Iodine for hypothyroidism: like gasoline on a fire?

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  1. qualia’s avatar

    how does hashimoto, as an auto-immune disease, respond to high-dose vitamin D treatment? my neurodermatitis simply went away at 5’000IU D3, which speaks for a strong immuno-modulatory effect i assume..  could hashimoto maybe just be another symptom of D deficiency? are there any studies correlating H. and D levels? just a thought.

  2. Chris Kresser’s avatar

    Yes.  Vitamin D is one of the therapies for Hashimoto’s I’ll be covering.  Most Hashimoto’s patients have vitamin D receptor polymorphisms that impair absorption and metabolisms of D.

  3. Mario’s avatar

    I was wondering when you would cite “Dr.” Kharrazian!
    But, anyway, you have to be congruent! If you theory about iodine is right, Drs. Abraham and Brownstein could not have “sucessfully” treated hypo patients with iodine!!
    On the link above, on item IV, Dr. Abraham propose a explanation about salt iodinization and incidence of Hashimoto:

    I, for one, will keep my daily intake of 50mg of Lugol’s. Unless my blood tests, that I have every 2 or 3 months, says otherwise. Until now, they didn’t.

  4. Chris Kresser’s avatar


    The human body isn’t a machine. It’s a complex web of interrelated connections. It may be possible for some Hashimoto’s patients to improve with iodine. I can’t rule that out. But that doesn’t mean most will, and it doesn’t mean that it’s the right choice for the majority of patients.

    Why did you put “Dr” in quotation marks? Because Dr. Kharrazian is a chiropractor? Does that somehow make him less intelligent, able and qualified to evaluate the research? I assure you it does not. He has Harvard MDs and PhDs coming to his Mastering Thyroid course. I was at the last one, and spoke with an MD that said it was by far the most comprehensive and cutting-edge course on thyroid treatment he had ever attended.

    Should we listen to all the MDs that tell us heart disease is caused by cholesterol, in spite of mountains of evidence to the contrary? That we should take antidepressants for depression, even though the evidence clearly shows they are no better than placebo in most cases? Heck, they’re MDs, so they must be right!

    That’s exactly the attitude that motivated me to start the blog.

    The weight of the evidence suggests that iodine is not a good choice for Hashimoto’s patients. You’re free to disagree, and I know that you do.

  5. Stephanie B.’s avatar

    I wanted to add a few comments about the concern over negative effects of iodine and hashimotos. 

    I run the IODINE group on Yahoo groups where there are over 3,900 members.  Many of these members have hashimotos and are taking iodine sucessfuly to treat it.  There are key nutrients that need to be taken with iodine to put the thyroid in balance.  These include Vitamin C (heals the NIS – sodium iodine symporters), unrefined salt (used in the symporters as well), magnesium (involved in enzyme reactions), and selenium (works in the oxidation process). 

    In the oxidation process where hydrogen peroxide is increased and interacts with TPO to reduce iodine to iodide for the creation of MIT & DIT (precursors to T3 & T4 hormone) another process comes into place when enough oxidizining has occured.  This is done by the δ- Iodolactone  (an iodolipid) – a liped that puts the “brakes” on the oxidizing (burning) process.  Intracellular calcium levels are also important in this process in not letting things get out of balance as occurs in a hashimotos situation.  This iodolipid is only created when iodine is supplied in amounts larger than RDA recommendations.  For many on my group this is 50 mgs or more.  Many with hashimotos have issues with swelling or painful glands at low iodine supplementing levels yet have the symptoms resolve at higher dosing. 

    Hashimotos also seems to accompany high levels of bromide toxicity.  The iodine saturation level as well as the bromide toxicity level can be obtained by ordering a 24 hour iodine loading test with bromide levels from  

    It is dicouraging to see posts warning against the supplementation of iodine with hashimotos when there is no evidence to show harm when all the appropriate supporting nutrients accompanied with detoxification are in place. 

    The Jod-Basedow Phenomenon seems to only be applicable in cases of autonomic functioning thyroid nodules.  Not in a normal goiter situation.

