Autoimmune Thyroid Disorders

Ron: Okay, doc, I'm going to pass the controls over to you. You will see
something pop on your screen. Okay, you should see something
right now popping up on your screen. I see your slides.

Dr. Brownstein: Okay.

Ron: And we are ready to go, looks good.

Dr. Brownstein: Let me just hold of that one second.

Ron: Yes.

Dr. Brownstein: Okay. Can I get going?

Ron: We are ready to go. Thanks doc.

Dr. Brownstein: All right. Thanks Ron. And I'm glad you are all here to hear my
talk on autoimmune thyroid disorders and we will discuss whether
iodine causes or prevents autoimmune thyroid disorders like
Hashimoto's disease.

So the conventional thoughts on autoimmune thyroid disorders is

don't take iodine because it will cause or worsen autoimmune
thyroid disorders and they say don't take desiccated thyroid
because it will cause or worsen autoimmune thyroid disorders. For
both of those statements, I will use the old Wendy's commercial
and ask where's the beef behind those statements because there
isn't any truth behind either of them. And I will in the next hour go
through that with you.

So they say iodine will cause or worsen autoimmune thyroid

disorders. Well, it's interesting that you can't experimentally induce
autoimmune thyroid disorders without using a goitrogen and
ensuring iodine deficiency. And they say dessicated thyroid can
cause or worsen autoimmune thyroid disorders and that's never
been shown to cause autoimmune thyroid disorders. Whenever I
talk about iodine, including this talk, I always talk about this quote
from Leo Tolstoy. And he said that I know that most men,
including those at ease with the problems of the greatest
complexity, can seldom accept even the simplest and most obvious
truth if it would oblige them to admit to the falsity of conclusions
they have delighted in explaining to their colleagues. There's no
more falsely made conclusions in any single nutrient than iodine.
And we'll go through that, a part of that tonight.

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These are the books that I've written. I have 13 books. I read about
topics that I see that number one, interest me and number two, I
see what works in my practice. And we will focus on iodine which
is second you know from the bottom, you know second from the
left on the bottom. That's the cover of my book. It's in its fifth
edition and you know I started using iodine in my practice about
12 years ago and it’s the best thing that we do in our practice. And
we get the best bang for our buck with iodine. And I'll take you
through some of that tonight.

So there are two common illnesses out there and they are called
medical iodophobia and that's the condition where practitioners are
scared of using iodine that's been used over three generations of
clinicians safely, effectively for helping treat and prevent thyroid
issues and for helping to treat autoimmune thyroid disorders, and
then medical desiccated-thyroidophobia and that's the fear of using
desiccated-thyroid in conditions like autoimmune thyroid
disorders. So hopefully we'll dispell both of those illnesses today.

So medical iodophobics claim iodine causes autoimmune thyroid

disorders. They claim it can cause iodine induced hypothyroidism.
We are going to talk about bullet number one for the next hour.
Bullet number two is just natural iodine deficiency causes
hypothyroidism. They say it causes hyperthyroidism. That's true in
a small number of people who have an autonomously functioning
nodule in their thyroid. You give them some iodine. And they can
produce excess amounts of thyroid hormone. I have had three or
four cases over the last 12 years. In those cases they either get that
autonomously functioning nodule removed or they can't take
iodine. These are the people, you give them iodine, they become
hyper right away, first dose or two, and you have to stop the
iodine. It's not very common but that can occur. They also say it
causes locusts, frogs, plague, darkness and more. If you want more
information on that look at the Haggadah for Passover which we'll
pass on tonight.

So how much iodine is stored in the body? About 1.5-2 gm when

stored at sufficiency. You could see where it is stored here, the fat
and the muscle the most. The thyroid 50mg at saturation for
comparison's sake. So the thyroid doesn't store a heck of a lot of
iodine in the body compared to the other tissues. Every organ and
all tissues contain iodine. And iodine has to be transported to every
cell in the body because every cell needs and requires iodine to
function optimally. In fact cells can't - the cells won't survive
without iodine. Many different glands and cells concentrate iodine
against the gradient. It's carried across the cell membrane by the

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sodium iodine symporter. It's like a little taxicab that moves iodine
from the serum into the cell and this, the taxicab transports iodide
in a gradient 20-50 times that of plasma. So in this case through
that sodium iodine symporter, one atom of iodine is transported
into the cell along with two atoms of sodium. And it's an ATP
dependent process.

So let's look at the mechanism of what happens to iodine after it's

absorbed. You could see here … Ron can you see my arrow here?

Ron: Yes, I can, I can see your arrow.

Dr. Brownstein: Perfect. So you could see that this is the taxicab that moves iodine
from the serum into the thyroid cell. And without these taxicabs,
iodine won't be able to move into the thyroid and the same
mechanisms' been shown in the breast and the ovaries. And I am
not sure it's the same mechanism now with the vital tissue. They
just haven't studied it. But to make these sodium iodine
symporters, you need TSH. So if there's not enough TSH you can't
make these symporters. So one of the things that can happen is
when you give someone iodine the TSH goes up a little bit. That's
a normal and expected response as the body is making more of
these taxicabs to move iodine in. Once iodine saturates the cells
and everything normalizes, the TSH will come back down to
normal. In most people it takes three to six months. Some people
little bit longer.

But anyways, so our mechanism continues with iodine being

transported by the sodium iodine symporter into the cell where it
has to undergo oxidation. The hydrogen peroxide is locally
produced and thyroperoxidase which is inside the thyroid cell. This
oxidation now produces iodide to iodine. So oxidation is you
remove the outer electron in it’s shell. So iodine is now organified
or bound to thyroglobulin and the RDA for iodine you have
thyroid hormone being produced. That's the mechanism of how
iodine is making thyroid hormone. So at a 100 times the RDA for
iodine, [the RDA is a 150 micrograms], that's about 15 mgs. You
can produce iodinated lipids such as delta-iodolactone which I'll
talk about in a second. However, we do not make these iodinated
lipids at the RDA for iodine.

