All 3 Chapters for Advancing Site Updated Mar '10

7/31/2019 All 3 Chapters for Advancing Site Updated Mar '10

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Thyroid 101 9

Chapter 1

Thyroid 101N order to understand the causes of low thyroid hormone symptoms it is

important to understand some of the basics about the thyroid gland, how it

works and what causes problems. Heres a very simple introduct ion to all the

characters that play their part in thyroid health.

Pituitary

The pituitar y is a pea-s ized gland in the brain. When thyroid hormones in the

bloodstream go down the pituitary makes a hormone called thyroid stimulating

hormone or TSH.

TSH

This hormone travels through the bloodstream to the thyroid gland and

stimulates the thyroid to make more of its hormones. Heres the thyroid.

I


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Thyroid 101 10

Well, OK. I thought this was better than a bloody thyroid gland. Anyway, when

your thyroid is stimulated by TSH it secretes primarily two thyroid hormones.

One is called T4 or thyroxine.

T4 is the primary hormone made by the thyroid. It is also known as the

prohormone or mother-hormone because it can become other thyroid hormones.

Notice the 4 atoms of iodine.

T4 is inactive. It doesnt do anything for the bodys metabolism or the making

of energy. It must be convert ed into T3.

This is T3 with one less atom of iodine. It is the active thyroid hormone. It is

also called triiodothyronine. The conversion of T4 to T3 happens primarily in

the liver. Conversion simply happens by removing 1 atom of iodine.

T4

Iodine

Iodine

Iodine

Iodine

T3

Iodine

IodineIodine

T4

T4T4


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Thyroid 101 11

That covers some of the basics of thyroid hormones so now lets review some of

the most common questions about the thyroid.

What is Hypothyroidism?

Hypothyroidism simply means that the thyroid isnt making enough T4 and T3

and so these two hormones are low in the blood and on blood tests.

There are two types of Hypothyroidism, one is Primary Hypothyroidism and the

other is Secondary Hypothyroidism.

With Primary there is plenty TSH and thus plenty of stimulation but the thyroid

gland isnt able to respond.

The blood test w ith Primary Hypothyroidism will show high TSH and low levels

of T4 and T3.

Secondary Hypothyroidism is very different when looking at blood test results.

With Secondary TSH is low for various reasons and since TSH is low the

thyroid is not getting enough stimulation to make its hormones.

So with Secondary the blood test will show low TSH and low T4 and T3.

Note that both conditions have low thyroid hormones so the way a person with

Primary Hypothyroidism feels and the way a person with Secondary

Hypot hyroidism will feel are prett y much the same. This is why lab test ing is

so important.

T4

Iodine

Iodine

Iodine

Iodine T3

Iodine

Iodine

Iodine

T4

Iodine

Iodine

Iodine

Iodine T3

Iodine

Iodine

Iodine

TSH

T SH


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Thyroid 101 12

If theres plenty of TSH why wouldnt the thyroidbe able to make more

thyr oid horm ones?

The thyro id needs nutrient s to make thyro id hormones. Just like your body

needs iron and B12 to make red blood cells so your thyroid needs iodine,selenium, zinc and iron. Most people don t necessarily need a prescription for

thyroid medication. They just need to feed their thyro id gland.

Whats the difference between the thyroid hormones T4 and T3?

T4 is the most abundant hormone produced by the thyroid. The 4 in T4 stands

for the number of attached iodine atoms. Its main purpose is to make other

thyroid hormones such as T3 and so it is referred to as a prohormone or mother

hormone. T4 does not directly control your metabolism. I know I am repeating

myself here but repetition helps to generate new brain cells and memory.

T4 must be converted to T3 which is the thyroid hormone that stimulates energy

production or metabolism. T3 regulates metabolism by slipping through the

membranes of your cells and attaching to nuclear receptors. Once attached it

regulates the cells activity.

T4

Iodine

Iodine

Iodine

Iodine

T3

Iodine

IodineIodine


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Thyroid 101 13

What about blood tests?

This is a most important question. To understa nd the causes of low thyro id

hormone symptoms you must have specific lab tests done. It is important to be

working with a professional who uses lab test results in their overall

assessment.

I think Ive made this clear with the two examples of Primary and Secondary

Hypot hyroidism. They both have low thyroid hormones and almost identical

symptoms but the reasons are completely different. One is a problem with the

thyroid being undernourished and the other is a problem with the production of

TSH by the pituitary gland.

There is normally a continual balancing act between TSH and T4. When T4

production by the thyroid gland goes down TSH should go up.

And when thyroid production of T4 increases then TSH should go down.

When T4goes down

TSHgoes up

TSH goesdown when

T4 goesup


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Thyroid 101 14

This is rather a simple concept to grasp and checking TSH and T4 in the blood

tells us a lot about the interaction between the pituitary and the thyroid gland.

Testing T4 levels tells us how much is being made by the thyro id gland. The T4

blood test also tells us t wo other things.

All the hormones in the blood stream are either bound to proteins or are free

floating and available. When you see a lab result for T4 this represents the total

T4, both the bound and free.

