Our toxic environment and modern lifestyle are killing us from the inside out. Degenerative and near epidemic diseases such as obesity, arthritis, arteriosclerosis, Alzheimer’s, osteoporosis, premature aging, and iatrogenic (caused by the healer) disease have tragically become part of every American family. Yet, as technology advances, the wisdom of the ages that it was better to prevent than to treat disease.
Two doctors, three opinions are given, but the opinion that is the most important is YOURS, the patient. It is not the physician who will suffer the most if good therapies go en getting wrong, an adverse drug reaction occurs, or the operation was a success, but the patient died, but you and you family. You should be in charge of your health both preventively and therapeutically! A healing relationship with your physician is important and teamwork is key, but it should be you as the patient that is responsible for the path to take. The doctor is the knowledgeable coach or adviser, perhaps a family member, the team manager, but there is no doubt that if you are in your right mind that the decision of care should be yours! It is incumbent for you to be as knowledgeable as possible on the medical problem on hand. Information from the Internet, perhaps starting at Wikipedia, then a noncommercial website should be considered. Speaking to other patients with a similar problem, reading magazine articles or books does give a good working knowledge on your medical issue. Even getting another professional opinion from a physician who is not in cahoots with your original doc is a good idea.
Too often Primary Care Physicians function as gatekeepers; they may open the floodgates and let the patient drown in too many medical procedures and medicines. Fragmentation in medical care also is rampant today. The patient who decides what organ or area their problem lies in sees that specialist. Therefore, there is a cardiologist for their heart, a pulmonologist for their lungs, a nephrologist for their kidneys, a hematologist for their blood, and a “Big Toe doctor” for their gout. That leaves us with no one to take care of the whole person; moreover, the left hand doesn’t know what the right hand is doing. The gastroenterologist does not effectively communicate with the neurologist. If your primary care doc does not function as a knowledgeable clinical coordinator, then that responsibility by default is on you. As I try to set forth in this book, it is not how old a person is that counts, but how they feel and function when they are old. Medicine and certainly not this book alone has all the answers, but with your significant participation you will enable yourself to age gracefully and to live a full and abundant life. It is imperative then to discover THE DOCTOR WITHIN!
Monday, June 6, 2011
IODINE INSUFFICIENCY
The “Spot of Gold” or Robbs test that we do on most of our patients gives an indication of Iodine Insufficiency. In the last 20 years, I have never found an individual who was sufficient – the spot lasting 24 hours. Dr. Guy Abraham arrived at his conclusion that we need 12.5 milligrams of iodine a day based not only on his own experience and observation but also with the help of an extensive research review. One study he points out was co-authored in 1954 by Roslyn Yalow (later a Nobel Prize winner). She and her co-worker found that the total amount of iodine in the adult human body ranges from 7 to 13 milligrams. The iodine “pool” is divided into two major compartments, the thyroid gland and the rest of the body.
Other researchers determined that the amount retained by the thyroid gland is 6-7 milligrams, which, according to Dr. Abraham, is the optimal amount to keep the thyroid gland itself operating at peak performance. Keep in mind, though, that’s just for thyroid health.
Another prominent iodine researcher, Dr. Benjamin Eskin, determined that female breasts need about 5 milligrams of iodine per day. Add that to the amount your thyroid gland needs, and you come up with the 12.5 milligrams Dr. Abraham recommends.
Dr. Eskin also established that our thyroids “prefer” to concentrate the iodide form of iodine, while breasts concentrate iodine. Iodine and iodide are not always interchangeable: “Iodine” is the basic element, consisting of two “I” molecules bonded to each other (I-I); an excellent analogy is chlorine, which is two “Cl” molecules bonded to each other (Cl-Cl), while “chloride” is just one Cl molecule. “Iodide” is one of those two iodine molecules, and is almost always found with another molecule, such as potassium (potassium iodide, or K-I). In experimental animals, the thyroid glands and the skin concentrated more iodide than iodine, while the stomach concentrated more iodine. Based on these and other findings, Dr. Abraham recommends that iodine supplementation should include both forms: iodine and iodide.
Also Iodine can flush potentially dangerous elements from your system. Iodine, chlorine, bromine, and fluorine are in the same “family” of elements. Although very tiny quantities of fluoride are likely useful for human health, the amounts poured into most American public water supplies are much too high and have been correlated with higher risk of a rare bone cancer as well as bone fracture in older women. Bromide also carries some risks at high quantities, including impaired thinking and memory, drowsiness, dizziness, and irritability. But iodine can actually help your body get rid of these potentially harmful elements, as well as others like lead, cadmium, arsenic, aluminum, and mercury.
Following observations by Dr. Abraham, Brownstein conducted a study to test iodine’s ability to help rid our bodies of fluoride and bromide. Eight individuals had “baseline” measurements taken of their urinary output of fluoride and bromide. Each research volunteer took one 50-milligram “loading dose” of iodine and then proceeded to take the 12.5 milligram optimal daily dose from that point on. Only one day after starting iodine, their urinary output of bromide and fluoride increased significantly and continued at this higher rate for all 30 days of the study. Our Dr Robert Doenges, who holds the only patent on a salivary and urinary iodine analyzer, has never seen anyone who was Iodine sufficient.
Working with 10 female volunteers, Dr. Abraham conducted safety studies of the optimal 12.5 milligram iodine/iodide dose. He checked each woman’s blood pressure, weight, muscle mass, and body fat prior to starting iodine treatment, then again three months later. There were no statistically significant changes, although the body fat percentages did go down.
Dr. Abraham also took before-and-after measurements of several different markers of thyroid function, which included thyroid gland volume, TSH, total T4, free T4 (the active form of the thyroid hormone T4), and free T3. Although total T4 for the group declined significantly, both the “before” and “after” values were well within normal ranges, and there were no significant changes in free T4. The next part of Dr. Abraham’s safety study involved taking glucose, BUN, creatinine, sodium, potassium, chloride, calcium, total protein, albumin, globulin, bilirubin, alkaline phospatase, and ALT and AST (liver-function measurements) before and after three months. Although all values were within normal ranges before and after, there were statistically significant improvements in creatinine, alkaline phosphatase, and AST.
Lastly, Dr. Abraham measured hemoglobin, hematocrit, and red and white blood cells before and after three months. None of them changed significantly.
Despite this apparent safety record, if you decide to adopt “optimal-dose” iodine/iodide supplementation, it’s best to work closely and carefully with a knowledgeable physician to monitor thyroid function and general iodine safety. Dr. Abraham estimates that 14-15 milligrams of iodine/iodide daily is the upper limit for safe intake; that’s not much more than the optimal dose. Japanese researchers have found cases of hypothyroidism caused by excess iodine (20 milligrams daily).
It’s possible to be allergic to iodine, although it’s considerably less common than people usually think. It is the organified Iodine such as is used in radio-contrast that can cause problems. (For more details about iodine safety, see the October 2002 issue of Nutrition & Healing.) I have seen Iodine burns on the skin, but never allergy to inorganic Iodine.
In the 1820s, the French physician Jean Lugol combined iodine (5 percent) and potassium iodide (10 percent) along with 85 percent water. Since iodine kills germs, he used it for nearly any infectious disease, as well as many other problems, frequently with success. The combination quickly became known as “Lugol’s solution” and was adopted by practicing physicians throughout Europe and the Americas. Lugol’s solution was widely used until the 1920s. In fact it was the most commonly prescribed medicine for many hard to categorize and treat diseases in 1930-33. Then research began in earnest and many new drugs were marketed. Many physicians recommended two drops daily for good health and more on occasion to help kill germs. After doing the spot test, I tell folks to take between 2 and 10 drops depending on how fast the spot disappears. Lugols Solution is relatively inexpensive but does take a prescription and is available in some regular pharmacies and in all of the compounding ones.
Other researchers determined that the amount retained by the thyroid gland is 6-7 milligrams, which, according to Dr. Abraham, is the optimal amount to keep the thyroid gland itself operating at peak performance. Keep in mind, though, that’s just for thyroid health.
Another prominent iodine researcher, Dr. Benjamin Eskin, determined that female breasts need about 5 milligrams of iodine per day. Add that to the amount your thyroid gland needs, and you come up with the 12.5 milligrams Dr. Abraham recommends.
Dr. Eskin also established that our thyroids “prefer” to concentrate the iodide form of iodine, while breasts concentrate iodine. Iodine and iodide are not always interchangeable: “Iodine” is the basic element, consisting of two “I” molecules bonded to each other (I-I); an excellent analogy is chlorine, which is two “Cl” molecules bonded to each other (Cl-Cl), while “chloride” is just one Cl molecule. “Iodide” is one of those two iodine molecules, and is almost always found with another molecule, such as potassium (potassium iodide, or K-I). In experimental animals, the thyroid glands and the skin concentrated more iodide than iodine, while the stomach concentrated more iodine. Based on these and other findings, Dr. Abraham recommends that iodine supplementation should include both forms: iodine and iodide.
Also Iodine can flush potentially dangerous elements from your system. Iodine, chlorine, bromine, and fluorine are in the same “family” of elements. Although very tiny quantities of fluoride are likely useful for human health, the amounts poured into most American public water supplies are much too high and have been correlated with higher risk of a rare bone cancer as well as bone fracture in older women. Bromide also carries some risks at high quantities, including impaired thinking and memory, drowsiness, dizziness, and irritability. But iodine can actually help your body get rid of these potentially harmful elements, as well as others like lead, cadmium, arsenic, aluminum, and mercury.