So here's the formula for iodinated lipids. You need iodine. You
need arachidonic acid. In the presence of thyroperoxidase it can
form delta-iodolactone. It's a key regulator for apoptosis and
cellular proliferation in the thyroid and it inhibits Epidermal
Growth Factor from thyroid follicles. Delta-iodolactone is now

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detected in human thyroid tissue when iodine deficiency is present,
but is present with iodine administration at a 100 times the RDA
for iodine.

So these MNU induced tumors which is what they give rats many
times to form breast cancer contains four times more arachidonic
acid than normal mammary glands. What that means is, the
arachidonic acid might not - doesn't have enough iodine to help
form delta-iodolactone, the arachidonic acid is building up in these
tissues. This would be a signal perhaps to give them more iodine.
Iodine supplementation is accompanied by a 10-fold higher delta-
iodolactone content in tumors. We know that it has apoptotic
properties to it. The same research shows that delta-iodolactone
and iodine have antiproliferative and apoptotic properties, just
what we wanted for cancer cells.

So organified iodine regulates the cell cycle here and here. And
now let's take a step up with this. This is the same pathway we just
reviewed. Iodide moving over the cell membrane, being oxidized
to iodine and organified to thyroid hormone at a 100 times the
RDA for iodine forms these iodinated lipids. But where does
peroxide come from? It comes locally produced via oxidative
phosphorylation from the NADPH-Oxydase System and there are
checks and balances on this because we don't want too much
peroxide which can damage TPO and cause sort of an oxidative
fire to start burning in the thyroid. So the checks and balances are
that iodinated lipids act as a break while calcium can stimulate this
pathway.

So let's look at this pathway again if iodine levels are too low.
Now, I did that first seminar with you guys and I showed you that
the RDA for iodine is much too low. I didn't start with it this time
because this is not the topic, but my premise is that the RDA for
150 micrograms is too low and even if 150 micrograms is
sufficient which I don't believe it is, 60% of Americans according
to the NHANE study are below the RDA for iodine. And according
to my research it's 97%. So I think low iodine is very common out
there and let's look at this pathway with the majority of Americans
who I think are taking a low iodine. So it's the same mechanism,
iodide is taken across by the sodium iodine symporter and it
undergoes oxidation the same way to iodine but we have lesser
amounts now because we weren't taking in enough. And you get
decreased organification and you get screwy thyroid hormone
levels.

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Now if you look at your thyroid hormone levels, you will see this
where T3 and T4 and in a reference range but T4 will be on a
lower side of reference range. T3 will be on the upper side of the
reference range. T4 should convert into T3. That's not what should
be happening here [see diagram on slides]. It always bothered me.
I never understood it for the first 10 years and I noticed this and so
I came up with this mechanism. So this is monoiodothyronine and
diiodothyronine. T1 and T2, also gets screwy when there's not
enough iodine in the system. So are we going to form delta-
iodolactone and iodinated lipids when we don't have enough
iodine? No.

Remember you need 100 times the RDA for iodine. No, we are not
going to form that but we are going to produce locally hydrogen
peroxide and are we going to have this break of iodinated lipids?
The answer is no because we are low in iodine, right from the start.
However we are going to have enough calcium in the system to
keep it going. My theory is that peroxide gets damaged. It damages
TPO and it starts the whole autoimmune thyroid syndrome going
on. So if we were alive [in 1929?] I would stop and ask everybody
what's the body's defense mechanism against this. What's this
oxidative fire that starts happening? Peroxide damages TPO. TPO
is a very highly oxidative substance that starts damaging all the
thyroid tissue, the thyroid cell. So the body tries to put out the fire
by producing Anti TPO and Anti Thyroglobulin antibodies. These
are the firemen that come in.

So what's the treatment for this? Well, you can talk … One of the
treatments is give them iodine. Perhaps another treatment to
counter the excess calcium you could give them magnesium.
There's a couple of things you give them. B2 and B3 to settle this
whole system down, these rate limiting effects for the NADPH-
Oxydase system. Selenium, if they have a selenium deficiency,
Vitamin C to help put out this oxidative fire that's happening, as
well as other antioxidants. That's pretty much the nutshell of what
I'm going to talk about today. So anyone wants to cut out you have
the meat of it right now. But let me go into a little bit more detail.

So the locally produced peroxide by oxidative phosphorylation,

here's the formula for breaking down and it's glutathione
peroxidase breaks down peroxide into two water molecules. This is
a magnesium and selenium dependent enzyme. So we need to
ensure adequate selenium levels and I can tell you most people are
magnesium deficient. So anyone with an autoimmune thyroid
disorder I put on magnesium and selenium if they are deficient in
it.

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So how much iodine should you take? I would say, you should
take enough iodine when there's no radioactive iodine uptake by
the thyroid gland. So if you go to a doctor and they inject
radioactive iodine in you, and they are trying to see how much
radioactive iodine gets uptake by the thyroid gland, it's normally
reported at 12 to 32% uptake is normal. I never quite understood
that if there's enough iodine in the thyroid it should just pass
through. It should be zero. But that proves to me that majority of
us are iodine deficient. Anyway, 12 to 32% is normal. So how
much is required to achieve sufficiency?

A study by Saxena found that three to 5 mg of iodine per day

decreased the absorption of radioactive iodine by the thyroid below
5%. Remember normal is 12 to 32%. Another study by Sternthal
found that increasing amounts of iodine, as shown here, results in
decreasing radioactive iodine uptake by the thyroid just as you
would expect since the iodine is now binding to its iodine
receptors, radioactive iodine is not what they are binding to. My
mentor in iodine, Dr. Abraham gave us this graph. On this graph
the X axis is a logarithmic scale of the daily iodine intake from,
you know, up to 100 mg. On the Y axis 24-hour radioactive iodine
uptake by the thyroid. And you can see as you get more iodine in,
radioactive iodine uptake goes down just as we showed you in the
last couple of … I showed you in the last couple of slides. And the
Z axis is the amount retained by the thyroid. As you take more
iodine in, not retained by the thyroid goes up to 600 micrograms
maximal.

