The Goiter Belt and the Importance of Iodine

rural bettendorf

Here in the Midwest (of the United States), we live in “the Goiter Belt.” A goiter is “an abnormal enlargement of your thyroid gland.” The thyroid gland, a butterfly-shaped gland in the neck, is an extremely important gland and can affect mood and body functions. The Mayo Clinic lists common signs and symptoms of hyper- (“high”) and hypothyroid (“low”) imbalances. This list is by no means exhaustive.

“Although goiters are usually painless, a large goiter can cause a cough and make it difficult for you to swallow or breathe.The most common cause of goiter worldwide is a lack of iodine in the diet.”

According to WH Foods, “iodine is a key component of the hormones made in the thyroid gland. These hormones are absolutely critical to human health, helping to control energy production and utilization in nearly every cell of the body.

The balance of iodine in the thyroid gland is tricky, and both too much and too little iodine can slow down the production of hormones. This is not a situation where more is always better.”
Also according to WH Foods, “the risk of iodine deficiency is substantial in the United States and has been on the rise. The average urinary iodine level—a good measure of recent dietary iodine intake—has dropped by more than half since the 1970s. …
…The reason iodine levels  are dropping in the population is two-fold. One is that within the world of commercial baking, many bread manufacturers have moved away from iodine-containing compounds to keep dough fresh. But a bigger change is that the average U.S. household is doing less and less home cooking and resorting more and more often to prepackaged foods, ready-to-eat foods, and restaurant eating (including fast food eating). …even though many prepackaged foods are high in sodium, the salt added to these foods has not necessarily been fortified with iodine…There is a good bit of unpredictability in the iodine content of prepackaged and ready-to-eat foods.”
“There are compounds called thiocyanates in some commonly consumed foods. At high concentrations, these chemicals can interfere with the uptake of iodine into the thyroid gland, making a person seem like they have iodine deficiency, when they may not. The common thiocyanate containing foods include cassava, soy, and Brassica Family vegetables “(commonly known as cruciferous vegetables). “Tobacco smoke also contains thiocyanates.”
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The proper intake of iodine–not too much, and not too little– is critical for the normal functioning of the thyroid gland. If there is not enough iodine taken in with natural foods and foods supplemented with iodine, goiter can result. Luckily, iodine is easy to find. One of the easiest ways to get it is to make sure you are using iodized salt. When I was growing up, Morton iodized salt seemed like the only type of salt to buy. Today there are myriad salt choices: sea salts, including Sel de Mer and Fleur de Sel ,have gained popularity. It’s important to realize that not all salt has iodine in it. Check the packaging for iodine content, or “iodized”on the packaging.

Here’s a handy chart of natural iodine sources and a great explanation of the importance of iodine in the diet. As you can see, sea vegetables provide the most iodine.

So, if your landscape looks like this…

rural landscape

…you might be deficient in iodine.

Of course, if you are having symptoms of goiter, hypothryoidism, or hyperthyroidism, please investigate further with your medical practitioner.

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Allergy Alerts

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In the Midwest, we are in the throes of allergy season. For me, grass pollen is the real kicker. I had an anaphylactic reaction to allergy skin testing from the grass family skin test serum. My entire back, where the skin test was placed, felt like it was on fire, and I was so nauseated I thought I would vomit. I felt my face tighten up and the roof of my mouth itch. I received two shots of epinephrine to keep the hives from spreading down the trunk of my body, and to keep my face from swelling further. I was given oral steroids and an epi-pen. Because of this reaction, I’m unable to receive allergy shots; it’s just too dangerous. So during grass pollen season, which is essentially from Memorial Day to Fourth of July, I take an over-the-counter antihistamine and go from one air-conditioned oasis to the next. I am generally not able to take part in outdoor activities during this window of the summer. Most allergists tell people with allergies that the first line of defense is to avoid what gives you grief. This seems self-evident, but is not always easy to avoid something as ubiquitous as grass.

The American Academy of Allergy, Asthma, & Immunology is a great resource to pinpoint what type of pollen and spores are in the air.

