87. The Truth About Iodine with Dr. Alan Christiansen

Dr. Alan Christiansen 0:05

If your health is not rewarded, nothing else is really going to line up for you.

Dr. Stephanie Gray 0:12

Welcome to the your longevity blueprint podcast. I'm your host, Dr. Stephanie gray. My number one goal with the show is to help you discover your personalized plan to build your dream health and live a longer, happier, truly healthier life. You're about to hear from Dr. Alan Christensen, who is an absolute thyroid guru and who is about to present to you new evidence on how too much not too little iodine may be causing so many thyroid problems. Yes, you heard me right, too much iodine. While iodine use has been controversial for years today Dr. Christiansen is going to break this subject matter down for us. I have a load of questions for him. So let's get rolling.

Welcome to another episode of The your longevity blueprint podcast. today. My guest is Dr. Alan Christensen. He's a board certified naturopathic endocrinologist who focuses on thyroid care, who's a New York Times bestselling author whose most recent titles include the thyroid reset diet and the Metabolism Reset diet. Dr. Christiansen has been featured on countless media appearances, including Dr. Oz, the doctors and the Today show. He's the founding president behind the endocrine association of naturopathic physicians and the American College of thyroid ology. Welcome to the show, Dr. Christiansen

Dr. Alan Christiansen 1:27

Hey, Stephanie, thank you for having me.

Dr. Stephanie Gray 1:29

I'll tell my listeners more about you. I told you before we started recording, I followed you for quite a while but tell us how you became such an adrenal and thyroid guru?

Dr. Alan Christiansen 1:39

Well, I guess, you know, I got into health care from just my own personal health struggles. As a kid, I had complications from cerebral palsy, I had seizures, I was pretty clumsy, couldn't do sports, things like that. And by adolescence, I was obese, I was really happy back then there wasn't really an idea of fat shaming, because it was just what you did, it was just normal. That's around the time in which, you know, one social position starts to become salient. And I mind sucked, and I really hate it. That is a real struggle, you know, I was always into books. So you know, astrophysics, Carl Sagan, stuff like that. And, yeah, out of desperation, I picked up a bunch of health books, read them and made some sense I did some of it, I stuck with some of it. And it just changed my life. And I realized that if your health is not rewarded, nothing else is really going to line up for you, you'll never really be happy otherwise, and also realize that the key to that was information. And so it became a passion to learn more, and you know, help others connect with what could help them.

Dr. Stephanie Gray 2:39

Awesome. Chapter six of my book, Your longevity blueprint is all about hormones. And so today, we're going to focus a little bit on hormones, specifically on thyroid. So we're just going to dive in topic, every new book, talk about new findings regarding the causes of thyroid disease. So I have to prep the listeners here a little bit, we're going to dive deep, because a little bit of what we're going to talk about maybe a little controversial, and they may not be prepared for what you're going to say. So tell us what you wrote about in your book here. The thyroid reset diet, what are new findings, again, regarding the causes of thyroid disease?

Dr. Alan Christiansen 3:11

Well, we've known forever that thyroid disease has a largely genetic basis. And this is funny, we always think the genetic means my parents must have had it, it actually doesn't mean that there's a tendency towards that. But half of our genes are not from our parents, they're randomly reassigned. So yeah, so it doesn't mean it's shown up in the family, but it means their genetic tendencies towards it. And what that means is, the body can do a better or worse job regulating the chemistry of the thyroid, you know, per per our genetics, we think that's about 79% of thyroid disease. The remaining 21% is some mixture of changes in other hormones that influence that, which largely comes down to estrogen and female hormones, and then also how the body regulates iodine. What we've known forever is that the thyroid needs iodine to function. And we've learned that iodine requirements are pretty predictable.

They do differ per age category, infants, children have different requirements from one to another. And they have very different requirements relative to adults. Adults requirements are pretty brittle based on body weight. But the new thing we've learned there's been two new insights. So the the floor of iodine intake, the minimal amount we need, pretty much we know that no big differences person a person, but the ceiling, you know how much we can tolerate? And what point is there too much. That's what does differ from person to person. And for many people, you know, extra amounts are our water off a duck's back. They're pretty harmless, but they're not the people who are prone to thyroid disease. So for those who are even tiny extra amounts can be harmful. And so one insight is that this is a driver of the disease. Now there's a concept called true but useless a lot of things We know might be true, but they might not be helpful. You know, the exciting thing is that this is not one of those. So even if that is what caused someone to develop thyroid disease, it doesn't mean they're stuck with it. So the second big insight is that for many people, if they deliberately go even lower than a certain level for iodine, they have a chance to reverse their disease.

Dr. Stephanie Gray 5:22

So I'm going to try to summarize a little bit of what you just said, You're so smart. So. So you talked about this concept of iodine kind of tolerance and regulating iodine intake. So let's talk about that kind of narrow, safe range. So how much do we need? How much iron do we need per year? And like for an average patient with average weight, I guess, what do you recommend from a daily standpoint, what what do you recommend their intake cannot exceed?