  6. Catherine’s avatar

    I am on Stephanie’s Iodine group and have employed the recommendations she cites here with MUCH success, not only with myself, but, with my clients as well.
    I must say that I have not as of yet read Dr. K’s book, so I am not familiar with the totality of what is written therein, but I would think if you have not read and implemented Dr. Brownstein’s recommendations, with Stephanie’s thoughts in mind, you’d be limited in your perspective greatly.

  7. Chris Kresser’s avatar


    As I said at the end of the article, I realize this is a controversial subject. And I’m open to hearing conflicting points of view.

    You mention that there is no evidence that iodine causes harm when all appropriate nutrients accompanied with detoxification are in place. Is there any evidence that it does not, or that it actually provides benefit? In the article I linked to studies demonstrating that iodine increases autoimmune activity, and that restricting iodine alone can induce a euthyroid state in Hashimoto’s patients. What is your explanation for these phenomena? Also, I have yet to read a convincing explanation of why iodine increases the incidence of Hashimoto’s rises so significantly in places where iodine is added to salt. If you claim that this happens because the dose is too low, or because these populations are deficient in co-factors like selenium, magnesium and vitamin C, I’d like to see evidence supporting that.

    There’s also the question of how iodine interacts with thyroglobulin polymorphisms commonly found in Hashimoto’s. From a study in Thyroid in 2004:

    “It is conceivable that Tg polymorphisms, combined with the explosive mix of iodine, TPO and H2O2 necessary for thyroid hormone synthesis, inadvertently provide the trigger for the autoimmune thyroid response.”

  8. Susan’s avatar

    I’m no expert like the others who have responded here, but I am a practicing herbalist and also have hypo/Hashi’s. I’m very interested to learn more about the iodine “controversy” as it relates to healthy thyroid function.
    From my perspective as a practitioner, the one huge hole I see in your logic is that the vast majority of my clients with hypothyroidism have been eating sea salt for years, and that is exactly why they are iodine deficient. In addition, many are “recovering” vegetarians, another category suffering from high levels of iodine deficiency. I think that you are missing a huge chunk of the hypothyroid crowd who are BOTH autoimmune and iodine deficient. Look forward to hearing your perspective on this idea!   -Susan

  9. Chris Kresser’s avatar

    There’s no hole in the logic. The relevant question is, how much iodine does the thyroid need to perform its function? That amount is very small. It’s roughly equivalent to the head of a pin per day or one teaspoon per year. Iodine deficiency must be very severe to cause Hashimoto’s. If someone is very deficient in iodine, it’s likely they’ll have a goiter. It’s certainly possible to have both Hashimoto’s and iodine deficiency, but that doesn’t necessarily mean iodine deficiency is the cause. Correlation is not causation.

  10. Jamie’s avatar

    Hi Chris
    Could you please comment on what level of iodine intake you feel becomes excessive in terms of what you have outlined.  New Zealand has soils very low in iodine and goitres are on the comeback following less use of iodised salt at the table, non-iodisation of salt in food processing, and the discontinuation of iodophors as disinfectants in the dairy industry.  And it would seem that the cleaner one eats, the less iodine they get.
    I am picking that some level of iodine intake is required to meet physiologic function.  Do you feel 150ug daily to be ‘excessive’ in the group you have written about above?

  11. Nathan’s avatar

    Interesting, thanks for this blog of yours! 

    The link to the Dr. Kharrazian blog post is broken… I went to his website and it is available at the link below, though:

  12. Stephanie B.’s avatar

    Unfortunately this is a complex subject to comment on a blog and autoimmune conditions are not related to iodine deficency alone.  Have you read Dr. David Brownstein’s book on Iodine?  He is my doctor and friend.  We research Iodine in thyroid conditions.  I think his book will answer many of the questions you have posed (above).  Iodine is more than just the thyroid gland.  Every gland and mucosal lining needs and uses iodine. 

