyroidism and i find taking Detoxadine a form of nascent iodine it has really helped me alot with it and keeps my thyroid in check is this normal for it to bring my tsh up?
Thank you for this helpful information. In your article you recommend taking antioxidants such as selenium and vitamin C when taking iodine. Do you recommend taking the antioxidants at the same time of day as iodine, or is there any reason to take the antioxidants separately? Is there any benefit in terms of absorption to taking Lugol’s iodine first thing in the morning with water on an empty stomach, or is it better taken with food? Thanks again for your help!
Hello Dr. Eric,
I wasn’t sure if you saw my comment from June 18th or if you could help with these questions. Thank you!
Hi David,
I’m not sure how I missed your question, but I just went ahead and responded!
Hi Dr. Eric,
I greatly appreciate your helpful reply!
You are very welcome David!
Hi David,
I typically would recommend taking the antioxidants at the same time as the iodine. Although the absorption of Lugol’s might be better when taken without food, I just about always recommend taking vitamins and minerals with food, as we weren’t meant to take minerals in isolation. Of course ideally we would want to get all of our vitamins and minerals with the food we eat, but in this day and age this is very challenging. That being said, I know some healthcare professionals would disagree with me not only with Lugols, but I know a few practitioners who recommend selenium to their patients on an empty stomach.
i have hyperthyroidism n i suffer from itching after cold bath usually,if applied pressure on skin marks n red colour rash with itching appear on skin.i am using neo mercazole 10 . my question is i live in a hostel ,they provide food with iodised salt,can i eat that them as it is only has low amount of salt n can i drink tea
Hi Teja,
Although I usually recommend natural sea salt, having a small amount of iodized salt probably will be fine, although of course everyone is different. As for whether you can drink tea, this also depends on the person, as many of my patients can drink green tea and herbal teas, but black tea is higher in caffeine, and if someone has adrenal problems it usually is a good idea to minimize the caffeine intake, and this even applies to green tea.
I was diagnosed with a low version of Graves about 3 months ago. My Endo has me taking 5mg of Methimazole every day. I also take 6000iu’s of D3, Chelated Magnesium, Super B complex, probiotics and L-Lysine daily. I use to take Iodine/Iodine Plus 2 daily and felt great from taking it but read a lot of people bashing the product, saying it wasn’t safe. The only side effect I had while taking it was sneezing. When I mention taking Iodine to my Endo, he looks at me like I’m from Mars! Any advise on how to approach him to see if he’ll check my Iodine levels since I’m sure they obviously didn’t cover much (if any) of this in medical school?
Sorry, I meant Iodine/Iodide
Hi Dr Eric.i have been recently diagnosed with Hyperthyriodism but my endocrionologist is not understanding if i am having post partum thyrioditis or Graves Disease because i gave birth last year and i have no symptoms instead i gained weight and some times my heart beat increase.i have been told to eat low iodine diet so does that mean i cannot eat table salt and dairy product at all?
Sobia, I usually have my patients avoid table salt and dairy (at least initially), but not because of the iodine. Sea salt is healthier than refined iodized salt, and while there are health benefits of dairy, it’s a common allergen. In fact, I’m more concerned about the allergenic properties of dairy than the iodine content.
Hi Dr Eric
How long do recommend taking Lugols for? Is this an everyday thing indefinitely? Thank you
Annie, I don’t necessarily recommend taking Lugols, as it depends on the person, and I always recommend doing a urinary iodine test first before supplementing with iodine. I’ll add that if someone has an iodine deficiency and they choose to correct it by taking Lugols then they would usually take it daily until the deficiency is corrected, and then perhaps take a maintenance dosage thereafter.
Dr. Eric,
You were very helpful with my previous question so I hope you don’t mind a follow up.
Have you heard of taking fulvic acid with iodine? Some things I’ve read suggest these two work together as the fulvic acid increases iodine absorption and availability. Thanks for your time!
Hi Dr. Eric,
Just a quick follow up to see if you have an opinion on taking fulvic acid with iodine. Thanks!
Hi David,
I haven’t heard of taking fulvic acid with iodine. So I’m honestly not sure if fulvic acid increases iodine absorption, but if you have any research please feel free to run it by me!