Health Matters
From "Maple Street Co-op News", Oct/Nov 2007

Iodine: Part 3
A Common Link Between Thyroid, Diabetes and Depression
By Kathryn Alexander, DThD

Hypothyroidism and diabetes
If I mention the symptoms of fatigue, weight gain, high cholesterol and depression, would it surprise you to learn that these symptoms are common to both low thyroid function (hypothyroidism) and diabetes? Not only do these conditions share symptoms, but also they are often found together.

Simply put, people with diabetes are also more likely to have poor thyroid function. There is a higher than normal prevalence of thyroid disorders in patients with type 2 diabetes (insulin resistant diabetes), and a staggering 33 per cent incidence of autoimmune thyroid disease with the autoimmune type 1 diabetes (insulin dependent diabetes). Medically, our experts are puzzled as to why this relationship exists, but with autoimmune conditions, give the assurance that people with one kind of autoimmune disease are at risk of developing another type.1

So we must look for a common factor. They are both endocrine disorders - one of insulin metabolism, and the other of thyroid metabolism. They both govern energy: thyroid hormone sets the metabolic rate and insulin ensures the uptake of glucose by the cells to make energy. They both govern cholesterol metabolism: in insulin resistance, excess insulin stimulates cholesterol synthesis and with hypothyroidism, insufficient thyroid hormone makes the liver inefficient in its cholesterol clearance. Each condition increases the risk factors for heart disease. If you have both conditions, then you may well double your risk. Sadly, sub-clinical hypothyroidism remains largely undiagnosed and untreated, and other drug-related treatments are recommended for both cholesterol reduction and the management of diabetes.

The breakthrough for a possible explanation to the link between both conditions came during a clinical study involving 4,000 women with fibrocystic breast disease (FBD), who were treated with inorganic iodine in amounts up to 50 mg/day over a prolonged period. Some of these women also presented with diabetes. It was found that patients with diabetes needed to monitor their blood sugar levels more closely, as the condition became more easily controlled on the iodine supplementation. This led to a clinical study of 12 diabetics, where all the patients were able to lower their medications, with six cases being weaned off drugs completely, their blood indicators for diabetes being maintained within normal parameters.2

The researchers then began looking at the role of hormone receptors, as there is a similarity in the families of receptors for thyroid hormone, the steroid hormones, insulin and the hypothalamus and pituitary stimulating hormones. These receptors require specific tyrosine residues without which the receptor fails to relay the signal from the hormone into the nucleus of the cell. It was postulated that the binding of iodine to the tyrosine residue made it functional. Two events highlighted this possibility. In patients on iodine supplementation there was reduction in insulin resistance and therefore better control of diabetes, and secondly, in hypothyroid patients, there was improved thyroid hormone activity on lower doses of thyroid supplementation. For me, what clinched this possibility was that patients diagnosed with insulin dependent diabetes (pancreatic failure to produce insulin) but still capable of producing insulin (C-peptide is measurable), started to produce insulin when supplemented with inorganic iodine. It is the insulin signal, via the receptors at the pancreas, which relays the instructions for the pancreas to make more insulin. If the receptors cannot receive the signal (insulin resistance) then the pancreas will not synthesise insulin. This produces the features of type 1 diabetes (IDDM). Similarly, insulin signals at the liver indicate to the liver that there is plenty of glucose in the circulation. If these signals fail, the liver goes into glucose production overdrive which leads to type 2 diabetes (NIDDM). If supplementation of iodine starts to reverse these conditions, then the common factor between diabetes and hypothyroidism may well be a primary iodine deficiency.

Depression, insomnia and ADHD
We all know of the serotonin connection with depression: low serotonin equals depression and poor concentration. Perhaps what is not so well known, is that tryptophan (an amino acid) is the precursor to serotonin, and that the brain only makes serotonin after we eat carbohydrates. What's the link here? Carbohydrates stimulate the release of insulin, and insulin receptors in the brain stimulate the uptake of tryptophan, which is then converted to serotonin! Imagine if you have insulin resistance in the brain, how a defective uptake of tryptophan could then affect your mood, concentration and learning. Similarly, melatonin, the sleep chemical, also requires tryptophan.

Invariably we see depression linked to insomnia. I have a patient who suffered severe insomnia for seven years. She also had sub-clinical hypothyroidism and heavy metal poisoning. Her urinary iodine test indicated severe iodine deficiency. We tried many methods over the years, but it wasn't until she began iodine supplementation that she started sleeping again, her thyroid rebalanced and many of her other symptoms reversed.

There is also a serotonin connection with ADHD. The drugs given to alleviate the symptoms act by elevating serotonin. Interestingly, a study in Sicily that compared two small groups of pregnant women, where iodine intakes were either moderately deficient (group A) or marginally sufficient (group B), found that 68 per cent of the children born to group A mothers were diagnosed with ADHD (compared to none in group B), and total IQ scores were also lower in group A.3 All the children had normal thyroid function, although 50 per cent of mothers in group A had thyroid failure during pregnancy. As the role of maternal thyroid hormone is to develop the brain neurons and terminals in the foetus, and as iodine is required for the synthesis of thyroid hormone, the evidence points yet again to a primary iodine deficiency as a possible key causative factor.

