Fitness

During my next 15 years, perhaps a dozen physicians told me to take thyroid tablets, but it is no easy trick to find the correct dosage. If you take too much, you become highstrung, nervous, wakeful; your heart nearly jumps out of your chest. Soon you become discouraged and give up until you either realize how important iodine is or are driven by sluggishness to try thyroid tablets again.

Later, for me, came the years of wanting children, with the accompanying heartaches and frustrations only a childless woman can understand. You spend hundreds of dollars trying to correct the unknown difficulty and take shots until you feel like a pin cushion. Hope rises at each intermenstrual period; crushing disappointment comes with the onset of each menstruation. Eventually you learn that the ovaries are usually damaged when the iodine deficiency has been too severe during the developmental period; taking iodine later cannot restore normal ovarian function. Then followed years of empty-armed despair, spent searching for children to adopt. Yet everyone of these abnormalities could have been prevented in my case and thousands of similar ones by five cents’ worth of iodine or at no cost if iodized salt had been available years ago as it is now.

In 1917, Drs. David Marine and O. P. Kimball showed that goiter could be easily prevented. These doctors gave iodine twice a year to 2,190 girls in Akron, Ohio; only five developed goiter. Among an untreated group of 2,300 girls, almost 500 relatively severe goiters developed. After this classic study iodized salt was made available; not one case of goiter should have ever again occurred. Yet recent surveys, made more than 30 years later, revealed that 55 per cent of the girls and 30 per cent of the boys in the Cincinnati schools had goiter; in Minnesota, 70 per cent of the girls and 40 per cent of the boys; in Portland, Oregon, 40 per cent of the girls and 22 per cent of the boys. In Cleveland, the incidence of goiter was found to be exactly the same as it was before iodized salt was put on the market. This valuable salt was not and is not being used. Figures like these are disgraceful. The ignorance and apathy which allow such abnormal conditions to be so widespread are likewise disgraceful. The amount of goiter among adults is not known, but the incidence is appalling when one considers that both prevention and cure have long been known.

The chief source of iodine is the ocean. The only parts of our country where adequate iodine may perhaps be obtained without using iodized salt is a narrow strip along the Atlantic seaboard, around the Gulf of Mexico, and in regions which in recent geologic ages formed the floor of the ocean, such as parts of Kansas, South Dakota, Utah, western Texas, and New Mexico. Foods grown on these soils usually contain some iodine. Other soils, although near the coast, contain little or no iodine. No food is a reliable source except ocean fish and seafoods. Even fresh-water fish in Minnesota are said to develop severe goiters. Many cities on the Pacific Coast use melted-snow water which is iodine free; despite nearness to the ocean, iodine deficiencies are common.

Iodized salt, approved by the American Medical Association, contains the amount of iodine that occurs naturally in unrefined ocean salt. When iodized salt is used throughout life, the iodine needs are supplied. No harmful effects can result from using this salt because iodine is lost continuously in urine, perspiration, and even exhaled air. Harm caused by not using it runs into millions of dollars spent for the surgical removal of goiter alone. The monetary value of the loss of efficiency resulting from an undersupply of iodine cannot be estimated. Surveys reveal that only 15 per cent of the salt purchased even in the goiter belts is iodized. So great is the contribution of this nutrient to health that the compulsory iodinization of all salt seems to be the only answer. Wherever this step has been taken, as in Switzerland and Austria, goiter has disappeared, and basal metabolic rates stay more nearly normal.

The iodine requirements are increased in early childhood, puberty, and adolescence, during pregnancy and lactation, and particularly at menopause. It is during menopause that goiters most often grow to be huge. No additional amounts of iodine need be taken at these times if iodized salt has been used continuously for years; the thyroid gland traps and stores iodine for future safety. If this valuable salt has not been used constantly, some form of iodine should be taken to meet current needs and make up the deficiency. Dr. William T. Salter, professor of Pharmacology at Yale University School of Medicine, writes (p. 132 of ref. 1, P: 35): “There are still clinicians and surgeons alive who favor one type of iodine preparation over another, but this is a problem in psychology rather than in clinical science.” This physician states that to correct goiter, one minim-a few drops-of Lugol’s solution every Sunday is sufficient. Any druggist can prepare Lugol’s solution in a couple of minutes; it costs little and is almost tasteless if added to % cup of water or milk. Often physicians who recommend Lugol’s receive poor co-operation because patients become discouraged by the slow improvement; goiters which could have disappeared are removed surgically at great cost. Despite the ease of prevention, every year millions of people who fail to obtain a normal supply of iodine pay for their neglect through a lack of mental and physical efficiency and alert- . ness; thousands more, through pain and misery.