But for a complete assessment as to why someone has low thyroid hormone

symptoms it s extremely important to know both the bound T4 and the free T4.

And to know this we must test the Total T4 AND the Free T4.

Here is an example to illustrate.

Here the total T4 (bound & free) is well within the normal range which tells us

that the thyroid is producing plenty of thyroid hormone. Yet look at the free

T4. It is low which means that most of the thyroid hormone T4 is bound up and

cant be used. And what is free T4 used for? It is used to make T3, the active

thyroid hormone.

This brings up another point. What good will it do to know the Free T4 if we

have no idea if it is being convert ed to the active T3 thyroid hormone? That s

why it is also very important to check for t his conversion by test ing the level of

available T3.

00

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00

01

01

01

01

Total T4 Free T4

>N

O

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A

L

>


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Thyroid 101 15

Heres another illustration.

Here we have plenty of free and availabl e T4 but low levels of free T3. This

indicates poor T4 to T3 conversion and uncovers another cause of low thyroid

hormone symptoms.

It is very important to understand the importance of these four lab tests because

without them you just cant determine the reasons for low thyroid hormone

symptoms.

A comprehensive thyroid panel must include TSH, Total T4, Free T4 and Free

T3. There are other tests as well which we will cover a little later on but these

are the foundation.

00

00

00

01

01

01

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Free T4 Free T3

>N

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L

>


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Summary of Causes 16

Low Thyroid Hormone Symptoms-7 Causes & 7 Solutions

Chapter 2

Summary of the Seven Causesext well go a little deeper in the causes of low thyroid hormone

symptoms. I believe you already have enough knowled ge to understand

these seven causes but Ill still keep it very simple and basic. Believe me when

I say that by the time you finish this book you will possess a very thorough

education on thyroid hormones and a comprehensive perspective on the reasons

for low thyroid hormone symptoms.

Lab Test Results

ab results are very important in the scientific approach to understanding a

perso ns illn ess ye t whe n it come s to the thyr o id ho w these result s are

often misinterpreted is the first cause of why low thyroid hormone symptoms are

often not treated.

Lets say that a person visits their physician with all the complaints of

hypothyroidism. The first thing the doctor must do besides examining the

pat ient is to order lab tests. Lets say that the physician, like most physicians,

orders the typical thyroid tests. Here are the results.

You may already recognize this and be able to understand what these results

mean and how to interpret them. Remember, when T4 goes down TSH should go

00

01

01

02

02

03

TSH Total T4

>N

O

R

M

A

L

>

N

L


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up in an attempt to stimulate the thyro id to make more hormones. In this case

there is more than enough TSH yet the thyroid is unable to respond which is

reflected in low T4.

To the physician these results confirm that the p atient is suffering from PrimaryHypothyroidism. This is a simple and straightforward case. The patient would

be prescribed a thyro id medicat ion. There is a lot more that can be done and

needs to be done which I ll explain in a later chapter.

Yet in the real world Hypothyroidism does not develop suddenly overnight. A

person just doesnt wake up one morning with symptoms that are reflected with

very high TSH and very low T4. Developing Primary Hypothyroidism wit h

these lab results can take years and even decades.

So how might the results have looked 5 years before for a person with Primary?

Here we have both TSH and Total T4 in the normal range with TSH being on the

high side and T4 on the low side. Ive seen this pattern hundreds of times. A

person with these lab results will often suffer from low thyroid hormone

symptoms because of sub-optimal thyro id hormone levels. To me these lab

results represent a pre-stage of hypothyroidism and need to be treated before

they develop into Primary Hypothyroidism.

This stage responds very well to supplements and nutrition which is covered in

another section. Peop le shouldnt have to wait another 5 years until their

thyroid finally fails and they are diagnosed with hypothyroidism. Using lab

00

00

00

01

01

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01

TSH Total T4

>N

O

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L>


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work is a great way o f knowing the reasons for symptoms and to begin treatment

before the condition becomes more severe.

Remember that we already covered Secondary Hypothyroidism where there

wasnt enough TSH to simulate the thyroid g land? Heres what the lab resultslook like for Secondary.

Here the level of Total T4 is on the very low side of normal primarily because

the thyro id is not being stimulat ed by TSH. Here the physician gives the

diagnosis of Secondary Hypothyroidism and must then investigate more deeply

the reasons for the low TSH. This is a more complicated condition than Primary

Hypothyroidism but there are certainly a number of things that can be done as

you will soon see.

Remember that two people, one with Primary Hypothyroidism and the other wit h

Secondary will have very similar symptoms because they both have low

circulating thyroid hormones.

Then what about these results?

00

00

00

01

01

01

01

TSH Total T4

>N

O

RM

A

L

>


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Here the TSH is approaching the lower limit of normal and the same for T4. Yet

because they both fall within the normal range this person would not receive any

diagnosis or help wit h improving their symptoms. Yet it is just a matter of time

until this person would become hypothyroid. At this stage it is time to take

action. It is still a very treatable condition as you will see and I ve seen the

treatment work over and over again.

The take-home here is that hypothyroidism, either Primary or Secondary,

develops gradually over years and decades.