Dr. Alan Christiansen 5:50

Well, I should back up even a step further. And I'm happy to talk about this in terms of micrograms. The difficulty is that that's not transparent, you know, we don't really have a good handle on what our daily intake is in micrograms. Nor are there easy ways we can test our iodine status. Happy to talk about that in more detail later. But yeah, but in terms of numbers, we've tracked many, many countries pre and post iodine fortification, and has given us really good insights on which ranges show the lowest rates of thyroid disease. And it turns out for adults, it's about 50 to 200 micrograms as far as total daily intake, that's where we see the least thyroid disease. And again, for some people, they can go above that, and not might not be a big deal. The World Health Organization has seen that somewhere around that 200 to maybe 1100 microgram range. If someone's not prone to thyroid disease, they can bump up there on occasion, probably without much harm. But the tough thing is, you don't know if you're prone to disease until you get it.

Dr. Stephanie Gray 6:50

Sure. You had a unique analogy in your book, I think you said, the amount of iodine we need per year. It's like the size of the lentil, like, teeny, teeny, teeny, and I never really thought of it in that way. And so let's talk about some ways, especially for those individuals, who are who already have thyroid disease who are more prone to needing less iodine, how are they exposed to iodine? So where are some ways they could be consuming excess iodine?

Dr. Alan Christiansen 7:16

Well, so we get it when it's fortified in salt, that's one big source. And that's directly with just salt usage, but also indirectly in other things that have salt that started in actually first was was Switzerland was the first country to do that. And the United States was second, we did that in 1924. First area was Michigan near the Great Lakes, there's an area that was called the goiter built and coming into World War One. A lot of young men were not eligible to go serve because they had goiters. And so that made the public health doctors think about this and say, hey, what can we do?

And some thought this would be the best solution. Some did not it was an acrimonious thing. There's a lot of controversy about that. And interestingly, this area was proximal to the Mayo Clinic, which was around back then as a real bastion of medical thought. And what they saw in the Mayo Clinic was now thyroid disease used to be the kind of thing that, you know, you learned about stuff in med school and a lot of things that you and I learned about, we've never seen or barely seen, there's pretty obscure stuff out there. And that's what thyroid disease used to be. In the years after salt fortification, the rate of autoimmune thyroid disease amongst women in their 30s and 40s. Went up 26 fold, not percent fold. So it went from obscurity to commonality. So yeah, so one big source is salt. So some salt has it fortified, some salt has it naturally occurring.

Dr. Stephanie Gray 8:42

Let's Let's pause for a moment there on salt because I'm someone who loves salt. I've always had low blood pressure. I feel like I need it for my adrenals and my stress, whatnot. Some of our listeners may also feel the same way. So which salt options do you approve of? So with what are how can we make better choices with our salt selection?

Dr. Alan Christiansen 9:00

We know and this is a cool thing. We'll talk more about other sources of hidden iodine. And by and large, there's easy substitutes. There's really painless substitutes for these things. So for salt, you don't have to give up salt. And not only not to give it up, but the choices that I propose are in alignment with what all top chefs recommend. So yeah, most chefs argue that we it's one part per 10,000 potassium iodide. That's how salt is fortified with iodine. And most chefs argue you can taste that that it tastes bitter that it disrupts the taste of the food. So yeah, so salt it's naturally free of iodine is readily available. My very favorite. I'm not tied into these companies. My very favorite is diamond brand kosher salt. And yeah, I've seen that. I love it because the ingredient list is salt. There's nothing else then it's just salt.

And then the shape of the crystals also just piggybacking on a lot of top chefs you know so the shape is such to where they argue that it does a better job penetrating foods, you know, coating improperly, that its structural physical shape is useful. My views on salt have evolved. You know, back in my early days in natural health, I was a fan of sea salt. And my thought was, you know, it's argued to have various nutrients, you're getting some more minerals out of the deal. Yeah, that does sound like a cool thing. But the more I thought about it, I looked at the amount of minerals we get from sea salt. So you know, case in point is potassium, sea salt has potassium, regular salt does not. So I think, Oh, if I eat you sea salt, I'll get more potassium.

Well, you do but the numbers so we need 234 or 5000 milligrams of potassium on a given day. If your daily salt intake of about a teaspoon of salt, if you swap that out for sea salt, you will boost your potassium intake by about three tenths of a milligram. So, yeah, so if you do 10,000 days worth of salt, you can get about one day's worth of potassium. Wow. It's a story. Yeah, but the same story for other minerals and salts. So when when sea salt, so once I went through them like okay, so salt is not a vitamin. Cool. So it's flavor. It's cooking. It's good stuff for those who need to put their blood pressure, like you said, and towards those goals. Yeah, I love kosher salts.

Dr. Stephanie Gray 11:15

Sure. Okay, let's go back to other areas of exposure. So what where else can we get excess iodine from?

