The Monitoring of Thyroid Peroxidase (TPO)

Thyroid peroxidase (TPO) is an enzyme found on the thyroid gland. It has an important role in the production of thyroid hormones: it catalyzes iodination of thyroglobulin and is involved in the coupling of the iodotyrosines to form free T3 or free T4.

In some disease states, people develop antibodies to thyroid peroxidase. These antibodies attack the thyroid gland and damage its function. Thyroid peroxidase antibodies are seen in all thyroid
autoimmune diseases, and the highest levels are most commonly seen in Hashimoto's thyroiditis. The existence of anti-TPO can be an indicator of developing thyroiditis: patients with a positive TPO antibody test may have symptoms of a thyroid imbalance, yet all other thyroid test levels may appear normal. Elevated concentrations of anti-TPO are also seen in patients with thyroid
cancer. Another useful application of TPO testing is in polycystic ovary syndrome (PCOS). Women with PCOS often have a greater occurrence of TPO antibodies; one study shows elevated TPO antibodies in 27% of women with PCOS.¹

Labrix offers many testing options to help you identify and treat patients with the conditions mentioned above. Our BloodDrop menu offers anti-TPO, which can be combined with different options in order to identify or monitor specific conditions.

The menu includes FT3, FT4, and TSH, which combined with an anti-TPO reflects thyroid function. In addition, our salivary test menu includes hormones that, combined with a serum anti-TPO, can help identify PCOS (testosterone, DHEA, estradiol, and progesterone).

We are excited to offer our new BloodDrop test menu. Give us a call for more information.

¹ "High Prevalence of Autoimmune Thyroiditis in Patients With Polycystic Ovary Syndrome". Janssen et.al Eur.Jour.Endo. (2004) 150 363-369.

Labrix Clinical Services blazes a new “curve” (path)!

We are changing the way Adrenal Function Testing specimens are collected:

Labrix continues its commitment to setting the standard for precision and reliability in laboratory testing. Our innovative research and development team has validated the following improvement in our services for immediate release: Only when the first morning sample is collected thirty minutes after awakening will the diurnal cortisol peak be maximally seen. You should now instruct your patients to collect their first morning sample 30 minutes upon awakening for precise adrenal evaluation. When specimens are collected before or after the thirty minute mark, the cortisol curve is substantially altered (see graph below). As practitioners, we need the most accurate assessments in order to provide the best therapeutic results. For adrenal function testing, this new information will increase that accuracy.

If applicable please call and order new saliva instructions.

Excerpt from: "Slim, Sane and Sexy; Pocket Guide to Natural Bioidentical Hormone Balancing."

By Jay H Mead MD and Erin Lommen ND.

Wow! The RDA in the US for iodine is 150micrograms/day, which is 1/89th of the 13.8milligrams consumed by the mainland Japanese population. And, guess what? The Japanese population has very little hypothyroidism and breast cancer compared to the US. As it turns out the US RDA was determined to be the minimal amount of iodine to prevent goiter (enlarged thyroid gland) and Cretinism (severe hypothyroidism with mental retardation) and does not take into account that every organ in body, not simply the thyroid gland, requires sufficient iodine for optimal function.

It is an urban legend that there is enough iodine in our salt. The amount of iodine in our salt is based upon the flawed RDA. In fact, until the 1980s, a slice of bread contained the iodine RDA, which helped somewhat. However, this was removed and replaced by Bromide, a goitrogen (enlarges the thyroid) that interferes with iodide utilization in the thyroid and most likely the breasts. Iodine has an anti-carcinogenic effect on the breast ("Orthoiodosupplementation: Iodine sufficiency of the whole human body." The Original Internist: 2002; 9:30-41) and is associated with fibrocystic changes (a precursor to cancer) and painful breasts. According to the WHO 15% of American women are iodine deficient and 1/3 of the world's population is iodine deficient.

So what? As with so many biological systems, optimization of function requires optimal nutrition, and iodine is a very important nutrient. A large percentage of Americans are marginally iodine sufficient, i.e. we ingest enough iodine to keep our glands from enlarging and prevent mental retardation, but not necessarily enough to minimize our risk of cancer and optimize our thyroid hormone production. It is estimated that the majority of patients taking thyroid hormone either don't need it or could reduce their dosage. And, what about the large numbers of patients, mainly female, who have symptoms of low thyroid (hypothyroidism) and are told they have "adequate" hormone levels and are given an anti-depressant. We believe this group of patients is often neglected by the conventional medical model.

The preferred test to determine iodine sufficiency is the "24hr urine loading test". A standard dose of iodine/iodide is ingested and amount passed in the urine over the next 24hrs determines sufficiency. If, for example, one passes less than 90% of the loading dose he or she is deficient and would benefit from iodine/iodide supplementation.

Iodine Fact Sheet

By Jay H Mead MD

GENERAL INFORMATION

Sufficient iodine is essential to good health. Although the primary function of iodine is in the production to thyroid hormones by the thyroid gland, many other organs require iodine for optimal function (1). Iodine deficiency is the associated with reduced mental performance (2,3), fibrocystic breasts disease and breast cancer (4,5,6,7,8) and is a potent antioxidant (9).