Following observations by Dr. Abraham, Brownstein conducted a study to test iodine’s ability to help rid our bodies of fluoride and bromide. Eight individuals had “baseline” measurements taken of their urinary output of fluoride and bromide. Each research volunteer took one 50-milligram “loading dose” of iodine and then proceeded to take the 12.5 milligram optimal daily dose from that point on. Only one day after starting iodine, their urinary output of bromide and fluoride increased significantly and continued at this higher rate for all 30 days of the study. Our Dr Robert Doenges, who holds the only patent on a salivary and urinary iodine analyzer, has never seen anyone who was Iodine sufficient.
Working with 10 female volunteers, Dr. Abraham conducted safety studies of the optimal 12.5 milligram iodine/iodide dose. He checked each woman’s blood pressure, weight, muscle mass, and body fat prior to starting iodine treatment, then again three months later. There were no statistically significant changes, although the body fat percentages did go down.
Dr. Abraham also took before-and-after measurements of several different markers of thyroid function, which included thyroid gland volume, TSH, total T4, free T4 (the active form of the thyroid hormone T4), and free T3. Although total T4 for the group declined significantly, both the “before” and “after” values were well within normal ranges, and there were no significant changes in free T4. The next part of Dr. Abraham’s safety study involved taking glucose, BUN, creatinine, sodium, potassium, chloride, calcium, total protein, albumin, globulin, bilirubin, alkaline phospatase, and ALT and AST (liver-function measurements) before and after three months. Although all values were within normal ranges before and after, there were statistically significant improvements in creatinine, alkaline phosphatase, and AST.
Lastly, Dr. Abraham measured hemoglobin, hematocrit, and red and white blood cells before and after three months. None of them changed significantly.
Despite this apparent safety record, if you decide to adopt “optimal-dose” iodine/iodide supplementation, it’s best to work closely and carefully with a knowledgeable physician to monitor thyroid function and general iodine safety. Dr. Abraham estimates that 14-15 milligrams of iodine/iodide daily is the upper limit for safe intake; that’s not much more than the optimal dose. Japanese researchers have found cases of hypothyroidism caused by excess iodine (20 milligrams daily).
It’s possible to be allergic to iodine, although it’s considerably less common than people usually think. It is the organified Iodine such as is used in radio-contrast that can cause problems. (For more details about iodine safety, see the October 2002 issue of Nutrition & Healing.) I have seen Iodine burns on the skin, but never allergy to inorganic Iodine.
In the 1820s, the French physician Jean Lugol combined iodine (5 percent) and potassium iodide (10 percent) along with 85 percent water. Since iodine kills germs, he used it for nearly any infectious disease, as well as many other problems, frequently with success. The combination quickly became known as “Lugol’s solution” and was adopted by practicing physicians throughout Europe and the Americas. Lugol’s solution was widely used until the 1920s. In fact it was the most commonly prescribed medicine for many hard to categorize and treat diseases in 1930-33. Then research began in earnest and many new drugs were marketed. Many physicians recommended two drops daily for good health and more on occasion to help kill germs. After doing the spot test, I tell folks to take between 2 and 10 drops depending on how fast the spot disappears. Lugols Solution is relatively inexpensive but does take a prescription and is available in some regular pharmacies and in all of the compounding ones.
NATURAL TREATMENTS FOR DIABETES AND ITS PREVENTION
Doctors in India have used the leaves of an herb called Gymnema sylvestre to treat blood sugar problems for generations. Now modern science proves that it truly works. Indeed, over 29 studies show that gymnema leaf lowers blood sugar and reduces your body's need for insulin.
And here's the most amazing thing about gymnema. Scientists were stunned when they discovered an increase in the number of "beta cells" in the pancreas of test subjects. That means gymnema could actually help repair and regenerate new pancreas cells that produce insulin!
This is unprecedented in the history of health sciences. Imagine, a single nutrient that can help lower blood sugar, support your body's ability to produce the insulin you need, and even repair your pancreas. Gymnema can do all this and more.
But as good as Gymnema and these other nutrients are, you'll really get the full effect when you take them in combination with this next ingredient…
Alpha-lipoic acid
Alpha-lipoic acid (ALA) is a powerful antioxidant. It regenerates other antioxidants in your body, such as vitamins C and E. And if you have high blood sugar, ALA can be a lifesaver. In one carefully controlled study, 74 patients were given ALA or a placebo. ALA boosted their ability to absorb and use blood glucose by 27%.
Another study shows that ALA improves your body's sensitivity to insulin. And your ability to burn blood sugar. ALA can also lower your fasting glucose levels and enable your cells to store more glucose for energy. Rather than having a blood sugar build-up. Astragalus, ginseng, gymnema, and ALA aren’t the only natural nutrients that can help balance your blood sugar...
The truth about cinnamon
It's no secret that eating too many sugary foods and refined carbs can cause your blood sugar to skyrocket. Over time, high blood sugar can damage and even kill off the "insulin receptors" on your cells. When that happens, your body's cells don't respond as well to insulin. So they don't absorb as much sugar into your muscles and fat cells, to produce or store energy.
Recently, scientists discovered that cinnamon could solve this problem. Researchers looked at 60 patients with high blood sugar. Half took a placebo. The other half took either 1, 3 or 6 grams of cinnamon daily. After just 40 days, the group taking cinnamon had reduced their fasting blood glucose by nearly a third.
And here's the most amazing thing about gymnema. Scientists were stunned when they discovered an increase in the number of "beta cells" in the pancreas of test subjects. That means gymnema could actually help repair and regenerate new pancreas cells that produce insulin!
This is unprecedented in the history of health sciences. Imagine, a single nutrient that can help lower blood sugar, support your body's ability to produce the insulin you need, and even repair your pancreas. Gymnema can do all this and more.
But as good as Gymnema and these other nutrients are, you'll really get the full effect when you take them in combination with this next ingredient…
Alpha-lipoic acid
Alpha-lipoic acid (ALA) is a powerful antioxidant. It regenerates other antioxidants in your body, such as vitamins C and E. And if you have high blood sugar, ALA can be a lifesaver. In one carefully controlled study, 74 patients were given ALA or a placebo. ALA boosted their ability to absorb and use blood glucose by 27%.
Another study shows that ALA improves your body's sensitivity to insulin. And your ability to burn blood sugar. ALA can also lower your fasting glucose levels and enable your cells to store more glucose for energy. Rather than having a blood sugar build-up. Astragalus, ginseng, gymnema, and ALA aren’t the only natural nutrients that can help balance your blood sugar...
The truth about cinnamon
It's no secret that eating too many sugary foods and refined carbs can cause your blood sugar to skyrocket. Over time, high blood sugar can damage and even kill off the "insulin receptors" on your cells. When that happens, your body's cells don't respond as well to insulin. So they don't absorb as much sugar into your muscles and fat cells, to produce or store energy.
Recently, scientists discovered that cinnamon could solve this problem. Researchers looked at 60 patients with high blood sugar. Half took a placebo. The other half took either 1, 3 or 6 grams of cinnamon daily. After just 40 days, the group taking cinnamon had reduced their fasting blood glucose by nearly a third.
There are plenty more studies that show the beneficial effects of cinnamon. But hold on a minute! Don't think that you can run out to the supermarket and grab any old cinnamon for these kind of results. Or that cinnamon supplements always do the trick. There's only one form of cinnamon that's been shown to work in human studies. It's called Cinnamomum cassia. That's the kind used in these studies. And the only kind of cinnamon you should ever buy to control your blood sugar. Some supplements just list “cinnamon bark extract.” This says to me that it’s not the same as the Cinnamomum cassia used in studies! So if you've tried cinnamon supplements and been disappointed with the results, that could be the reason why.
- Chromium — which has been shown to lower blood glucose levels. Chromium also reduces your cravings for sweets and carbs, so your blood sugar doesn't spike so high after a meal.
- Algimate® — a soluble fiber derived from seaweed. It sticks to the sugars in your digestive system. Research shows it can slow the absorption of both fats and sugars in the small intestine.
- Fenugreek — slows the absorption of sugars in the stomach. It stimulates insulin production. And it lowers cholesterol and triglycerides.
- Cordyceps — used for thousands of years as a tonic for lung, kidney and heart problems. Cordyceps became famous when two female Chinese athletes set new track and field event world records in 1993. Their coach attributed their success to high altitude training and a diet containing Cordyceps.
- Maitake — lowers blood glucose and improves cholesterol levels.
- Kudzu root — supports pancreatic cells and stimulate insulin production.
- Holy basil leaf — reduces both fasting and post-meal glucose levels. Holy Basil is high in antioxidants. Having high blood sugar is an inflammatory condition. Antioxidants are powerful anti-inflammatory nutrients.
- Jambolan seed — also thought to lower blood sugar, and have antioxidant and anti-inflammatory properties. One study showed Jambolan may even protect the pancreas by restoring protective enzymes such as glutathione back to normal levels.
- L-taurine — this sulphur amino acid is well known for protecting the heart. How? By reducing free radicals in blood fats. This translates into lower cholesterol and higher levels of "good" HDL cholesterol. Taurine also protects your eyes and actually regenerates worn-out retinal tissues.
- Ophiopogon — treats the fluid imbalance that causes many people with high blood sugar to urinate frequently and be thirsty.
- Chinese yam — strengthens the spleen and kidney function, combating the thirst and frequent urination associated with high blood sugar.
- Anemarrhena rhizome — decreases insulin resistance in those with high blood sugar. Yet it leaves people with "normal" blood sugar levels untouched.
- Henon bamboo — protects your eyes by fighting a nasty enzyme called aldose reductase. Aldose reductase destroys bloods vessels in your retina.