Treating these pre-stages is very important not only for prevention but for

helping the pat ient to recover their health and vita lity. There are many ways of

improving these pre-hypothyroid conditions including nutrition, supplements

and pharmacy.

Problem with Lab Ranges

We just covered the reasons for t reating a person before their lab results fell out

of the labs normal reference range. But what about these ranges that dictatewhat is normal and what is not?

As an example lets look at TSH to understand the problem we physicians are

faced with. TSH was the first lab test doctors used to diagnose hypothyroidism.

00

00

00

01

01

01

01

TSH Total T4

>N

O

RM

A

L

>


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Before that doctors based their diagnosis on the appearance and complaints of

the patient.

When the TSH blood test was introduced in the early 60s doctors were confused

because the blood test results for some patients came back in the normal rangeon patients who the doctor knew was obviously hypothyroid. Physicians who

had been treating hypothyroid patients for years decided that the new TSH lab

test was unreliable.

Since that time the TSH lab test has remained the same. What has changed is

the reference range. The upper normal limit has come down over the years.

About a year ago it was 5.5. Now it is 4.5. The American Association of

Clinical Endocrinologists (AACE) wants it to be even lower, to 3.0. Lets look

at the old and the suggested new upper normal and what it might mean to the

public and to physicians.

Here we have results for TSH and T4. With the old upper normal of 4.5 this

person would not be diagnosed with Primary Hypothyroidism. But if labs would

lower this to the new upper normal of 3.0 as suggested by the ASCE this person

would now receive the diagnosis and a prescription. This means that potentially

0

0.2

0.4

0.6

0.8

1

1.2

TSH Total T4

Old >

New >

>


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millions of people formerly considered normal would now receive a diagnosis.

So really, it all comes down to whether or not a physician is willing to use these

new AACE guidelines.

I hope you are beginning to recognize not only how important thyroid labtesting is but also the importance of working with a physician who is able to

interpret lab results based upon research and current physician guidelines.

There is a lot more information on lab reference ranges and the pre-stages of

hypothyroidism in the Advanced chapter. Thi s has only been an overview or

summary.

Poor Conversion of T4 to T3

oor conversion is the second leading cause of low thyroid hormones.

Remember that T4 is the inactive thyroid hormone and must be converted to

the active T3 hormone by simply removing 1 atom of iodine. This is called

conversion.

If you have poor conversion then youll have low levels of T3 and because of

this youll have the same symptoms as a person with either Primary or

Secondary Hypothyroidism.

Just as a reminder here is an example of the lab results for poor conversion.

Here we have plenty of free and available T4 but its not being converted to T3

and thus free T3 is low.

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00

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01

01

01

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Free T4 Free T3

>N

O

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L

>

P


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If you read any medical physiology book publishing in the last 10 years it

describes T3 as the thyroid hormo ne that controls and regulates the bodys

metabolism and that T4 must be converted to T3. Yet most doctors do not

include free T3 in their lab requis ition. Also there is no formal medical

diagnosis for hypothyroidism due to poor conversion.

As mentioned, this conversion happens primarily in the liver as well as inside

cells. Knowing how to improve liver funct ion and which specific supplements

promote optimal conversion are provided in the chapter on t hyroid solutions.

Hypothyroidism

At first you may wonder why Ive included h ypothyroidism as the t hird cause of

low thyro id hormone symptoms. The reason is because many people diagnosed

with hypothyroidism and taking thyroid medication are still having low thyroid

symptoms. There are a few reasons for this which Ill briefly mention.

The most widely prescribed thyroid medications are Synthroid and L -Thyroxine.

Both of these are synthetic mimics of the T4 our thyroid makes. And just as our

T4 needs to be converted to T3 so does this thyroid medication. Therefore one

reason for a person not feeling 100% better on their thyroid medication is

because of poor o r incomplete conversion.

There is also the fact that in the first place the primary cause of low thyroid

hormones is the lack of specific essential nutrie nts. Just because you ve

replaced your thyroid hormone doesn t mean you still wont be having other

problems due to these deficiencies.

And also remember that there are at least 6 other causes for low thyroid

hormone symptoms and a person diagnosed with hypothyroidism must still

investigate all these ot her reasons.

Is hypothyroidism a cause of low thyroid hormone symptoms? Most definitely

and it takes more than a thyroid prescription to resolve them. Sometimes a

thyroid prescription is absolutely necessary but this doesnt mean its the only

thing that will help.


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Shortly I will be explaining exactly how to optimize thyroid hormone levels for

those taking a t hyroid prescription.

Autoimmune Thyroid Disease (AITD)

utoimmune thyroid disease is the fourth reason for low thyroid hormone

symptoms and besides nutrient deficiencies is the major underlying cause

of hypothyro idism. By auto immune is meant that the immune system is

attacking the bod ys tissues and with AITD it is the thyroid.

AITD can exist during any pre-stage of hypothyroidism. One typical set of

symptoms of AITD is the roller-coastering symptoms of feeling racy one day

and exhausted the next. It can also present as simply fatigue as well as all the

other low thyroid hormone symptoms.