It is estimated that 15% of American women are below the World Health Organization's classification for iodine sufficiency and this is conservative estimate (10) and almost one third of the world's population lives in areas of iodine deficiency (11). The most recent trend in the US is a 50% reduction in urinary iodine excretion between the 1970 and 1990 (11).

The RDA for iodine is 150 mcg/day, which pales in comparison with the daily average intake of 13.8mg/day for the mainland Japanese population. The mainland Japanese consume on the average 89 times the US RDA and have reduced rates of many chronic diseases (1). In fact, the optimal iodine consumption level has never been determined (11); yet, the incidence of breast cancer is much lower in the Japan (12).

In 1829 Jean Lugol, a French physician, discovered a method to dissolve iodine in an aqueous solution. This is known as Lugol's solution and has been for a myriad of maladies for more than 150 years. The collective experience of clinicians over this period led to recommended daily amount of Lugol's equivalent to be 12.5-37.5 mgs, which so happens to be the recommended dosage to maintain whole body sufficiency using the recently developed iodine/iodide loading test (13).

RATIONAL FOR THIS FORMULATION

Administration of a liquid iodine/iodide solution may stain clothing, has an unpleasant taste, may cause gastric irritation and can vary in accurate delivery. Whereas in a tablet form consisting of 7.5 mg of iodide and 5.0 mg of iodine in a colloidal excipient coated with a pharmaceutical glaze is more precise and pleasant to ingest.

DOSAGE SUGGESTIONS

Dosage varies with the individual. The daily optimal dosage of one tablet (12.5mg) closely mimics the daily average consumption in Japan. Whereas, higher daily doses may be needed to correct total body insufficiency, e.g. 4 tablets (50mg) for up to 3 months.

ALLERGIC REACTIONS POSSIBLE ADVERSE EFFECTS

Anaphylactic reactions are essentially non existent according to the American Academy of Allergy Asthma and Immunology. Patients who report allergic reactions to topical preparations, seafood or contrast media are reacting to a component other than iodide (14).

Dr Abrahams clearly describes the known risk to idodide/iodine supplementation and reports that doses in the ranges suggested here that these adverse effects are extremely uncommon if not non-existent (15). Potassium iodide when used to in large doses, e.g. S.S.K.I solution for asthma ((up 4 grams (4,000mg) in a single dose)) the adverse effects were reported as 16% (16).

Potential adverse effects related to iodide include:

Thyrotoxicosis
Iodine Induced Goiter
Brassy taste
Increased Salivation
Coryza
Sneezing
Headache
Mild acneiform lesions in the seborrheic areas

REFERENCE LIST

1. Abraham, G.E., et al, Orthoiodosupplementation: Iodine sufficiency of the whole human body. The Original Internist, 2002, 9:30-41.
2. van den Briel, T. et al, Improved iodine status is associated with improved mental performance of schoolchildren in Benin. Am J Clin Nutr. 2000 Nov, 72(5):1179-85
3. van den Briel, T. et al. Mild iodine deficiency is associated with elevated hearing thresholds in chlren in Benin. Euro J Clin Nutr. 2001 55:763-768
4. Ghent W.R., et al. Iodine replacement in fibrocystic disease of the breast. Can J Surg. 1993 Oct;36(5):453-60
5. Eskin, B.A., Iodine and mammary cancer. Adv Exp Med Biol. 1977, 91:293-304.
6. Strum, J.M., Effect of iodide-deficiency on rat mammary gland. 1979 May 31; 30(2):209-20.
8. Carmen, A., et al. Is Iodine a Gatekeeper of the Integrity of the Mammary gland? Journal of Mammary Gland Biology and Neoplasia. 2005, 10(2):189-196
9. Winkler R, et al. Effect of iodide on total antioxidant status of human serum. Cell Biochem Funct. 2000 Jun; 18(2):143-6.
10. Abraham G.E., The safe and effective implementation of orthoiodosupplementation in medical practice. The Original Internist, 2004 11:17-36.
11. Dunn JT, What's Happening to Our Iodine? J Clin Endo and Metab 1998; 83(10):3368-3400
12 Toshihiko Kawamura and Tomotaka Sobue. Comparison of Breast Cancer Mortality in Five Countries: France, Italy, Japan, the UK and the USA from the WHO Mortality Database (1960-2000). Japanese Jounrnal of Clinical Oncology. 2005; 35(12):758-759.
13. Abraham, G.E., et al. The Safe and Effective Implementation of Orthoiodosupplementation In Medical Practice. The Original Internist, 2004 Mar, 11:17-36/
14. Academy Position Statement: The Risk of Severe Allergic Reactions from the Use of Potassium Iodide for Radiation Emergencies. American Academy of Allergy Asthma and Immunonology. February 24, 2004.
15. Abraham GE, et al. Optimal Levels of Iodine for Greatest Mental and Physical Health. The Original Internist, 2002; 9:5-20
16. Peacock L, Davison H. Observations on Iodide Sensitivity. Ann Allergy, 1957 Mar-Apr;15(2):158-164.