    The thyroid gland when totally saturated holds approximately 50 mgs of iodine.  It needs approximately 6 mgs of Iodine / day to create sufficient thyroid hormones.  Dr Abraham believes that daily requirements are 13 mgs for the total body.  However, with the increase in toxic halides more and more are needed to overcome the barage of toxins (perchlorate, bromide, fluoride and mercury).  When deficient the body attempts to use the halides in place of the iodine.  It is not clear the mechanism by which this occurs. 

    When I started to use 50 mgs of Iodine for thyroid cancer (after 3 failed RAI’s – read my story on my website @ – blog) I was pushing out 24 ug/L of bromide.  But when I started to use 100 mgs of Iodoral and then tested my levels they rose to 66 ug/L.  My son when 9 yrs old was sending out 45 ug/L when on 12.5 mgs / day.  It’s the toxins that seem to be the biggest issue in autoimmune thyroid conditions – combined with low iodine (which is cancer protective – research the P53 gene and its needs for iodine – Book: Minerals For The Genetic Code). 

    Consuming sea veggies is problematic.  They have been found to be high in toxic halides and arsenic.

    Finally – how is euthyroid defined?  Many times this is defined as a TSH lab value that is within the ”almighty” TSH range (.5 – 5.0).  This is NOT how euthyroid should be determined.  All the research I have read regarding this has been a TSH value.  When supplementing with iodine it is very common to see TSH values rise to levels as high as 75 for up to 6 mos without any clinical signs of hypothyroidism.  The body is doing what it should do as increased iodine increases TSH to stimulate the production of thyroglobulin to bind to more iodine in the hormone creation process.  High thyroglobulin levels are actually an indication of iodine deficiency.  It is best to use Free T3 and Free T4 lab values to determine thyroid status since these represent the unbound proteins that are available for usage by the body.  In 99% of the cases I have seen on my group where the TSH increases but the free’s remain in a normal range.  TSH does not increase to high levels in all cases though.

    When many of the members begin higher supplementing of Iodine they experience detoxing symptoms – for those that can test they are finding it is bromide.  What was once considered to be iodism is now being linked to bromism as they share the same symptoms. 

  13. Chris Kresser’s avatar


    I agree this is a complex subject. I hesitated to even begin writing this series for that reason.

    I’ve read Dr. Brownstein’s Overcoming Thyroid Disorders book, but I haven’t read his iodine book. But he does talk about bromides and other toxins in that book and I’m aware of those mechanisms.

    For now we’ll just have to agree to disagree. Thanks for sharing your perspective.

  14. Belinda’s avatar

    According to my rheumatologist, a one time positive TPO/ TG result is not a true indication of Hashimoto’s. He says one must be tested repeatedly over time and if antibody levels are steadily increasing over time then Hashimoto’s is indeed present. Having never heard this before, I’m not sure what to believe. What do you think?

  15. Chris Kresser’s avatar

    I’ve heard that before, and I don’t understand the logic behind it. Once the immune system tags a tissue (by producing antibodies), it never forgets. This is a benefit in the case of foreign invaders, but a liability when it’s our own tissue being tagged. A positive TPO/TG test indicates the body is attacking those enzymes and proteins, and that’s Hashimoto’s.

    On the other hand, a negative TPO/TG antibody test doesn’t rule out Hashimoto’s. Nor does it indicate a clinical improvement or remission. Why? Because Hashimoto’s is a Th1 dominant condition. When the Th1 system is dominant, the Th2 system is suppressed. The Th2 system is involved in antibody production. So, if the Th1 system is out of control, we could see low antibody levels because the Th2 system is so depressed it can’t produce them. This is hardly a good thing – but it could be interpreted that way if someone believed that low antibody levels were a reflection of improvement.

  16. Sarah’s avatar

    “The relevant question is, how much iodine does the thyroid need to perform its function? That amount is very small. It’s roughly equivalent to the head of a pin per day or one teaspoon per year”
    Exactly!  I am a Nuclear Medicine Technologist and we do thyroid uptake scans which test the function of the thyroid by giving the patient a small amount of radioactive iodine (the amount of iodine is equivalent to 1/2 of a single grain of table salt).  IF the patient consumes ANY iodine (from vitamins, food or medication sources) in the 3 weeks previous to their scan, their uptake value goes from a normal 15-30 % to nearly zero or very often less than 5%.  This is because the thyroid stores iodine so well and it needs VERY little iodine daily.  And these are normal thyroids….

