As I have been suggesting, doses of supplemental iodine in the range of 6 -12 mg per day are quite safe in terms of thyroid related side effects for the vast majority of patients. However, as I suggested in the last installment, some patients who are more prone to iodine-related reactions, such as those patients with pre-existing autoimmune diseases such as celiac disease, may present significant risk even at these doses, which are fairly low in terms of the standards set hy Abraham and colleagues. Nevertheless, even though the risk is low at these doses which some consider minimal, is low good enough? This is an important question to ask since, in terms of optimizing patient compliance, it is crucial early on in treatment that patients notice no significant adverse reactions to our recommendations. Assuming the answer is no, we then need to ask another question. Does a clinically effective dose of supplemental iodine exist above the RDI levels of 150 meg per day, for which the risk of either thyroid or non-thyroid related reactions is virtually non-existent in almost all patients? Fortunately, several studies have addressed this question. In "Intermittent oral administration of potassium iodide solution for the correction of iodine deficiency" by Todd and Dunn^ 304 children aged 7-13 years from the Hwedza District in eastcentral Zimbabwe, an area known to have a high prevalence of iodine deficiency disorders, were treated. Some of these children demonstrated presence of goiter and some did not. The duration of the study was one year.
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