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calcium level that needs to be obtained. This EH EDVHG RQ D FRKRUW RI RQO\ WZHQW\ VHYHQ KRVSLWDO ZRUNHUV LQ
level actually shows that more people are now Edinburgh, Scotland, set by Professor Anthony Toft, the lead researcher
running calcium levels that are too high, contrib- of that study. There was no evidence that this cohort of study subjects
uting to heart attacks, kidney stones, joint and completely excluded anyone with mild hypothyroidism.
tendon problems, etc., and that there is too much Based on several epidemiological studies showing that TSH levels
public emphasis on the need for calcium in most DERYH P 8 / ZHUH not normal, the hundreds of thyroid and lab experts
people. from around the world who make up the NACB concluded that, rather
WKDQ RU WKH QHZ UDQJH VKRXOG EH FRQVLGHUHG DV $QG
OVER-RELIANCE ON TSH LEVELS of course this range only applies when there is a question of primary hy-
I kid you not: TSH is regarded as the most pothyroidism on its own.
accurate measure of thyroid function simply If there is any element of secondary, tertiary or non-thyroidal-illness
because the test itself is very accurate for what (NTI) hypothyroidism present, then the normal range cannot be any higher
it measures: The thyroid stimulating hormone is than 0.01-1.00, in my opinion. In practice this is the range that I aim for
not a thyroid hormone and its level in the blood is LQ PRVW RI P\ WUHDWHG FDVHV RI K\SRWK\URLGLVP ZKLOH NHHSLQJ WKH )7
DQ LQGLUHFW WHVW RI WK\URLG IXQFWLRQ LQÀXHQFHG E\ and FT3 levels optimal for their age and medical condition—most often
many factors other than the amount of the thyroid high-normal but scaled down from that to the mid-range or even slightly
hormone levels in the blood! It is assumed that below that in frail, cardiac or very elderly patients.
because the TSH test is an accurate test for the In January 2003, the American Association of Clinical Endocri-
substance that it measures, that it is an accurate QRORJLVWV VXJJHVWHG WKH UDQJH VKRXOG EH DQG VDLG WKDW WKLV ORZHU
gauge of thyroid function! As I said, the people range would now mean that 13 million more Americans would be treated
making this judgment are intelligent people; I for hypothyroidism annually. A year or two later, Carol Spencer, one of
can only assume they have a mental blind spot the top researchers of the Endocrine Society, and its reigning president
about this. at the time, Leonard Wartofsky, MD, MPH, suggested a range of 0.3-2.0
The other issue about the TSH test is the —which I had been using since I started treating hypothyroidism in 1989!
long time that it is taking most physicians, labo- Unfortunately, to this day, the labs and most treating physicians are still
ratories and medical journals to accept the newly using the old, higher range. It should never be forgotten that these ranges
UHFRPPHQGHG UDQJH RI DV QRUPDO ZKLFK apply only for the diagnosis of purely primary hypothyroidism. The range
was set by the National Academy of Clinical Bio- GURSV VLJQL¿FDQWO\ IRU WKH RWKHU W\SHV DORQH RU LQ FRPELQDWLRQ ZLWK SUL-
chemistry (NACB), back in September 2002. mary hypothyroidism.

Before that, the normal range was considered to As a psychiatrist, I had already learned the importance of good thyroid

SERIOUS THOUGHTS ABOUT IODINE

It is well known that the original cause of most cases of hypothyroidism was iodine deficiency. In an effort to deal with
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that issue in a cost-effective manner, public health officials called for the substitution of iodized salt for non-iodized salt on
all our grocery store shelves. This measure has taken the edge off the iodine deficiency problems of yesteryear—although
not by any means completely, as good measurements of both organic and inorganic iodine levels in patients’ blood or
urine would show. But has anyone in thyroidology stopped to recognize the fact that we have actually substituted many
more cases of autoimmune thyroiditis and primary hypothyroidism for the relatively fewer cases of iodine deficiency
hypothyroidism that existed previously?
Could the mechanism for this phenomenon be that we used the wrong form of iodine—inorganic instead of or-
ganic—as a food supplement, and that this harsh form of iodine actually damages the thyroid tissue enough to trigger
our immune systems to react against it? I believe this is a question that, at the very least, deserves serious consideration
and investigation. I have laid out this case to physicians and researchers who have focused on iodine deficiency, and
who recommend taking Lugol’s liquid iodine or Iodoral tablets—which contains inorganic potassium iodide as well as
organic iodine—but none of them has responded. Iodide is inorganic and harsh, burning flesh and other living matter
with which it comes into contact; iodine is organic and gentle, usually cushioned or bound to proteins or other organic
matter, providing the benefits of iodine to living matter without the harsh burning interactive effect.
In the mean time, I am recommending that my patients forego the iodized salt on the shelves of their grocery stores
and use genuine 80-mineral sea salt instead, which also tastes much better! And, if their organic iodine serum level is low
(measured at Boston University’s Iodine Research Lab), to take 4-6 drops of organic iodine (such as Thyactin by TriMedica)
after breakfast and supper daily (8-12 drops per day) rather than Lugol’s liquid iodine or Iodoral tablets.

SUMMER 2009 Wise Traditions 31