- Tiger lily bulb — which is used in traditional Chinese medicine to protect your heart and eyes.
Wednesday, May 18, 2011
DON’T BE A GLUTTON FOR GLUTEN
There is yet no cure for Celiac Disease which is vastly under diagnosed and takes an average of 11 years between the first appearances of bowel symptoms until it is identified. Adding insult to injury, it often remains silent in the intestine while extra intestinal problems (headaches, arthralgias, thyroid problems and liver abnormalities) are occurring. To date there is no help for this malady other than completely avoiding this protein found in wheat and other grains, (the acronym B.R.O.W.S.: B for Barley, R for Rye, O for Oats, W for Wheat and S for Spelt). In the future, several medicines will be available to denature some of this protein that incidentally slips in with other foodstuffs. Still there is no long lasting for those who consume gluten. Much controversy exists in the literature with gluten allergy, sensitivity and true Celiac Disease. The three criteria for the disease by most knowledgeable physicians are a genetic predisposition, consumption of gluten and a triggering event of a physical or emotional nature.
To document the diagnosis, blood anti-transaminase, anti-myelysin and anti-gliadin studies are preformed. But they are only positive if the patient has significant bowel disease when the blood is drawn and he/she has been consuming gluten on a regular basis. The markers of HLA-DQ2 or HLA-DQ8 haplotype, which show the genetic predisposition can also be tested, but are more expensive and do not guarantee that the patient really does have the disease. According to Ken Fine, et al. (The prevalence and causes of chronic diarrhea in treated celiac sprue. Gastroenterology 1997; 112:1830-1837) the most cost effective test to diagnose celiac disease is an anti-gliadin stool test while the suspect is consuming gluten. This is the test we used to diagnose and follow the treatment results .
BRALY'S SIGN: A visible trait of Hashimotos Thyroid Disease which is common in Celiacs was first noted in Poland in 1953 and presented to the Western Europe by the English Gastroenterologist, James Braly, MD. The majority of Celiacs have a foreshortened 5th finger now designated as Braly’s Sign. (J Pediatric Gastroenterology and Nutrition 2000; volume 31 (Suppl.3): S29. New England Journal of Medicine, August 18, 1999). A positive sign is that the end of the fifth finger is shorter than the last joint of the ring finger. We used this external marker as a hallmark of the disease also in our study. In the combined experienced of the two of us and another colleague, Susan Solomon, a clinician in Raleigh N.C. we have found this marker positive in almost 85% of Celiacs that were either biopsied proven or had the positive genetic marker of the disease.
HYDROGEN BREATH TEST: This is an inexpensive, paid by insurance study that is a presumptive assessment for intestinal disease such as gluten intolerance. Actually, it detects bacterial overgrowth in the small intestine. This is common in intestinal diseases in which the mucosa of the intestine is compromised like celiac, but also small intestinal diverticulosis, abnormal flora, parasites and previous surgery where the usual anatomy of the intestine has been changed. An example of this is bypass surgery for weight loss. Also if the intestine cannot make the enzymes to break down food stuff it also causes abnormal gases due to the fermentation from normal bacteria. Lactose intolerance is an illustration.
Normally there should be NO hydrogen in the breath since the bacteria and the enzymes and the anatomy is doing its job. But if something is awry then hydrogen which is normally produced in minute amounts goes up. Gastroenterologist picked the cut point of 10 parts per million or more to be abnormal. The test is done by holding one's breath for 30 seconds then exhaling through a carboard tube into a special handheld device. In 20 seconds, the results are apparent.
To document the diagnosis, blood anti-transaminase, anti-myelysin and anti-gliadin studies are preformed. But they are only positive if the patient has significant bowel disease when the blood is drawn and he/she has been consuming gluten on a regular basis. The markers of HLA-DQ2 or HLA-DQ8 haplotype, which show the genetic predisposition can also be tested, but are more expensive and do not guarantee that the patient really does have the disease. According to Ken Fine, et al. (The prevalence and causes of chronic diarrhea in treated celiac sprue. Gastroenterology 1997; 112:1830-1837) the most cost effective test to diagnose celiac disease is an anti-gliadin stool test while the suspect is consuming gluten. This is the test we used to diagnose and follow the treatment results .
BRALY'S SIGN: A visible trait of Hashimotos Thyroid Disease which is common in Celiacs was first noted in Poland in 1953 and presented to the Western Europe by the English Gastroenterologist, James Braly, MD. The majority of Celiacs have a foreshortened 5th finger now designated as Braly’s Sign. (J Pediatric Gastroenterology and Nutrition 2000; volume 31 (Suppl.3): S29. New England Journal of Medicine, August 18, 1999). A positive sign is that the end of the fifth finger is shorter than the last joint of the ring finger. We used this external marker as a hallmark of the disease also in our study. In the combined experienced of the two of us and another colleague, Susan Solomon, a clinician in Raleigh N.C. we have found this marker positive in almost 85% of Celiacs that were either biopsied proven or had the positive genetic marker of the disease.
HYDROGEN BREATH TEST: This is an inexpensive, paid by insurance study that is a presumptive assessment for intestinal disease such as gluten intolerance. Actually, it detects bacterial overgrowth in the small intestine. This is common in intestinal diseases in which the mucosa of the intestine is compromised like celiac, but also small intestinal diverticulosis, abnormal flora, parasites and previous surgery where the usual anatomy of the intestine has been changed. An example of this is bypass surgery for weight loss. Also if the intestine cannot make the enzymes to break down food stuff it also causes abnormal gases due to the fermentation from normal bacteria. Lactose intolerance is an illustration.
Normally there should be NO hydrogen in the breath since the bacteria and the enzymes and the anatomy is doing its job. But if something is awry then hydrogen which is normally produced in minute amounts goes up. Gastroenterologist picked the cut point of 10 parts per million or more to be abnormal. The test is done by holding one's breath for 30 seconds then exhaling through a carboard tube into a special handheld device. In 20 seconds, the results are apparent.
Monday, May 9, 2011
SUSTAIN YOUR BRAIN
ALZHEIMER’S DISEASE (AD) may be in your future, but you can head it off! A person must be proactive rather than reactive to prevent this devastating disease. After its onset, it is too late to reverse this most common form of dementia. It is an incurable, degenerative, and terminal disease which was first described by the German psychiatrist and neuro-pathologist, Alois Alzheimer in 1906 and was subsequently named after him. Generally, it is diagnosed in people over 65 years of age, although the less-prevalent “early-onset” of Alzheimer's does occur before this age. In 2011, there were 36 million sufferers in the US. Alzheimer's is predicted to affect 1 in 3 over the age of 65. By 2050, half of all people over the age of 80 are predicted to have it! Medical science already has the tools to prevent it, but very few Doctors know about them, let alone make their recommendation.
The risk factors for AD includes family history, gluten intolerance, heavy metal excess, fever blisters, glucose intolerance, obesity, head trauma, drug, age, physical and psychological stress. Stress can not only be diagnosed, but quantified by a simple office test: Heart Rate Variation (HRV). Also, if one has a single gene Apo E4 there is a 75% chance and if a double E4 a 94% chance of the disease.
The earliest observable symptoms are often mistakenly thought to be “age-related” senior moments. The inability to acquire new memories, the difficulty in recalling recently observed facts are noted first by the individual, then by loved ones and lastly by friends. These individuals, particularly those with a high social IQ, cover up these mental lapses with believable excuses. As the disease advances, symptoms include confusion, irritability, aggression, mood swings, language breakdown, long-term memory loss and the general withdrawal of the sufferer as their senses decline. Gradually, bodily functions are lost, ultimately leading to death. Individual prognosis is difficult to assess, as the duration of the disease varies. AD develops for an indeterminate period of time before becoming fully apparent, and it can progress undiagnosed for years. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnosis. When AD is suspected, the diagnosis is usually confirmed with behavioral assessments and cognitive tests, such as a MMSE. A Psychological Inventory Test (to be covered in a later posting) that checks nine different brain areas of function also helps in diagnosis and prognosis. It is best to pick up the disease in its earliest stages when much can be done to delay or even prevent it. Often I will order a MRI to look at the hippocampus volume, and if in real doubt do a PET scan with a PIB contrast.
If Alzheimer’s is in your future, much can be done to greatly delay, or better yet, prevent it. Despite the many ways to determine if you are in harms way, there is no guarantee that it will arrive until after it is too late. Therefore, an ounce of prevention should be considered before a ton of care. One cannot change their genes (Apo E or Family History), but can certainly amend them in what is now termed epigenetic modification. The research indicates that AD is mainly an inflammatory process albeit a slow ongoing oxidative smoldering process. Involved in this process are two key moleules, Nrf2 and BDNF. Nrf2 is a master regulator molecule of the antioxidant response. This response is important to diminish our oxidative stressors. Because Nrf2 is able to induce genes important in combating oxidative stress, it activates the body’s own protective response, Nrf2 is able to protect from a variety of oxidative stress-related complications, even in situations where the administration of exogenous antioxidants (such as Vitamin C and Vitamin E) have failed. The other important player, BDNF keeps nerve cells alive and stimulaes the growth of new ones. Recent studies shows that it prevents and reverse Alzheimer’s independent of the amyloid plaque tangles. BDNF levels can be naturally boosted by heavy exercise and caloric restriction. Nutrients that also help make BDNF or protect it from declining are acetyl-l-carnitine, fish oil, blueberries, and curcumin.