When one has suffered personally from a deficiency of a nutrient, it is perhaps difficult not to overemphasize its value. I have been guilty of that. Years ago I found an unopened box of salt on the kitchen sink; since its label assured me it was free running but not iodized, I tossed it into the trash can. Later, my husband asked if I had seen the salt; I told him what I had done and why. He was understandably a bit irritable as he explained that he had wanted to put it into the toilet of our mountain cabin to keep the water from freezing and that he did not consider its iodine content of great importance.

The National Research Council recommends 12 milligrams of iron daily for adults and 15 milligrams for adolescents and pregnant women. Probably slightly larger amounts are more nearly ideal for women with heavy menstrual flow. Any diet adequate in protein and the B vitamins, supplied by natural sources, will be more than adequate in iron. If anemia does persist after a sound nutrition program is adhered to, a physician should certainly be consulted.

A blood analysis tells a physician many things; it usually tells you nothing you could not learn by examining yourself carefully before the mirror. If your ears are red and if your forehead, neck, and skin not hidden by rouge have a glow of health, you can assume that your bloodstream is satisfactory. You have one of the fundamental attributes of genuine beauty and probably the vivacity which helps to make up the intangible qualities known as charm and personality.

Too little iodine can be even worse than a lack of iron.

When iodine is undersupplied in the mother’s diet during pregnancy, the baby fails to develop normally; if the deficiency is quite severe, he may become an idiot, or cretin. I am told that institutions for subnormal children in goiter belts are filled with such cases. When a severe lack of iodine occurs later in life, myxedema results. I have seen only one case each of these abnormalities and, please believe me, one of each is too many. The child, the first of wonderful parents, is eighteen months old, sluggish, disgustingly fat, still toothless, and covered with eczema; so many behavior problems are developing that the conscientious young mother is already nearly insane. Her physician told me, “Her troubles haven’t even started yet.”

I hesitate to tell of the other case, it is so unbelievable; a woman of perhaps forty-eight, unable to leave her home. I saw her on a sweltering day in August. A daughter opened the door and took me to the living room where the mother sat on a davenport, wearing a heavy winter coat, her knees covered with a blanket, a small gas heater burning at her feet, and every door and window in the room tightly closed. One could scarcely breathe in the room. The woman was stuporous, her eyes were glassy, and her movements and thinking were unconceivably sluggish. The condition had come on gradually. Her physician had given her thyroid, but she had failed to consult him again when the cumulative effect of repeated doses had made her extremely nervous and had caused frightening heart palpitations. She had stopped the thyroid weeks before. A small amount of iodine daily could have prevented both conditions and all others like them.

Iodine is needed by the thyroid glands, situated on either side of the windpipe. These glands produce an iodine-containing hormone known as thyroxin, which can be produced in normal amounts only when adequate iodine is supplied. Thyroxin has a profound effect upon growth, mental and physical development, and the maintenance of health throughout life. Although minute amounts of iodine are found in all parts of the human body, it is concentrated in the adrenal cortex, the ovaries, and particularly the thyroid gland which soaks it up like a sponge.

Thyroid activity is now measured by analyzing the blood for protein-bound iodine. A normal basal metabolic rate, or BMR, means that energy is produced as it should be. The normal range is from minus 10 to plus 10; persons with such a BMR have iodine values of 4 to 8 micrograms for each ~ cup (100 cc.) of blood. Persons with less than 4 micrograms of iodine have a BMR of minus 10 to minus 50. It must be remembered, however, that low blood sugar or an undersupply of protein, vitamin Bi, or anyone of several other nutrients decreases energy production. If a person’s diet is inadequate in any of these nutrients, his basal metabolic rate can he far below normal even though the iodine intake is adequate.