Dr. Alan Christiansen 11:22

Well, so salts, one that does come to mind readily for people. One that often does not, is personal care products. And this one really surprised me. So we used to use iodine in hand sanitizers. And by us too, I mean, up to 2018, it turns out that somewhere around four and a half percent of iodine will penetrate healthy, intact skin. So it does go into our blood streams. And what happens is, iodine is a really useful thing. You know, it's a, it's a great disinfectant, it really makes creams stay smooth, you know, it's an antioxidant. So it's very useful in a lot of ways. And if you're making up creams at a better industrial scale, it's helpful.

And so many things that are cream based, have you included that. And what's been shown now is that the amount that absorbs is actually relevant. So it was pulled out of hand sanitizers, because it was shown that hospital workers were being harmed by it. They were getting enough in their systems to be unsafe, and many are developing thyroid disease disproportionately. And the steps have not yet been taken in terms of personal care products past that point. But if you look at the volume of things used, like like conditioner, or body lotion, or face cream, you look at the volume used. You look at the amount of ingredients that contain iodine, you look at what percent iodine, those ingredients have, you know, how much would absorb, you know how much you'd walk away with. And what happens is that if a safe upper limit for many people is 200 micrograms, you might get 10 times that by using a hair conditioner, you know, so sometimes they can really add up.

Dr. Stephanie Gray 13:01

Never want to thought, can you speak to I can't pronounce it? What is PvP stand for that you mentioned in your book? We pronounce

Dr. Alan Christiansen 13:07

PvP just fine. Okay. Holly polyvinylpyrrolidone.

Dr. Stephanie Gray 13:15

There you go. Yeah. So interestingly, my husband, which probably shouldn't even say this on the podcast, but he bought Crest White Strips, and I unpackaged them from the target bag, right? And I just thought, oh, there's going to look at the ingredients because something told me Crest White Strips are probably not healthy. Guess what the first ingredient on Crest White Strips was PVB. Wow. Okay. I never would have thought I had just read your book. I thought, Oh, my goodness. This is exactly what Dr. Christiansen is talking about. Right kind of hidden sources. Never would have known that there was iodine. You know,

Dr. Alan Christiansen 13:45

I want to be cautious. But I always want to think through like a mountain dose, just kind of like with a sea salt. And I think about that both for good things and bad things. So there's some things that a lot of our peers worry about that I don't because I've run the numbers on. And so PvP, there's a lot of it in some personal care products that I don't think are relevant. So mascara is has high amounts of PvP. But if we crunch the numbers on how many actual milligrams or micrograms of mascara is applied, how much volume is there, and how much that really comes into the bloodstream? I don't think it's relevant. So I don't think that anything that has that label is like horribly dangerous. But I do think that things that we use a fair volume of and that actually penetrate our skin are worth taking into account. Sure, sure.

Dr. Stephanie Gray 14:28

What about Carageenan? Ever we pronounce that also. Yeah, that also so

Dr. Alan Christiansen 14:35

it can be any No, I when I first started reading the book, I was concerned about that being present in a lot of consumer products. And the more I looked at things, the more I found that most companies have moved away from it. So especially, you know, I talked about dairy being another big source and then you know, non dairy options being substitutes. It used to be that many of those did use Carageenan as a texturizer. But by and large that's that's disappeared, and I think a lot of work that's been made against it has been useful in this context. Sure. What about fish oil products? Yeah, so certainly a concern I do assay my fish oil to to be that is not containing too much. As a generalization though, this comes back to the dosage consideration. So most fish oil comes in at around one to three parts per million per iodine. And for a dose of, you know, 1000 milligrams or 2000 milligrams, that tends not to be substantial. So it's something I do people want to be wary of, but there are a lot of easy workarounds for it.

Dr. Stephanie Gray 15:32

So are we mostly getting iodine from food like dairy is that our main source? So food

Dr. Alan Christiansen 15:36

is a big source of supplements are a huge source, too. And not for everyone. But for those that do consume supplements that have iodine, it can be the biggest single factor, you know, some are just iodine, but then many others have it. You know, one recent study looked at prenatal vitamins. And they took 120 of the most popular ones, some are prescription, some are not. And they randomly sampled a set of 70 out of 120. And they asked aid the iodine content. And they compare that against the labeled iodine content, you know, what the product said it had, versus how much it actually had when they measured it. And it turned out that not a single product was in the ballpark, like not one products within 5% of its labeled iodine content. And a lot of them were two or three or four fold above their labelled content well. So for many people, any labeled any amount added in can be too much if they're trying to manage their thyroid function. But people should know that what they're taking may not be what they think they're taking.

Dr. Stephanie Gray 16:36

Sure, sure. Good point, I want to go down both the supplement and the food route. So let's bring it back to food for a moment here. So yeah, you can correct me if I'm wrong here. But I think another point that I took from your book is that a lot of individuals who have the autoimmune Hashimotos thyroiditis, who go gluten dairy egg free may see reduction in their thyroid antibodies and improvement in thyroid function, which from a functional medicine standpoint, we think, Okay, well, they're reducing inflammation. And you know, that's likely very helpful for them. But I think in your book, the other parallel you're drawing is that well, their, their thyroid may be improving, because they're reducing their iodine by taking those foods out, is that correct?