  17. Belinda’s avatar

    If I understand him correctly he believess the antibodies can be present for a variety of reasons but simply not active unless shown to be so  over time by rising lab levels.
    He does seem to be very concerned about reducing inflammation though, but only has prednisone in his arsenal. Will you be blogging more on this topic?

  18. Chris Kresser’s avatar

    If you mean will I be talking more about reducing inflammation, the answer is yes.  I will also explain the immune system disruption in more detail.

  19. Elaine’s avatar

    Thank you for starting this much needed topic. I too would like to see the evidence that iodine is effective in treating Hashimoto’s. Dr. Kharrazian’s new article at addresses this topic in more depth.
    It is not enough to check antibodies. You need to check cytokine levels and the ratio between T-suppressor and T-helper cells to see whether iodine is truly dampening the autoimmune effect.
    Like Chris, I am open to the possibility of iodine being effective with the cofactors as so many believe, but I would like to see the evidence. There is plenty of evidence from around the world on the other side. Testing antibodies alone is not sufficient.

  20. Chris Kresser’s avatar

    Exactly. I briefly explained why antibody levels are poor indicators of the disease state below in comment #19. Antibodies may be low because the condition has improved, or they may be low because the Th2 system is so depressed it can’t produce antibodies anymore. This is one of the most misunderstood subjects in the thyroid world.

  21. Catherine’s avatar

    Stephanie gave you lots of information to consider as well as recommending Dr. Brownstein’s book, and, if you didn’t notice, she also is a patient of his as well. If you truly wanted to get to foundational information, you would AT LEAST read Dr. B’s book on Iodine and/or take full opportunity to seriously consider Stephanie’s personal success and that of MANY others on her forum. Until then, your credibility as a journalist or informed consumer is compromised. Any further engaging of the discussion of this topic is futile when all relevant data is not considered, by you or anyone else.

  22. Catherine’s avatar

    Just in case anyone else might be interested in reading further documentation:

  23. Chris Kresser’s avatar

    I’ve read Dr. Brownstein’s other book, I’ve read Dr. Abraham’s online information, and I’ve read the Williams Textbook of Endocrinology chapter on iodine as well as several other sources.

    I already mentioned that Dr. Brownstein has treated hypothyroid patients successfully with iodine in the article.

    I’m not a journalist, nor did I ever claim to be.  I’m presenting a point of view on this blog. If you don’t like it, you’re not required to read it or participate here.

    Please consider the possibility that others including myself have considered the relevant data and reached a different conclusion.

  24. Chris Kresser’s avatar

    From Dr. K’s most recent article:

    This also explains why the use of iodine can produce a negative antibody panel in Hashimoto’s. Iodine has been shown to stimulate the autoimmune attack against the thyroid, which increases inflammation, a TH-1 response. In a TH-1 dominant person—statistically most people with Hashimoto’s—this further stimulates TH-1 while suppressing TH-2, again producing negative antibody results and giving many the impression the Hashimoto’s has been “cured.” Also, high doses of iodine can stimulate the production of TPO, the enzyme that is the target of autoimmune attack, to the point that it becomes inactive and the autoimmune attack ceases. However TPO is necessary for thyroid function and this is not a desirable approach when we have other methods that work better.

  25. Elaine’s avatar

    I have read Dr. Brownstein’s book on iodine and talked to Dr. Abraham on the phone several years ago. I have done iodine loading myself and used to frequent the iodine group when it first started. (Even with the cofactors and the detoxing, i could never hack higher doses of iodine so i stopped.)
    I’m familiar with the oxidation explanations, i have seen it described many times (although i confess i wish someone could use lay language to explain it more simply). I’m  just personally curious about before and after immune panels, to see whether the cytokines are at normal levels and in balance. There are a lot of negative stories concerning Hashimoto’s and iodine too — it has really harmed some people, but there seems to be little tolerance for that information. So why does it work for some and not others? I’m not saying we need clinical trials, but it would be interesting to see some before-and-after immune panels on folks.

