What is the n-factor of iodine

Iodine and thyroid disorders

One hears again and again that people with thyroid diseases such as Hashimoto's thyroiditis or Graves' disease should generally avoid iodine and that iodine is even dangerous for that group of people. But is this information based on clear facts? One thing is certain: an average of around 2-5% of the population has an autoimmune thyroid disease (1). In a German region with a relatively pronounced iodine deficiency, 33% of 96,278 employed adults between the ages of 18 and 65
which were examined by means of ultrasound, thyroid nodules or a goiter, mostly specific for iodine deficiency, were found. Thyroid nodules over 1 cm in diameter were found in 12% of this population - a trend that increased with age. In patients with a single palpable lump, 20-48% have additional lumps, as demonstrated by ultrasound
became (2). Should all these people be given extra iodine now?

Even if there are some interesting arguments, for example too high doses (see below) (3), the topic is quite complex and can be described as a double-edged sword (1, 4), because the effects of different doses of iodine cannot be uniform or clear statement can be made. This means that Jorod can be beneficial in one context and harmful in another. Here it is important to be careful, to get to know or get to know your body and, in case of doubt, to talk to appropriately competent people. But where does this complexity with regard to iodine actually come from?

This is due to the fact that every person seems to react differently to iodine and studies turn out differently accordingly (5). The (positive / negative or neutral) effect of iodine is determined by the thyroid status (i.e. its proper structure and function) itself and the context, i.e. the co-intake of selenium and other nutritional cofactors - although there is some disagreement and further research is needed here, because, for example, vitamin C can reduce antibodies specific for Hashimoto just as effectively as selenium (6-10). But that's not all, certain genetic and epigenetic factors (11-14), the inflammatory status and the supply of antioxidants in the body (15) as well as exposure to environmental toxins and hormones (16-19) play important roles. The intestines (20) -, kidneys (21) - and
Liver health (22) and its interaction (23), as well as the health and interaction within the hypothalamus-pituitary-adrenal cortex axis (especially under stress) (24-25) and the form of iodine (radioactive iodine = poison, iodine salt compounds (inorganic ; Iodides, iodates or triiodine complexes (not for healthy people) and the dose itself does the rest. (26) All of these factors influence the effects of iodine, thyroid function and hormone production.

At least in normally healthy people, an average of optimal values ​​for an adequate iodine supply with inorganic iodine can be calculated. There is a sweet spot in the low dosage range - the best cost-benefit ratio, which is a maximum of 450 mcg for healthy people. However, there is no clear answer to various pathological conditions, e.g. Hashimoto's thyroiditis (27). That one has different

Because the study situation on the subject of iodine and Hashimoto's thyroiditis is anything but uniform, which is certainly related to the complexity of the individual health status. It is certain that prolonged mild to severe iodine deficiency with reintroduction of iodine mainly for the development of iodine-Basedow diseases due to iodine excess, presumably
Even with an existing iodine deficiency and subsequent iodine excess can be responsible for the development of hypofunction caused by Hashimoto's thyroiditis, but there are many potential ways in which the disease can develop, especially with a second disease, e.g. previous treatment with drugs containing iodine (e.g. amidarone) or surgical interventions on the thyroid gland (1, 28).

Iodine alone (i.e. non-radioactive, inorganic) does not seem to be the cause of autoimmunity in the thyroid gland. This means that there must be a correspondingly stressed environment in the organism beforehand so that iodine works like fuel in the fire. One study sums it up