Dr. Alan Christiansen 17:16

That's exactly correct. And you know, I've struggled with that, because I've heard many people and many practitioners say that they've seen some do better by making those changes, and then all look at the medical literature. And oftentimes, those changes have been looked at in controlled settings, especially the gluten element, there's a lot of good studies, looking at how gluten affects people with celiac disease and thyroid disease, you know, and it doesn't seem to pan out, it doesn't seem to be a relevant variable. But yet many say that in their experience, it seems to. And so I think this may be the solution. If we look at our total source of all the various contributors in the diet to iodine, they've been rather steady, with the exception of two categories. And a change in iodine in two food categories, has roughly tripled the iodine intake in the last several decades. And that's, that's processed grains and dairy food. So the amount in those two categories has gone up. You know, we've gotten it from other sources, but those sources really haven't changed much, but those two have.

Dr. Stephanie Gray 18:12

So what happens when we exceed? Well, I guess maybe I should back up like how do we do we know at what rate we excrete iodine? Or is that the problem that we're not excreting, and we're getting this huge burden of iodine? And that's making the thyroid quit working? Can you explain the dilemma or the problem with too much iodine? And how that impacts the thyroid?

Dr. Alan Christiansen 18:29

Yeah, well, for starters, we've got to take all of our valid or valid intuitions about how nutrients work and just throw them out the window, because none of them apply to iodine, you know. So we got to start. You know, we take vitamin C, and there's arguments about, oh, a spec will prevent scurvy. But of course, more than that is better for optimal health. And if you take too much, you're not going to die from that, you know. So we've got these intuitions that are largely valid for most nutrients, but they just don't apply. So here's some of the reasons why it's different. We only know of one crucial role that it has, and in only one part of the body. And the other big thing is that the quantities of it in play, so the amount of it in our bloodstream is not sufficient for its chemical purposes. And that's not true for other nutrients. So it's got a pump, it's got a designated concentrator, it's called the sodium iodide, symporter. And yeah, the basal circulating amount of iodine could not allow our thyroid to work.

So we pull it in and we concentrated against a gradient. So the amount of iodine in the thyroid is 50 to 200 fold above what it is elsewhere in the body. So it's a separate compartment. And iodine is oxidized within the thyroid. So now to be more precise, we really want to say IO died, because by and large when it's in the diet, in the gut in circulation, it's in a reduced form called IO died, but there's an enzyme called thyroid peroxidase. That oxidizes that into iodine. So now it's become a hot potato. And I get this image of like the scientist with the big gloves and the long tongs holding this smoldering beaker at arm's length. You know, it's kind of like that. It's something that's useful, but it's dangerous. And so we make a little bit, just rewind it. And everywhere else in the body, we do not have iodine, because we don't have the tools to make it or to tolerate it. Now, the one difference is that if we're if we ingest so much that it spontaneously makes iodine, then it becomes fatal.

And it was actually a popular means of suicide 100 years ago. So yeah, it's dangerous and excess. Now, because the thyroid concentrates it, there's a lot of checks and balances, and one of those just shuts off all the thyroid machinery when there's too much iodine. And if that wasn't there, if it kept on concentrating it and running the assembly line, when we had more iodine, we would make radically unsafe amounts of thyroid hormone. So to prevent that, we just hit a switch, we shut down the whole assembly line, and we stopped making thyroid hormone when there's too much iodine. That's not intuitive. The other thing is that since iodine is a source of free radicals, that's why it's a disinfectant. When there's a little bit extra inside the thyroid, it makes the thyroid damaged and it creates an environment that recruits immune cells, and they start perceiving thyroid structures as being foreign. And that's basically the onset of thyroid autoimmunity.

Dr. Stephanie Gray 21:31

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Now let's get back to the episode. Interesting, interesting that I want to ask you five more questions based on that. I want to go back to back to where you're saying we know the one organ that iodine has a role in right. Yeah. What about patients who believe iodine is helpful for breast like for fibrocystic breast health whatnot. Even in my fellowship program, I remember Jonathan Wright saying there was a case where they actually painted the cervix with iodine and right there on you know, they there was a demonstration the patient's fibrocystic breast tissue basically just melted away dissolved. Like there are some compelling case testimonies, not that I have done that with my patients to the benefits of high dose iodine, you know, for other organ systems in the body. So what's the rebuttal? Or what do you say about the evidence there?

Dr. Alan Christiansen 23:09

For sure. So what I was saying was iodine requirements, not the same as iron metabolism. So now, the device that pulls iodine inside the thyroid is called Nia is the sodium iodide symporter. That is present in other tissues. And some of those reasons are just embryologic overlap. Some of the tissues that evolve in form into thyroid tissue are also multipurpose and made into other parts of the body. So in some cases, and is shows up elsewhere, not for reasons that it's used there. But just because there's common embryologic origins. Now, the one exception is breast tissue. And I was saying before how the basal amounts of iodine in the serum are not adequate for the thyroid. They're not also adequate nutritionally for a nursing fetus. So the breast tissue has the expression of this same concentrator, and that allows breast milk to have an adequate concentration of iodine.