  26. Elaine’s avatar

    I just reread Stephanie’s post. Is this saying that high levels of iodine suppress TPO? If so, that is what Dr. Kharrazian says. Because TPO is attacked by the immune system for most people with Hashi’s, suppressing TPO  would suppress the autoimmune attack. Is this the approach that is favored? If so, Dr. Kharrazian personally does not support suppressing TPO as a means to manage Hashimoto’s, but rather to address immune imbalances instead.

  27. Becky’s avatar

    Question (if it’s not to off topic):

    What would Lithium do to a person with Hashi’s/Hypothyroidism?

    Just curious. I’ve been off all psych meds since 9/2008 but in 2007 Lithium was added to the cocktail of drugs I was on (Cymbalta, Lamictal & Vyvanse). 

    Or, what would a cocktail of drugs like that and withdrawaling from them do? I got off 3 of those drugs around 4/08 and tapered Lamictal thu 9/08. My TSH went haywire for quiet some time afterwords. Part of this (after 9/08) was due to changing thyroid meds, I’m sure. Thankfully, its closer to 1. something now.



  28. Becky’s avatar

    Sorry, those numbers didn’t transfer right

  29. Elaine’s avatar

    Lithium is known to depress thyroid function. When your TSH is all over it means your autoimmune thyroid condition is acting up, perhaps in response to getting off the meds. The book at addresses this autoimmune issue and what to do.

  30. Chris Kresser’s avatar

    Elaine beat me to it! What she said.

  31. Uncle Herniation’s avatar

    “Why does this happen? Because increased iodine intake, especially in supplement form, increases the autoimmune attack on the thyroid.”

    This citation links to an article titled Drugs and Thyroid Function published in 1995 in NEJM. It is a review article, not an empirical study. Within the article, I could not find any references to original sources that provide empirical support for the claim that increased (increased relative to what?) iodine (not iodide) in supplement form (e.g., not a side-effect of another medication) increases the autoimmune attack on the thyroid (how measured?).
    Since this is the crux of your argument, I’m sure your readers would prefer reference to randomized controlled trials rather than reviews that don’t cite original sources.

  32. Chris Kresser’s avatar

    “Iodine might exert influence on the level of CD4/CD8, and thus the production of thyroid antibodies might directly or indirectly take part in the process of thyroid autoimmunity. Both low iodine and 100 times normal iodine intakes might activate the immune state on some degrees.”

    “It is conceivable that Tg polymorphisms, combined with the explosive mix of iodine, TPO and H2O2 necessary for thyroid hormone synthesis, inadvertently provide the trigger for the autoimmune thyroid response.”

    Also consider the study linked to indicating iodine restriction alone can induce a euthyroid state.

  33. Markus’s avatar

    Chris, you are doing an excellent job handling the comments – especially those that disagree. Polite, factual and concise. Thumbs up!

  34. Chris Kresser’s avatar

    Here are a few more, some more conclusive than others:

    “In genetically predisposed individuals the iodine intake modulates autoimmune thyroid reactions. Especially with acute or chronic increase of iodine intake it leads to a significant increase in the incidence and intensity of autoimmune thyroid disease.”

    “Thyroid antibodies, both thyroglobulin (TgAb) and peroxidase (TpAb) or microsomal, were not detected in serum from patients with endemic goiter, but became positive in 43% of subjects three and six months after therapy with iodized oil, and there developed transient hyperthyroidism. Similarly, the addition of iodine to the diet or the administration of iodine-containing medications increases the frequency of ATD and the severity of existing autoimmune thyroiditis. Furthermore, autoimmune thyroiditis has been induced by the administration of excess iodide to strains of chickens and rats that are genetically predetermined to develop the disease.”