Theories

There are a few theories about how AITD develops. One is that the origin is

viral or bacterial. Another is that thyroid cells become inflamed and begin to

self destruct. Ill briefly explain.

Thyroid cells make hydrogen peroxide which causes iodide to become iodine.

This is a necessary step in the making of thyroid hormones.

What stimulates the production of H2O2 inside thyroid cells is TSH and you

know what stimulates TSH. It is low levels of thyroid hormones in the blood.

Now as TSH goes up because of low thyroid hormones it will stimulate the

production of H2O2 inside thyroid cells . But what do you think will happen if

these thyroid cells don t have enough iodide?

Insuffic ient iodide results in the low product ion of thyro id hormones. Low

production of thyroid hormones will continue to cause the pituitary to produce

more and more TSH. Continued product ion of TSH will maintain abnormally

high levels of H2O2 in thyroid cells which creates more inflammation.

Now if a person is deficient in antioxidants such as glutathione to quench this

inflammatio n there will be some degree of destruction of the thyro id cells. This

A


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is when the immune system steps in to clean up the debris and this increases the

likelihood of developing autoimmune thyroid disease.

Unfortu nately most peop le are not screened for AITD. As you will learn in the

Advanced chapter until AITD is addressed through supplements and pharmacya person will be unable to recover normal thyroid hormone levels or their

health.

The solutions section will give details on a protocol that has been effective in

over 80% of the cases. This protocol includes the necessity of specific

supplements, changes in nutrition and a thyroid prescription.

Poor Binding of T3 to Cell Receptors

he fifth reason for having low thyroid hormone symptoms is due to T3

being unable to bind to thyroid receptors inside the cells of the body. T3 is

the active hormone but if it cant bind it cant improve the metabolism of the

cell. If a good portion of free T3 cannot bind to these receptors a person will

experience low thyroid hormone symptoms.

There are primarily three reasons for why T3 cant bind.

The first two reasons relate to a protein complex which is attached to thesereceptors. When levels of this protein complex are low then T3 cannot

optimally bind. This protein complex is made of vitamin D, a retinoid (vitamin

A) and a protein.

A person with suboptimal levels of vitamin D and vitamin A may experience low

thyroid hormone symptoms due to poor binding of T 3 to these protein complexes

on receptors. I will explain exactly how to interpret vitamin D lab tests and the

dosing of a vitamin D supplement.

The third reason for poor binding of T3 to receptors is due to a deficiency of

cortisol, a hormone produced by the adrenal glands. Low cortisol levels are

another cause of low thyroid hormone symptoms. I ll explain the best way of

testing cortisol levels and some options on how to optimize cortisol levels.

T


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Bound Thyroid Hormones- Estrogen & Progesterone

ou already know that thyroid hormones are circulating through the

bloodstrea m as either bound to protein or free and available. When a

large percentage of thyroid hormones are bound then a person will experiencelow thyroid hormone symptoms.

One protein that binds thyroid hormones is called thyroid binding globulin or

TBG. TBG is made in the liver and its production is increased when a persons

estrogen levels are elevated. Remember what the lab results look like for

elevated binding of T4?

This result tells the physician that too much T4 is bound up and unavailable.

The most common reason for low free T4 with a normal total T4 is increased

estrogens due to estrogen birth control pills. Other than oral contraceptives

increased estrogens can also be caused by poor liver metabolism or break-down

of estrogens, the use of an over the counter hormone called DHEA, and excess

body fat.

The first thing to do is to assess estrogen levels but always in relation to

progesterone. When progesterone levels are very low it will exaggerate the

negative effects of estro gen. Thus there is an optimal ratio of progester one to

estrogen. Even if estrogen is within the normal range, if progesterone is very

low it can give rise to excess binding of TH.

00

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Total T4 Free T4

>N

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>

Y


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Assessing estrogen and progesterone is very easy through saliva hormone

testing. I ll explain about how you can get these tests done with kits delivered

to your home and the most natural and effective ways to improve the ratio of

estrogen to progesterone.

Environmental & Nutritional Factors

This last cause of low thyroid hormone symptoms includes a wide variety having

to do with our environment, nutrition and the ecology of our intestinal tract.

The External

Environmental chemicals disrupt the normal functioning of the thyroid and ot her

glands of the endocrine system. These chemicals have been given the name ofendocrine disrupting chemicals or EDCs and are found in cosmetics, pesticides

and other common sources. Their negative effects are many and peop le who are

most susceptible are deficient in the protective trace element iodine.

We are also exposed to another category of elements called halogens. Halogens

include bromine, fluorine, chlorine and iodine. When iodine becomes

insufficient these other elements bind to iodine receptors in the body causing

low thyro id hormone production and a number of other problems. The use of

iodine to displace these other halogens is one effective solution.

Please do not jump to the conclusion of taking high doses of iodine and

potassium iodide. As you will find in later chapters iodine can be harmful if

you have a thyroid autoimmune condition or have a deficiency of antioxidants.

I will explain more later on.

