Thyroid Deal Breakers

Iodine and tyrosine

Discover the crucial nuances of managing thyroid conditions: iodine and tyrosine aren’t always suitable. Learn why iodine, essential for T4 production, can be a double-edged sword in thyroid health. Despite its seeming logic, iodine supplementation may not be the solution, especially with widespread iodized salt consumption. Explore the complexities of thyroid management beyond textbook approaches for informed decisions.

Iodine and tyrosine are not always appropriate for people with thyroid conditions. Iodine intake as it relates to thyroid hormones is a double-edged sword. Iodine is needed forT4 production. If a practitioner looks at a textbook concerning thyroid hormone metabolism, iodine seems a logical choice to use for low thyroid. However, in the United States we have iodized salt and now healthy grocers are stocking iodized sea salt. This means that anytime a person eats salt they are getting iodine supplemented, especially with people eating an unhealthy diet of processed food. 

Excess iodine intake will first result in a Wolff-Chaikoff effect which is reversible if iodine intake is removed. However, many healthcare practitioners and health food stores recommend continued iodine supplementation. This may then cause Iodine-induced hyperthyroidism, or Jod-Basedow phenomenon.1El-Shirbiny AM, Stavrou SS, Dnistrian A, Sonenberg M, Larson SM, Divgi CR. Jod-Basedow syndrome following oral iodine and radioiodinated-antibody administration. J Nucl Med. 1997 Nov;38(11):1816-7. Erratum in: J Nucl Med 1998 Mar;39(3):489, 2Navarro FA. [Jod-Basedow phenomenon: who was Dr. Jod?] Rev Clin Esp. 1997 Jul;197(7):531. Spanish, 3Goday-Arnó A, García Rico A, Martínez-Riquelme A, Cano-Pérez JF. [Graves Basedow disease following treatment with magistral formulae for obesity. Jod-Basedow phenomenon?] Rev Clin Esp. 1996 Aug;196(8):536-8, 4Gómez de la Torre R, Enguix Armada A, García L, Otero J. [Thyroid nodule disease in a previously endemic goiter area] An Med Interna. 1993 Oct;10(10):487-9. Spanish., 5Yamada T. [Jod-Basedow (iodine-induced hyperthyroidism)] Ryoikibetsu Shokogun Shirizu. 1993;(1):367-9. Review. Japanese., 6Woeber KA. Iodine and thyroid disease. Med Clin North Am. 1991 Jan;75(1):169-78., 7Maberly GF, Corcoran JM, Eastman CJ. The effect of iodized oil on goitre size, thyroid function and the development of the Jod Basedow phenomenon. Clin Endocrinol (Oxf). 1982 Sep;17(3):253-9., 8Maberly GF, Eastman CJ, Corcoran JM. Effect of iodination of a village water-supply on goitre size and thyroid function. Lancet. 1981 Dec 5;2(8258):1270-2., 9Livadas DP, Koutras DA, Souvatzoglou A, Beckers C. The toxic effect of small iodine supplements in patients with autonomous thyroid nodules. Clin Endocrinol (Oxf). 1977 Aug;7(2):121-7., 10Birkhäuser M, Burer T, Busset R, Burger A. Diagnosis of hyperthyroidism when serum-thyroxine alone is raised. Lancet. 1977 Jul 9;2(8028):53-6., 11Spaulding SW, Burrow GN, Ramey JN, Donabedian RK. Effect of increased iodide intake on thyroid function in subjects on chronic lithium therapy. Acta Endocrinol (Copenh). 1977 Feb;84(2):290-6. Wolff-Chaikoff effect is used to describe hypothyroidism caused by ingestion of a large amount of iodine. It is an autoregulatory phenomenon which inhibits formation of thyroid hormones inside of the thyroid follicle.12Markou K, Georgopoulos N, Kyriazopoulou V, Vagenakis AG.,  Iodine-Induced hypothyroidism. Thyroid. 2001 May;11(5):501-10.,  13Lesher JL Jr, Fitch MH, Dunlap DB., Subclinical hypothyroidism during potassium iodide therapy for lymphocutaneous sporotrichosis. Cutis. 1994 Mar;53(3):128-30.,  14Wémeau JL., [Hypothyroidism related to excess iodine], Presse Med. 2002 Oct 26;31(35):1670-5.,  15Eng PH, Cardona GR, Previti MC, Chin WW, Braverman LE.,  Regulation of the sodium iodide symporter by iodide in FRTL-5 cells. Eur J Endocrinol. 2001 Feb;144(2):139-44.,  16Alexandrides T, Georgopoulos N, Yarmenitis S, Vagenakis AG., Increased sensitivity to the inhibitory effect of excess iodide on thyroid function in patients with beta-thalassemia major and iron overload and the subsequent development of hypothyroidism. Eur J Endocrinol. 2000 Sep;143(3):319-25.,  17Bando Y, Ushiogi Y, Okafuji K, Toya D, Tanaka N, Miura S., Non-autoimmune primary hypothyroidism in diabetic and non-diabetic chronic renal dysfunction. Exp Clin Endocrinol Diabetes. 2002 Nov;110(8):408-15.,  18Frey H. Hypofunction of the Thyroid Gland, due to Prolonged and Excessive Intake of Potassium Iodide. Acta Endocrinol (Copenh). 1964 Sep;47:105-20., 19Reinhardt W, Luster M, Rudorff KH, Heckmann C, Petrasch S, Lederbogen S, Haase R, Saller B, Reiners C, Reinwein D, Mann K.  Effect of small doses of iodine on thyroid function in patients with Hashimoto’s thyroiditis residing in an area of mild iodine deficiency. Eur J Endocrinol. 1998 Jul;139(1):23-8. This becomes evident secondary to elevated levels of circulating iodide. Wolff-Chaikoff effect lasts several days (around 10 days), after which it is followed by an “escape phenomenon”, which is described by resumption of normal organification of iodine and normal thyroid peroxidase function. High levels of intracellular iodide are known to suppress the transcription of thyroid peroxidase (TPO) enzyme, along with NADPH oxidase. The downregulation of transcription of colloid enzymes that attach iodide to thyroglobulin causes a reduction in the synthesis of the downstream product, thyroxin. 