There are both prescription drugs and supplements that are recommended for AD. The three drugs that are FDA approved to increase an important chemical in neuro-transmission, Acetyl Choline, are Aricept, Exelon and Razadyne. The other FDA medication is Nemanda which tries, but not completely successfully, to inhibit the neurons from “burn out” from excessive excitation. Because 90% of folks who have Alzheimers also have the Herpes Simplex-2 Virus, taking a daily antiviral, such as Acyclovir may also be prevention, although not FDA approved for this. Other prescriptions that are used in that AD which by some researchers is considered to be Type 3 Diabetes are Metformine and Actos.
A supplement representing more than 30 years of neuroscience research, is BrainSustain. This is a unique powdered drink formula, developed by Board-Certified Neurologist, David Perlmutter, MD, FACN, to enhance brain performance and health. It is usually given in a smoothie or Almond Milk Shake. BrainSustainTM improves the energy production of brain mitochondria providing generous antioxidant support to combat the damaging effects of excess free radicals. It contains the following underlined ingrediants. Broccoli Seed Extract, which is the Johns Hopkins non heated patented extract of the phytochemical in broccoli (sulforaphane glucosinolate). Extensive research demonstrates that this compound upregulates the Nrf2 system, enhancing the production of important antioxidants such as glutathione and superoxide dismutase as well as activating vital Phase 2 detoxification enzymes. N-Acetyl-L-Cysteine (NAC), a derivative of the amino acid, L-cysteine, is the precursor to glutathione, one of the brain’s most important antioxidants. The aim of oral supplementation is to augment the body’s reserve. NAC itself is a potent antioxidant shown to reduce formation of nitric oxide, a free radical implicated for a causative role in neurodegenerative disorders. Phosphytl Serine (PS), a component of lecithin, plays an important role in neuronal energy production and enhances neuronal communication. After careful examination of scientific evidence, the FDA granted “qualified health claim” status to PS, stating that “Consumption of PS may reduce the risk of dementia in the elderly”. N-Acetyl-L-Carnitine (aka ALCAR), an acetylated form of the amino acid, L-carnitine, is able to cross the blood brain barrier, where it acts as an effective antioxidant and protects brain cells from toxic chemical and stress-induced damage and deterioration. N-Acetyl-L-Carnitine enhances neuronal energy production by transporting fuel sources into the mitochondria and removing energy production waste products from them. Carnitine is readily converted into acetlycholine, a neurotransmittter essential for learning and concentration. Alpha Lipoic Acid also provides more antioxidant action and regenerates other important brain antioxidants including vitamins E, C, and glutathione. Unlike other antioxidants, alpha lipoic acid is both fat and water-soluble, greatly enhancing its ability to be absorbed from the gut and penetrate into the brain. Coenzyme Q10 measurably increases the efficiency of cellular energy production and serves as a potent antioxidant that may protect the brain from oxidative stress damage, which is believed to be partially responsible for neurodegenerative disease. A special DHA, (a2), derived from algae is not only vital to brain health, but 25% of the brain is made up of it. DHA-a2 facilitates optimal structure and functioning of the brain cell membranes.
BrainSustainTM also contains VegaProTM, XYMOGEN’s proprietary pea/ rice protein blend, as well as fat soluble antioxidants, vitamins D3 and E (as mixed tocopherols), and activated B vitamins, including 50 mg of riboflavin and folic acid (as calcium folinate). Available in Vanilla Delight, Chai & Creamy Chocolate, BrainSustainTM costs from $40 to $80 a month depending on whether an individual takes one or two scoops of this product daily. In general I advise one to prevent and two to treat Dementia.
The risk factors for AD includes family history, gluten intolerance, heavy metal excess, fever blisters, glucose intolerance, obesity, head trauma, drug, age, physical and psychological stress. Stress can not only be diagnosed, but quantified by a simple office test: Heart Rate Variation (HRV). Also, if one has a single gene Apo E4 there is a 75% chance and if a double E4 a 94% chance of the disease.
The earliest observable symptoms are often mistakenly thought to be “age-related” senior moments. The inability to acquire new memories, the difficulty in recalling recently observed facts are noted first by the individual, then by loved ones and lastly by friends. These individuals, particularly those with a high social IQ, cover up these mental lapses with believable excuses. As the disease advances, symptoms include confusion, irritability, aggression, mood swings, language breakdown, long-term memory loss and the general withdrawal of the sufferer as their senses decline. Gradually, bodily functions are lost, ultimately leading to death. Individual prognosis is difficult to assess, as the duration of the disease varies. AD develops for an indeterminate period of time before becoming fully apparent, and it can progress undiagnosed for years. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnosis. When AD is suspected, the diagnosis is usually confirmed with behavioral assessments and cognitive tests, such as a MMSE. A Psychological Inventory Test (to be covered in a later posting) that checks nine different brain areas of function also helps in diagnosis and prognosis. It is best to pick up the disease in its earliest stages when much can be done to delay or even prevent it. Often I will order a MRI to look at the hippocampus volume, and if in real doubt do a PET scan with a PIB contrast.
If Alzheimer’s is in your future, much can be done to greatly delay, or better yet, prevent it. Despite the many ways to determine if you are in harms way, there is no guarantee that it will arrive until after it is too late. Therefore, an ounce of prevention should be considered before a ton of care. One cannot change their genes (Apo E or Family History), but can certainly amend them in what is now termed epigenetic modification. The research indicates that AD is mainly an inflammatory process albeit a slow ongoing oxidative smoldering process. Involved in this process are two key moleules, Nrf2 and BDNF. Nrf2 is a master regulator molecule of the antioxidant response. This response is important to diminish our oxidative stressors. Because Nrf2 is able to induce genes important in combating oxidative stress, it activates the body’s own protective response, Nrf2 is able to protect from a variety of oxidative stress-related complications, even in situations where the administration of exogenous antioxidants (such as Vitamin C and Vitamin E) have failed. The other important player, BDNF keeps nerve cells alive and stimulaes the growth of new ones. Recent studies shows that it prevents and reverse Alzheimer’s independent of the amyloid plaque tangles. BDNF levels can be naturally boosted by heavy exercise and caloric restriction. Nutrients that also help make BDNF or protect it from declining are acetyl-l-carnitine, fish oil, blueberries, and curcumin.
There are both prescription drugs and supplements that are recommended for AD. The three drugs that are FDA approved to increase an important chemical in neuro-transmission, Acetyl Choline, are Aricept, Exelon and Razadyne. The other FDA medication is Nemanda which tries, but not completely successfully, to inhibit the neurons from “burn out” from excessive excitation. Because 90% of folks who have Alzheimers also have the Herpes Simplex-2 Virus, taking a daily antiviral, such as Acyclovir may also be prevention, although not FDA approved for this. Other prescriptions that are used in that AD which by some researchers is considered to be Type 3 Diabetes are Metformine and Actos.
A supplement representing more than 30 years of neuroscience research, is BrainSustain. This is a unique powdered drink formula, developed by Board-Certified Neurologist, David Perlmutter, MD, FACN, to enhance brain performance and health. It is usually given in a smoothie or Almond Milk Shake. BrainSustainTM improves the energy production of brain mitochondria providing generous antioxidant support to combat the damaging effects of excess free radicals. It contains the following underlined ingrediants. Broccoli Seed Extract, which is the Johns Hopkins non heated patented extract of the phytochemical in broccoli (sulforaphane glucosinolate). Extensive research demonstrates that this compound upregulates the Nrf2 system, enhancing the production of important antioxidants such as glutathione and superoxide dismutase as well as activating vital Phase 2 detoxification enzymes. N-Acetyl-L-Cysteine (NAC), a derivative of the amino acid, L-cysteine, is the precursor to glutathione, one of the brain’s most important antioxidants. The aim of oral supplementation is to augment the body’s reserve. NAC itself is a potent antioxidant shown to reduce formation of nitric oxide, a free radical implicated for a causative role in neurodegenerative disorders. Phosphytl Serine (PS), a component of lecithin, plays an important role in neuronal energy production and enhances neuronal communication. After careful examination of scientific evidence, the FDA granted “qualified health claim” status to PS, stating that “Consumption of PS may reduce the risk of dementia in the elderly”. N-Acetyl-L-Carnitine (aka ALCAR), an acetylated form of the amino acid, L-carnitine, is able to cross the blood brain barrier, where it acts as an effective antioxidant and protects brain cells from toxic chemical and stress-induced damage and deterioration. N-Acetyl-L-Carnitine enhances neuronal energy production by transporting fuel sources into the mitochondria and removing energy production waste products from them. Carnitine is readily converted into acetlycholine, a neurotransmittter essential for learning and concentration. Alpha Lipoic Acid also provides more antioxidant action and regenerates other important brain antioxidants including vitamins E, C, and glutathione. Unlike other antioxidants, alpha lipoic acid is both fat and water-soluble, greatly enhancing its ability to be absorbed from the gut and penetrate into the brain. Coenzyme Q10 measurably increases the efficiency of cellular energy production and serves as a potent antioxidant that may protect the brain from oxidative stress damage, which is believed to be partially responsible for neurodegenerative disease. A special DHA, (a2), derived from algae is not only vital to brain health, but 25% of the brain is made up of it. DHA-a2 facilitates optimal structure and functioning of the brain cell membranes.
BrainSustainTM also contains VegaProTM, XYMOGEN’s proprietary pea/ rice protein blend, as well as fat soluble antioxidants, vitamins D3 and E (as mixed tocopherols), and activated B vitamins, including 50 mg of riboflavin and folic acid (as calcium folinate). Available in Vanilla Delight, Chai & Creamy Chocolate, BrainSustainTM costs from $40 to $80 a month depending on whether an individual takes one or two scoops of this product daily. In general I advise one to prevent and two to treat Dementia.