SAD or seasonal affective disorder, caused by lowered exposure to sunlight,

leads to lethargy and depression. The connection with low thyroid hormonesymptoms is that with SAD an enzyme that transports T3 into the brain is

reduced. T3 is believed to have a direct effect upon the metabolism and

regulation of brain neurotransmitters.


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As you know a limited exposure to sunlight also lowers the bodys production of

vitamin D. Weve already briefly mentioned the importance of vitamin D for

the binding of T3 to cell receptors.

The Internal

The ecology of the small and large intestines has a great influence upon our

health. Part of this ecology includes the billions of beneficial bacteria that

provide important B vitamins and protect us from bacteria, parasites and an

over-gro wth of yeast. This flora also helps to absorb and recycle iodine.

There are a couple of important forms of good bacteria that I ve found to be

most effect. These are in the chapter that covers the best supplement s and

supplement manufacturers.

Nutrient Deficiencies

There are many nutrients necessary for the production, metabolism and

utilization of thyroid hormones. We will cover them all in detail very shortly.

For now lets look at just one of them, vitamin A.

Besides its importance in T3 receptor binding, vitamin A deficiency can cause

an improper response of TSH to circulating thyroid hormones. Here are two

examples of how vitamin A deficiency can show upon on thyroid lab results.

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TSH Total T4

>N

O

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A

L

>


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Look familiar? It looks like the pre- stage of Secondary Hypothyro idism. One

of the reasons for the low TSH is because vitamin A is necessary for the

product ion of TSH. Vitamin A also improves the convers ion of T4 to T3.

We ll be covering all of the essential vitamins and minerals necessary foroptimal thyroid hormone production

Dieting

The temperature of our body is an expression of our metabolic rate and is

directly related to the number of calories we eat during the day. If we dont eat

enough calories our body cools because our metabolism slows down. This

happens because our body s response to eating less food is to lower the

product ion of thyroid hormones and the conversion of T4 to T3. This is an

adaptation mechanism to conserve the bodys fuel.

This is why low caloric dieting doesnt work for losing weight. It may

temporarily but not in the long run. Well cover the best approach to die ting in

another chapter.

Summary

This has been an overview of the 7+ causes of low thyroid hormone symptoms.I believe by now you are ready to move on to the next level and to hear some

interesting stories from researchers from around the world. So lets get started

on the second leg of our journey.


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Breast Cancer 63


Chapter 5

Breast CancerIn the last 40 years there were two very important studies on breast cancer. One

was published in The Lancet in 1976. It presented a global perspect ive,

searching for answers to the question of why breast cancer was higher in some

parts of the world than others. This investigation uncovered the fact that

Japanese women had a much lower incidence of breast cancer than women living

in the United States. Examining cultural and lifestyle differences they

discovered that the nutritional intake of iodine in the Japanese diet was about 15

times that of the U.S.

During that same time the hottest research was focusing on the link between

estrogen and breast cancer and the study hypothesized that iodine might help to

metabolize or shift estrogens away from the estrone (E1) form towards estriol

(E3). As a result of The Lancet study research into iodine and breast disease

began.i

The other important study on breast cancer was done at the University of Pisa in

Italy. They examined the incidence of thyroid disease in 102 women with ductal

infiltration carcinoma. All had thyroid blood tests and thyroid ultrasounds.

The results were significant. Of the 102 women just under half of them had a

thyroid disease. With what youve already learned about subclinical and

suboptimal hypothyroidism along with the lack of using extended thyroid lab

testing and the call for lowering the upper normal limit for TSH by the

American Association of Clinical Endocrinologists, Im sure that the number of

women in this study with thyroid disease would have been even higher.

This studys conclusion focused solely on a recommendation tha t physicians

treating women with breast cancer should be screening them for thyroid disease.

But I believe the results uncovered something of much greater significant.ii


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Breast Cancer 64


Might these two studies hold the keys for preventing and possibly treating

breast cancer?

Could it mean that the causes for a wo men developing nontoxic goiter or thyroid

autoimmune disease or low thyroid hormones be the same causes behind thedevelopment of breast cancer?

Could it mean that the development of thyroid disease is a risk factor for breast

disease?

Could it be that if we know how to prevent and treat the various thyroid diseases

and through the optimization of thyroid hormone levels that we could also

prevent and treat breast disease and breast cancer?

I believe the answer to all four of these questions is yes!

Breast Tissue

First lets examine what we know about breast tissue and the development of

breast cancer and known risk factors.

Breast cancer does not develop overnight. Breast tissue does not advance from

healthy to malignant without going through the various stages of dysplasia,

cystic and fibrotic with tenderness, pain and swelling. With all our

sophisticated imaging technology searching for the smallest of malignant

growths we have forgotten the fact that benign breast tissue changes are a risk

facto r for develop ing breast cancer and need to be treated and prevented. The

search for the cure for breast cancer is driven by research primarily supported

by the ideal of a drug which targets cell receptors or genes or a medical

procedure. Research must broaden its focus to include prevent ion.