So where do you want to be on the scale? Here's the RDA for

iodine. I don't think that looks like a good space to be in. I say you
want to be here. You want to maximize iodine uptake by the
thyroid, minimize radioactive iodine uptake which shows that the
iodine receptors are iodinated as they should be. So that is – here's
10 mg, here's probably 50 mg. Is it 50? 75? 100? Somewhere in
there. So I say the RDA is inadequate to supply the body's need.
Here's a combination of iodine and iodide. For autoimmune
thyroid disorders the doses generally range from 6 to 50 mg per
day.

So iodine is an essential ingredient in thyroid hormones. T4

contains 4 iodine atoms. T3 contains 3 iodine atoms. Without
sufficient iodine, the thyroid is unable to make thyroid hormone.
Thyroid tissue will become hyperplastic in a state of iodine
deficiency. That is a precursor to autoimmune thyroid illness. And
it's different from hypertrophy which is an enlarged thyroid gland.

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So here's the autoimmune thyroid illness. We will focus on the first

two, Graves' and Hashimoto's since they are the most common.
This is not Denard Robinson, our quarterback who finally beat
Ohio state few years ago and we've had a bad run against them, but
that's going to change with our new coach, even though we've lost
a devastating game a few days ago. I want you all to know I
recovered from that loss and I was feeling better yesterday about it.
But this is my daughter Haley. And Haley is a senior at UVM right
now and she just got into medical school a few weeks ago which
made her father very happy but this also made her father very
happy as you can see.

The reason I'm showing you this picture is it's good when Ohio
State loses. It makes me very happy but Haley was diagnosed with
Hashimoto's disease when she was 12 years old and here's her first
blood test. Of course I didn't diagnose her. My wife diagnosed her
because Haley was complaining of headaches and feeling tired.
Even though she was doing all the kids stuff you know she was
playing soccer and things. And finally one day at dinner my wife
said do you think she's got a thyroid problem? And it was almost
like the V8 commercial you hit yourself on the head and I'm like
holy cow I do this all day and can't see it in my own kid. Of course
you know all the signs of it. And I draw her blood work and here's
what we find that you can see she's got thyroid antibodies. She's
got Hashimoto's disease. The TSH was 5.1 here. I treated her with
Nature Throid, desiccated thyroid at half a grain. And I put in 25
mg of iodine which is pretty much my standard dose for
autoimmune thyroid patients when I start.

So a follow-up blood test with Haley, this follow-up is about 10

months later. I read old thyroid antibodies here. So she's down
significantly in half TG and three-fold lower in thyroperoxidase.
The THS is now down to 3.74 but it's still little high. Her
headaches are much better but she's still tired. So I up her thyroid
to 1gn and I up her iodine to 37.5 mg. So here she's 15 years old
and here at 16 years old. You could see her thyroid levels have
normalized and her autoimmune signs are all gone. Her
autoimmune signs are all gone. So a follow-up test with her, a few
months later, found that her thyroid was up a little bit. I upped her
nature thyroid and also upped her iodine to 50 mg a day. But she's
still producing no antibodies. So here's a example where iodine in
conjunction with – you know Haley was on some vitamins and
minerals too but she was on that stuff before. It was really the
thyroid and iodine management that I think cured her of
Hashimoto's disease.

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So if people spot off their desiccated thyroid replacement or iodine

cause autoimmune thyroid disease, I see examples of medical iodo
and desiccated thyroidophobia. And they just need to go away
because they are just not true.

It is true that association does not equal causation. That is 100%

true. However, what's also true is that negative association
disproves causation. So I know that's sort of a double negative in
that last sentence but it bears repeating. A negative association
disproves causation. So in the case of iodine, over the last 40 years
from the NHANES study, iodine levels have fallen over 50% in the
United States. During that same time, Hashimoto's, Graves'
hypothyroidism, thyroid cancer, have increased at epidemic rates.
This is a negative association. Iodine levels have fallen while those
illnesses have gone up. That disproves iodine as the cause of
autoimmune thyroid disorders. Period.

So Mark Twain said it's easier to fool people than to convince

them that they are fooled. They've been fooled. You know we've
been fed in our respective schools that iodine causes thyroid
problem and Hashimoto's, even though there's really no data
behind that. And I think it's easy to understand when you look at
this quote from Mark Twain.

So you know you could ask a question, are autoimmune thyroid

illnesses caused by iodine deficiency? We could look at two areas
of Denmark. These were all adults and what they found was the
median iodine excretion in Aalborg was 53 ug/L, in Copenhagen
68. Now these areas are both – this is severely iodine deficient.
This is moderately iodine deficient. And so both areas are iodine
deficient but you would think if iodine was causing autoimmune
thyroid disorders, which country, which area would have more
autoimmune thyroid disorders, you would think Copenhagen.
That's not true. Just the opposite. Aalborg has 2.6 fold higher
iodine. And again this is another one of those negative associations
disproves causation. It can't be iodine.

So minor differences in iodine excretion produce large increases in

thyroid disorders. So X-ray fluorescence scanning used to be done
you know across the US and they stopped again in the mid 1970s.
No one does it anymore here. But there are some old articles with
it and you can measure the stable iodine content of the thyroid
gland. There's a mean value of 10 mg of iodine per thyroid in the
normal population. If you recall from my previous slide, I told you
the thyroid can hold 50 mgs at saturation.