    “The best-established environmental factor is excess dietary iodine. Increased iodine consumption is strongly implicated as a trigger for thyroiditis, but only in genetically susceptible individuals.”

    “High iodine intake, selenium deficiency, pollutants such as tobacco smoke, infectious diseases such as chronic hepatitis C, and certain drugs are implicated in the development of autoimmune thyroiditis, primarily in genetically predisposed people.”

    “In our investigations, we have shown directly that T cells from humans with chronic lymphocytic thyroiditis proliferate in the presence of iodinated but not in the presence of noniodinated human thyroglobulin… if iodine is added to the drinking water, the prevalence and severity of the thyroid lesions increase markedly. The immune response is specific for thyroglobulin, both in terms of the antibody response and T-cell proliferation.”

    “A body of clinical and epidemiologic evidence points to excessive ingestion of iodine as an environmental agent. In genetically determined thyroiditis in animals, iodine enrichment has been shown to increase the incidence and severity of disease.”

    “Autoimmune thyroiditis, a model of organ-specific autoimmune disease, is associated with iodine as a precipitating environmental factor. T cells from patients with chronic thyroiditis proliferate in response to normal human thyroglobulin, but fail to react with non-iodinated thyroglobulin.”

    “A causative relationship between dietary iodine and thyroiditis has been clearly established in animal models of thyroiditis, including the NOD.H2(h4) mouse strain, which develops enhanced thyroiditis spontaneously after supplementation of drinking water with sodium iodide.”

  35. Uncle Herniation’s avatar

    Thanks for the reply.
    As you quoted from the first article, “Both low iodine and 100 times normal iodine intakes might activate the immune state on some degrees.”

    This study was conducted in rats. Since you apparently feel comfortable generalizing these findings to humans, do the results apply to those who are euthyroid or those with thyroid dysfunction (e.g., Hashimoto’s)? And if a person’s diet is iodine deficient, supplemental iodine in normal dosages is likely to be beneficial, correct? It would seem, based on these results, that adequate iodine in the diet is necessary, just not 100x normal amounts. But again, we are talking about a study in rats. We don’t know how this can be applied to humans, and whether we can use the results to make recommendations to those with Hashimoto’s based on this one animal study.

    Also, I noticed that the first article was in Chinese. Were you able to read the entire article, or just the abstract? I often find it necessary to review the methods and results in greater depth to accurately understand the strengths and weaknesses of the research. Unfortunately, I can’t read Chinese.

    The second article you cited is also a review article that does not provide any citations to randomized controlled trials in humans that support the statement you quoted.

    So, we are back where we started.

  36. Elaine’s avatar

    Uncle, so where are the studies to the contrary? Also, how do you account for the anecdotal evidence, of humans, of iodine making Hashimoto’s worse in people? Also, are the high doses of iodine suppressing TPO and hence the autoimmune reaction in people with Hashimoto’s? Is that how it is working? If so (because i’m not sure i totally understand the oxidation thing) then there is no argument.Also, how do you account for the study, on humans, of an iodine-restricted diet resolving Hashimoto’s symptoms in the majority of subjects? Where is the evidence that high iodine for Hashimoto’s brings cytokine and CD/CD8 levels to normal?

  37. Uncle Herniation’s avatar

    Thanks for the additional citations. I am not arguing for or against a particular point, per se. I am simply asking that all crucial points be backed up by rigorous science. I’m happy to review these studies and form my own opinion, rather than just accept something.

  38. Chris Kresser’s avatar


    That’s exactly what I advocate.  I’m happy to provide the citations.  I don’t include them all in the original articles because I don’t want to overwhelm people.

  39. Chris Kresser’s avatar

    Another issue with using iodine to shut down TPO is that it doesn’t address the overall immune imbalance present in Hashimoto’s.  Studies show Hashimoto’s patients often have antibodies to other tissues in addition to the thyroid.  The best approach is to regulate the immune system so that all affected tissues are protected.