Monday, May 2, 2011
ASPIRIN WORKS
Aspirin is frequently called the “wonder drug” because of its many beneficial properties. Two of the most significant are the prevention of cardiovascular events and cancer. It makes the blood platelets which are 1/10 of the size of a red blood cell less sticky . The drug works by inhibiting the production of prostaglandins forming on the outside membrane of these. Additionally, aspirin induces the formation of Nitric Oxide-radicals an independent mechanism of reducing inflammation in the blood vessels. More recent data also suggests that aspirin modulates signaling through NF-κB, a transcription factor complex, plays a central role in many biological processes, including cancer. This may be why folks who take a low dose aspirin daily for at least five years have a 30% less incidence in breast, prostate, stomach, esophagus, lung, and ovarian cancer. Additionally, if they already have the tumor, have far less distant spread.
Although Hippocrates, in 400 B.C left historical records of treatments, with the mother of aspirin from the bark and leaves of the willow tree, it was not until 1828, that Johann Buchner, professor of pharmacy at the University of Munich, isolated a tiny amount of bitter tasting yellow, needle-like crystals, which he called salicinin and Leroux had extracted salicin, in crystalline form for the first time, and Raffaele Piria succeeded in obtaining the salicylic acid in its pure state. A hundred and fifty years later (1971), British pharmacologist John Robert Vane in London, showed aspirin suppressed the production of prostaglandins and thromboxanes. For this discovery, he was awarded both a Nobel Prize in Physiology and Medicine in 1982 and a knighthood.
More than 50 million people in the U.S. take aspirin every day to help prevent heart attacks, strokes and cancer. However, research has demonstrated that up to 25 percent of these individuals may not benefit from the anti-clotting effect of aspirin, and are more than three times more likely to die from a heart attack or stroke. So Aspirin does not have the same effect on everyone. This suboptimal response to aspirin by an individual is commonly known as aspirin resistance or insensitivity Since these individuals are at increased risk of heart attack or stroke, doctors are beginning to recognize the importance of testing for aspirin effect. On the other hand, the higher doses of aspirin, not only in some will produce a paradoxical clotting effect, but in others a hemorrhage!
Until recently, there was no quick, accurate and effective way to test for aspirin effect. An ADP adhesive study or a specific prostaglandin assay was used in research settings and not paid for by insurances. But now, with the AspirinWorks Test, we can be sure the aspirin is working with a simple no fasting urine test. The AspirinWorks Test is FDA cleared for use in apparently healthy individuals, and test samples can be collected in the doctor’s office at any time. The AspirinWorks Test determines the effect of aspirin on platelets by measuring the level of the biomarker called thromboxane B2 (11dhTxB2). The higher the levels of thromboxane B2, the stickier the blood platelets, and the less impact the aspirin is having. This crucial information allows physicians to individualize a patient’s therapy, which may be as simple as adjusting the dose.
When prescribing blood pressure or cholesterol medication, doctors routinely check the patient’s blood pressure or cholesterol to make sure the patient is getting the right dose of medication. Similarly it is important to know if the dose of aspirin you’re taking is effective. Now, when prescribing aspirin we can then decide to increase or decrease your aspirin dose or if additional medication is needed. As mentioned in my previous writings that just as important is the aspirin to prevent blood from clotting within the blood stream, acetaminophen is needed to inhibit the clot on the arterial wall!
Therefore acetaminophen (Tylenol) has been shown to work in conjunction with the aspirin. At the University of Georgia, Dr. Phillip Greenspan found that the acetaminophen is a potent inhibitor of the enzyme, myeloperoxidase. This enzyme oxidizes the LDL, modifies it in such a way that it is more delectable to the certain white cells (macrophages) that reside within the wall of our arteries. These ingest the LDL cholesterol and cause the plaque and obstruction, which is the father of atherosclerosis. In that the acetaminophen blocks the activity of this enzyme, there is less transformation of the bad cholesterol (LDL) that is available for the macrophages to ingest. This research was presented at the conference on arteriosclerosis, thrombosis and vascular biology in Denver, May 21, 2000 and in 2006 documented by John Merrill PhD at Rutgers. This can also be taken to prevent pain. Some people state it helps them to sleep, when taken at bedtime. Also a recent study at the University of Florida demonstrated that acetamenaphen elevates the mood. The bad press that Acetaminophen has recently had makes this well studied drug almost a curse word. It is true in very high doses like over 6,000 mg a day it can negatively affect the liver and perhaps the kidney, but 1000mg/day is positively healthy for all who want protect their blood vessels.
THE BOTTOM LINE-“Betwixt and between, Aspirin and Tylenol will keep the artery clean” One each 81 mg Aspirin and 500 mg Acetaminophen (TylenolR), both twice a day, will keep the heart attack and stroke away!!
Although Hippocrates, in 400 B.C left historical records of treatments, with the mother of aspirin from the bark and leaves of the willow tree, it was not until 1828, that Johann Buchner, professor of pharmacy at the University of Munich, isolated a tiny amount of bitter tasting yellow, needle-like crystals, which he called salicinin and Leroux had extracted salicin, in crystalline form for the first time, and Raffaele Piria succeeded in obtaining the salicylic acid in its pure state. A hundred and fifty years later (1971), British pharmacologist John Robert Vane in London, showed aspirin suppressed the production of prostaglandins and thromboxanes. For this discovery, he was awarded both a Nobel Prize in Physiology and Medicine in 1982 and a knighthood.
More than 50 million people in the U.S. take aspirin every day to help prevent heart attacks, strokes and cancer. However, research has demonstrated that up to 25 percent of these individuals may not benefit from the anti-clotting effect of aspirin, and are more than three times more likely to die from a heart attack or stroke. So Aspirin does not have the same effect on everyone. This suboptimal response to aspirin by an individual is commonly known as aspirin resistance or insensitivity Since these individuals are at increased risk of heart attack or stroke, doctors are beginning to recognize the importance of testing for aspirin effect. On the other hand, the higher doses of aspirin, not only in some will produce a paradoxical clotting effect, but in others a hemorrhage!
Until recently, there was no quick, accurate and effective way to test for aspirin effect. An ADP adhesive study or a specific prostaglandin assay was used in research settings and not paid for by insurances. But now, with the AspirinWorks Test, we can be sure the aspirin is working with a simple no fasting urine test. The AspirinWorks Test is FDA cleared for use in apparently healthy individuals, and test samples can be collected in the doctor’s office at any time. The AspirinWorks Test determines the effect of aspirin on platelets by measuring the level of the biomarker called thromboxane B2 (11dhTxB2). The higher the levels of thromboxane B2, the stickier the blood platelets, and the less impact the aspirin is having. This crucial information allows physicians to individualize a patient’s therapy, which may be as simple as adjusting the dose.
When prescribing blood pressure or cholesterol medication, doctors routinely check the patient’s blood pressure or cholesterol to make sure the patient is getting the right dose of medication. Similarly it is important to know if the dose of aspirin you’re taking is effective. Now, when prescribing aspirin we can then decide to increase or decrease your aspirin dose or if additional medication is needed. As mentioned in my previous writings that just as important is the aspirin to prevent blood from clotting within the blood stream, acetaminophen is needed to inhibit the clot on the arterial wall!
Therefore acetaminophen (Tylenol) has been shown to work in conjunction with the aspirin. At the University of Georgia, Dr. Phillip Greenspan found that the acetaminophen is a potent inhibitor of the enzyme, myeloperoxidase. This enzyme oxidizes the LDL, modifies it in such a way that it is more delectable to the certain white cells (macrophages) that reside within the wall of our arteries. These ingest the LDL cholesterol and cause the plaque and obstruction, which is the father of atherosclerosis. In that the acetaminophen blocks the activity of this enzyme, there is less transformation of the bad cholesterol (LDL) that is available for the macrophages to ingest. This research was presented at the conference on arteriosclerosis, thrombosis and vascular biology in Denver, May 21, 2000 and in 2006 documented by John Merrill PhD at Rutgers. This can also be taken to prevent pain. Some people state it helps them to sleep, when taken at bedtime. Also a recent study at the University of Florida demonstrated that acetamenaphen elevates the mood. The bad press that Acetaminophen has recently had makes this well studied drug almost a curse word. It is true in very high doses like over 6,000 mg a day it can negatively affect the liver and perhaps the kidney, but 1000mg/day is positively healthy for all who want protect their blood vessels.
THE BOTTOM LINE-“Betwixt and between, Aspirin and Tylenol will keep the artery clean” One each 81 mg Aspirin and 500 mg Acetaminophen (TylenolR), both twice a day, will keep the heart attack and stroke away!!
Tuesday, April 26, 2011
PHYSIOLOGY OF IODINE
A compilation by: W. Robert Doenges, ND
Background:
An excellent source of information regarding iodine historical use in medicine, present day assumptions, sufficiency, safety and physiological implications is available in papers written by Dr. Guy Abraham, Dr Jorge Flechas and Dr. David Brownstein for The Original Internist publication. These papers are available from the web at www.optimox.com. Or a search in Google for the iodine supplement Iodoral will yield the same results.
We encourage the reader to acquaint themselves with the aforementioned papers. A brief summary of their work is included as follows:
History summary:
Swiss physician J.F. Coindet in 1812 had success treating goiter (extreme hypothyroidism) with seaweed and reasoned elemental iodine was the primary reason for his patient’s improvement. He tried tincture of iodine at 250 mg per day with great success in 150 goiter patients. Over the last century physicians refined the iodine compounds until French physician Gene Lugol’s in 1829 devised his formula of 12.5 to 37.5 mg of iodine with potassium iodide in water as the most efficient and sufficient dose. Addition of potassium iodide increased the solubility of iodine sufficiently to be more clinically valuable.