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If you believe that iodine causes autoimmune thyroiditis one would

think there would be more iodine in the thyroid patients with
autoimmune thyroiditis but that's not what this study found. 56
subjects with autoimmune thyroiditis and normal thyroid levels
had a mean value of half that of the normal population. It’s iodine
deficient, it should be 50 mg. But so when you drop it in half you
get more autoimmune thyroid disorders. And 13 subjects with
autoimmune thyroiditis and hypothyroidism now were half of that,
so the worse it gets, the less iodine is in thyroid. The same thing
with general thyroid cancer. It just gets lower and lower. So I call
it the iodine deficiency continuum. In the thyroid gland if you have
enough iodine, you have a normal architecture of the thyroid gland.
If you are iodine deficient the person would have cysts start to
form. If it goes on longer those cysts become hard and nodular. If
it goes on longer then it could become hyperplastic and cancer is
the end of that road. And it's the same phenomenon for all the
glandular tissue because all the glandular tissue needs and requires
iodine for normal architecture. That includes the breast, the
ovaries, uterus, prostate, pancreas, thyroid. I feel like I'm missing
one.

But what are we suffering epidemics of? One in seven women

have breast cancer, one in three men have prostate cancer, thyroid
cancer is the fastest growing cancer across the United States.
Pancreatic cancer is increasing at epidemic rates. Ovarian cancer
increasing at epidemic rates. I see the answer, part of the answer,
it's just right there, it's iodine and iodine deficiency that's affecting
us. If iodine were the cause of autoimmune thyroid disorders you
would expect more iodine in an affected gland, not less.

So the lowest concentration of iodine in the thyroid was found in

thyroid cancer, just as I mentioned before. NOW, here's a study
that the iodine naysayers were spouting off saying that it's causing
autoimmune thyroid disorders. So the results of the study were
potassium iodide in a solution of 30mM and higher were found to
inhibit the normal growth curve of thyroid cells. And they – this
study, here's how they concluded it. This study showed that iodine
excess inhibited human primary thyroid proliferation. In the
presence of low dose interferon, potassium iodide could induce
lymphocytic infiltration that's Hashimoto's disease in the thyroid
gland and secretion of proinflammatory cytokines inflammation
basically. This could explain the development of hypothyroidism
after adding iodine in a diet of persons that already have
lymphocytic infiltration and/or mild inflammation of the thyroid

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gland. So this was touted as another study showing that iodine
causes Hashimoto's disease.

However, they said 30mM if you look back here 30mM and
higher. How much iodine is 30mM? I mean they should put in the
study because who knows it. So how much iodine do you need to
adjust to achieve a serum level of these. This is what they looked at
in the study. Well, iodine in these substances you could study
because about 98% if it's taken orally is excreted in the urine. So if
you know the real clearance of iodine which is 42.5 liters per day,
you know the molecular weight of iodine 127 moles per liter. You
can do your calculations like we used to do in inorganic chemistry
and come up with what the serum level should be. So let's look at
that. 1mM of potassium iodide is 127 mg per liter. We know the
renal clearance of iodine is here. If we just multiply these numbers
out, like we were good at when we were younger, we come up
with 1mM is 5,398 mg per day. So if we fill our graph in, here's
what they found in the study. If you take 161,000 mg of iodine per
day you run into problems in the thyroid. So I would say don't use
that dose. We are not talking about using that dose.

So the conclusion of the article was normal human thyroid cell

proliferations inhibited in a dose-dependent manner by iodine
concentrations over 10mM. Remember that's a 161 g per day.
Oops. It's 30mM. I just had that wrong. So 161 g per day. I say
that's medical iodophobia. The real conclusion is iodine doses up
to 161 g per day did not cause changes in normal human thyroid
cell proliferation. Iodine is not associated with autoimmune thyroid
illness unless it's given in large doses along with a goitrogen such
as interferon which is what they used in that study.

So in all the animal studies with autoimmune thyroid disorders

they would have to have a goitrogen involved to produce it. Iodine
alone won't do it. You have to have a little bit of iodine to get
proliferation going in the cell. So in vitro studies with purified
fractions of calf thyroid glands showed a 10-5 molar concentration
of iodine protects TPO against oxidative damages. 10-5 molar
concentration is exactly what you get if you take about 15 mg of
iodine per day which is what you know my average dose is 25 to
50 mg for most people. Those that have autoimmune thyroid
disorders need a little bit more because they need to reach this
molare concentration to protect their TPO so it doesn't oxidatively
damage the thyroid.

This is Alex. And his mother brought him in to me. Alex is I

believe 16 years old here. And he had seen an endocrinologist and

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he's got this big old thyroid that you can just see in the picture.
When he’s palpated it's about 2.5 times normal size and it's all
nodular and hard. And he didn't really complain about much but
the endocrinologist said you need to have radioactive iodine. Mom
read about it, read what I wrote about radioactive iodine. She didn't
want that. So she brought him to me. He had goiter for three years.
He was also diagnosed with Hashimoto's disease during that time.
When I saw him I did a spot urine iodine and an iodine loading test
and here are the results. His spot urine iodine didn't detect
anything. The iodine loading test, 20% excretion, normal is 90%,
so he's severely iodine deficient. He was euthyroid upon initial
testing, meaning his T3 and his T4 were okay. And he had normal
selenium levels on red blood cells testing and hair testing.

So I treated him with unrefined salt, at least a teaspoon a day. If

you are going to use iodine, you need to use unrefined salt with it.
Unrefined salt helps to usher out fluoride and bromide which have
accumulated in the presence of iodine deficiencies since they are
all part of the Halides. And I put him on Vitamin C as an
antioxidant. Here's the dose of iodine I gave him and I gave him
magnesium, just like we looked at in the previous mechanisms
how iodine works in the thyroid. That was my protocol for him,
that's my protocol for a lot of my patients. And here's the original
Alex. Here's Alex eight months later. And if we look here, to here,
you can certainly see the difference and feel the difference. He's
2.5 times normal with his thyroid here. He's about a little large
here. I would say 1.5 times normal. All his nodules are down and
to compare him next to each other, you can clearly see a big
difference in 8 months.