Digestion, absorption and gut parasites
Another symptom of hypothyroidism (or more accurately, iodine deficiency), is reduced hydrochloric acid (HCl) output which results in poor protein digestion, poor absorption of iron, calcium and B12, and an increased incidence of helicobacter pylori and gut parasites. Stomach cells require iodine, which concentrates chloride in the parietal cells ready for output as HCl when food hits the stomach. The acidity generated causes the unfolding of dietary protein and the activation of pepsin, a protein digesting enzyme. High acidity also keeps the gut sterile, kills any micro-organisms that may have been ingested or any potentially resident pathogens, such as H pylori. Iodine is also a powerful disinfectant, and is used by the immune system when infection is present. This is why illness may produce a transient hypothyroid state in patients, as thyroid hormone is broken down to release its iodine, which is made available for the immune system.

Many of our herbs used for gut parasites, such as black walnut hull, contain iodine. Iodine in the gut is hostile to harmful pathogens. Some amoebicidal medications, such as Iodoquinol, contain organic iodine in amounts up to 1,248 mg/day - this is 25 times the upper amount of inorganic iodine (50 mg) recommended. Iodine has been used to disinfect water since the early 1900s, and is still the lightest, cheapest and simplest method of water purification.

Heavy metal toxicity
Being a halogen, iodine will displace and remove other more toxic halogens such as bromine, fluorine and chlorine, the levels excreted via the urine increasing proportionally to the amount of iodine ingested. Iodine can also remove heavy metals. Dr Guy Abraham has shown that iodine promotes the excretion of heavy metals such as lead, mercury and cadmium, of which excretion rates increased several-fold after just one day of supplementation. Aluminium elimination took longer, being excreted after one month on supplementation.4 This is an additional bonus for people whose health problems are compounded by heavy metal toxicity. Simply put, if you are iodine sufficient, you should not accumulate heavy metals.

How can I tell if I am iodine deficient or hypothyroid?
• Ask your GP for a urinary iodine test. In most cases this will indicate your iodine status.
• Determine if you have sub-clinical hypothyroidism. If your temperature on waking is below 36.3¼C over a few consecutive days, then you may well be hypothyroid.
• Ask your GP for a thyroid function test; if your TSH (thyroid stimulating hormone) registers over 2.0 then this is an indicator for sub-clinical hypothyroidism, even though your levels of circulating thyroid hormones may be normal.
• If your TSH is above 4.0 then ask your GP to run tests for any thyroid antibodies to determine if you have an autoimmune condition.

What can I do?
Although I like to give self-help advice, I have to warn you against supplementing with inorganic iodine (Lugol's solution) unless your thyroid function is being monitored by a professional. If you are hypothyroid and it's due to a simple iodine deficiency, then taking Lugol's solution may fix the problem. But if the gland has any pathology (such as autoimmune thyroiditis or nodules), then taking Lugol's solution, even if you are iodine-deficient, can aggravate the condition. However, even if you do aggravate it, it is reversible once you stop the iodine supplementation. In the meantime:

• Eat fish, seaweed and take kelp;
• Ensure adequate selenium supplementation, as selenium protects against damage to the thyroid gland in autoimmune conditions, and is also required for the conversion of thyroxine to its active form;
• Ensure adequate iron, which catalyses the synthesis of thyroxine;
• If you are hypothyroid, avoid foods which contain goitrogens, such as soy products, the cabbage family, millet and peanuts;
• Ensure a good magnesium status;
• Avoid calcium supplementation, as this inhibits the uptake of magnesium, iron and iodine; and
• If you are a female, reduce soy intake and avoid calcium supplementation, as these may be counter-productive and provide no health benefits.

Endnotes
1. Patricia Wu, MD, "Thyroid disease and diabetes Clinical Diabetes" Vol 18:1 Winter 2000 http://journal.diabetes.org/clinicaldiabetes/v18n12000/Pg38.htm
2. Jorge D. Flechas, M.D. "Orthoiodosupplementation in a Primary Care Practice"
http://optimox.com/pics/Iodine/IOD-10/IOD_10.htm
3. F. Vermiglio, et al; "Attention Deficit and Hyperactivity Disorders in the Offspring of Mothers Exposed to Mild-Moderate Iodine Deficiency: A Possible Novel Iodine Deficiency Disorder in Developed Countries"
The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 12 6054-6060, http://jcem.endojournals.org/cgi/content/full/89/12/6054
4. Guy E. Abraham, M.D. "The historical background of the Iodine Project", http://optimox.com/pics/Iodine/IOD-08/IOD_08.htm

[Kathryn Alexander has written extensively on health issues, drawing on her training, her 20 years as a practitioner in detoxification and her expertise from nutritional healing research. Kathryn has a clinic in Maleny, offering a wide range of services from advice on treating simple ailments through to developing a suitable long-term plan for a chronic disease. To make an appointment,
email kathryn@getalife.net.au or call (07) 5435 8138 during office hours.]

[From "Maple Street Co-op News", October/November 2007; published by The Maple Street Co-operative Society Ltd, 37 Maple Street, Maleny, Qld 4552, Australia, tel (07) 5494 2088, email maplest.coop@serv.net.au,
website http://www.maplestreetco-op.com.au]