Calling All Vegans. Tell Me About Your Periods

vegan diet and periodsIf you follow my blog, you know how much I care about women and women’s health. I want women to be fully nourished and eat in a way that supports ovulation and hormones.

I am, therefore, concerned about any diet that seems to impair ovulation. That can include a low-carb or keto diet, which can stop ovulation and periods. That can also include an exclusively plant-based or vegan diet, which can stop ovulation, but more often seems to cause long cycles and progesterone deficiency.

If you’re vegan, I encourage you to keep reading and join the conversation in the comments. I particularly want to hear from anyone who has been vegan for at least a year. (And see below for a tally of the comments so far.)

Read moreCalling All Vegans. Tell Me About Your Periods

What Estrogen Does in Your 40s (and How Progesterone Can Help)

Estrogen rollercoaster of perimenopause Hot flashes, sleep problems, mood swings, and crazy heavy periods. Is this menopause already? And you’re only 42? No, menopause may still be a decade away. This is perimenopause, which is the two to ten years of hormonal change before periods stop.

Perimenopause can be a tricky time and causes more symptoms than menopause itself. Conventional medicine has surprisingly little to offer. Your doctor will say you’re too young for hormone replacement, so she will likely prescribe the pill or an antidepressant, or tell you just to ride it out.

Read moreWhat Estrogen Does in Your 40s (and How Progesterone Can Help)

Why I Prescribe Iodine for Breast Pain, Ovarian Cysts, and PMS

Iodine for female hormones.Iodine is one of my favorite supplements for women’s health (just behind magnesium and zinc).

I prescribe iodine for breast pain, ovarian cysts, ovulation pain, and PMS, and I prescribe it even when there is no thyroid problem. In fact, I am more cautious with iodine when there is a thyroid problem because iodine can be dangerous for thyroid.

Benefits beyond thyroid

Iodine is required for the health of many parts of the body, including the brain, immune system, prostate gland, ovaries, uterus, and breasts. In fact, more than 70 percent of the body’s iodine is concentrated in those tissues—and not in the thyroid. Iodine is in those tissues because it plays a key role in immune function, detoxification, and mitochondrial regulation.

Iodine also affects ovulation and estrogen.

Iodine promotes ovulation

There’s more iodine in the ovaries than any other organ except the thyroid. Sufficient iodine promotes healthy ovulation. It also reduces ovulation pain, prevents ovarian cysts, and boosts progesterone (because ovulation is how you make progesterone). Read Road Map to Progesterone.

Iodine reduces estrogen

Iodine also promotes the healthy detoxification of estrogen and also makes cells less sensitive to estrogen.

That makes iodine one of the most important treatments for estrogen excess or “estrogen dominance” symptoms such as breast pain, ovarian cysts, and PMS.

👉 Tip: Additional treatments for PMS include a dairy-free, histamine-reducing diet, magnesium, and vitamin B6.

Conditions that benefit from iodine

If you suffer any of these conditions, then you likely need a small dose of iodine. That is true even if you have autoimmune thyroid disease (Hashimoto’s). I don’t agree that thyroid disease means you must avoid all iodine. But if you have Hashimoto’s, you need to stay low with the dose. See below and talk to your doctor.

👉 Tip: The term “ovarian cyst” refers to abnormally large cysts or functional cysts. It does not refer to the multiple small follicles of polycystic ovary syndrome becuse those are not cysts. Read Maybe It’s Not PCOS.

Best forms of iodine

There are three main forms of supplementation: potassium iodide (KI), molecular iodine (I2), and seaweed which contains a mix of KI, I2, and iodate (IO3-).

Compared to iodide, molecular iodine is absorbed more slowly into thyroid and more rapidly into breast tissue. That makes molecular iodine like Violet brand safer for thyroid and better for women’s health. Popular products such as Lugol’s solution provide a combination of high-dose I2 and potassium iodide.

A safe dose of iodine

There is no topic in natural medicine more controversial than the dosing of iodine.

On the one hand, conventional medicine is very conservative. The RDA is 150 mcg (0.15 mg) with an upper tolerable limit of 1,100 mcg (1.1 mg). Thyroid experts argue that doses greater than 500 mcg (0.5 mg) can trigger autoimmune thyroid disease, and doses greater than 225 mcg (0.25 mg) are not safe for pregnant women.

On the other hand, practitioners like David Brownstein advocate for mega-doses up to 50,000 mcg (50 mg) per day. That is 100 times (10,000 percent) greater than what your doctor considers safe.

👉 Tip: Too much iodine can worsen acne.

I agree that the RDA of 150 mcg is far too low. It prevents goitre (enlarged thyroid) but is not enough for ovaries and breasts. At the same time, I am not convinced that mega-dosing is safe. It can suppress thyroid function and trigger autoimmune thyroid disease. Read Megadose iodine: an idea whose time has gone. Even the Japanese, who are the world’s highest iodine consumers, do not consume more than 5280 mcg (5.2 mg) as part of their daily diet.

I usually prescribe in the 300 – 3000 mcg (0.3 – 3 mg) range, but only after first testing for thyroid autoimmunity (see below).

Testing

Random “urinary iodine” is the most common test. It’s not a perfect test and is primarily recommended for population studies, not individual assessment. Read Controversies in urinary iodine determinations. Deficiency is defined as less than 100 mcg/L (after adjustment for creatinine). To make the test more reliable, I ask my patients to test in the morning and to avoid iodine-containing supplements, foods, or thyroid medication for 24 hours prior.

A 24-hour urine test is more accurate, but is still not perfect and is a chore to do.

There is something called an iodine challenge test but I don’t trust its accuracy. Also, it involves giving a single dose of 50,000 mcg (50 mg) to a patient, which is arguably not safe (especially for anyone with autoimmune thyroid disease).

Thyroid antibodies (thyroid autoantibodies, anti-thyroid antibodies, anti-TPO antibodies) is the single most important test to do before supplementing. It is a marker of underlying autoimmune thyroid disease and can predict if supplementation is likely to trigger full-blown thyroid disease (Hashimoto’s). You can still take some iodine with autoimmune thyroid disease (remember, you need it for your breasts and ovaries!), but you probably want to stay at a low dose like 250 mcg (0.25 mg).

Breast tenderness is a reliable symptom of deficiency. I find it more useful than any test.

Who is at the greatest risk of iodine deficiency?

Selenium

The mineral selenium protects the thyroid from damage and over-stimulation by iodine. I usually recommend 100 mcg selenium.

Food sources of iodine

The food content of iodine varies greatly, which is why I generally prefer to supplement.

  • Seafood (10 – 190 mcg per 100 grams).
  • Seaweed or kelp (2 – 800 mcg per 100 grams). Unfortunately, kelp also contains bromine, which prevents the uptake of iodine, and may contain toxic metals.
  • Grass-fed butter, but only if it’s grown on rich soil.
  • Iodized salt (400 mcg per teaspoon).
  • Plant foods such as mushrooms and leafy greens, but only if they’re grown on rich soil.

Final word

I love iodine for women’s health. That’s why I include it among the top five nutrients for period health in my book Period Repair Manual.

What do you think? Do you take or prescribe iodine?

The Ups and Downs of Estrogen. Part 2: Estrogen Excess

estrogen excessEstrogen is a powerful hormone. We don’t want too little (see Part 1: Estrogen Deficiency), but we definitely don’t want too much.

Estrogen excess causes heavy periods, breast pain, fibroids, and premenstrual irritability. It also suppresses thyroid and increases the risk of breast cancer.

Read moreThe Ups and Downs of Estrogen. Part 2: Estrogen Excess

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