I found out that today, June 2, 2014, trees, grass, and mold all have high concentrations, and weeds have a moderate concentration.
You can sign up for alerts based on the US region in which you live. It’s easy to sign up to have free alerts sent to your email, and can help you plan your activities based on what is in bloom.Be well!

pink peony

Anatomical Gifts and Organ Donation

dad greenery

Photo of my father on his honeymoon.

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I am passionate about anatomical gifting and organ donation. I wrote a piece about this and the poetry of Kevin Young on my blog, “Therese: The World Is My Atelier.” Please consider becoming an organ donor or donating your body for medical education purposes.

Be well.

 

The Wahls Protocol

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Look at this beautiful, unusual eggplant on the vine. Yum!

I recently heard an amazing interview on IPR (Iowa Public Radio). The interview was with Dr. Terry Wahls, who was diagnosed with multiple sclerosis (MS). She started having symptoms of MS during medical school.

The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine” is now available. It’s a fascinating, and encouraging story of recovery for anyone suffering from auto-immune disorders.

Dr. Terry Wahls had a very successful TED talk a few years ago. Dr. Wahls also has a Web site where you can read other success stories from other people who have changed their diet.

My hope is that her message will help you who are suffering from auto-immune disorders to regain your health.

Be well!

Alzheimer’s Disease vs. Vitamin B12 deficiency

tGnGAment 1986

Most people have the experience of momentarily forgetting someone’s name, or a street address, or to have a word on the “tip of their tongue.” But when we know what we want to say, and the words aren’t there, or we experience confusion about simple things, it can be truly upsetting. Not being able to find the words you want to use is called “expressive aphasia,” or “anomic aphasia” and can happen after a person suffers a stroke. It can happen for other reasons too.

I experienced expressive aphasia  and anomic aphasia when I was vitamin B12 deficient. I was diagnosed with Postural Orthostatic Tachycardia Syndrome, or POTS, in 2008. But this was not the full story.

My POTS symptoms came from being vitamin B12 deficient for, most likely, decades. I finally got a diagnosis of pernicious anemia in February of 2012. Pernicious anemia prevents absorption of vitamin B12. My memory problems, aphasia, and “foggy head” still come back when my vitamin B12 level drops. Before my pernicious anemia diagnosis, I often opened my mouth to speak, and was unable to find the words I wanted.

My memory issues were once so severe, I found myself standing outside of my apartment building looking at my keys, trying to remember what I was supposed to do with them, and trying to remember what they were called. It invoked a feeling of terror in me; I felt like I was losing my mind. It became commonplace for me to search for a word, and to have to substitute another word besides the one I wanted was not there. At the time, I was in my early 40s and wondered if I had early-onset Alzheimer’s Disease, or some other type of dementia. Of all of my myriad symptoms, “losing my mind” was one of the scariest. I feared there might be a grain of truth to what some doctors were telling me– doctors who diagnosed me with “somatoform disorder” (“it’s all in your head”), depression, anxiety, and “dysthymia.” The truth was that I had bone-deep fatigue, and other symptoms, the cause of which eluded doctor after doctor. However, there are psychological changes that can occur with vitamin B12 deficiency.

In their book, Could It Be B12?: An Epidemic of Misdiagnoses, authors Sally Pacholok, RN, and Jeffrey Stuart, DO, have an entire chapter devoted to troublesome symptoms that can mimic the symptoms of “normal” aging, including memory loss, forgetfulness, and signs of dementia.

According to Could It Be B12?: An Epidemic of Misdiagnoses, (pg 32) “between fifteen and forty percent of people over sixty have low serum B12 levels. This means that at least one in seven people over sixty—and possibly as many as four in ten—are at risk of suffering from nerve, brain, heart, and blood vessel damage caused by an often ‘silent’ deficiency.” The authors state there is a critical window of time in which low vitamin B12 needs to be treated, before permanent cognitive changes and damage result.