Lugol’s formula was used very successfully until the 1930s for the treatment of hypothyroidism, hyperthyroidism and other medical conditions that demonstrated efficacy. It is noteworthy that only 0.05 mg/day of iodine is necessary to prevent goiter. This amount is available in iodized salt thereby eliminating goiter as a prevalent health concern. However 0.05 mg/day is not enough for optimal health. Iodine is the one halogen (chlorine, bromine and fluorine are the others in order of increasing oxidizing potential) the body requires for many biochemical processes.
History of sufficiency:
In the 1930s physicians started using the recently developed thyroid hormones for treatment of thyroid hypo- or hyper- activity. The assumption was that iodized salt provided iodine sufficiency. Even though the chloride in table salt is a competing halide (chlorine - halogen) there is enough uptake of iodine in iodized salt from the potassium iodide to prevent goiter. Therefore synthetic (patentable) thyroid hormone replacement was developed to increase the thyroid’s production of T4 (thyroxine).
Hintze et al (1) compared the response of patients with simple goiter to administration of I at 400 ug/day and to the administration of T4 at 150 ug/day…. Iodine was more effective by itself than the administration of the T4 hormone by itself.
Most people get iodine in their diet from seafood and iodized salt. However, only about 50% of Americans use iodized salt and because of concerns about high blood pressure, many people have reduced their salt intake. One gram of salt contains 77 mcg of iodine. Because of the high chloride content in table salt, some experts estimate that only about 10% of the iodine in iodized salt is actually absorbed. The recommended daily allowance (RDA) of iodine is 150 mcg (somewhat higher for pregnant women and certain other groups). Though 150 mcg daily may be sufficient to prevent an enlarged thyroid (goiter) and cretinism (severe iodine deficiency in babies leading to mental retardation and impaired development), these values are far short of the optimal values of 12,500 mcg (12.5 mg) recommended by Dr. Abraham. But, even using the lower values, many people still do not get the RDA and tests have shown that the average blood levels of iodine have decreased significantly over the past 30 years, in part no doubt, due to the substitution of bromide for iodide in baked goods in the early 1980’s.
A popular assumption is that physiologic doses of iodine are toxic. In the 1940s a study linked non-radioactive iodine to toxic reactions. It was plainly not true. T4 (thyroxine has 4 iodine atoms) and T3 (triiodothyronine has 3 iodine atoms) are the thyroid’s hormones that are control metabolism. Both have iodine atoms in their molecules. It is obvious that iodine sufficiency is needed for optimal metabolism.
Is there a relationship between iodine and chronic fatigue and other disorders?
Dr. Brownstein writes: “The illnesses that iodine/iodide has helped are many. These conditions include Fibromyalgia, thyroid disorders, chronic fatigue immune deficiency syndrome, autoimmune disorders as well as cancer. Most patients who are deficient in iodine will respond positively to iodine supplementation. In fact, I have come to the conclusion that iodine deficiency sets up the immune system to malfunction which can lead to many of the above disorders developing. Every patient could benefit from a thorough evaluation of their iodine levels.” (2)
Is there a probable relationship to fibrocystic breast disease (FDB)?
Mainland Japanese women have a very low incidence and prevalence of FDB and breast cancer. (13) Several investigators have proposed that the essential element I was the protective factor in mainland Japanese. (4 – 10) If indeed, the essential element I is the postulated protective factor, the administration of I to American women in amounts equivalent to that consumed by mainland Japanese women would be expected to protect them from breast cancer and improve FDB, as previously proposed by Stadel for breast cancer and confirmed for FDB by Ghent et al. (7) Based on data supplied by the Japanese Ministry of Health, the average daily I intake in mainland Japanese is 13.8 mg. (6)
The administration of thyroid hormones to I-deficient women may increase further their risk for breast cancer. In a group of women undergoing mammography for screening purposes (14) the incidence of breast cancer was twice as high in women receiving thyroid medications for hypothyroidism (most likely induced by I deficiency) than women not on thyroid supplement. The mean incidences were 6.2% in controls and 12.1% in women on thyroid hormones. The incidence of breast cancer was twice as high in women on thyroid hormones for more than 15 years (19.5%) compared to those on thyroid hormones for 5 years (10%).
Sodium – iodide symporter:
The ability of the thyroid gland to transport and concentrate iodide from blood is absolutely necessary for the synthesis of thyroid hormones. The key player in this process is the sodium-iodide symporter, an integral membrane protein that resides in the membrane of thyroid epithelial cells. As its name indicates, the sodium-iodide symporter simultaneously transports both Na+ and I- ions from extracellular fluid (i.e. blood) into the thryoid epithelial cell. Considering critical role of iodine trapping in thyroid function, it is not surprising that abnormalities in expression or function of the symporter can lead to thyroid disease.
The sodium-iodide symporter is most highly expressed in thyroid epithelial cells. Lower levels of expression can be detected in mammary gland, salivary gland, stomach and colon, but none of these tissues is known to organify iodide. The presence of the symporter in mammary gland leads to secretion of iodine in milk, which is probably important for thyroid function in neonatal animals. (18 – 22)
One atom of iodine is transported into the cells for every 2 atoms of sodium via the sodium/iodine symporter (NIS). There is also a chloride/iodide symporter called pendrin. Normal saliva/serum iodide ratio is approx. 42. Less than 20 may be due to toxins or very high levels of bromine/fluorine binding to the symporter.
Goitrogens, including
- bromine (from fruit fumigants and processed bakery products)
- chlorine (chloramine byproduct from drinking water chlorination)
- ammonium perchlorate (rocket fuel found in tap water)
- fluorine (naturally occurring in well water plus drinking water fluoridation)
- thiocyanate (from cigarette smoke)
can bind to the NIS (receptor) and damage it preventing iodine from entering the cell. The receptor can possibly be repaired with vitamin C (3000 mg/day) and Celtic (unrefined) sea salt. (16)
The basil membrane of the thyroid cell has the specific ability to pump iodine into the interior of the thyroid cell. This is called Iodide Trapping. In a normal gland the iodine pump concentrates the iodide to about 30 times the concentration in blood. The rate of trapping is influenced by TSH in a negative feedback control method. (17)
Clinical experience:
For clinical experiences the following references are useful.
Fibrocystic Breasts by Jonathan V. Wright, M.D., Published in “Nutrition & Healing” – July 1995
David Brownstein, MD., Iodine. Why You Need It Why You Can’t Live Without It. 2nd Ed. 2006
Saliva iodine significance:
There is ample evidence of renal iodine clearance in the literature in Dr. Abraham’s references and some evidence of salivary uptake from other sources. According to Mr. Zareba under a NASA grant, the mean correlation coefficient ( r ) between iodine elimination for blood/saliva was 0.99, for blood/urine, 0.95, and for saliva/urine, 0.97. The absolute value of iodine concentrations in urine revealed marked variability, which was corrected by adjusting for creatinine levels. (15) That is, with normal symporter there is excellent correlation between the iodine concentration increase in serum and saliva. However, the timing is different.
From Bruger and Member, thyroxine was not concentrated from the blood to saliva but elemental potassium iodide (KI) was from 5 to 7 times that of the blood. The maximal amount of iodine concentrated in the saliva occurred 1 to 2 ½ hours after ingestion of KI peaking to 1200 times the initial salivary iodide. The salivary/blood iodine ratio in the control period was 6 and reached a maximum of 28, 8 hours after ingestion of the iodide. (18) Obviously measuring salivary iodide within several hours of supplementation will result in a very high unusable reading. This effect has been verified by our own tests. Note that normal iodide trapping in the thyroid is about 30 times that in the blood.
Implications:
The hypothesis is that since the salivary iodide uptake from the interstitium and thyroid trapping iodide from the blood is approximately the same order over time, the saliva uptake can be a rough indication of thyroid uptake. If this is true then the saliva/urine ratio can be a rough indication of thyroid iodide sufficiency. There is some anecdotal evidence from non-traditional research to suggest this relationship. Examples are as follows:
J was supplementing Iodoral® (7.5 mg KI + 5 mg Iodine per tab) at the rate of 50 mg/day for nine months (without adverse effect) encouraged by the idea of clearing mercury toxicity (a dental assistant) and tested at 25 PPM saliva and 60 PPM urine iodide. One would expect that after nine months supplementation at this dosage, iodine sufficiency would have been reached. The saliva/urine ratio of
< 1 suggests this conclusion.
Dr. T supplementing for many years with an organic bound iodine in seaweed extract tested 17 PPM saliva and 15 PPM urine. The supplementation will continue but one would expect sufficiency with this long term supplementation. Again the ratio approached 1.
B supplementing 6 months 12.5 mg/day Iodoral® tested 9 PPM saliva and 6 PPM urine suggesting a higher dosage could be used to approach higher residual levels and a lower ratio suggesting sufficiency as not reached. The 24 hour urine iodine loading test would be appropriate.
M was not supplementing but ate substantial amounts of seafood and mostly Mexican foods but very little US produced processed foods. M’s saliva tested 17 PPM and urine 15 PPM.
20 other subjects were tested who were not supplementing except for iodized salt and multivitamin tabs with iodine in the 100 ug range. None were consuming substantial ocean dwelling foods. Usual tests were 1 PPM saliva and 0.1 PPM urine. The absolute values are very low and the ratio is 10. Again a 24 hour urine loading tests would probably support this conclusion.