“A review of observational and in vitro studies found that iodine alone is not responsible for thyroid autoimmunity. Experimental models to explain the iodine excess as the cause of the autoimmunity of the thyroid gland do not induce autoantibodies of the thyroid gland unless iodine is in the presence of excess inflammatory cytokines (interferon [IFN] -γ) and hydrogen peroxide (H2O2). In iodine-deficient populations, regulatory mechanisms to limit oxidative stress and excess iodine are lost. Thyroid stimulating hormone (TSH) activates the sodium iodide symporter permanently, while the iodine concentrations are not high enough to produce iodolactones
to produce, which are responsible for the modulation of NADPH oxidase and H2O2 production [oxidative processes / metabolic stress]. Subsequently, when iodine is reintroduced, the thyroid becomes vulnerable to oxidative stress. The oxidation of thyroid peroxidase and
Thyroglobulin initiates the release of inflammatory cytokines (IFN-γ) and lymphocytic infiltration, which induce autoantibody production and autoimmunity of the thyroid. Population studies showed that administration of iodine even below the recommended food intake changes the autoimmunity of the thyroid. Despite an increase in thyroid antibodies, these changes are temporary.

Interestingly, there are reports of the successful use of iodine in combination with other nutrients and standardized plant extracts to restore thyroid function. On the basis of this, it can be seen that a loss of regulatory mechanisms due to an already existing iodine deficiency, followed by iodine repletion, as opposed to an excess of iodine, is a causal factor for development
a thyroid autoimmunity. ”(29)

This also fits the inconsistent study picture regarding the topic of iodine at Hashimoto; it seems to be very much determined by the individual metabolism of the organism and its ability to deal with stress, so that a fundamentally healthy one and of micronutrients
Rich diet plays a role, as in nearly every medical condition (30). While some people with Hashimoto's thyroiditis can tolerate normal amounts of iodine well, there is again a subgroup of patients who cannot tolerate even small amounts of iodine, which, however, is the exception. In fact, in the majority of those affected, a low iodine dose of less than 100 mcg also appears to be helpful in thyroid autoimmunity; 20 mcg iodine should not be less than 20 mcg in order not to worsen the symptoms (27). A study by Rink shows that iodine can also have positive effects for Hashimoto patients
et al from 1999. In a group of 377 patients with a daily supplementation of 200 mcg iodine over an 800-day study, a positive effect on the course of Hashimoto's thyroiditis, while in a healthy group without Hashimoto's consisting of 355 patients a dose of 1.53 mg (!) Once a week during the same period quadrupled the number of occurrences of Hashimoto's thyroiditis with correspondingly increased TgAb and TPOAb values! So, even in apparently healthy subjects, it is not a good idea to start supplementation with high doses, while low-normal doses can be beneficial for healthy patients and potentially also for Hashimoto's patients (31-32).

In addition, in a study with Graves' disease patients who supplemented iodine in the form of 10 g iodized salt for 24 months after anti-thyroid drug treatment, the relapse rates decreased:
“Within 12 months of stopping antithyroid therapy, the mean urinary iodine concentration in the iodine supplement group was higher than that in the iodine restricted group. No differences were observed between the two groups for thyroid function at 0, 3, 6, 9 and 12 months. The iodine supplement group [consisting of 202 patients with 135-162 mcg iodine / L] had a lower total recurrence rate (35.5% compared to 45%) compared to the iodine restriction group [consisting of 203 patients with 30-58 mcg iodine / L] , 5%), with the cumulative recurrence rate in the supplementation group falling by 38.1% in the 12 months after discontinuation of antithyroid therapy. ”(33-34)

Why is it that Graves' disease patients experience fewer relapses after treatment of their symptoms with additional iodine supplementation? It stands to reason that it is due to the function of iodine itself, for the correct differentiation and structure of different tissues,
in particular to contribute to the thyroid gland. This also fits in with the fact that people who have long suffered from iodine deficiency are more likely to develop thyroid nodules. In the case of Graves' disease, in addition to the typical antibodies directed against thyroglobulin, inflammation of those nodes can also lead to so-called autonomous or “hot nodes” that produce too much thyroid hormone. This knot formation would presumably be drastically reduced by constant, sufficient iodination of salt and food. If salt iodination programs are started by countries or regions, the formation of knots within the population decreases independently of the decrease in hypothyroidism itself (29, 35-37 ).