  40. labrat’s avatar

    Interesting but very confusing. If you don’t mind giving your opinion (and anyone else as well) what do you make of my daughter’s case. I am trying to make sense of it.

    16 y/o female. Likes to sleep a lot, is always cold (today was over 90 and she wore a light weight long sleeve  shirt, a long skirt and knee high boots and was comfortable – I was hot just looking at her) and is photophobic, she really hates bright light and sunshine.

    She’s been tested several times in the past year or so and her results are pretty stable.
    TSH 1.0 +/- 0.5, FT4 1.0 +/- 0.2, TG Ab negative TPO Ab 54-107.

    We’ve decided to just keep our eye on her TSH going forward – should I be worried about the low level of anti-TPO? Do you think restricting iodine would resolve it?

  41. Chris Kresser’s avatar

    Your daughter has elevated TPO antibodies. That suggests autoimmune thyroid disease.

    Her TSH is normal from a conventional perspective (0.5 – 5.0), but low from a functional perspective (1.8 – 3.0). FT4 is also low from a functional perspective when it drops below zero. Positive TPOAbs combined with low TSH and low T4 suggests autoimmune hypothyroidism secondary to pituitary hypofunction. Chronic stress is at the root of this pattern. Stress taxes the pituitary until it can’t release enough TSH to trigger thyroid hormone production. Stress management and supporting healthy pituitary function are essential to working with this pattern.

    Keep in mind that it’s impossible to provide a diagnosis on the internet with something as complex as a thyroid condition. These are just a few ideas to consider.

  42. Steve’s avatar

    Chris much respect! Keep up the awesome work.
    Quick question in all your studies on Iodine, do you believe an iodine deficiency plays a role in inadequate stomach HCL levels?
    I don’t have any thyroid issues, however among a host of guy dysbiosis problems (SIBO, yeast) I’m correcting I have low stomach acid. I’ve been supplementing with betaine HCL for over 6 months hoping that it would correct the problem (no luck) and in some of Pro-Iodine camp literature I was reading that the parietal cells need iodine to collect chloride to make HCL.  I started supplementing with Iodine this month in hopes this might help me restore my stomach acid levels however I can’t seem to find any medical literature/studies explaining/confirming this hypothesis.  Thoughts?

  43. Chris Kresser’s avatar

    Physiologically it’s plausible, though it isn’t discussed much in the literature. More typically hypochlorhydria is caused by bacterial overgrowth in general, and H. pylori in particular. Have you ruled out H. pylori with a urea breath test? H. pylori suppresses stomach acid production in order to create a more hospitable environment for itself.

  44. Steve’s avatar

    I just had a Genova CDSA done a month ago and had them check for H. pylori, test results were negative.  Is it smart to get a urea breath test as well to confirm?  After being on the SCD diet for over 6 months (amazing turnaround) and with the confirmation of the CDSA test my bacteria levels seem to be under control besides a very small level of Candida.  Am I missing another link in the stomach acid puzzle (nutrient deficiency, signaling pathway)?  Or after several years of SIBO I should just be patient?  Thanks!

  45. Tamra’s avatar

    Chris, thanks for starting this great discussion. I tried iodine last year and made it to three Idoral drops per day, but I just couldn’t take the swelling. I kept telling myself that if I continued with the regimen, the swelling would subside. At one time, I belonged to the iodine FB group and did read success stories from other thyroid patients. I tried again, and again my thyroid swelled to the point that it was difficult to swallow food.
    During my third attempt to introduce Idoral’s drops into my diet, my friend told me to stop the drops and read Dr. K’s book. I did, and decided maybe Dr. K. was right about iodine. I then gave up gluten and I am now seeing a doctor who practices Dr. K’s methods. I am taking supplements to balance my TH1 dominance. I’m feeling better than I’ve felt in a very long time.
    Neither have I read Dr. Brownstein’s book, nor have I been able to work up to 50 mgs per day. Therefore, I cannot fully comment on Dr. Brownstein’s methods. I can only comment on my limited experience with iodine and with my alternative wellness program.
    I do have a concern about lack of iodine in my diet, not for my thyroid, but for the rest of my body, especially since my grandmother died of breast cancer. I have read that iodine supplementation cuts down the risk of breast cancer.
    Any thoughts on this?
    :) Tamra