So let's look at Graves' disease. It's more common in women.

These are the bulging eyes and more common in women who've
just given birth. This is my nurse Denni and Denni has been with
me since residency and Denni has also suffered Graves' disease
since she had her first child who's – how old is Derrick, Derrick is
probably 30 years old now. And Denni had been on antithyroid
medications you know over the intervening 30 years and you
know, much of the time. She had really not felt well much of the
time. She would suffer periods of thyroid excess when she would
get palpitations, nervous, jittery. Her eyes would bulge when she
had symptoms really bad. And she would go on and off. She never
really felt good. She would basically go on and off just not feeling
good.

So I asked Denni to do a test where we drew her blood every hour

here and we gave her 50 mg of iodine. In the orange is six women

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without any thyroid illness in six healthy women who did the same
test for. And you could see the six women, their iodine when they
took 50 mg here their serum levels peak about three to four hours
and then they are down and out by 12 hours, you know, 24 hours
of pretty much where they were. I mean it's in and out in 24 hours.

Here's Denni in gray. So she peaks about an hour and then she's is
out three hours you know. It's pretty much gone three hours here.
So did Denni absorb the iodine she took? Sure she absorbed it. Did
Denni utiliz the iodine? Did her iodine get utilized inside her cells?
The answer is no. She got it in and her body kicked it out really
fast.

Now, at the same time we did this test with Denni, I did a – I
checked her bromide levels in the same samples. So shown here is
her bromide levels. The yellow arrow is high bromide. And in the
baseline before she took iodine, she's got almost 150 mg per liter
of bromide in her blood. 200, I should have a redline up here is
considered lethal levels of bromide. So she takes 50 mg of iodine
in her body normally displaces bromide as you would expect and
the bromide goes up. And this is her long day at the office on
Tuesday and Denni is not happy here. Her symptoms have flared.
Her eyes are bothering her and she's got all her hyperthyroid
symptoms and she just doesn't feel good. She's got headaches.
She's not happy with me. And trust me, Denni let's me know when
she's not happy with me. And you could see here pretty much, it's
just like the iodine a few hours later. It's pretty much back to
baseline. But she didn't feel good this whole day that she did it.

So the question is, what do you diagnose her with and what do you
want to treat her with? Well, I diagnosed her with a symporter
defect. Her taxicabs weren't working to move the iodine from the
bloodstream into the serum. I diagnosed her with bromine toxicity,
probably oxidative stress from this bromine toxicity. And what do
you want to do with her? Well, at this point to counter the
oxidative stress I put her on Vitamin C. I asked her to take iodine
which she wouldn't take because she didn't feel good when she
took it. And I told her to take salt, to help salt out the bromine. The
chloride can help salt out the bromine. It's an old time treatment for
bromine toxicity.

So I put her on a teaspoon of salt and 3000 mg of Vitamin C and

we repeat the test which is three months later, three months later.
So now you can see Denni is much more aligned with the six
women. However, she felt crappy again at the hour mark of taking
the iodine. So these were nothing different than herr other

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symptoms when she wasn't taking iodine and she had a flare-up of
her Graves' disease. So perhaps her flare-up of Graves' disease is
caused by bromine you know going excess for some reason. But
whatever.

So Denni is mad at me again here. We screwed up the bromine part

of the test so I don't have it to show you. But at this point she
wouldn't take iodine but she agreed to take that salt and Vitamin C
and that's all she did. So five years later she's just taking the salt
and Vitamin C. She becomes euthyroid for the first time and really
since she had her first child. Her TPO titers for the first now were
within normal limits. And she agreed to do another loading test on
this day.

So here's her new loading test five years later which looks pretty
good. This time we didn't screw up the bromine levels. Here's her
bromine in red, the new one. This is much more normal for what I
see it for people. This was her before. Most people are down in
here with bromine. So she is still a little bit higher but she's
reasonable amount. This time when she took the iodine, she didn't
say I feel awful here. She basically – she didn't necessarily say she
felt better. But she didn't feel awful.

So, she was still going to take iodine. But - I'm sorry, she did agree
to take iodine after this because she didn't feel awful. So now we
are in 2014. She's been feeling well for six months on iodine. She's
on 50 mg. She has taken no antithyroid medications for – since
when was this test done, three years which was a long time for her.
She agreed to do another loading test. So here's her newest loading
test which certainly looks better than the other ones. Here's her
new bromide levels down in peak. She was feeling pretty good.

So then we had an iodine transport problems. Now interestingly

Denni was on iodine. She was feeling good. She wasn't on thyroid
meds. She was – you know her energy was back. And all of a
sudden somewhere you know a few months ago her Graves' came
back, out of the blue. You know people could blame the iodine but
she was feeling good on it and she had been on it for a while. It
wasn't the iodine. I don't know what it was. But she came off the
iodine. Her doctor put her back on the antithyroid meds. We’re just
taking her off that again and we had to start her back on the iodine.
And it's something else that's causing it. Iodine is the easy one to
blame but she had her symptoms when she wasn't taking iodine. So
I can't quite explain what it is with her but she's certainly been
doing better once we started her with some iodine.

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So there’s transport problems we want to support the detoxification
system with things like this. Vitamin C, salt, hydration, liver and
kidney support, clean up the diet and exercise you know. These are
really important things. The liver and kidney support, I have a
product called TLC, Total Liver Care that I designed which we sell
on our office. And that helps to rev all the detox pathways, the
liver and the colon. If you are interested in that, that's – you can
look at my website, my office website,
centerforholisticmedicine.com.

So this is proof positive that iodine can treat Graves' disease. This
letter is from an ophthalmologist and it's about a patient of mine
who happens to be the wife of someone I went to medical school
with. And my friend asked me to see his wife because they
couldn’t get her Graves' disease under control. She is miserable
and Dave can you help me. So I see her. I do my workup. I see her
back and I treated – just like I told you I would treat her. Put her on
50 mg of iodine, magnesium, Vitamin C, salt, and a good
multivitamin. And he calls me up when she comes home from
there and says Dave I don't think we should – I thought we were
told not to give iodine to people that have Graves' disease. And I
said Steve she's going to do just fine. She had no iodine levels
when I checked her. The iodine wasn't causing her Graves' disease.

