Why do I need to follow a low-iodine diet?

Low-Iodine Diet: Preparing to receive radioactive iodine

Before you receive radioactive iodine (tracer or therapy dose), you must follow a low-iodine diet for about 2 weeks to prepare. By limiting iodine in your diet, you deplete your bodys iodine supply. This makes your thyroid gland hungry for iodine so that it will absorb more radioactive iodine. Increased uptake of radioactive iodine will make your treatment more effective or your scan more accurate.

How will I know which foods are high in iodine so that I can avoid them?

Iodine is an essential mineral your body uses to make thyroid hormones.

What is iodine?

How much iodine can I consume on the low-iodine diet? How much iodine do Americans usually consume?

Because the iodine content of food is not listed on food labels, nutrient counter books, or websites, you cannot track how much iodine you consume. The foods highest in iodine are dairy (milk and milk-based products), egg yolks, fish, shellfish, seaweed, chocolate, and a few specific grains. Beyond these foods, most iodine in the American diet comes from iodized salt used at the table and from a few food additives. The document, Low-Iodine Diet Food List, will help you choose wisely.

On the low-iodine diet, your intake must be less than 50 micrograms of iodine per day. You do this by limiting high iodine foods. The Recommended Daily Allowance (or RDA, the amount of iodine necessary for most adults), is 150 micrograms per day. The usual intake in the United States is about 150-550 micrograms. By comparison, the low-iodine diet is much lower in iodine than a persons average intake. You must follow this diet for only a short time: 2 weeks before treatment or testing with radioactive iodine.
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This list will tell you: o What foods to avoid o What foods you can consume, but in limited amounts o What foods you can eat in unlimited amounts

Reading Ingredient Labels for Iodine Not-allowed Ingredients

These ingredients are not allowed in any amount. Check ingredient labels.

o Bread conditioners: Calcium iodate or

o Sea salt

potassium iodate Avoid commercial breads and baked goods unless you can verify the type of bread conditioner used. Note: Home-made bread/baked goods are allowed.
Low-Iodine Diet: Preparing to receive radioactive iodine

o Red Dye #3 (E127 in Europe), also

called eryrythrosine This is rare now, but check labels on foods dyed red or orange. o Alginate, algin, agar-agar, carrageenan, nori, algae, alginates, kelp, seaweed These are seaweed or seaweed-derivatives and should be avoided. Alginates thicken jellies, soup, ice cream, salad dressings, and toothpaste. Sushi contains seaweed. o Egg yolk (the yolk contains the iodine)

More about eating low-iodine

Limited Ingredients

The following foods are very high in iodine and are not allowed as whole foods. But because it may be difficult for you to find products without these ingredients, they are allowed as ingredients in small amounts. o Cream or milk o Chocolate o Whole egg o Cheese

Processed foods Many canned, packaged, or frozen foods contain added salt, and the label rarely says whether salt in a food is iodized or not. At the time of this publication, most large manufacturers use non-iodized salt (See the list in this document, Food brands using non-iodized salt, for specific brand names.) Always check for notallowed ingredients. o Small manufacturers may use iodized salt or sea salt, so you should try to avoid those products during the short time you follow this diet. o Non-iodized table salt is okay to use while on a low-iodine diet.

How small is a small amount? There is not an easy answer to this question. Less is better since you must limit your iodine intake. Think in terms of teaspoons not measuring cups. Also know that ingredients are listed on the label from largest to smallest amounts by weight. This means that if one of these appears at the end of a long list of ingredients, it most likely is present in only small amounts.

allowed on your low-iodine diet. o Make special requests that food be prepared without added salt, marinades, or sauces. o Use simple oil and vinegar instead of dressing on a salad, or bring your own. .
Low-Iodine Diet: Preparing to receive radioactive iodine

o Choose plainly prepared foods that are

Restaurant foods Eating out on the low-iodine diet poses two challenges. First, you will usually not know what type of salt restaurants use, and most prepare foods with lots of added salt. Second, restaurants often make their own marinades, spice mixes, dressings, and sauces with iodized salt. So, if you eat out in a restaurant, follow these tips:

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o Spices and herbs without salt are

allowed to flavor food. restaurants.

o Home preparation: Similar to eating in Other iodine-containing products to avoid

Red Dye: Red Dye #3 (E127 in Europe), erythrosine Red Dye # 40 is okay. With this in mind, check about any pills or capsules artificially dyed red, orange, or brown. Supplements o Calcium supplements made from oyster shells may be high in iodine and should be avoided.

o Fish oil is also likely to be high in iodine o Multi-vitamins also may contain iodine
avoided. Toothpaste Some toothpastes contain alginates. Check the label to find an acceptable product for brushing your teeth. and should be avoided. (Omacor brand is one exception and is allowed.) and should be stopped while following the low-iodine diet.