Wolff-Chaikoff

The Wolff–Chaikoff effect is the reduction in thyroid hormone levels caused by ingestion of a large amount of iodine. 

It was discovered by Drs. Jan Wolff and Israel Lyon Chaikoff at the University of California, Berkeley: in 1948, they reported that injection of iodine in rats almost completely inhibited organification (thyroglobulin iodination) in the thyroid gland.

Patients with Graves’ disease are more sensitive than euthyroid patients, and iodine has been used to manage Graves’ disease.

The Wolff–Chaikoff effect is known as an autoregulatory phenomenon that inhibits organification in the thyroid gland, the formation of thyroid hormones inside the thyroid follicle, and the release of thyroid hormones into the bloodstream. This becomes evident secondary to elevated levels of circulating iodide.

The Wolff–Chaikoff effect is an effective means of rejecting a large quantity of imbibed iodide, and therefore preventing the thyroid from synthesizing large quantities of thyroid hormone. Excess iodide transiently inhibits thyroid iodide organification. In individuals with a normal thyroid, the gland eventually escapes from this inhibitory effect and iodide organification resumes; however, in patients with underlying autoimmune thyroid disease, the suppressive action of high iodide may persist. The Wolff–Chaikoff effect lasts several days (around 10 days), after which it is followed by an “escape phenomenon,” which is described by resumption of normal organification of iodine and normal thyroid peroxidase function. “Escape phenomenon” is believed to occur because of decreased inorganic iodine concentration inside the thyroid follicle below a critical threshold secondary to down-regulation of sodium-iodide symporter (NIS) on the basolateral membrane of the thyroid follicular cell.

The Wolff-Chaikoff hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks after iodide withdrawal, but transient T4 replacement therapy may be required in some patients. The patients who develop transient iodine-induced hypothyroidism must be followed long term thereafter because many will develop permanent primary hypothyroidism.

It is observed in individuals without underlying overt thyroid disorder, and especially in patients with autoimmune thyroiditis or those previously treated for thyroid.

Jod-Basedow Phenomenon

The Jod-Basedow effect (also Jod-Basedow syndrome and Jod-Basedow phenomenon) is hyperthyroidism following administration of iodine or iodide, either as a dietary supplement, for iodinated contrast medical imaging, or as a medication (mainly Amiodarone).

Jod-Basedow Phenomenon, a thyrotoxic condition caused by exposure to increased amounts of iodine, has historically been reported in regions deficient in iodine. However, when a person is given iodine supplements combined with dietary intake on a continual basis without monitoring, they develop a hyperfunction autoimmune response. It causes an increased activity of TPO antibodies that multiply dramatically with iodine supplements. 

The iodine skin patch test will not in any way show a person what their TPO antibodies are and will be different for each person due to different rates of absorption and elimination. 

Tyrosine Supplements

Tyrosine supplementation in many cases will actually suppress thyroid function. Again, if one looks at the textbooks, tyrosine may sound beneficial. However, no studies have show tyrosine supplements have the ability to increase thyroid hormones. 

There are several studies showing tyrosine has the ability to immediately increase catecholamines. Catecholamines have suppressing effect on TPO, which is the limits the rate of thyroxine. Therefore, tyrosine has an immediate impact on suppressing thyroid hormone production. This is especially important if you have been under stress. Tyrosine should not be used if you have indication of a stress response.