So I get this letter from her ophthalmologist after she'd been on

this therapy for about three months. And it says here, I saw Joy
today for follow-up. She's doing incredibly better. All of these
subtle changes related to Graves' disease in the periorbital area are
continuing to diminish. In fact, the lower lids are tightening
beautifully and the bulging that is present that she thought was
familial may in fact have a partial familial component. I am going
to reevaluate her after the Jewish holidays but to hold her that if
she continues to improve surgery is not warranted and in fact could
be contraindicated.

If this could work on a doctor's wife, it can work on anybody.

Because everyone knows doctors' wives and kids are the worst
patients to treat because they always have problems and side
effects and worst conditions. So this is proof positive as well.

So the first Double-Blind Cohort study in Graves' disease was

done in 1863 by Dr. Armand Trousseau when he accidentally
treated a Graves' patient with iodine instead of digitalis which was
the treatment of choice. The patient improved. Upon realizing his
mistake he stopped the iodine and gave him digitalis, the patient
worsened. So he didn't know what was given the patient. The

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patient didn't know he was taking. This is our Double-Blind Cohort
study. And iodine has got a long history of treating people with
Graves'. His dose was 75 to 100 mg of Lugol's iodine.

First iodine studies were done in 1923 by Dr. Plummer. His

hypothesis was the hyperthyroidism of Graves' disease was due to
iodine deficiency. Before surgery, iodine was used to control the
high mortality of surgery for Graves' disease and thyroid storm
was wanted to be prevented. So he administered iodine at these
doses, a 130 to 195 mg pre-op, 62 mg post-op. He reported
mortality declined from high to zero. They knew this a 100 years
ago that iodine should be the treatment for this stuff.

This was a study, I can't see the date here. This was a study where
a female, 39 was gestational age was born to a mother with Graves'
disease. They treated the mother with PTU. I don't understand this
nonsense. Never give a pregnant mother these PTU, these
antithyroid medications. They should be given iodine. But because
of the PTU the fetal goiter was detected on ultrasound and the
newer born had hyperthyroid symptoms from the second to third
day of life. Now, they got smart and they finally treated him with
iodine which is what they should have done to her when she was
pregnant. And after 13 weeks, there was a normalization of thyroid
test and iodine was discontinued. This would have been all halted
if they would have just treated the mother with iodine in utero,
with the baby in utero.

Hashimoto's disease is an autoimmune illness. They say it's 2% of

the population. Those of us that are checking for this know it's
much higher. I would estimate probably a third of the population as
of now. It's much more common in women than men. In
pregnancy, TPO antibodies were found in 10% of women in early
pregnancies. TPO antibodies are associated with 50% of risk of
postpartum thyroiditis. The presence of TPO antibodies at 32
weeks gestation has resulted in a significant IQ decrease in
children even when mothers were euthyroid. This stuff needs to be
treated before these moms are pregnant and the only way to treat
this is iodine. It's iodine deficiency that causes this.

So thyroid antibodies will only be formed when there's oxidative

damage to the thyroid. Here's one of the ways you can damage
your thyroid. PARVO B19 which was detected in 91% of
Hashimoto's subjects compared to 44% of normal thyroid tissue. I
do check this on my patients. If they have it, I give them nutritional
support and I give them iodine. Since iodine has antiviral
properties to it. There's no virus that's been shown to be resistant to

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Autoimmune Thyroid Disorders
iodine. In 1912 Dr. Hashimoto reported the histological changes in
four thyroid glands. He described it here which is basically
Hashimoto's disease. And it wasn't observed in the US at the time
he reported it.

So before iodized salt, Dr. Hashimoto's findings were not seen in

the US. So it is reasonable to ask if iodine is causing Hashimoto's
disease. That's how it all started because of that stuff, because of
what I just told you with Dr. Hashimoto. So this was a study done
where they looked at slides taken 1915 to 1920 – thyroid slides
taken 1915 – and biopsies from thyroidectomies from 1915 to 1920
before iodized salt. And what they found was no lymphocytes in
their thyroid gland. And you need lymphocytes to get Hashimoto's
disease. So the authors commented, it should be emphasized that
the thyroid glands prior to the use of iodized salt were devoid of
lymphocytes and nodular colloid goiters with dense lymphocytic
infiltrates were found only after the introduction of iodized salt.
This is kind of where the iodine equals Hashimoto's disease came
into vogue. But remember association does not equal causation as I
showed you before.

This was another study in Mayo Clinic. They looked at 3 time

periods. I show them here. This was all after iodized salt which
came about 1927-28. What they found was the further you moved
in time, the more Hashimoto's there were. So could salt be the
cause of this? Or could it be iodine that's in salt? And that's a
reasonable question when you look at that.

But the NHANES study showed iodine levels have fallen over
50% in the last 40 years so it can't be iodine. Could it be salt?
Could it be a goitrogen, such as bromine, chlorine or fluoride? Or
is it a combination of iodized salt and goitrogens which is exactly
what I think is happening why the Hashimoto's came after iodized
salt. It’s all the goitrogens people were exposed to in the form of
these three things, particularly this one and this one.

Remember iodine levels have fallen 50% in the last 40 years. It

can't be iodine causing autoimmune thyroid disease. So why does
Hashimoto's form? It ain’t iodine. And this probably has some play
to it, especially goitrogens. But what they don't comment on is it's
impossible to experimentally induce Hashimoto's disease in lab
animals by administering iodine alone. You can only use anti-
thyroid drugs or goitrogens can induce Hashimoto's disease in lab
animals when there is a little bit of iodine there as well. Goitrogens
induce not only hyperplasia, they cause iodine deficiency.