Some symptoms of low vitamin B12 which sometimes are attributed to old age include: leg pains; difficulty walking; falls; confusion; memory loss; and neuropathy. Pacholok and Stuart make a solid case that  low levels of  vitamin B12 lead to brain atrophy. They reference studies that show that low vitamin B12 levels precede Alzheimer onset, and so can be a factor in (contribute to) the development of Alzheimer’s Disease.  They state, “In 2008, an article in the [periodical] Neurology reported that low B12 causes brain atrophy (shrinkage) and is linked to the cognitive  impairment in the elderly.” Brain atrophy is associated with confirmed Alzheimer’s Disease, and so is vitamin B12 deficiency.

If you or your loved one have memory loss, depression, dementia symptoms, or any of these signs, consider that it may be an easily reversible case of vitamin B12 deficiency–easily reversible if caught in time, so do not delay in asking your doctor for a serum (blood) vitamin B12 level. Keep in mind, the US parameters for this lab have a “gray zone”, which is discussed in Could It Be B12?: An Epidemic of Misdiagnoses. Any reading below 400 pg/mL, if the patient is symptomatic, warrants follow up testing. The video by the same name covers this, as well as other important information about vitamin B12 deficiency. Vitamin B12 deficiency and pernicious anemia are far too often misdiagnosed.

Be Well & B12!

BEAT Ovarian Cancer: Subtle Signs and Symptoms

Recently a friend of mine took part in a fundraiser for NOCC, the National Ovarian Cancer Coalition. Her mother has been battling ovarian cancer for many years. Ovarian cancer can be an especially insidious type of cancer. Often, by the time symptoms become severe, the disease is in very advanced stages. The signs and symptoms can be very subtle and can sometimes mimic other, less serious, maladies. Though there is a test for ovarian cancer–the CA-125– the results are sometimes misleading.

From the CA-125 “About” website:

“One of the major flaws in the use of the CA-125 to screen for ovarian cancer in average risk women is that an elevated CA-125 level doesn’t always equal ovarian cancer. Elevated CA-125 levels can be caused by a myriad of conditions, such as endometriosis, diverticulitis, cirrhosis, uterine fibroids, pregnancy, and even menstruation. Certain cancer treatment drugs can also influence the test, producing a false positive.”

It may be used in the future for screening specific subsets of women, and according to the About site, there may be a correlation to the BRCA1 or BRCA2 gene mutation (related to breast cancer):

“The door is not closed on the possibility of a CA-125 screening test for ovarian cancer. Several studies are underway to determine how the test could be used to screen at average risk women, much like a Pap smear. Who Should Get the CA-125 Test? Women who are at a high risk of developing ovarian cancer may benefit from regular CA-125 screening. If you have a strong family risk of ovarian or breast cancer, it may be recommended that you have regular screenings. Some doctors may want to do a genetic test to see if you have a mutated BRCA1 or BRCA2 gene before making a recommendation about screening. When these genes are mutated, it can greatly increase the risk of ovarian cancer in women.”

This fall, I went for a screening mammogram. In the dressing room were small, laminated cards from the Norma Leah Foundation Inc. They are an organization dedicated to increasing awareness about, and providing information about ovarian cancer. These small cards used the acronym “BEAT.”

Bloating that is persistent

Eating less and feeling fuller

Abdominal pain

Trouble with your bladder and bowels

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The Norma Leah Foundation Inc. states: “Recognizing these early warning signs is your best chance for survival. If any of these symptoms persist for more than two weeks, please see your doctor.”

The Norma Leah Foundation also reminds women that a Pap Smear does not detect ovarian cancer.

http://www.normaleahfoundation.org

http://www.ovarian.org/

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Spread the word and let’s BEAT ovarian cancer!