Now, not true for the nutrients, the nutrients in breast milk pretty much parallel the nutrients in the bloodstream, with the exception of iodine because we concentrate that, so then we think about the role that NIS has outside of lactation. And it turns out that as a sodium iodide symporter, as a sodium pump, it does also pull fluid inside of breast cells. So it causes a hypertrophy of existing cells that they swell. And we now know there's a spectrum of NIS activity. So non lactating women with healthy breast tissue, there's no real active in is activity, lactating women, there's more expression, the next step up is now called Fibro adenomatous breast disease since B fibrocystic breast disease, and in that case, there's an exaggerated activity of NIS expression. And so what happens is part of the mechanism of this disease process is that device that pump is causing fluid retention, and there's cellular hypertrophy, and there's pressure from that and there's pain From out.

Now, if we go back to what I was saying about iodine in the thyroid, a lot of iodine stops the thyroid nuts because it stops and is. So we know about this like in the case of Graves disease, if someone's thyroid is putting out fatal amounts of hormone, the only way you can stop it in that moment is to give a massive amounts of iodine. That's like the most aggressive way to stop it and those worst case scenarios. So with fibrocystic breast disease, if you give a high dose of iodine, you can stop the expression of NIS, you can stop the activity that pump and you can lower the overall hydration status in the breast tissue. Many took that factoid, and misinterpreted that to mean that these women had a higher nutritional need for iodine. It's important to know that nutrients can work as nutrients, they can also have pharmacologic effects, they're independent. You know, niacin is a great example of Ouch, we need it for turtles is a B vitamin, and in massive amounts, it lowers an enzyme that makes cholesterol.

So it would be a misunderstanding to say that cholesterol elevation is a nice and deficiency and that people only reverse that with a massive dose. No, it's a pharmacological of niacin. And so to have iodine has pharmacologic effects. And so a pharmacologic effect of iodine is that it lowers the activity of NIS in breast tissue. So then the other speculation has been made is okay, if there's this thing going on fibrocystic breast disease, and with with the mistaken thought that it was because of nutritional requirements for iodine, then some speculated that there may be a similar effect occurring with breast cancer. And the plausible piece of data that seems to fit that is, oh, Japanese women, they consume more iodine, they have less breast cancer. So it seems to SureFit that iodine would be prevented for breast cancer. And what we now know is that that continuum of NIS activity, again, the basal no amount is non lactating breast tissue.

The peak of that is breast cancer. So breast cancer has the most exaggerated NS activity. And Japanese women have less breast cancer. But of course, their identity is not the sole difference. There's many other differences between them and other groups of women. And they've shown that within Japanese women, you can take groups of them, and you can look at those who do develop breast cancer, some still do. And you can look at those that don't. And their iodine excretion predicts their breast cancer risk. So the higher they are in terms of their iron intake, the more likely they are to develop breast cancer,

Dr. Stephanie Gray 27:23

which is the opposite of what I yeah, I would have thought,

Dr. Alan Christiansen 27:26

right. And this has been shown in other cultures as well. And we also now know that because of this NIS activity, there's research taking place as to perhaps radio iodine may be a useful treatment for breast cancer, because it preferentially takes up iodine like thyroid cells do. So yeah, there's been talk about iodine being a screening tool for breast cancer risk, but also as a treatment for breast cancer. So this is one of many cases to where ideas that have gotten popularized in one group are pretty much the exact opposite of what biomedical research tells us.

Dr. Stephanie Gray 27:59

Fascinating. Okay, so for the listeners, again, I got to dumb this down a little bit.

Dr. Alan Christiansen 28:04

Basically, if you were fearful about lowering your iodine intake, because you're worried that it might hurt your breasts? No, probably the exact opposite

Dr. Stephanie Gray 28:11

opposite. Literally the opposite. Yes, you summed that up well. So I want to talk about supplements. And I think I may bring in something another piece here that I wanted to talk to you about together on this topic. So from a supplement standpoint, historically, like through my functional medicine, training, I've been taught iodine is beneficial for thyroid health, and therefore most thyroid support products are going to contain some iodine, right? I think T four and T three are literally made out of iodine like we'd need iodine. But essentially, you're saying we're getting too much iodine between the combination of food and supplements and personal care products and whatnot right? Then, so you're you recommend which I want to get to at the end here, the diet that you propose, but you're also recommending that we screen our supplements.

So, literally, you're saying prenatal vitamins have iodine, a lot of thyroid support products have iodine, multivitamins are going to have iodine that we need to be screening. I want to bring in kind of the Brownstein camp here. I did mention Dr. Bronson in my book in chapter six. Because at that point, I was in agreement that I thought, Okay, well, we need iodine. And he is in the camp that we need lots and lots of iodine. So how do you kind of rebuttal that? And that? Do you feel like the literature that he kind of proposes that we need high dose iodine? Do you just feel like there's not? Do you feel like there's not evidence to support that?