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So the mechanism for thyroiditis – I'm not going to go over it. We
just went through it when I drew all those little arrows up. Let me
spell it out here. Only magnesium, iodine, Vitamin C and
selenium, if they are selenium deficient can reverse that
mechanism. So selenium – there are studies showing selenium can
help autoimmune thyroid disorders but that's only in selenium
deficient areas. If there's enough selenium I don't find selenium a
big help for this. So I check people – hair and red blood cell
selenium testing, before I prescribe it. Because there's toxicity with
selenium out there.

So the conventional approach to treating autoimmune thyroid

disorders – just checking my time here – is they use drugs such as
beta blockers and PTU to block thyroid. They use radioactive
iodine. The theory is iodine is taken up by the thyroid gland and
radioactivity destroys the thyroid cells.

Hippocrates said give no deadly medicine to anyone. Well, if 10 to

32% of radioactive iodine uptake is gone by the thyroid, I told you
that was the normal radioactive iodine uptake test. Where does the
rest of it go? Where does the other 90 to 68% go? It goes extra
thyroidal. Here's where it goes. And if it binds to this tissue and
destroys it, it binds to all these tissue and destroys it and alters the
DNA of these tissues. That does not sound like a good therapy for
me.

In [inaudible 00:46:03] thyroid they say radioactive iodine is

effective, safe and relatively inexpensive. Well, it's only effective
if the goal is to destroy the thyroid. However, only if the cause of
autoimmune thyroid disorders is too much thyroid tissue that needs
to be destroyed, well, that's not the cause, that's just excess thyroid
tissues is the consequence of the illness, not the cause.

Radioactive iodine is overused. It's been shown to not improve the

outcome on patients with papillary carcinoma managed by near-
total thyroidectomy and by conservative nodal excision. Now
radioactive iodine binds to where iodine is bound to its all the
glandular tissues. So you are going to disrupt the DNA in the
normal architecture of all these tissues that's what we are all
suffering problems with, which is not a good therapy. I think it
should be outlawed. 6800 patients with thyroid cancer have
received an average dose of this much radioactive iodine which the
office reported dose dependent increases in cancer of salivary
gland, bone, soft tissue and colorectum. And increase of primary
malignancy of 27% of any site. And this is the conventional

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accepted treatment for goiter and Graves' disease and stuff. It's
nonsense.

Here's a study where they looked at mortality after radioactive

iodine and correlated with the cancer site they had and it was just
up in all the tissues. I mean you know these numbers are
ridiculous. The cost of radioactive iodine can vary from $3000-
6000 per treatment. Iodine costs less than $0.50 per day.

Now, radioactive iodine only works in an iodine deficient state. So

maybe there's a reason they want us to be iodine deficient. They
take the iodine away from bakery products which they did in the
1970s. And they like us to be iodine deficient so all these
radioactive iodine tests and treatments can work. But if radioactive
doesn't treat the underlying cause of any illness, why is it the
primary treatment used for autoimmune thyroid disorders and
thyroid cancers. It shouldn't be.

How do you prevent radioactive iodine from damaging the

thyroid? Ingest enough iodine to maintain iodine sufficiency and
therefore maintain maximal suppression of radioactive iodine
uptake by the thyroid gland. How much iodine do you need to do
this? We went through this. Well, on our graph here. We want to
maximize iodine uptake by the thyroid to 600 micrograms. We
want to minimize radioactive iodine uptake – where are we? Back
to 50 to 75 to 100 mg.

So a holistic approach is clean up the diet, gluten-free does help.

Clean out aspartame you know these Splenda, you know these
other sweeteners. You clean up transfats and you will eat whole
foods. Take the right vitamins and minerals, balance the hormone
system. If they have underlying infections treat that. Rectifying
iodine deficiency and detoxify. That's a holistic way that works
pretty well and can get people over there illness.

So, this is a patient of mine. She is – she's got Hashimoto's disease.

We are doing iodine loading test. She is very low in iodine
excretion, 50% is you know low in iodine excretion and about 90 –
I am sorry 90% or higher. I palpated her thyroid and I feel a cyst
that feels about centimeter in size. I send her for a biopsy and - you
could see here it's about 1 cm in size here. So I put her on 50
milligrams of iodine and I ask her to go get this centimeter cyst
biopsy or centimeter lesion biopsy. And she doesn't want to do it.
[And you know I got the wrong slide her. It should say that she's
got a 1 cm cyst] and she doesn’t want a biopsy.

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So she took the 50 mg of iodine. I had her come back in six months
and then I sent her for another ultrasound. And what they found
was here was the conclusion of that ultrasound. The previously
described nodule in the left lobe of thyroid was difficult to
delineate and therefore biopsy was deferred. So she didn't really
need a biopsy six months later. I'm sorry that's [the slide] a little bit
out of order there.

And that's what we've seen in our practice. We see cysts and
nodules of the thyroid, ovaries, uterus breasts, prostate, getting
markedly smaller and many times go away when they get on
iodine. This is what you would expect since iodine can maintain
normal architecture of glandular tissue and move that pathway
back that I just described that went from normal architecture to
cyst to nodules to hyperplasia to cancer. Iodine can reverse that.

This is Nick, 52-year-old editor with Graves' disease. He was

miserable with Graves' disease. He was on antithyroid medications
on and off. He couldn’t stand taking them because they make
everybody feel miserable. He was seeing me for two years. He was
on 25 mg of iodine. He was stable, feeling good, he wasn't on
antithyroid medication. He was on every few months before that.
And here are his thyroid levels, not bad, you know fairly stable. So
he comes to me now, 2010 and he's got hyperthyroid symptoms.
Did I cause this from giving him iodine? He's clearly hyperthyroid
here. So what did I do with him? I upped his iodine from two pills
a day or 25 milligrams, to six a day which is 75 milligrams. I put
him on lithium. Lithium is a nice adjunct to iodine to help calm the
thyroid down. I put him on Vitamin A which also helps as an
antioxidant in thyroid. And I put him on thymus extract, thymus
glandular. And if you looked at the date 02/24/2010 and six
months later he called me up about you know a few weeks after, he
said he was feeling much better. So when he comes back for blood
work here, clearly he's out of his hyperthyroid range. Basically, it
was a combination of upping his iodine and obviously all the other
supplements.