Medications Some medications contain iodine (most notably levothyroxine and triiodothyroinine). Check with your doctor to learn whether any of your medicines contain iodine or should be stopped. Do not stop any medication without speaking with your doctor first. Antiseptics Some people use Betadine or other iodine-containing products on their skin as an antiseptic. Avoid using this product while on the low-iodine diet. Instead choose hydrogen peroxide for cleansing and an antibiotic cream if necessary. Creams, lotions Avoid creams or lotions made from seaweeds (including kelp and spirulina) while on the low-iodine diet. Water purification Avoid using iodine tablets while on this diet.

o Selenium supplements should also be

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Low-Iodine Diet: Preparing to receive radioactive iodine

The following manufacturers report using non-iodized salt in their food production (as of this publication). You may safely use foods prepared by these manufacturers if they are on the allowed food list. Each manufacturer typically produces many brands, and many appear below. If you want a more comprehensive list, you can always check the companys website. Campbell Soup Brands http://www.campbellsoupcompany.com/our_ brands.asp Campbell Soup Campbell Pepperidge Farm V8 Pace sauces Prego Swanson broths Conagra http://www.conagrafoods.com/ Chef Boyardee David Seeds Egg Beaters Healthy Choice Hebrew National Hunts Kid Cuisine Marie Callenders Orville Redenbachers Pam
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Food brands using non-iodized salt

Reddi-Whip Slim Jim

Kraft Brands http://www.kraft.com/Brands/ A1 Alpen Gold Breakstones CapriSun CarteNoir CheezWhiz Chips Ahoy Club Social Cool Whip Cote DOr California Pizza Kitchen Cracker Barrel Crystal Light Deluxe DiGiorno Estrella General Foods - International Gevalia Grand Mere Handi-snacks Honey Maid Jacks Jacobs Jell-O Kenco Kool-Aid Kraft Marabou

Low-Iodine Diet: Preparing to receive radioactive iodine

Maxwell House Milka Miracle Whip Nabisco Newtons Nilla Nutter Butter Onko Oreo Oscar Mayer Philadelphia (cream cheese) Planters Polly-O Post Premium Prince Ritz Royal Simmenthal South Beach Stove Top Tang Tassimo Toblerone Tombstone Trakinas Triscuits Velveeta Wheat Thins

General Mills http://www.generalmills.com/brands.aspx Betty Crocker Bisquick Bugles Cascadian Farm Cheerios Chex Forno de Minas Frescarini Fruit by the Foot Fruit Gushers Fruit Roll-Ups Fruit Shapes Gardettos Gold Medal Green Giant Haagen-Dazs Latina Muir Glen Nature Valley Pillsbury Pop Secret Progresso Totinos/Jenos Trix Wheaties Yoplait/Columbo 8th Continent (soy)

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Low-Iodine Diet: Preparing to receive radioactive iodine

Heinz http://www.heinz.com/ Bagel Bites Boston Market Delimax Guloso Heinz Jack Daniels Sauces Mr. Yoshidas Sauces Nancys Ore-Ida Smart Ones T.G.I. Fridays Weight Watchers Wylers
http://www.hormelfoods.com/brands/default.aspx

Chi-Chis Dinty Moore Farmer John Jennie-O HerbOx Lloyds Stagg Chili World Food

Hormel

Kashi: http://www.kashi.com/products

FritoLay http://www.fritolay.com/index.html Baken-ets Chesters Cracker Jack Cheetos Doritos El Isleno Flat Earth Fritos Funyuns Gamesa Cookies Grandmas Cookies Lays Maui Style Potato Chips Munchos OKeeleys Quacker Snack mix Rold Gold Ruffles Sabritones Santitas Smartfood Stacys brand Sun Chips Tostitos

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Low-Iodine Diet: Preparing to receive radioactive iodine

Quaker http://www.quakeroats.com/home.aspx Aunt Jemima Capn Crunch Kretschmer Wheat Germ Life Mothers Natural Foods Near East Quaker Quisp Pasta Roni Rice-A-Roni

Unilever http://www.unilever.com/brands/ Bertolli Blue Band Country Crock Heartbrand Hellmans Knorr Lipton Slim-Fast Wish-Bone

PepsiCo (also owns Frito Lay and Quaker, previously listed): http://www.pepsico.com/ Gatorade Propel Pepsi Tropicana

What if the brand of the food I want to eat is not on this list?

This list does not name all food companies or their brands. By including a company on this list, NIH is in no way endorsing them. If you know of a brand not listed here, use your best judgment to decide whether to include the food. The guideline is that foods by large manufacturers/ companies are generally prepared with non-iodized salt. Foods prepared by smaller companies have a greater risk for containing iodized salt and being high in iodine.

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Low-Iodine Diet: Preparing to receive radioactive iodine

This information is based on written inquiry in January 2009. While manufacturing practices may change, we suggest that this information is reliable. Please check the NIH Clinical Center website for the most up-to-date information. We will make every attempt to confirm the use of non-iodized salt by these manufacturers once a year. We can also provide references if you ask for them.

Is this information up-to-date?

This information is prepared specifically for persons taking part in clinical research at the National Institutes of Health Clinical Center and may not apply to patients elsewhere. If you have questions about the information presented here, talk to a member of your health care team. Products/resources named serve as examples and do not imply endorsement by NIH. The fact that a certain product/resource is not named does not imply that such product/resource is unsatisfactory. NIH is not responsible for the content at provided Internet site links; nor does NIH endorse, warrant, or guarantee the products or services described or offered at these Internet sites. National Institutes of Health Clinical Center Bethesda, MD 20892 Questions about the Clinical Center? http://www.cc.nih.gov/comments.shtml

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4/2012

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Low-Iodine Diet: Preparing to receive radioactive iodine