Testing was performed in the morning with no fast required. It is recommended that a 12 hour fast, 8:00 PM to 8:00 AM for example, be required in order to minimize the effects of hydration.
Future studies
The QFA 1500 analyzer does not purport to provide sensitivities less than 0.1 mg/L (PPM) but is sensitive enough to measure the uptake effects of iodine supplementation whether in Lugol’s formula (as Iodoral® of 7.5 mg potassium iodide and 5 mg elemental iodine) or other organic form such as kelp, dulse or seaweed extract.
The hypothesis of measuring the ratios of saliva vs urine iodine as a measure of sufficiency and blood vs. urine as an indicator of availability of iodine for the tissues (iodine symporter) is unproven except from anecdotal information. Nevertheless a good body of information will be obtained through this simple test coupled with other observation to arrive at conclusions outside traditional expensive and sometimes inaccurate or incomplete medical studies.
References:
1. Hintze, G., Emrich, D., Kobberling, J., Treatment of endemic goitre due to iodine deficiency with iodine, levothyroxine or both: results of a multicentre trial. European Journal of Clinical Investigation, 19:527-534, 1989.
2. Brownstein, D., Clinical experience with inorganic, non-radioactive iodine/iodide. The Original Internist, 12(3):105-108, 2005
3. Eskin B., Bartuska D., Dunn M., Jacob G., Dratman M., Mammary Gland Dysplasia in Iodine Deficiency, JAMA, 200:115-119, 1967.
4. Eskin, B., Iodine Metabolism and Breast Cancer. Trans. New York, Acad. of Sciences, 32:911-947, 1970.
5. Funahashi, H., Imaj, T., Tanaka, Y., et al, Suppressive Effect of Iodine on DMBA-Induced Breast Tumor Growth in the Rat. Journal of Surgical Oncology, 61:209-213, 1996.
6. Ghent, W., Eskin, B., Low, D., Hill, L., Iodine Replacement in Fibrocystic Disease of the Breast, Can. J. Surg., 36:453-460, 1993.
7. Derry, D., Breast Cancer and Iodine, Trafford Publishing, Victoria B.C., 92, 2001.
8. Vishnyakova, V.V., Murav’yeva, N.L., On the Treatment of Dyshormonal Hyperplasia of Mammary Glands, Vestn Akad Med Navk SSSR, 21:19-22, 1966.
9. Cann S., Netten J., Netten C., Hypothesis: Iodine, selenium and the development of breast cancer, Cancer Causes and Control 11:121-127, 2000.
10. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976.
11. Epstein, S.S., Steinman, D., Breast Cancer Prevention Program. Macmillan, NY, 1998, pg 5.
12. Waterhouse, J., Shanmvgakatnam, K., et al, Cancer incidence in five continents. LARC Scientific Publications, International Agency for Research on Cancer, Lyon, France, 1982.
13. Stadel B., Dietary Iodine and Risk of Breast, Endometrial, and Ovarian Cancer, The Lancet, 1:890-891, 1976.
14. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976.
15. Grazyna Zareba, Elsa Cernichiari, Lowell A. Goldsmith, and Thomas W. Clarkson., Biological Monitoring of Iodine, a Water Disinfectant for Long-Term Space Missions. (1) Center for Space Environmental Health, (2) Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 USA, (3) Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 USA16.
16. David Brownstein, MD., Iodine. Why You Need It Why You Can’t Live Without It. 2nd Ed. 2006
17. Guyton & Hall, Textbook of Medical Physiology 10th ed.:858, 859)
18. Maurice Berger, Samuel Member, On The Excretion of Iodine in the Saliva, From the Research Laboratory, Department of Medicine, New York Post-Graduate Medical School and Hospital, Columbia University
19. De la Vieja A, Dohan O, Levy O, Carrasco N: Molecular Analysis of the Sodium/Iodide Symporter: Impact on Thyroid and Extrathyroid Pathophysiology. Phys Rev 80:1083-1105, 2000.
20. Dohan O, De la Vieja A, Paroder V, etc: The sodium/iodide symporter (NIS): Characterization, regulation and medical significance. Endocrine Reviews 24:48-77, 2003.
21. Fugiwara H, Tatsumi K, Miki K et al: Congenital hypothyroidism caused by a mutation in the Na+/I- symporter. Nature Genetics 16:124, 1997.
22. Spitzweg C, Heufelder AE: The sodium iodide symporter: its emerging relevance to clinical thyroidology. Europ J Endocrinol 138:374, 1998.
Background:
An excellent source of information regarding iodine historical use in medicine, present day assumptions, sufficiency, safety and physiological implications is available in papers written by Dr. Guy Abraham, Dr Jorge Flechas and Dr. David Brownstein for The Original Internist publication. These papers are available from the web at www.optimox.com. Or a search in Google for the iodine supplement Iodoral will yield the same results.
We encourage the reader to acquaint themselves with the aforementioned papers. A brief summary of their work is included as follows:
History summary:
Swiss physician J.F. Coindet in 1812 had success treating goiter (extreme hypothyroidism) with seaweed and reasoned elemental iodine was the primary reason for his patient’s improvement. He tried tincture of iodine at 250 mg per day with great success in 150 goiter patients. Over the last century physicians refined the iodine compounds until French physician Gene Lugol’s in 1829 devised his formula of 12.5 to 37.5 mg of iodine with potassium iodide in water as the most efficient and sufficient dose. Addition of potassium iodide increased the solubility of iodine sufficiently to be more clinically valuable.
Lugol’s formula was used very successfully until the 1930s for the treatment of hypothyroidism, hyperthyroidism and other medical conditions that demonstrated efficacy. It is noteworthy that only 0.05 mg/day of iodine is necessary to prevent goiter. This amount is available in iodized salt thereby eliminating goiter as a prevalent health concern. However 0.05 mg/day is not enough for optimal health. Iodine is the one halogen (chlorine, bromine and fluorine are the others in order of increasing oxidizing potential) the body requires for many biochemical processes.
History of sufficiency:
In the 1930s physicians started using the recently developed thyroid hormones for treatment of thyroid hypo- or hyper- activity. The assumption was that iodized salt provided iodine sufficiency. Even though the chloride in table salt is a competing halide (chlorine - halogen) there is enough uptake of iodine in iodized salt from the potassium iodide to prevent goiter. Therefore synthetic (patentable) thyroid hormone replacement was developed to increase the thyroid’s production of T4 (thyroxine).
Hintze et al (1) compared the response of patients with simple goiter to administration of I at 400 ug/day and to the administration of T4 at 150 ug/day…. Iodine was more effective by itself than the administration of the T4 hormone by itself.
Most people get iodine in their diet from seafood and iodized salt. However, only about 50% of Americans use iodized salt and because of concerns about high blood pressure, many people have reduced their salt intake. One gram of salt contains 77 mcg of iodine. Because of the high chloride content in table salt, some experts estimate that only about 10% of the iodine in iodized salt is actually absorbed. The recommended daily allowance (RDA) of iodine is 150 mcg (somewhat higher for pregnant women and certain other groups). Though 150 mcg daily may be sufficient to prevent an enlarged thyroid (goiter) and cretinism (severe iodine deficiency in babies leading to mental retardation and impaired development), these values are far short of the optimal values of 12,500 mcg (12.5 mg) recommended by Dr. Abraham. But, even using the lower values, many people still do not get the RDA and tests have shown that the average blood levels of iodine have decreased significantly over the past 30 years, in part no doubt, due to the substitution of bromide for iodide in baked goods in the early 1980’s.
A popular assumption is that physiologic doses of iodine are toxic. In the 1940s a study linked non-radioactive iodine to toxic reactions. It was plainly not true. T4 (thyroxine has 4 iodine atoms) and T3 (triiodothyronine has 3 iodine atoms) are the thyroid’s hormones that are control metabolism. Both have iodine atoms in their molecules. It is obvious that iodine sufficiency is needed for optimal metabolism.
Is there a relationship between iodine and chronic fatigue and other disorders?
Dr. Brownstein writes: “The illnesses that iodine/iodide has helped are many. These conditions include Fibromyalgia, thyroid disorders, chronic fatigue immune deficiency syndrome, autoimmune disorders as well as cancer. Most patients who are deficient in iodine will respond positively to iodine supplementation. In fact, I have come to the conclusion that iodine deficiency sets up the immune system to malfunction which can lead to many of the above disorders developing. Every patient could benefit from a thorough evaluation of their iodine levels.” (2)
Is there a probable relationship to fibrocystic breast disease (FDB)?
Mainland Japanese women have a very low incidence and prevalence of FDB and breast cancer. (13) Several investigators have proposed that the essential element I was the protective factor in mainland Japanese. (4 – 10) If indeed, the essential element I is the postulated protective factor, the administration of I to American women in amounts equivalent to that consumed by mainland Japanese women would be expected to protect them from breast cancer and improve FDB, as previously proposed by Stadel for breast cancer and confirmed for FDB by Ghent et al. (7) Based on data supplied by the Japanese Ministry of Health, the average daily I intake in mainland Japanese is 13.8 mg. (6)
The administration of thyroid hormones to I-deficient women may increase further their risk for breast cancer. In a group of women undergoing mammography for screening purposes (14) the incidence of breast cancer was twice as high in women receiving thyroid medications for hypothyroidism (most likely induced by I deficiency) than women not on thyroid supplement. The mean incidences were 6.2% in controls and 12.1% in women on thyroid hormones. The incidence of breast cancer was twice as high in women on thyroid hormones for more than 15 years (19.5%) compared to those on thyroid hormones for 5 years (10%).