The general category for all breast tissue changes other than cancer is called

benign breast disease (BBD). According to a 2005 article in the New England

Journal of Medicine BBD is a risk factor for developing breast cancer.iii

Logically, then, to lower the incidence of breast cancer we need to treat and

prevent BBD.


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Breast Cancer 65


In 1997 the Ghent Report was submitted to the FDA. It was a double blind

study involving 92 women with Fibrocystic Breast Disease which falls within

the categor y of BBD. The women were treat ed with iodine with significa nt

improvement in breas t tenderness, nodularity, fibrosis, turgidity, and the

number of macrocysts.iv

The research clearly indicated a viable and effective

treatment for benign breast disease. The Ghent Report was refused by the FDA

saying it could not endorse the trial since iodine is a natural substance and not a

drug.

Another study published in The Breast Journal in 2004 involved 111 women

with Cystic Mastalgia, painful breasts due to cysts. These selected participants

had to have moderate to severe breast pain for 6 days o r more each month. A

significant improvement in breast pain, tenderness and breast nodularity was

experienced within 3 months using 6mg of iodine taken daily.v

Might it be a simple case that the higher intake of iodine in the Japanese women

simply reduced the incidence of benign breast disease which lowered their risk

of developing breast cancer? Could it be that simple? Lets hope so.

NIS Channels

There is another quality about breast tissue that was recently discovered. For a

long time we knew that the absorption of iodine into the thyroid gland was

regulated by a specific channel called the sodium-iodide symport (NIS).

In the early 2000s we discovered that breast tissue also has these same NIS

channels. Initially we thought these appeared in breast tissue only during the

last trimester of pregnanc y in order to supply iodine during lactation. Yet these

channels also appear in the ductal cells of the breast, those cells most

susceptible to breast cancer.vi

So now we know that iodine helps to improve BBD and that breast tissue has

specific NIS channels for iodine absorption. Knowing this brings up several

concerns that need to be addressed.


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Breast Cancer 66


The first is that the National and Nutritional Surveys in the 1990s determined

that approximately 36 million people in the U.S. are iodine deficient.vii

This

figure I am sure could easily be doubled if we were to include the category of

iodine insufficiency. Everyone with iodine deficiency and iodine insufficiency

are at risk for thyroid disease.

The second concern is for the people diagnosed with hypothyroidism who are

taking a thyroid prescription. As you know by now the primary cause of

hypothyro idism is a lack of iodine. This fact that most people wit h

hypothyroidism are deficient in iodine has been confirmed.viii

And even though

their prescription is correcting a deficiency of thyroid hormones they will still

suffer the consequences of an iodine deficiency and the increased risk of

developing breast disease.

The third concern is again for a person taking a thyroid prescription. With

Synthroid or L-Thyroxine a persons thyroid hormone levels will increase while

their TSH will decline, often significantly. This presents a danger because

maintaining optimal TSH levels ensures the number and upregulation

(activat ion) of NIS channels in the thyroid, breast and other tissues. Low levels

of TSH, often occurring with thyroid medication, will indirectly reduce the

uptake of iodine into the breast and other tissues. ix x xi Fortunately, for many

people, iodine and iodide optimizes TSH levels.

It is my belief that everyone with thyroid disease is at risk for developing

benign breast disease.

Breast Tissue & Estrogens

At puberty normal breast tissue growth is primarily governed by estrogens

which bind to estrogen receptors on breast cells. Research in the 1970s

discovered that malignant breast cell growth was stimulated by estrogens if

these cells had estrogen receptors. It was also discovered that the estrone (E1)

form of estrogen binds (stimulates) to these receptors 5 times longer than the

other two forms of estrogen, estradiol (E2) and estr iol (E3).xii


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Most research has been directed towards estrogens and their receptors on breast

cancer cells and very little on estrogens and benign breast disease even though

BBD is a known risk factor. In 2008 the Journal of the National Cancer

Institute disclosed a study showing that women taking estrogen have twice the

risk of developing BBD. Their conclusion; The prevailing hypothesis

concerning the natural history (progression) of breast cancer is that benign

proli fe rat ive br east dis easerepresent s su ccess iv e st ep s preceding the

development of invasive breast [cancer].xiii

Again, we need to focus on

prevention as well as treatment.

So now we know that estrogens are related to the development of BBD and we

know that iodine improves the symptoms and cellular changes of BBD. The

question then is how might iodine help to reduce the negative effects of

estrogen?

Iodine

First lets examine some global statistics on breast cancer. I pulled out one

study from a year before the Lancets 1976 global cancer survey that I believe

helps to prove a po int.

Before the spread of international fast food chains most people primarily ate the

food of their culture that was grown and raised locally. Older studies may offer

clearer insights than more recent studies because of food importation and the

relocation of populat ions.

I took a look at the growth of the largest fast food chain with the greatest

influence upon the eating habits of people around the world.

In 1948 McDonalds was founded. By 1958 it had sold 1,000,000 hamburgers

ranging in price between 15 and 19 cents. By 1967 McDonalds opened in

Canada and Puerto Rico. By 1978 the 5,000t h

McDonalds opened in Kanagawa,

Japan. Of course I am not saying or inferring that McDonalds hamburgers are

the cause of higher rates of BBD or breast cancer in the United States but I am


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trying to recognize the variable of substituting food outside ones region and

culture.