However, a sufficient iodine status also has an impact on numerous other vital functions, above all on early childhood and child development, and even on the chance of being born. If mothers are not adequately supplied with iodine before and during and accordingly the fetus during and the child after pregnancy and childbirth, this can have far-reaching consequences. The iodine requirement is increased by ≥ 50% during pregnancy. Deficiency of iodine during pregnancy can cause maternal and fetal hypothyroidism and affect neurological development of the fetus. The consequences depend on the
The timing and severity of hypothyroidism. The most severe manifestation is cretinism. In areas of moderate to severe iodine deficiency, controlled studies have shown that iodine supplementation before or during early pregnancy eliminates new cases of cretinism, increases birth weight, lowers perinatal and infant mortality rates, and development scores in young children generally by 10% -20 % elevated. A slight iodine deficiency in the mother can lead to a dysfunction of the thyroid gland. However, whether this affects the cognitive and / or neurological function of the offspring remains uncertain. Two
Meta-analyzes have estimated that iodine-deficient populations experience a mean decrease in IQ of 12-13.5 points (38).

In addition to cretinism, delayed development, neurological (as the simplest and most important factor for avoiding brain damage) and motor deficits and increased child mortality, the iodine supply and the presence of endocrine disruptors have more recent studies
after also potentially with the increased development and development of the autistic spectrum, AD (H) D and other neurodiverse personality types as well as dyslexia and learning disabilities
do (39-41). In addition, the increased environmental pollution from endocrine disrupting chemicals plays an important role when it comes to hormonal functions and thus also to the thyroid. Especially since many environmental toxins use the thyroid signaling pathway (hypothalamus
Pituitary thyroid gland) with substances that intervene in the thyroid metabolism and can partially displace iodine for hormone formation, it seems sensible to strengthen it
ensure that there is an adequate iodine supply (42).

Since the safe use of different, especially higher doses of iodine and the context of other factors that influence its effect (such as nutrient deficits, environmental toxins, etc.) have not yet been adequately investigated, the official recommendations on iodine intake continue to apply (43). For normal healthy adults, these are between 180-200 mcg (+ ~ 50% for
Women who want to have children and who are pregnant and breastfeeding). In pathological conditions, an average intake of ~ 100 mcg iodine and potentially more (Hashimoto) or less (Graves disease) (see above and below in the BfR assessment) can probably be a good starting point for almost all patients with those autoimmune thyroid diseases

However, this does not mean that there would be the end of the therapeutic spectrum of effects of iodine in certain pathological conditions, even if it is again difficult to give a general answer to many other health-related questions. These include, for example, what the interaction between iodine and the cell and immune function of various non-thyroidal tissues (e.g. in breast cancer and fibrocytic disease) (44-47) or various micronutrients with iodine (48) looks like. Precisely because of the suspected prophylactic and anticacernogenic effects, especially in breast cancer (therapy; experimental tests in animal studies
are even in the milligram range (!)), iodine should not be viewed unilaterally as bad or dangerous in relation to patients with Hashimoto's thyroiditis or Graves' disease, but instead should be investigated in further studies. In a review on the effects of iodine outside the thyroid tissue (49), a scientific team comes to the following position:
"We are reviewing evidence showing that iodine is not only a component of thyroid hormone, but also an antioxidant, as well as an anti-proliferation and differentiation agent that helps maintain the integrity of multiple organs with the ability to absorb iodine.
In animal and human studies, supplementation with molecular iodine (I2) has a suppressive effect on the development and size of benign and cancerous neoplasms. "

Those researchers go on to say:
"We suggest that the International Council for the Control of Iodine Deficiency Diseases recommend increasing iodine intake to at least 3 mg / day I2 [molecular iodine] in certain pathologies in order to achieve the potential extrathyroid benefits described in this review

So more research and a cost-benefit analysis of the health consequences are necessary, especially for high-risk patients, whereby in most cases (especially in healthy patients, but also with certain pathologies) the advantages of iodine supplementation have the disadvantages clearly predominate (50). Studies of the effective therapeutic use of iodine in the range between 3-15 mg (!) Did not show any harmful effects of iodine on the thyroid function in those studies (47), so that clinical, double-blind, placebo-controlled studies with iodine (5 mg / day) or Placebo can be used as the sole medication in early breast cancer and as an adjuvant in advanced cancer (51). Thus, future
Results show how and with what effects even higher doses of iodine act in the living organism (in vivo / in clinical studies).