This is Tracy. She is holding her six-month-old baby here. She

developed Graves' disease after the baby. She goes to her doctor in
there and she can't think clearly and he does her TSH levels and all
he drew was 175 and he says to her you need thyroid hormone,
you’re severely hypothyroid so he puts her on Synthroid. Look at
her face here. She is clearly hypothyroid. She is puffy. So Tracy
was treated with Synthroid and her TSH is now 1.0. Does she look
any better here? Not really. I think she even looks more puffier.
Her brain is still not working here. She still feels miserable. She

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goes back to her doctor. He gets her TSH back and he says you
need to be on an antidepressant. She says I'm not depressed, I don't
feel good. She can't think clearly and she's fixing up the kids
lunches and fairly miserable. She gets a hold of my Thyroid and
Iodine books and makes an appointment and comes to see me and I
switch her over to dessicated thyroid and I give her 50 mg of
iodine and her TSH is 2.5 here and look at the difference in her
face you know, with that one.

Tracy now runs a thyroid support group and takes care of you
know couple of hundred people and you know she's not in a – she's
one of my higher thyroid users. She’s on about six grains of
thyroid. And she takes a 100 mg of iodine. And that keeps – she
was diagnosed with hypothyroidism and Graves' over this time
period as seen here. So iodine deficiency has been known to affect
the thyroid, and known to cause goiter from over a 100 years ago.
It's been known to cause hypothyroidism. It's been known to cause
autoimmune thyroid illness and thyroid cancer. All those
conditions have been rising over the last 40 years while iodine has
been falling. Iodine can't be the cause of all these – any of these
conditions because a negative association disproves causation.

The one thing I will restate is iodine can cause hyperthyroidism if

they have a hyperfunctioning autonomous nodule to rare and a
couple of patients in 12 years. These are the patients you give a
dose of iodine to when they become hyper right away. You need to
stop the iodine. I would say, put them on salt and Vitamin C and
the other stuff for two weeks. Retry it again and see if that
happens. If it happens again, they need to see somebody to get
their nodule taken out of their – they can't take iodine.

So hopefully I can pronounce you all cured of medical iodophobia.

And I will just give you my final thoughts. Iodine levels have
fallen 50% during the last 40 years. During that time we've seen
elevations of all the autoimmune thyroid illnesses, autoimmune
disorders in general as well as thyroid cancer, breast cancer,
prostate cancer, pancreatic cancer, and other endocrine cancers. All
those conditions can be caused by iodine deficiency.

Start slow. Get ultrasounds if you palpate anything [inaudible

00:55:49] palpating with thyroid. Most importantly combine it
with a holistic treatment plan. If you want more information on
this, I've explained it in my book. Use the combination of iodine
and iodide. You can use Lugol's Solution or tableted Lugol's
solution. Doses are generally from 6 to 15 mg per day. Most

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Autoimmune Thyroid Disorders
people 25 to 50 mg, those with autoimmune thyroid disorders
maybe more, 50 to 100 mg.

Albert Szent-Gyorgyi won a Nobel Prize in 1937 said discovery

consists of seeing what everybody else has seen and thinking what
nobody has thought. That's why we are all here tonight. Again, if
you want more information, my books are available on my website
which is drbrownstein.com.

So I thank you for listening and Michigan will recover from their
loss just as they've recovered as of yesterday and expect us to win
out through the remainder of the year. So thank you for listening
and Ron I'll turn it back over to you.

Ron: Thanks doc. Do you have a min for just a few questions?

Dr. Brownstein: Sure.

Ron: Just a couple of questions. We’ve already passed the nine o'clock
mark. I will just make it quick. Let's see here, hang on one second,
let me just get this thing real quick.

Dr. Brownstein: I'm going to see them or you are going to read them to me?

Ron: I'm going to read it to you doc. Let's see here. One question, iodine
therapy has recommended doses in this lecture. Have you ever
seen candida, what form of iodine do you recommend, I guess
from …

Dr. Brownstein: Iodine – candida there's no yeast, parasite, virus, bacteria that's
shown to be resistant to iodine. Iodine can be part of an anti-
candida program. So same doses that I talked about here.

Ron: Okay. Second question, are these patients on this level of iodine
for life to avoid having the condition return?

Dr. Brownstein: Unfortunately our iodine requirements have gone up over the years
because our exposure to fluoride and bromide and other toxic
allergens have gone up. So yeah they are going to be on it for life.
We can't – 50 years ago iodine requirements weren't as high as
they are now. 100 years ago they weren't just as high as they are.
Our requirements are higher now in the toxic world we live in.

Ron: Okay. One final question, last question, when you are testing
someone for iodine, which is their specific company you
recommend lab for iodine challenge?

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Autoimmune Thyroid Disorders

Dr. Brownstein: There's three major labs that I recommend. You can use Doctors
Data, you can use FFP Labs and you can use [audio gap 00:58:43]
Labs. They are all in my book. They all do a fine job. I have no
financial dealings with any of them. And then the test runs about
$80 I think, $80 or $100. And a spot urine test can be done with
Quest or LabCorp or any of local labs.

Ron: Doctor listen, thank you so much. I really appreciate it. I hope
Michigan does well okay. And everyone participating thank you
again for taking time out of your schedule and once again doc,
thank you for your time so much. I really appreciate it. Have a
great evening.

Dr. Brownstein: Thanks guys and remember you always say let's go blue. We will
see each other.

Ron: Okay. Take care. Bye-bye.

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