  46. Alice’s avatar

    I’ve read Dr. Brownsteins Iodine book and as a hashimoto’s patient I tried Iodoral in the hopes it could help….this was before I read Dr. K’s book. When I first tried Iodoral at 12.5mgs I had side effects of metallic tast in my mouth and salty feeling eyes (hard to explain) When I raised to a higher dose of 50mgs this went away. I only tried this for a couple of weeks and never felt any better but no worse either….then I stopped when i started reading Dr. K’s book. I’m curious  since as you mention most hashi’s are TH1 Dominant if this could have anything to do with how some hashi’s react to iodine supplementation. I’m TH2 dominant and as I said I had no negative reaction. don’t know if there’s any correlation at all but thought i’d put it out there. Also wondering about any connection between  Gluten free diet being so important and without consuming bromide containing breads and products perhaps this helps prevent iodine from being displaced in the body? Not sure if GF products contain bromides…i’ll have to check some labels….

  47. Elaine’s avatar

    labrat, whenever you see positive TPO antibodies you are looking at Hashimoto’s, which is primarily an immune disease more so than a thyroid disease. Does her TSH fluctuate? It can swing from low to high with Hashimoto’s.
    The most important first step your daughter can take is to completely eliminate gluten from her diet. There are strong links between gluten and Hashimoto’s in many studies. A gluten-free diet is paramount. If not, she is at risk of developing autoimmune diseases against other tissues. For instance, Type I diabetes is also correlated with gluten.
    For more information, you can learn more from the book at

  48. labrat’s avatar

    Chris and Elaine

    Thank you for your input. From my perspective – stress makes sense to me as I have always felt her symptoms were more related to psycho-social issues. She is also an asynchratic gifted child. Very high intellect with suppressed emotional and social developement. She is quite eccentric and does not have much in common with her peers. I have her in counselling for executive function issues and with a gifted and talented counsellor. We have also been through a very contentious divorce in the past 4 yrs. Can you elaborate on how to support healthy pituitary function?

    Elaine – no. I’m a lab tech – I have checked her TSH regularly over the past year and it has basically remained stable. I have actually considered gluten-free but have hesitated as it would be a very difficult thing to implement. She is a very picky eater and it’s hard to find things that she will eat as it is. I did check her for anti-gliadin ab and it was negative.

  49. Mario’s avatar

    Bromide exposition does not come only from bread. Far from that. Is all around any modern city, but, due it’s flammability laws, it is specially high in USA. Californian citizens have the highest exposures in the world. Bromide is in the dust, carpets, textiles, foams, electronics and plastics:

    And, for those of us in a high fat paleo diet, in USA, fat from red meat and pultry is a possible source too:

    For those on a low sodium diet, elimination of bromine, at least in rats, is dependent of sodium intake:

    Again, at least in rats, bromide can affect iodine absorption in thyroid and mammals glands:

    It can also decrease body temperature and body weight:


    Greenpeace, Chemical Footprints in Blood:

    The question is: does a good and balanced immune system is enough to get ride of all this bromide?

    A diet low in iodine, that showed to normalize TSH in that China study, will work in USA or other country with high bromide contamination?
    Dr. Datis Kharrazian doesn’t mention bromide, fluoride nor bisphenol-a on his book. At same time, Drs. Brownstein and Abraham never mention how one can improve the immune system. And neither of them mentions LDN, which is one of the best things (after a paleo diet) you can use to improve your immune system.
    So, no one have all the answers nor is 100% correct all the time.

  50. Chris Kresser’s avatar

    In some of the studies indicating increased autoimmune activity with iodine, the authors claim that it is more prevalent in people with a “genetic predisposition”. They’re not referring to Th1/Th2 dominance, and I can’t think of a mechanism where that would influence iodine’s effect on TPO, but I can’t rule it out either.

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