Related Keywords:

  • Thyroid health
  • Hypothyroidism symptoms
  • Hashimoto’s thyroiditis treatment
  • Non-thyroid conditions mimicking hypothyroidism
  • Thyroid function tests
  • Thyroid hormone replacement therapy

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References

  • 1
    El-Shirbiny AM, Stavrou SS, Dnistrian A, Sonenberg M, Larson SM, Divgi CR. Jod-Basedow syndrome following oral iodine and radioiodinated-antibody administration. J Nucl Med. 1997 Nov;38(11):1816-7. Erratum in: J Nucl Med 1998 Mar;39(3):489
  • 2
    Navarro FA. [Jod-Basedow phenomenon: who was Dr. Jod?] Rev Clin Esp. 1997 Jul;197(7):531. Spanish
  • 3
    Goday-Arnó A, García Rico A, Martínez-Riquelme A, Cano-Pérez JF. [Graves Basedow disease following treatment with magistral formulae for obesity. Jod-Basedow phenomenon?] Rev Clin Esp. 1996 Aug;196(8):536-8
  • 4
    Gómez de la Torre R, Enguix Armada A, García L, Otero J. [Thyroid nodule disease in a previously endemic goiter area] An Med Interna. 1993 Oct;10(10):487-9. Spanish.
  • 5
    Yamada T. [Jod-Basedow (iodine-induced hyperthyroidism)] Ryoikibetsu Shokogun Shirizu. 1993;(1):367-9. Review. Japanese.
  • 6
    Woeber KA. Iodine and thyroid disease. Med Clin North Am. 1991 Jan;75(1):169-78.
  • 7
    Maberly GF, Corcoran JM, Eastman CJ. The effect of iodized oil on goitre size, thyroid function and the development of the Jod Basedow phenomenon. Clin Endocrinol (Oxf). 1982 Sep;17(3):253-9.
  • 8
    Maberly GF, Eastman CJ, Corcoran JM. Effect of iodination of a village water-supply on goitre size and thyroid function. Lancet. 1981 Dec 5;2(8258):1270-2.
  • 9
    Livadas DP, Koutras DA, Souvatzoglou A, Beckers C. The toxic effect of small iodine supplements in patients with autonomous thyroid nodules. Clin Endocrinol (Oxf). 1977 Aug;7(2):121-7.
  • 10
    Birkhäuser M, Burer T, Busset R, Burger A. Diagnosis of hyperthyroidism when serum-thyroxine alone is raised. Lancet. 1977 Jul 9;2(8028):53-6.
  • 11
    Spaulding SW, Burrow GN, Ramey JN, Donabedian RK. Effect of increased iodide intake on thyroid function in subjects on chronic lithium therapy. Acta Endocrinol (Copenh). 1977 Feb;84(2):290-6.
  • 12
    Markou K, Georgopoulos N, Kyriazopoulou V, Vagenakis AG.,  Iodine-Induced hypothyroidism. Thyroid. 2001 May;11(5):501-10.
  • 13
    Lesher JL Jr, Fitch MH, Dunlap DB., Subclinical hypothyroidism during potassium iodide therapy for lymphocutaneous sporotrichosis. Cutis. 1994 Mar;53(3):128-30
  • 14
    Wémeau JL., [Hypothyroidism related to excess iodine], Presse Med. 2002 Oct 26;31(35):1670-5.
  • 15
    Eng PH, Cardona GR, Previti MC, Chin WW, Braverman LE.,  Regulation of the sodium iodide symporter by iodide in FRTL-5 cells. Eur J Endocrinol. 2001 Feb;144(2):139-44.
  • 16
    Alexandrides T, Georgopoulos N, Yarmenitis S, Vagenakis AG., Increased sensitivity to the inhibitory effect of excess iodide on thyroid function in patients with beta-thalassemia major and iron overload and the subsequent development of hypothyroidism. Eur J Endocrinol. 2000 Sep;143(3):319-25.
  • 17
    Bando Y, Ushiogi Y, Okafuji K, Toya D, Tanaka N, Miura S., Non-autoimmune primary hypothyroidism in diabetic and non-diabetic chronic renal dysfunction. Exp Clin Endocrinol Diabetes. 2002 Nov;110(8):408-15.
  • 18
    Frey H. Hypofunction of the Thyroid Gland, due to Prolonged and Excessive Intake of Potassium Iodide. Acta Endocrinol (Copenh). 1964 Sep;47:105-20.
  • 19
    Reinhardt W, Luster M, Rudorff KH, Heckmann C, Petrasch S, Lederbogen S, Haase R, Saller B, Reiners C, Reinwein D, Mann K.  Effect of small doses of iodine on thyroid function in patients with Hashimoto’s thyroiditis residing in an area of mild iodine deficiency. Eur J Endocrinol. 1998 Jul;139(1):23-8.