Why is iodine found in vly's milk alternative?
When compiling vly, care was taken to carefully consider whether and if, in what dose and form, iodine should be included in the product and on what basis this decision was based. When making the decision, the added value for the population and also the consideration of risk groups should be taken into account. The Federal Institute for
Risk assessment (BfR) (43):

“The data show that around 30 percent of the adults included and 44 percent of the children and adolescents included have an iodine intake below the estimated mean requirement. This means that these people have an increased risk of undersupply of iodine
consists. In children and adolescents, the estimated daily iodine intake has fallen by 13 percent since the baseline survey (2003 to 2006). A longitudinal study with infants, toddlers and schoolchildren (Dortmund Nutritional and Anthropometric Longitudinally Designed Study; DONALD Study), which has been carried out in Dortmund for many years, was also carried out in children aged 3 to under 6 and in children aged 6 to 12 in recent years a downward trend in iodine supply has been observed.

“This means that the iodine supply in Germany is still a critical and important topic in terms of health that deserves appropriate attention. The BfR also comments on the treatment of Hashimoto's thyroiditis and Graves' disease:

“The medical societies recommend neither abstaining from iodine nor a diet low in iodine in the case of Hashimoto's thyroiditis. It is also not necessary to dispense with iodized table salt. However, additional iodine intake, e.g. through dietary supplements and vitamin preparations containing iodine, should be avoided. "

"The current mean iodine intake [~ 100mcg] is also not a problem for patients treated for overactive thyroid due to Graves' disease [autoimmune hyperthyroidism]."

Thus, when the vly milk alternative was enriched with iodine, the aim was to address these problems in the population as well. Autoimmune thyroid patients also need to be loud
different instances of the iodine doses we use do not have to worry about an oversupply of iodine. With a content of 30 mcg / 100 ml (20% of the nutrient reference value), 500 ml would have to be consumed daily in order to meet the officially recommended daily requirement of iodine. For a lower iodine consumption in terms of the mean iodine intake of 100 mcg (see above), as it is for some patients with Graves' disease or
could possibly be possible for Hashimoto's thyroiditis, approx. 333 ml would still be necessary, so that even with an extensive breakfast, e.g. as muesli, no critical values ​​would be reached for those groups of people. According to studies, enrichment with sodium selenate does the rest to maintain and strengthen thyroid health, among other things
for the formulation of a plant milk can be regarded as innovative (52) - also because sodium selenate, in contrast to the commonly used sodium selenite, does not react with vitamin C, zinc or copper and thus their effect is retained (53).

Because when switching from cow's milk to a plant-based milk alternative, a similar spectrum of potentially critical nutrients should ideally be present or covered. Unfortunately, iodine and selenium are fortified in a few other plant-based milk alternatives (54). Regarding the iodine content, a recent analysis of the nutritional content of many plant-based milk alternatives showed that although many products are fortified with calcium, only three out of 47 plant-based milk alternatives have been fortified with iodine. These data confirm similar results from previous research in the United States that looked at iodine levels in a
A large number of milk alternatives were measured in which far less iodine was found than in milk products. This is particularly relevant for people who strive for a purely plant-based, vegan diet. Since there is little in this form of nutrition apart from a few foods
If iodine is contained and iodine is supplemented in animal husbandry, vegans have a higher risk of suffering from an iodine deficit (55-57). Thus, vly covers this requirement directly.

Why Potassium Iodate?
Potassium iodate is reduced to potassium iodide in the intestine, so it fulfills the same role, but has the advantage that it is more stable and, with the same effect as potassium iodide, can therefore be better used in our products (57-58).

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