Sunday, October 28, 2007

In case you were wondering...

A little clarification, it is impossible to go iodine-free. Iodine is in everything, so I'm trying to go low-iodine (still very challenging). I should probably eat this way all the time. I mostly live on homemade wheat bread (w/special salt), brown basmati rice, fresh fruit, fresh chicken (small amounts), salads with homemade oil and vinegar dressing, unsalted pb from the health food store (which I salt up with non-iodized salt), from scratch oatmeal, homemade jam (again w/special salt), and almonds.

Even a small amount of iodized salt, messes up the low-iodine thing. The whole reason for the low iodine diet is to starve any remaining cancer cells so they will suck up the radioactive iodine greedily for a nice green glow on the scan.

And if you want to be bored out of your skull, read the following guidelines to see just how present iodine is in your everyday life.

Okay foods:

Fresh fruits and fruit juices, except rhubarb, maraschino cherries (if they contain Red Dye #3), and fruit cocktail with maraschino cherries.

Vegetables, preferably raw and fresh-cooked or frozen without salt. (But not skins of potatoes, soybeans, and, according to the NIH diet, some other beans like pinto, lima, navy, red kidney, cowpeas).

Unsalted nuts and unsalted nut butters.

Grain/cereal products in moderate amounts.

Fresh chicken, beef, and other meats in moderate amounts.

Sugar, jelly, honey, maple syrup, and unsulfured molasses.

Black pepper and fresh or dried herbs.

All vegetable oils. Salad dressings provided they contain only allowed ingredients.

Homemade foods (see the free Low-Iodine Cookbook from the ThyCa web site.
Cola, diet cola, lemonade, sodas (except those with Red Dye #3), non-instant coffee and tea.

Food prepared from fresh meats, fresh poultry, fresh or frozen vegetables, and fresh fruits should be fine for this diet.

Avoiding these foods:

Iodized salt and sea salt and any foods containing iodized salt or sea salt. Non-iodized salt may be used. For example, Kosher salt is okay unless the label says that it is iodized or sea salt.The reason to avoid sea salt is that all products from the ocean tend to be high in iodine.You can usually find plain, non-iodized salt next to the iodized salt at your grocer. Read the label. (One teaspoon of iodized salt has 400 mcg of iodine.)

Seafood and sea products (fish, shellfish, seaweed, seaweed tablets, kelp). These are all very high in iodine and should be avoided.

Foods or products that contain these sea-based additives: carrageenan, agar-agar, algin, alginate, nori (these food additives are seaweed by-products).

Dairy products (milk, cheese, cream, yogurt, butter, ice cream, powdered dairy creamers, whey, casein, other dairy products). Note: Nondairy creamers often have iodine-containing ingredients, too. It reported that 250 ml of milk (about 8 ounces, or 1 cup, or 16 Tablespoons) contained from 88 to 168 micrograms of iodine and averaged 115 mcg. It noted that sources of iodine in milk include iodine in cattle feed, the products containing iodine used to clean teats and udders, and a small amount from equipment cleaning products.

Egg yolks or whole eggs or foods containing whole eggs. Egg whites are acceptable, because they contain little or no iodine.

Commercial bakery products. Avoid bread products that contain iodine/iodate dough conditioners (usually small bakery breads are safe; it’s best to bake it yourself or substitute with Matzos). If you read labels closely, you may also be able to find crackers made only with flour and water. While a few commercial bakery products have tested low in iodine, manufacturing processes can change over time. The study published in the Journal of Clinical Endocrinology and Metabolism in 2004 reported that the iodine content of single slices of 20 different brands of bread ranged from 2.2 mcg to 587 mcg.

Red Dye #3. However, Red Dye #40 is OK. We suggest that you avoid red, orange, or brown processed food, pills, and capsules. Many red, red-orange, and brown food dyes contain iodine and should be avoided. The problem with food colors is specific to Red Dye FD&C #3 (erythrosine) ONLY. However, the problem is that some food labels do not specify which red dyes are used. Better safe than sorry. For medications, the best source is the Physician’s Desk Reference (PDR), which clearly states the ingredients.

Most Chocolate (for its milk content). Cocoa powder and some dark chocolates are permitted. Check the label for other ingredients not allowed on the low-iodine diet. The ThyCa cookbook has recipes with permitted chocolate.

Some Molasses. Avoid if sulfured or blackstrap, which is concentrated and has a bitter taste. It's okay to use the milder, fairly sweet unsulfured molasses usually used in cooking and that is the type most often available in grocery stores in the USA. Sulfur is not related to iodine. However, it's a term used on molasses labels. Some diets don't make distinctions between kinds of molasses and say to avoid all molasses.