POTS vs. Vitamin B12 Deficiency: a Venn Diagram

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I had been severely, surreal-ly sick for years–decades actually. My heart palpitations started in 2005, but I had symptoms before that. In 2008, I got the diagnosis of “Postural Orthostatic Tachycardia Syndrome” (POTS). According to my primary doctor at the time, my tilt table result was “impressive.” The tilt table test is the method by which POTS is diagnosed. My heart rate spiked into the 140 beats-per-minute range just standing upright for a few minutes. I became severely short of breath as I continued to stand. I told my cardiologist I thought it was asthma I’d been experiencing. She said, “No, your heart is just working that hard.” POTS is a syndrome, a cluster of symptoms, and therefore, not a diagnosis of a definitive disease. From researching online after my diagnosis, I found that POTS does not have a known cause or cure. It is not deadly, and sometimes people have spontaneous remission. Medications, compression stockings, and dietary approaches helped some people manage the symptoms of POTS, but were not curative. Here are just some of the symptoms I experienced with my “POTS”:

  • fatigue
  • dizziness
  • neurological symptoms
  • tachycardia (rapid heart beat)
  • heart palpitations
  • neuro-psychological symptoms
  • problems with memory, confusion, trouble with word recall
  • pallor (pale skin)
  • anorexia (decreased appetite)
  • nausea
  • weight loss
  • syncope or feeling lightheaded, like passing out
  • restless legs
  • depression
  • parasthesia (numbness, tingling, burning sensations)
  • severe shortness of breath
  • exertional dyspnea (shortness of breath with physical exertion)

POTS is categorized as an autonomic nervous system disorder, or “dysautonomia.” My cardiologist explained that, though it affected my heart, POTS is actually a neurological disorder. The nerves in my legs were not getting the signal to contract; contraction of the large muscles in the lower extremities is a main way that blood from the lower extremities returns to the heart and head. I found a dysautonomia support forum on the Mayo Clinic website. The stories were heartbreaking. A mother described her teenage daughter’s debilitating illness. She said her daughter’s life was ruined. This story was repeated over and over again, and mirrored my story.

In September 2011, I received a diagnosis of a vitamin B12 deficiency. This was before I was diagnosed with pernicious anemia, in February 2012, as the cause of my vitamin B12 deficiency. Nearly four years passed between my diagnosis of POTS and pernicious anemia (PA). I was under the impression that, though my symptoms pretty much destroyed my life as I knew it, POTS would not kill me. I was wrong, because I was actually suffering from pernicious anemia, which, as “pernicious” means, is deadly. I gratefully received a correct diagnosis of PA before I died, or ended up in a wheelchair, but people still die from this autoimmune disease. The American Journal of Public Health published a study which shows that autoimmune diseases are a leading cause of death in young and middle-aged women in the United States.

Between September 2011, and February of the following year, I researched vitamin B12 deficiency online. When I brought up a website which listed symptoms of vitamin B12 deficiency, I was shocked. It listed all of my “POTS” symptoms. In fact, if one were to do a Venn diagram, it would be overlying circles, instead of a mere intersection of circles. When my doctor gave me a pernicious anemia diagnosis in February, he said, “This absolutely explains all of your POTS symptoms.” And as for the possibility of recovery he added, “It’s going to be a long haul,” but told me of a colleague who had numbness from her knees down, because of a delayed diagnosis of vitamin B12 deficiency. After many years of vitamin B12 treatment, she regained the feeling in her legs.

It occurred to me that if my POTS diagnosis was actually from a vitamin B12 deficiency, others with POTS were also suffering from an undiagnosed vitamin B12 deficiency or pernicious anemia. They, too, were told they had a mysterious, inexplicable disorder, for which there were only palliative measures. Perhaps most of these POTS sufferers are actually vitamin B12 deficient.

So if you have received a diagnosis of POTS, a dysautonomic disorder, or a neurological/autonomic nervous system problem, I encourage you to pursue finding a cause for your symptoms. If you have depression, bone-deep fatigue, or any of the other symptoms mentioned above, and you feel your doctors are “missing something,” please do not give up searching. Consider having your doctor test you for a vitamin B12 deficiency. Continue to research possibilities. A good place to start is by reading, Could It Be B12?: An Epidemic of Misdiagnoses, by Sally Pacholock, R.N. and Jeffrey Stuart D.O..

Trust your intuition. Trust what your body is telling you. Persevere.