Dr. Alan Christiansen 29:29

Yes, very strongly, and we should be more accurate. It's not fair to call it the Brownstein camp. This is really the Abrams camp. So this was not unique to David Brownstein. This is data that he just took directly from Guy Abrams. Guy. Abrams was a gynecologist from LA he's deceased. He was a he was a kind man. He was a dear man. I spoke to him many times in great length. I read all of his work followed all of his references. So I was in a window of opportunity that David bouncing was in as well. We were really paralleling our interest in Abrams work. Other differences that I also read outside of his work? It was highly theoretical, it was highly based upon these these plausible mechanisms. And much of the ideas were plausible. And if you think about it, and the way we think about other nutrients, a lot of it seems intuitive.

You know, we think that if the thyroid needs iodine and the thyroids in it, does it need some fruit to work for no debate about that. And not everyone's getting too much, I don't want to make that sound to be the case. It's not low, in all cases, all people. But the idea that the amounts we need are far in excess of what everyone else has said, is simply not true. We've got a massive data set in the last century of how iodine influences thyroid disease. And it's intuitive to think that if a nutrient does something more of a nutrient would do more of that same thing, but that's just not how nutrients work in the body. You know, we think about a nutrient almost like a gas pedal, the harder you push it, the faster the car goes, you know, and I think about the more like keys, if the keys not there, your car will not budge, you know, I've driven Jeeps for like 30 years, I do a lot of time in the backcountry. My Jeeps aren't fast, right? That's just not how they are. And if I got 20 sets of keys, my jeep would not be a Ferrari, it's just not how it works. If the keys missing, the Jeep will move. On the other hand, if I'm driving along, and there's some mechanical problem taking place in the Keys already in the ignition, more keys also won't help without.

And there are times like in this situation where more keys are counterproductive. So yeah, so these are ideas that seem internally like they might make sense. But once you've hold them up against the massive datasets we have from the last century of looking at iodine for literally 1000s of different populations, mechanistic models, interventional trials, we've seen all this. And it makes me sad, because if you also go to medical databases, you'll find many case reports. And there's many of these written up very detailed about how people have followed those types of guidelines to catastrophic results. There's now five published cases of babies born with congenital hypothyroidism, and that may permanently ruin someone's whole life arc. And these papers, specifically state brown stains work, and they specifically state his protocols, and that the women were following them as they were told to do in his books.

So yeah, these things are talked about. They're not safe. I don't doubt that they were made with good intent and with genuine belief, but it just doesn't align with the facts that we have. Yeah. Good answer. I'll share a link with you. I've given a better answer to this. I've just gone to like tons of references that they've shared. And I've talked to this in about a 20,000 word blog post that I wrote about the whole controversy, and I'll share that for yourself and your listeners, and anyone that wants to go through that in full detail. It's, it's available.

Dr. Stephanie Gray 32:39

Thank you. Thank you. Thank you. Let's go back to supplements for a moment. So if we're not going to give iodine to support thyroid function for patients who are lower end, can you briefly mention I know you, you have thyroid supplements, as well? What are your top agents like the top nutrients that support thyroid function that you're for?

Dr. Alan Christiansen 32:57

Well, your thyroid is really a homologue of your body. So all nutrients have some relevance. Selenium may be the most important. The biggest question I get that I think about is what can help someone with thyroid disease, you know, if they're already on treatment, or not yet in treatment, what can turn that around for them? And I don't see a lot of examples to where a lack of nutrients is the cause, and to where that really reverses it. I've not really found evidence published about that being a factor. So I do think their health is served and that any outcomes they embark upon will be more effectively met. If they're not missing some key nutrients. But I don't see that as a standalone solution for thyroid disease.

Dr. Stephanie Gray 33:32

Well, let's talk about your solution, which is gonna thyroid reset diet. Can you briefly I mean, you map it out very well, in your book, different phases? Can you briefly summarize for the listeners, what you propose then so for patients who have thyroid disease, who iodine intake is too high? What is the the reset diet in your book, you propose to help them get rid of iodine and improve thyroid function?

Dr. Alan Christiansen 33:56

One thing I'd love to if no one takes anything else away from the talk than this, this is one thing I hope you'll hold on to. If you hear things and you're not sure if they're true or not in the medical world, just ask yourself Is someone talking about how something might work? Or what's actually been shown to happen? You know, it's very easy to get deep into mechanisms. This does this as mitochondria, therefore, it's good for us. But it's actually been shown to do something in a living human, you know, that's in a meaningful way. This is the part that matters the most to me, we can make mechanisms for anything we want all day long, both directions, the arguments, no problem. So what really compelled me was one first clinical trial. And in this clinical trial, a group of people were taken who had advanced thyroid disease, they were not on medication. They had been hypothyroid for between four to five years.

And for some of your listeners, this might make sense, but their average TSH scores were 14.1. So they were quite a ways away from normal Fairbanks never far out of range. There's nothing subtle about it. And they had also been tracked for about the past two years to show that they were steady at the state. They weren't in the process of random fluctuations, they were pretty much stabilized and plateaued where they were. Many in the group had worse scores so that TSH scores in the 50 to 200 range will come back to them. So for a three month period, what they had them do was lower their iodine intake, nothing else. Now, this was inspired because people have been asked to deliberately lower their iodine intake before they do medical procedures, there's two that are done in which your thyroid has to be hungry for iodine for the procedure to be effective. Sure, and many had observed that those preparing for the procedures had spontaneous improvements to their thyroid health, the more became known about the mechanisms of excess iodine being harmful, the more some wondered, hey, maybe this was actually helped. This is why they got better.