Sodium – iodide symporter:
The ability of the thyroid gland to transport and concentrate iodide from blood is absolutely necessary for the synthesis of thyroid hormones. The key player in this process is the sodium-iodide symporter, an integral membrane protein that resides in the membrane of thyroid epithelial cells. As its name indicates, the sodium-iodide symporter simultaneously transports both Na+ and I- ions from extracellular fluid (i.e. blood) into the thryoid epithelial cell. Considering critical role of iodine trapping in thyroid function, it is not surprising that abnormalities in expression or function of the symporter can lead to thyroid disease.
The sodium-iodide symporter is most highly expressed in thyroid epithelial cells. Lower levels of expression can be detected in mammary gland, salivary gland, stomach and colon, but none of these tissues is known to organify iodide. The presence of the symporter in mammary gland leads to secretion of iodine in milk, which is probably important for thyroid function in neonatal animals. (18 – 22)
One atom of iodine is transported into the cells for every 2 atoms of sodium via the sodium/iodine symporter (NIS). There is also a chloride/iodide symporter called pendrin. Normal saliva/serum iodide ratio is approx. 42. Less than 20 may be due to toxins or very high levels of bromine/fluorine binding to the symporter.
Goitrogens, including
- bromine (from fruit fumigants and processed bakery products)
- chlorine (chloramine byproduct from drinking water chlorination)
- ammonium perchlorate (rocket fuel found in tap water)
- fluorine (naturally occurring in well water plus drinking water fluoridation)
- thiocyanate (from cigarette smoke)
can bind to the NIS (receptor) and damage it preventing iodine from entering the cell. The receptor can possibly be repaired with vitamin C (3000 mg/day) and Celtic (unrefined) sea salt. (16)
The basil membrane of the thyroid cell has the specific ability to pump iodine into the interior of the thyroid cell. This is called Iodide Trapping. In a normal gland the iodine pump concentrates the iodide to about 30 times the concentration in blood. The rate of trapping is influenced by TSH in a negative feedback control method. (17)
Clinical experience:
For clinical experiences the following references are useful.
Fibrocystic Breasts by Jonathan V. Wright, M.D., Published in “Nutrition & Healing” – July 1995
David Brownstein, MD., Iodine. Why You Need It Why You Can’t Live Without It. 2nd Ed. 2006
Saliva iodine significance:
There is ample evidence of renal iodine clearance in the literature in Dr. Abraham’s references and some evidence of salivary uptake from other sources. According to Mr. Zareba under a NASA grant, the mean correlation coefficient ( r ) between iodine elimination for blood/saliva was 0.99, for blood/urine, 0.95, and for saliva/urine, 0.97. The absolute value of iodine concentrations in urine revealed marked variability, which was corrected by adjusting for creatinine levels. (15) That is, with normal symporter there is excellent correlation between the iodine concentration increase in serum and saliva. However, the timing is different.
From Bruger and Member, thyroxine was not concentrated from the blood to saliva but elemental potassium iodide (KI) was from 5 to 7 times that of the blood. The maximal amount of iodine concentrated in the saliva occurred 1 to 2 ½ hours after ingestion of KI peaking to 1200 times the initial salivary iodide. The salivary/blood iodine ratio in the control period was 6 and reached a maximum of 28, 8 hours after ingestion of the iodide. (18) Obviously measuring salivary iodide within several hours of supplementation will result in a very high unusable reading. This effect has been verified by our own tests. Note that normal iodide trapping in the thyroid is about 30 times that in the blood.
Implications:
The hypothesis is that since the salivary iodide uptake from the interstitium and thyroid trapping iodide from the blood is approximately the same order over time, the saliva uptake can be a rough indication of thyroid uptake. If this is true then the saliva/urine ratio can be a rough indication of thyroid iodide sufficiency. There is some anecdotal evidence from non-traditional research to suggest this relationship. Examples are as follows:
J was supplementing Iodoral® (7.5 mg KI + 5 mg Iodine per tab) at the rate of 50 mg/day for nine months (without adverse effect) encouraged by the idea of clearing mercury toxicity (a dental assistant) and tested at 25 PPM saliva and 60 PPM urine iodide. One would expect that after nine months supplementation at this dosage, iodine sufficiency would have been reached. The saliva/urine ratio of
< 1 suggests this conclusion.
Dr. T supplementing for many years with an organic bound iodine in seaweed extract tested 17 PPM saliva and 15 PPM urine. The supplementation will continue but one would expect sufficiency with this long term supplementation. Again the ratio approached 1.
B supplementing 6 months 12.5 mg/day Iodoral® tested 9 PPM saliva and 6 PPM urine suggesting a higher dosage could be used to approach higher residual levels and a lower ratio suggesting sufficiency as not reached. The 24 hour urine iodine loading test would be appropriate.
M was not supplementing but ate substantial amounts of seafood and mostly Mexican foods but very little US produced processed foods. M’s saliva tested 17 PPM and urine 15 PPM.
20 other subjects were tested who were not supplementing except for iodized salt and multivitamin tabs with iodine in the 100 ug range. None were consuming substantial ocean dwelling foods. Usual tests were 1 PPM saliva and 0.1 PPM urine. The absolute values are very low and the ratio is 10. Again a 24 hour urine loading tests would probably support this conclusion.
Testing was performed in the morning with no fast required. It is recommended that a 12 hour fast, 8:00 PM to 8:00 AM for example, be required in order to minimize the effects of hydration.
Future studies
The QFA 1500 analyzer does not purport to provide sensitivities less than 0.1 mg/L (PPM) but is sensitive enough to measure the uptake effects of iodine supplementation whether in Lugol’s formula (as Iodoral® of 7.5 mg potassium iodide and 5 mg elemental iodine) or other organic form such as kelp, dulse or seaweed extract.
The hypothesis of measuring the ratios of saliva vs urine iodine as a measure of sufficiency and blood vs. urine as an indicator of availability of iodine for the tissues (iodine symporter) is unproven except from anecdotal information. Nevertheless a good body of information will be obtained through this simple test coupled with other observation to arrive at conclusions outside traditional expensive and sometimes inaccurate or incomplete medical studies.
References:
1. Hintze, G., Emrich, D., Kobberling, J., Treatment of endemic goitre due to iodine deficiency with iodine, levothyroxine or both: results of a multicentre trial. European Journal of Clinical Investigation, 19:527-534, 1989.
2. Brownstein, D., Clinical experience with inorganic, non-radioactive iodine/iodide. The Original Internist, 12(3):105-108, 2005
3. Eskin B., Bartuska D., Dunn M., Jacob G., Dratman M., Mammary Gland Dysplasia in Iodine Deficiency, JAMA, 200:115-119, 1967.
4. Eskin, B., Iodine Metabolism and Breast Cancer. Trans. New York, Acad. of Sciences, 32:911-947, 1970.
5. Funahashi, H., Imaj, T., Tanaka, Y., et al, Suppressive Effect of Iodine on DMBA-Induced Breast Tumor Growth in the Rat. Journal of Surgical Oncology, 61:209-213, 1996.
6. Ghent, W., Eskin, B., Low, D., Hill, L., Iodine Replacement in Fibrocystic Disease of the Breast, Can. J. Surg., 36:453-460, 1993.
7. Derry, D., Breast Cancer and Iodine, Trafford Publishing, Victoria B.C., 92, 2001.
8. Vishnyakova, V.V., Murav’yeva, N.L., On the Treatment of Dyshormonal Hyperplasia of Mammary Glands, Vestn Akad Med Navk SSSR, 21:19-22, 1966.
9. Cann S., Netten J., Netten C., Hypothesis: Iodine, selenium and the development of breast cancer, Cancer Causes and Control 11:121-127, 2000.
10. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976.
11. Epstein, S.S., Steinman, D., Breast Cancer Prevention Program. Macmillan, NY, 1998, pg 5.
12. Waterhouse, J., Shanmvgakatnam, K., et al, Cancer incidence in five continents. LARC Scientific Publications, International Agency for Research on Cancer, Lyon, France, 1982.
13. Stadel B., Dietary Iodine and Risk of Breast, Endometrial, and Ovarian Cancer, The Lancet, 1:890-891, 1976.
14. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976.
15. Grazyna Zareba, Elsa Cernichiari, Lowell A. Goldsmith, and Thomas W. Clarkson., Biological Monitoring of Iodine, a Water Disinfectant for Long-Term Space Missions. (1) Center for Space Environmental Health, (2) Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 USA, (3) Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 USA16.
16. David Brownstein, MD., Iodine. Why You Need It Why You Can’t Live Without It. 2nd Ed. 2006
17. Guyton & Hall, Textbook of Medical Physiology 10th ed.:858, 859)
18. Maurice Berger, Samuel Member, On The Excretion of Iodine in the Saliva, From the Research Laboratory, Department of Medicine, New York Post-Graduate Medical School and Hospital, Columbia University
19. De la Vieja A, Dohan O, Levy O, Carrasco N: Molecular Analysis of the Sodium/Iodide Symporter: Impact on Thyroid and Extrathyroid Pathophysiology. Phys Rev 80:1083-1105, 2000.
20. Dohan O, De la Vieja A, Paroder V, etc: The sodium/iodide symporter (NIS): Characterization, regulation and medical significance. Endocrine Reviews 24:48-77, 2003.
21. Fugiwara H, Tatsumi K, Miki K et al: Congenital hypothyroidism caused by a mutation in the Na+/I- symporter. Nature Genetics 16:124, 1997.
22. Spitzweg C, Heufelder AE: The sodium iodide symporter: its emerging relevance to clinical thyroidology. Europ J Endocrinol 138:374, 1998.
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