Dr Abraham's Misrepresentation of Iodine-Thyroid Research in June 2008 Original Internist

[Guest guest]

I was diagnosed with Graves Disease in 2004 and used Methimazole treatment for 1.5 years followed by naturopathic remedies (Lugol's Solution, Bugleweed and Lemon Balm) thru last January. Although I am euthyroid with normal TSH/T3/T4 and high normal TSI, my TPOAb are still above normal (185) and I've been experiencing several hypoT symptoms for the past 1-2 years. As a result, I am considering supplementing with Iodoral or Iosol provided there exists sufficient evidence that doing so will not increase TSI or TPOAb. I have been gradually perusing PubMed and reading information published by orthoiodosupplementation advocates and researchers such as Guy E. Abraham MD, Brownstein MD, Shevin MD DHt, MD and Byron J. s.

I recently came across an article written by Dr. Abraham in the June 2008 issue of the Original Internist, titled " Facts about Iodine and Autoimmune Thyroiditis, " in which he states the following: " Since the 2006 publication by Teng, et al,[1] reporting a positive association between iodization of salt in China and autoimmune thyroiditis (AIT), I have received a lot of calls and e-mails questioning the use of iodine in patients with autoimmune thyroiditis. Iodophobes were elated with this publication, which vindicated their iodophobic viewpoint. However, a year later in 2007, the same authors, using the same data[2] retracted their original statement and concluded that: 'Chronic iodine excess does not apparently increase the risk of autoimmune thyroiditis.' "

Dr. Abraham references two journal articles: [1] Teng W, et al, 2006 and [2] Yang F, et al, 2007. Full bibliographic and URL references for these are listed below. I downloaded and read the full text PDF of each article, both conveniently available for free. Much to my surprise, I discovered that Dr. Abraham had blatantly misrepresented the research of Yang F, et al, 2007. The quote he references, " Chronic iodine excess does not apparently increase the risk of autoimmune thyroiditis, " does not appear anywhere in the referenced article. The following similar quotes do appear:

" Chronic iodine excess does not apparently increase the risk of autoimmune hyperthyroidism, suggesting that excessive iodine intake may not be an environmental factor involved in the occurrence of autoimmune hyperthyroidism. " [Yang F, et al, 2007:403]

" Chronic iodine excess does not apparently increase the risk of autoimmune hyperthyroidism or influence the incidence and outcome of subclinical hyperthyroidism, which suggests that chronic excessive iodine intake may not be involved in the occurrence of autoimmune hyperthyroidism as an environmental factor. [Yang F, et al, 2007:407]

Dr. Abraham's quote is not even a valid paraphrase of Yang F., et al, 2007 because the term " thyroiditis, " referencing in this context hypothroidism, has been substituted for the term " hyperthyroidism. " Dr. Abraham's quote is blatantly false.

Dr. Abraham uses this " quote " to assert that Yang F., et al, 2007 have explicitly retracted the claim made in their 2006 article [Teng W, et al, 2006] that adequate or excessive iodine intake may result in autoimmune thyroiditis. This assertion of a retraction by Yang F, et al, is also false. Their 2007 article does not contain any implicit or explicit retractions. In fact, the authors conclude exactly the opposite:

" This may suggest that in the comparison of the tendency of hypothyroidism, partly induced by thyroid autoimmunity due to the elevated iodine intake, long-term excessive iodine intake as an environmental factor does not seem to be involved in the occurrence of autoimmune hyperthyroidism. " [Yang F, et al 2007:407]

It is disturbing and disappointing that Dr. Abraham has chosen to blatantly distort the research of Teng W, et al, 2006. I appreciate the work that Dr. Abraham has done to educate patients, practitioners and researchers about the history, unexamined assumptions and potential therapeutic benefits of iodine supplementation. Unfortunately, however, it appears that he has become overly invested in iodine's unequivocal usefulness at the expense of necessary objectivity.

Please share your thoughts, feedback and comments.JimREFERENCESAbraham, Guy E. " Facts about Iodine and Autoimmune Thyroiditis. " Original Internist, 2008; 15(2):75-76.http://www.clintpublications.com/TheOriginalInternist.html

[1] Teng W, et al. " Effect of iodine intake on thyroid disease in China. " New England Medical Journal, 2006; 354:2783-93.http://content.nejm.org/cgi/content/abstract/354/26/2783

[2] Yang F, et al. " Chronic iodine does not increase the incidence of hyperthyroidism: A prospective community-based epidemiological survey in China. " Eur J Endocrinol, 2007; 156(4):403-8.http://www.eje-online.org/cgi/content/abstract/156/4/403