So they did a formal trial to test out. And in the three months after they got their iodine, they target the writing below 100 micrograms, they track these people. And so they were tracked beforehand for their iodine status. And we can talk more about the how they were tracked afterward. And it turned out that we were humans, not everyone was compliant. So some people just did not get to a therapeutic lower level of iodine. So their outcomes we have to take with a grain of salt. Sorry about that. But salt. So yeah, so before we even talk about who did to do the die, and who really didn't 78.3% of them had normal thyroid function in three months. They didn't go on medication, they didn't take supplements, they didn't meditate, they didn't clean up their diets, tons of things that might have been good in various ways they didn't do all they did was target a reduced iodine intake, and 70.3% were perfectly normal. So if that's all we had, that would be awesome. I've watched for years and tried to find things that helped thyroid function.

And everything else I've seen in terms of diet and lifestyle has been subtle at best. It's been maybe small changes in scores of a few percent or subtle changes in indirect markers of the disease like antibodies, but nothing like that. Nothing to where the disease reversed for like most people in it. I've never seen anything like that before. So 70.3% were totally better. So that's not all. If that were all, that'd be great. But now let's think about the fact that some people didn't do the diet. Okay, so they were part of those who didn't get better. The other consideration is that some of the people that didn't get better, did get better, but they didn't come back to normal ranges. They were the ones who had the massively high TSH scores. So they came down by on average 50%. But they didn't yet come back into the normal range. So if we look at it and say, okay, of those who really did do it, how many actually got better in a meaningful degree? That number is 97%. So 3% of people who did it saw no useful change their thyroid health. So now, yeah, rested? Yeah, the rest of them did. Yeah.

Dr. Stephanie Gray 37:55

You probably know vitamin D based on its relationship to seasonal affective disorder or sad in the winter. And it's true. People experiencing sad generally have low levels of vitamin but vitamin D isn't just beneficial during the cold, dark winter months. I've tested 1000s of my patients vitamin D levels over the years and rarely do I find the patient doesn't need to supplement regardless of the time of year. Vitamin D is a steroid vitamin A group of fat soluble pro hormones that are best known for the role they play in supporting bone health, and aiding in the absorption of calcium and phosphate from the gastrointestinal tract. However, a growing body of research highlights its important role in supporting other body systems as well, including cardiovascular and blood sugar balance, as well as increasing musculoskeletal strength, neurologic and immune function enabled by its ability to target over 200 different genes throughout the body.

At the same time, deficiency and insufficiency of this important nutrient has reached epidemic proportions around the world, making the achievement of optimal levels extremely important to overall health, known as a sunshine vitamin, yes, you can get some from the sun, but fish and milk are also decent sources as well. But if you listen to this podcast, you know, I'm not one to recommend dairy. So it's best to supplement and it's best to have your levels tested to see how low you are and how high of a dose you need to take. We carry 1005 1000 international units of vitamin d3 With and without Ketu as well as a 50,000 iu dose pack. Usually patients take that high dose pack short term, use code vitamin D for 10% off these products at your longevity blueprint calm. Now let's get back to the show. So is this something I don't know? Was your book published this year? Is this a 2021 year application? Yeah. So obviously you've had this knowledge prior to writing the book. Do you use to read the book? How long in your clinics? Have you been implementing this? And are you seeing this over and over again with your patients then to speak from experience?

Dr. Alan Christiansen 39:48

I am I do have to say that? I've had a thyroid focus practice. I don't practice I haven't practice for about seven years now but I oversee my doctors and that's been like 97% of what we treat is thyroid disease. As such, we really don't see people that are not under treatment they already are before they come in to see us. So we're seeing a different group. There have since that book was published, there was a large study done like that, except for those on thyroid treatment. And in this study, they gave very, very basic recommendations about avoiding iodine supplements avoiding iodized salt, avoiding seafood, they didn't go in much depth passed out. But what this study saw was that of those on treatment 84% could successfully reduce their treatment with no ill effects. And 50% could basically discontinue treatment with no ill effects with no symptoms and stable thyroid levels. And yes, we've seen similar trends.

Dr. Stephanie Gray 40:43

Wow, that's amazing. So if you're listening and you want to try reducing iodine in your diet, Dr. Christiansen maps out how for you to do that in his book. Absolutely. I want to ask your opinion on another, I guess back to diet diet trend, which is intermittent fasting, Are you for or against that with Ira disease? Like what is your theory, good or bad?