In a 1975 article in Health & Policy Planning they also reviewed the

international incidence of breast cancer. In 1975 in North America there wereapproximately 105,300 women diagnosed with breast cancer, an average of 57

for every 100,000. That same year Japanese women had 11,500 with an average

of 20 for every 100,000.xiv

Later studies have shown that Japanese women

relocating to the U.S. have an almost identical rate of breast cancer as women

living here.

Maybe iodine is the major factor and maybe it isnt. But as we go into this next

section let us hypothesize for the moment that iodine is the primary means of

preventing BBD and breast cancer.

Iodine Research

One method of researching a substance with suspected anti-carcinogenic effects

is through animal studies. This often involves using genetically designed rats

who respond to a specific carcinogen by developing the corresponding specific

cancer. To test a substances anti -carcinogenic ability it is given

simultaneously with the carcinogen to observe its effect in prevention or in

delaying the onset of the cancer.

In 2001 a study used iodine in the form of an extract from seaweed to observe

its protective effects against the carcinogen DMBA. The rats were placed in

three groups. One group was fed commercial feed while the other 2 were fed

the same feed mixed with differing amounts of the seaweed extract.

The conclusion was, significant suppression of tumor growth was observed in

groups 1-B and 1-C (seaweed mixed into feed) compared with 1-A (regular

feed). These results suggest that iodine is transported through the serum into

mammary tissues and induces apoptosis (death of the cancer cell). Wakame

(seaweed) suppressed the pro liferation of DMBA induced mammary tumors.xv


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Their second study took a different route for the ingestion of the seaweed

extract, extremely strong suppressive effect in rat mammary carcinoge nesis

when used in daily drinking water.xvi

Another study from 1996 expressed their results by stating, The direct uptakeof inorganic iodine by breast tumors led to the suppression o f tumor growth.

xvii

Another way that research can investigate a substance is through the use of

human cell cultures. These studies are referred to as in vitro or outside the

body. One study observed the effect of the seaweed extract upon 3 kinds of

human breast cancer cells. Again, the same apopto sis or cell death was

observed . These effects were stronger than those of chemotherape utics widely

used to treat human cancer cells.xviii

Even though these studies are very impressive it still remains unclear as to how

iodine works.

Iodine & Estrogen

Weve already covered the beneficial effects of iodine upon benign breast

disease with one of the leading causes of BBD being high estrogens. So what is

the link between estrogen and iodines ability to counteract the effects of it?

Some believe that iodine shifts the three estrogens, E1, E2 and E3, towards E3.

This would help since E1 stimulates breast cells 5 times longer than E2 or E3.

Yet I could not find any research that proved this effect. All was hearsay and

speculation.

But what has surfaced in the field of genetic research explains how iodine

reduces the stimulat ory effect s of estro gens. I promise to keep this very simple.

Iodine and iodide alter the expression of several genes in the estrogen pathway.

Iodine and iodide down regulate (quiet) several estrogen receptor genes with the

result being a slowing or repressing of estrogens effects on breast cancer cell

metabolism. This helps to explain the role of iodine in both prevention and

treatment of BBD and breast cancer if breast cells have estrogen receptors.


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This research went one step further. Currently one prescription used for the

prevention and treatment of estrogen receptor positive breast cancer is

Tamoxifen. How Tamoxifen works is not fully underst ood but is supposed to fit

onto the estrogen recepto r to block estroge n engagement. Yet this drug has the

primary side effect of causing drug resistant cancers because Tamoxifen

stimulates a gene termed CCND1. These genes lead to a type of untreat able

cancer. As it turns out their ext ensive study showed that iodine and iodide

decrease CCND1 replication and thus enhances the efficacy of Tamoxifen

therapy.xix

Thyroid Hormones

It looks like weve come full circle. To begin at the beginning lets examine

the Pisa study for a moment and remember that 46% of the women with breast

cancer suffered from obvious thyroid disease.

Nontoxic goiter was the most pronounced. It is caused by a combination of two

things, low iodine and elevated estrogen. Low iodine and increased estrogens

are both involved with breast disease and the increased risk of developing breast

cancer.

Elevated estrogen blocks the uptake of iodine into the thyroid cells and

increases thyroid cell growth.xx

Research has shown that women with goiters

have three times the incidence of breast cancer.xxi

The other major thyroid disease in the Paris study was women with autoimmune

thyroid disease. One theory on the origin of AITD is an iodine deficien cy which

weve already covered in detail in the Advanced chapter. Research is no w

beginning to make another connection between AITD and breast cancer. There

is evidence that patients with AITD may also have antibodies which attack the

NIS channels in various tissues including breast which lowers iodine uptake.xxii

This evidence is still inconclusive yet a nother study remarked, this inhibition of

iodine uptake is due to unknown factors present in the sera (blood) of

Hashimotos and Graves patients.xxiii


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These two reasons, low iodine levels as the primary underlying cause of AITD

and the inhibition of iodine absorption into breast tissue seem very plausible

causes or at least risk factors for AITD patients to develop BBD and breast

cancer.

