After binging on seafood and meat this week, the day has come for me to start the Low Iodine Diet (LID). A dark, dark day indeed.
In order to explain the Low Iodine Diet, I will start with a biology lesson.
Not what I meant, Sweet Brown.
The thyroid gland is pretty much the only gland in the body that makes use of iodine. Iodine is the raw material for what thyroid tissue converts into thyroid hormones, which the body needs for purposes surrounding metabolism, among other things. I'll probably discuss thyroid hormones specifically in another post down the road.
In any case, in preparation for my dose of radioactive iodine on July 31st, my doctors have asked me to begin the LID exactly two weeks before receiving the dose. The rationalization behind this is simple: if you starve the remaining thyroid cells in your body of iodine, the one thing that they need to do their job, then the moment I take the radioactive iodine dosage, the thyroid cells will desperately cling on to the first sign of iodine that it can find. Even if the iodine has radioactivity that is trojan-horsed inside of it. Once those thyroid cells cling on to the radioactive iodine and try to break it down, the radioactivity will go to work and destroy the cell.
However, if I continue to consume iodine in the lead-up to the radioactive dosage, then it is possible that some of the radioactive iodine will pass over any thyroid cells that already have iodine in them. And we don't want that, now do we?
Grumpy Cat doesn't like cancer.
Hence, you have the LID.
In all of my research leading up to this, the LID is pretty confusing. First of all, there are many cases of doctors who don't believe in it and don't have their patients do it. A few studies even seem to try to prove that it isn't effective (http://press.endocrine.org/doi/abs/10.1210/jc.2009-1624). However, the rationale behind it is logical, and going on a 2-week diet seems like a small sacrifice to destroy cancer, so I won't even go there.
Then, there's the length of time. My doctors have prescribed a 2-week LID, but other people have done 3 or more weeks. I'm no doctor, so I'm going to stick to my orders and do 2 weeks. Well actually, 2 weeks and 2 days. They want me to stay on it 2 days after the radioactive dosage, just to give my thyroid cells more time to absorb.
Then, there is the diet itself. There are tons of resources online devoted to the LID, but many of them seem to conflict with each other, which makes it hard to perform any research. I've done my best to sort through the noise...while there are tons of intricacies to the LID, I'll do my best to spell out the major rules. In the end, it is a LOW iodine diet, and not a NO iodine diet. Little errors here or there won't necessarily hurt. In fact, since there are doctors that don't even prescribe the LID and still have success stories under their belt, it's hard to even say if ANY errors will hurt. But oh well, ahead I shall charge.
- No IODIZED salt
This is the biggest and baddest rule, but it's important to note the word IODIZED. That's why I put it in caps. Most kosher salt is not iodized, so it is fair game in the LID. So is any salt specifically designated as non-iodized. Many people mistake the LID for a low-sodium diet. Not the case at all. However, this is the rule that pretty much prevents me from eating out. There's no way to know what kind of salt gets used in a restaurant, or in processed foods in general. Therefore, all self-prepared foods from here to the end.
Interesting side note: most table salt is iodized in the US as a result of the observation of severe iodine deficiencies in the past. There was a movement in the US in the 1920s to iodize salt as a result of a problem with goiters, which are enlarged thyroid glands due to iodine deficiency. Ever since this was done, the incidence of goiters has been significantly reduced.
- All seafood, and anything from or derived from the sea (e.g. seaweed, sea salt)
Oh, this one hurts. Anyone who knows me knows how much I love seafood. On most days, I prefer it to any land-based proteins (I'm looking at you, beef).
All I see is iodine.
Iodine occurs naturally in the ocean/sea, so as a result, I cannot consume any of the creatures depicted in the picture above.
Seaweed-based ingredients can sneak into a lot of things, which makes the LID tricky. For example, did you know that most almond milks contain an ingredient named carrageenan, which is derived from seaweed? So no almond milk for me, which brings me to my next no-no...
- Dairy
That's right. Milk, cheese, etc. None of that. I thought about replacing milk with almond milk, but it seems like all almond milks contain either carrageenan or sea salt. Milk chocolate? Get out of here. My yogurt that I have every morning for breakfast? Say goodbye. Milk and cereal? Hold the milk. Butter? You better believe it's not butter. Anything and everything dairy goes out the window. I have to act like I'm lactose intolerant.
- Egg yolks
Eggs contain iodine, almost entirely in the yolk. Anyone who knows me also knows that I also love the living crap out of eggs. This one sucks. However, I'll get by with my good friend Costco. Gotta avoid any foods with egg listed as an ingredient, too.
My new best friend.
- Soy
Yup, you heard me right. The incognito building block of the typical American diet is out of the picture. You always read about how soy gets used as fillers in various processed foods. Well, I'm about to learn the hard way. It's OK, I guess. I've heard having excess soy isn't good for guys due to what it does to estrogen production. I don't really want to have breasts anyway.
So how am I going to survive? Well, luckily for me, in the past I've tended not to have a problem with eating repetitively, especially when trying to lose weight. In addition, in a huge clutch move, Trader Joe's has asserted that any time salt is listed as an ingredient in its self-branded food, it is non-iodized salt, with the only exception being if they list "sea salt" specifically. I used to really like TJ's, but I have a feeling I'm about to fall in love with them now.
So, the following meals are going to become staples to my diet.
- Oatmeal, with honey and fruit
- Egg white omelettes, with fresh veggies
- Whole wheat pasta, with marinara/pesto sauces from TJ's
- PB&J sandwiches (Low-sodium Ezekiel brand bread, unsalted almond butter, blackberry preserves)
- Unsalted Kettle chips (I may Kosher-salt them myself)
- TJ's unsalted corn tortilla chips, with TJ's hummus
- Unsalted nut mix from Costco
- Eating my own hands (I may Kosher-salt them myself)
That's that. LID commences today. Wish me luck. Next time you see me, I may not have my hands anymore.
-W
For anyone interested in more information, here's some literature I found online about the LID that seems to be from a reputable source:
Thyroid Cancer Surviver's Association (ThyCa) LID Page:
http://www.thyca.org/pap-fol/lowiodinediet/
This site has a low-iodine cookbook with recipes, as well as LID guidelines.
National Institute of Health Clinical Center LID Guidelines:
http://www.cc.nih.gov/ccc/patient_education/pepubs/lo_io_diet.pdf
The NIH is a reputable source of info in my book. This has LID guidelines, as well as a list of brands and foods that they have verified do not contain iodized salt. This is dated 2012 though, but that's the latest version I could find, so hopefully this info isn't outdated.
The Low Iodine Diet Blog:
http://thelowiodinediet.blogspot.com/
A popular site that I've seen many people link to as a source of info.
Thyroid Cancer Canada (Thry'vors) Winter 2011 Newsletter
http://www.thyroidcancercanada.org/userfiles/files/Winter_2011_English_final_web.pdf
An interesting article where the investigate and compare the various LID rules out there, and try to debunk some as myths. An interesting read, despite its Canadian-ness. Keep in mind that a lot of the food manufacturing rules and regulations they discuss are Canada-specific.
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