Dr. Alan Christiansen 41:03

Well, good or bad? If it's after this, so there's two scenarios here. So it's after the fact someone says, Hey, my weights never budged. I did this now I lost weight. I'm for it. So now, the other way I the question gets asked is, I've tried everything I don't know what to do next is the data suggest this will work for me, like Well, the biggest datasets we have on intermittent fasting and thyroid disease come from Ramadan, actually, there's the largest number of people that we've had that have been tracked, and they're doing something a lot like intermittent fasting, they don't eat throughout the daylight hours and then eat at night.

And there's been three large studies in which their thyroid function has been tracked. mechanistically, we know that when someone's food intake goes down a lot, or their food timing changes radically, or their carbohydrate intake changes, a lot goes down greatly, the body can perceive that they're in a starvation state. And the thyroid is one of the biggest levers that controls our basal metabolic rate. So when the body perceives a starvation state, it often lowers thyroid output, and it lowers the activation of thyroid hormones in circulation. So we know that from mechanistic models, and we've seen that from ketogenic diets with children things along those lines. So in adults in Ramadan, the average TSH scores of those on their retreatment go up by about 50 to 75%. After the course of doubt, there hasn't been long term follow up to see if this has longer lasting effects after that's over. But we do know that in the weeks and first month afterward, that the thyroid has to work harder by about 50 to 75%.

Dr. Stephanie Gray 42:40

I have not heard that. Happy to hear that. Okay, wonderful. You're a wealth of knowledge. You're so smart. Thank you so much for coming on the show today. I have just a few more points here. I definitely want to make sure listeners can connect with you. So where can they find you? And what is this amazing free gift that you have?

Dr. Alan Christiansen 42:55

So easiest source is Dr. christiansen.com, Dr. christiansen.com. And one more thing, if you go there, you'll see my social media links. I do something called Office Hours live. I've been doing this lately, most Mondays, three o'clock Pacific, a jump on all the channels on Instagram, Facebook and YouTube Live. And I just talked for about an hour and field some questions. There's usually a few things I've got top of mind that I think are worth sharing. But I'll start with Sure. But then I watch for really good detailed questions. And I have some conversations with people. So that that's a really easy way to just connect actually in person. Yeah, office hours live. So the story we talked about the whole idea and thing. Yeah, it's counterintuitive. It's surprising. And it's often just shocking. These hidden sources. So I filmed a well made Docu series all about that. This is called the invisible iodine. And it's a seven part series and you can your listeners can check that out for free. We've given you a special link by which they can get to that and they can learn a ton more and figure out how they might wish to pursue this if it's relevant for them or not.

Dr. Stephanie Gray 43:54

I absolutely want to watch that myself. Wonderful. I conclude every episode with your top longevity tip. I'm sure you have several. But if you had to pick one, what would your top longevity Tip Be?

Dr. Alan Christiansen 44:04

Yeah, that's a good one. You know, I've thought a lot about that I've given different answers. When I thought about this in different times. At this point in my life, I think it's going to be speaking your truth, no and living living your truth. When I wrote the adrenal reset diet, there was the Whitehall two study that had come out rather recently. This was done on British Civil Servants, pretty big age range, like 20 to 70. And it just washed them for a four year period and saw you know who died and who didn't. And there was a lot of health metrics that were tracked on these people. Some were common ones like blood pressure, cholesterol, they also tracked markers of social stress, including cortisol slope. And what they saw was that social stress was a stronger predictor of early death than any other factor was. So. So yeah, I think that we're in a time in which there's so much divisiveness and I think we really walk around on eggshells quite a bit of different views than we Do and I think we hold in a lot. I think that we don't engage in a lot of conversations that could be healthy and could be productive. So I think right now my my biggest thing is trying to speak once truth

Dr. Stephanie Gray 45:12

is beautiful. Yeah, good timing for that. Well, thank you so much Dr. Christiansen for coming on the show today and shedding light on this. I'll still say a controversial topic. But thank you for for sharing just the this idea of iodine intolerance, intolerance and hopefully these tips that you offer today will help qualify listeners with their thyroid health and I encourage they all connect with you. So thanks again for coming on the show.

Dr. Alan Christiansen 45:33

My pleasure. Really good questions. I appreciate the interview.

Dr. Stephanie Gray 45:39

Well, that was definitely an interesting interview. Dr. Christiansen has the best laugh. I appreciate his approach to it and regulation and look forward to watching his documentary and as a reminder, check out the show notes for his links and His free gift. Be sure to check out my book your longevity blueprint. And if you aren't much of a reader, you're in luck. You can now take my course online where I walk you through each chapter in the book. Plus for a limited time the course is 50% off, check this offer out at your longevity blueprint.com and click the Course tab. One of the biggest things you can do to support the show and help us reach more listeners is to subscribe to the show. Leave us a rating and review on Apple podcasts or wherever you listen. I do read all the reviews and would truly love to hear your suggestions for show topics guests and for how you're applying what you learn on the show to create your own longevity blueprint. The podcast is produced by the team at counterweight creative as always, thank you so much for listening and remember, wellness is waiting.

The information provided in this podcast is educational. No information provided should be considered to be or used as a substitute for medical advice, diagnosis or treatment. Always consult with your personal medical authority.

Transcribed by https://otter.ai