Soybeans and most soy products (soy sauce, soy milk, tofu). However, soy oil and soy lecithin are both okay.

Some beans besides soybeans.The National Institutes of Health diet says to avoid these beans: red kidney beans, lima beans, navy beans, pinto beans, and cowpeas. Other diets do not limit beans.

Some diets diets say to avoid rhubarb and potato skins. The inside of the potato is fine.
Iodine-Containing Vitamins, and Food Supplements. Also products containing iodate or iodide. Check the label and ingredients and discontinue completely if iodine is included. Most vitamins with minerals contain iodine.

If you are taking a Medication that contains iodine, check with your physician.

Limit the Amounts of these Foods
Some diets from thyroid cancer specialists and researchers recommend limiting the daily intake of foods that are moderate in iodine: 5 to 20 mcg per serving.

Fresh meats. Up to 5 ounces per day of fresh meats such as chicken, beef, pork, lamb, and veal are fine on the low-iodine diet. (Up to 6 ounces, according to one of the researchers, who noted that meat contains 25-130 mcg of iodine per pound.) Whole cuts tend to contain less iodine than do ground meats. Also, check the package label on meats, including whole turkeys, turkey breasts, turkey cutlets, chicken, and all pork products. Many food makers inject broths into turkey or chicken or pork. The label may not indicate whether the broth contains iodized salt. If you are not sure, go to your local butcher for fresh turkey, pork, or chicken.

Grains, cereals. Up to 4 servings per day of grains, cereals, pasta, and breads without iodine-containing ingredients are fine on this diet. The iodine content depends on the iodine content of the region where the grain was grown. Homemade baked goods and cereals are best on this diet. If you use processed foods, read the labels carefully to avoid iodine-containing ingredients. Also, remember that labels are not always accurate or up to date.

Rices. Like grains, rices vary in the amount of iodine depending on the region where grown, so rice should be eaten only in limited amounts. Some low-iodine diets recommend avoiding rice. Basmati rice has been mentioned as the best for the diet.

What About Restaurant Foods and Fast Food?
Although restaurants generally use non-iodized salt, it is not possible to know whether a particular restaurant is using iodized salt or sea salt. The manager or serving staff may not know what product is being used, or whether butter or other dairy products are present in foods. The ingredients that chain and fast-food restaurants use may change.

Therefore, we suggest that you avoid restaurant foods other than plain juices or soft drinks, or the inside of a plain baked potato. For most restaurant foods, there is no reasonable way to determine which restaurants use iodized salt. Avoid if in doubt.

What About Manufactured and Processed Foods?
Some published low-iodine diets and researchers' presentations allow salty processed foods and other processed foods. Some of these foods include potato chips and cured and corned foods such as hot dogs, ham, corned beef, sauerkraut, bacon, sausage, and salami.

Currently, manufacturers of processed foods in the USA generally use non-iodized salt. However, food processing techniques can change and labels are not always accurate or up to date.

For that reason, if fresh foods are available, many patients prefer to eat fresh foods during the short period of being on the low- iodine diet. They avoid processed food, because it is not known for sure whether or not iodized salt has been used. For any processed food, it is also important read the label to be sure there is no Red Dye #3.

In the past some patients have contacted manufacturers asking whether or not they used iodized salt in their products or iodine-containing cleansers or sanitizers for their equipment and surfaces involved in food processing. Doing this is NOT recommended for the following reasons:
Manufacturers cannot guarantee that the ingredients they receive from their suppliers do not contain iodized salt.

Manufacturers may change procedures and may use iodine-based cleaners or sanitizers on food-processing surfaces, utensils, equipment, and containers used in processing steps.
Because fewer and fewer manufacturers in the USA have been using iodized salt in their food processing, there seems to be a rise in iodine deficiency. It might become the practice to start using iodized salt again.Also, some spice blends like chili powder may contain added salt.
Read the ingredient labels on all packaged foods and spices.


Cocoa said...

Sounds like it's not too bad except that you have to check labels all the time.

So do you fix one meal for yourself and something different for the rest of the family?

Heffalump said...

How long do you have to be on this diet?

Corrie said...

It wouldn't be so bad except my energy is lagging (due to the no thyroid) so cooking oatmeal and rice or reheating veggies is about all I'm good for.

I do have freezer meals I can heat up for everyone else.

Corrie said...

heff - it takes about 2 weeks to get the cancer cells sufficiently iodine-starved for the radioactive iodine to most effective. At the end of that time, if my TSH is above 30, I can get the scan dose and see if anything 'glows.'

Anonymous said...