Also presenting at the Science of Nutrition in Medicine Conference this year was Professor Eastman who is a world-renowned Australian endocrinologist with a primary interest in global iodine deficiency. He is also Deputy Chairman elect of the International Council for the Control of Iodine Deficiency Disorders (ICCIDD) and is frequently consulted by Australian health authorities and medical groups on the issue of iodine deficiency in Australia. Boy did he have some things to say…and it kind of went like this:
- Substantial epidemiological research has shown that 95% of euthyroid patients have a TSH between 0.04-2.5 mIU/L (note the current reference range suggests results < 4 mIU/L are okay, Eastman strongly refutes this)
- The mean TSH in a disease free population is actually 1.5 mIU/L
- In fact Professor Eastman was emphatic that the mean TSH in iodine replete individuals is actually 1 mIU/L
- While acknowledging the limitations of spot urinary iodine testing for the assessment of individual iodine status, he genuinely seemed at a loss to understand GPs reluctance to refer for this test when patients exhibit risk factors for hypothyroidism and in his article (Screening for thyroid disease and iodine deficiency. Eastman CJ. Pathology. 2012 Feb;44(2):153-9.) he argues strongly for screening of all mature age women, pregnant women (1st trimester) and school children, using the urinary iodine and TSH together
- And while we’re stirring the pot how about this: Professor Eastman says that hyperthyroid individuals who have a low urinary iodine result should still be given judicious iodine! Such sacrilege!!
- But wait…before you get too excited and join the ‘too much iodine is never enough… just look how much the Japanese eat’ camp…I was very relieved to hear Professor Eastman remind the audience that while the Japanese diet does provide substantially more iodine than the Western one, it is not without problems, with very high rates of thyroid disease especially thyroid cancer and in fact, Japanese health authorities are concerned about excessive intake and are currently investigating ways to cut back. And lastly, if you’re not convinced by this, he says perhaps you should talk to one of the many litigants in the current class action against Bonsoy, who developed severe thyroid diseases thanks to excessive iodine exposure from the milk (7.5mg/cup)!
So keep arguing for urinary iodine assessment and for addressing individuals with ‘within range reference results’ for TSH that are clearly not healthy ones. Check out Professor Eastman’s article, there’s a goldmine of information in there and while we’re talking about incredible resources in nutritional medicine – take a moment out to thank Dr. Tini Gruner (previously from Southern Cross University) for her significant contribution to naturopathic nutrition education in Australia. She was a mentor and inspiration to me and many others. She sadly passed away this week and we will miss her dearly.