Just recently, in 2008, the Critical Review of Oncology and Hematology

published an article from the USC/Norris Comprehensive Cancer Clinic and the

Keck School of Medicine at USC in Los Angeles, California. We believe that

the thyroid disease-breast cancer relationship provides a unique opportunity to

find out the causes of breast cancer.xxiv

They propose that the reduction of breast cancer in hyperthyroid patients or with

increased levels of thyroid hormone, or iodine to be the driving biochemical

mechanism that generates apoptosis or the destruction of cancer cells.xxv

Their

research examined thyroid conditions which lowered the incidence of breast

cancer.

Another reason why plenty of thyroid hormones are important in the prevention

of BBD and breast cancer is because these hormones stimulate the production of

SHBG or sex hormone binding globulin.xxvi

SHBG is a protein that binds

estrogen. If SHBG goes down then more estrogens are free and liberated to bind

to estrogen receptors throughout the body including breast tissue. With

hypothyroidism or lower thyroid hormones this will lead to a lowering of SHB G

and the increase in free estrogens.

Progesterone

A very simple study was perfor med by Linda Cowan and her team. From 1945

to 1965 a total of 1,083 women were evaluated and treated for infertility. These

women were placed in 2 groups, one having infertility because of a progesterone

deficienc y and the other having non- hormonal causes. They were then followed

through 1978 to determine breast cancer incidence.

Women in the progesterone deficiency group had 5.4 times the risk of

premenopausa l breast cancer compared wit h the second group. Cowan could not


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explain this higher risk to be anything other than low progesterone. Compared

with controls this progesterone deficiency group experienced a 10 fold increase

in deaths from all malignant neoplasms.xxvii

How might this relate to the Pisa study and The Lancetarticle? Nontoxic goiter,thyroid autoimmune disease and low levels of iodine cause subclinical and

suboptima l hypoth yroidism. This leads to lower levels of free T3 because as far

back as 1999 research has shown how T3 stimulates the ovary cells to convert

pregnenalone into progesterone. Low thyroid hormones lead to low

progest erone and according to Cowan s research this in creases a woma ns r isk

for developing breast cancer.xxviii

HuffPuff

I know your head must be spinning by now. Mine is! This chapter has taken me

by far the longest time because of so many interconnections.

One last consideration and that is environmental carcinogens and their impact

upon breast tissue. Carcinogens have been in the pub lics mind for the last 20

to 30 years. The word carcinogen refers to any substance or particle that

promotes cancer by inducing uncontrolled, malignant division and the formation

of tumors.

In 1977 a journal showed how, Iodine deficient breast tissues are more

susceptible to carcinogen action and promote lesions earlier and in greater

profu sio n.xxix

We already discussed the Paris study from 2008 which identified endocrine

disrupting chemicals found in cosmetics and pesticides leading to developmental

defects and altered thyroid metabolism with t he major target of these chemicals

being the NIS channels. This report confirmed that the negat ive effect s of these

chemicals were most pronounced in people with iodine deficiency.


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Summary

The WHO estimated 2 billion of our worlds population suffer from iodine

deficiency and our National Health Survey estimated that 36 million Americans

suffer the same. I believe these figures would be increased considerably if we

were to include those wit h iodine insufficiency. The world and especially our

nation is suffering from obesity and a host of symptoms related to the multiple

causes of low thyroid hormone symptoms, hormone deficiencies, BBD and

cancers.

I truly believe that the prevention and treatment of BBD and breast cancer must

integrate the use of iodine and iodide and must comprehensively investigate the

seven causes of low thyroid hormone symptoms and thyroid disease.

I believe that as we optimize thyroid hormone levels in the earliest stages we

will prevent hundreds of millions of women from suffering the consequences of

benign breast disease and breast cancer.

Treatment

Could I venture to say that there is a treatment for breast cancer? I wonder how

long it would take before the critics would dig their claws into this book to tear

apart the research and global stud ies Ive sited.

My suggestion then is not to treat breast cancer directly but to investigate your

thyroid hormone status and to correct any causes that may be leading to low

thyroid hormone sympto ms. Simple? Mais oui!

iLancet . 1976 Apr 24;1(7965):890-1.

iiJournal of Clinical Endocrinology & Metabolism. 1996; 81:990 -994.

iii New England Journal of Medicine. 2005 Jul 21;353(3):229 -37.iv

Extrathyroidal Benefi ts of I odine. Dr. Donald W. Miller ,Jr . ,M.D.,www.jpans.orgv

The Breast Journal . 2004; 10(4);328-336vi

Medicina 1997;57(Suppl 2):81-91.vii

Journal of Clinical Endocrinology & Metabolism. 1998 Oct;83(10):3401 -8.viii

Physiology Mosby Press 4t h

Edit ion 1998 p.912ix

Molecular Endocrinology. 2006 May;20(5):1121 -37.x

Endocrine Reviews. 2003;24(1):48-7 7.xi

Journal of Biological chemistry 2001;276(24):21458-63.


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