A partial or severe lack of iodine causes goiter, or enlargement of the thyroid glands. The enlarged glands often use the limited iodine supply more efficiently than can normal glands; hence the amount of thyroxin produced may remain the same, and the BMR may not drop below normal. Aside from a slight fullness and perhaps a mild pressure in the neck, there may be no other symptoms. The swelling in the neck may be so slight as to go unnoticed; yet every person, in my opinion, should learn to detect even a small goiter. Stand before a mirror and turn your head as far as you can from side to side; if you can scarcely see the ligaments in your neck as you turn your head, your thyroid glands are probably somewhat enlarged, and your iodine intake should be increased. Even large goiters disappear when sufficient iodine is taken together with an adequate diet; the process is slow, but eventually new, healthy cells do replace the abnormal ones. The seriousness of goiter often lies in its very mildness, which can easily lead to neglect. Goiter is a danger signal, pointing to possible troubles ahead, years and years of possible troubles.

I grew up in a goiter belt and know these troubles only too well. Mine were typical difficulties associated with iodine deficiency. When I was about fourteen, came blinding, pressure headaches associated with the menstrual period; each time I felt as though my neck would burst and my head would blow apart. A physician pointed out my goiter at that time and recommended iodine, which I considered a sort of aspirin substitute and failed to continue; he was the only physician who ever recommended iodine for me. The headaches continued for years. In a nutrition class at the University of Wisconsin the famous Dr. Amy Daniels mentioned that it was difficult to find an adolescent girl in the Middle West whose thyroid glands were not enlarged; she pointed out several girls with goiter in the class, then glanced at me and said, “You have a bad one.” I still did not take iodine; correction was not stressed.

Later, as the need for iodine decreases, the goiter disappears, but a low metabolic rate persists. There is no spontaneity or JOy in work or exercise; energy is not produced normally. You are cold when other people are comfortable; your hands are clammy; your feet are so cold at night that you cannot get to sleep. Your cooling system, however, does not work right either; in hot weather you are still more miserable. You are mentally and physically sluggish. College is difficult, and you learn by the plodder method, envying friends who complete an assignment at first reading. You gain weight easily, forever trying to reduce and forever staying too fat. The heavy-hipped, thick-legged, goiter-belt figure, resulting from iodine deficiency during growth and particularly at puberty, can be recognized the world over. Probably everyone of the millions of women who have it hates hers as much as I hate mine. Taking iodine after growth had ceased cannot change it.

The greatest single cause of iron-deficiency anemia is the refining of breads, cereals, and molasses. Although much has been said about the iron in “enriched” flour, only 6 milligrams per pound is added; whole-wheat flour contains approximately 18 milligrams. Brewers’ yeast and wheat germ are both excellent sources supplying per lh cup 18 and 8 milligrams, respectively. Blackstrap molasses is not only one of the richest sources of iron but also of many other minerals and of inositol. It supplies about 9 milligrams of iron per tablespoon; dark unrefined molasses, 1.5 milligrams; sugar, none. As a by-product of sugar refining, thousands upon thousands of gallons of blackstrap molasses are available. The dumping of blacks trap in Cuba became a public health hazard because it attracted so many gnats and bugs. It seems an affront to the human ego that insects, with their minute brains, can appreciate nutrition so much better than people can.

I used to recommend blacks trap stirred into milk or tiger’s milk. Then I saw a formerly anemic child of three whose parents, super interested in nutrition, had given him directly from the tablespoon almost a half cup of blackstrap daily. The child had never been allowed to taste candy even at Christmas, but his teeth were decayed to the gum margin. Since then I have been afraid to recommend blackstrap.

This reason, of course, may be only rationalized, the real one being that I can no longer take the ribbing. The blackstrap gags have become shopworn. The following, however, written before a geologist, Dr. Natland by name, left for Arabia, is no isolated example:

Camel’s milk, boiled goat, dates and cheese,
Poor Nat will starve if he can’t eat these;
Sun-warmed, fly-specked and sprinkled with sand,
Sounds like a diet Adelle Davis had planned.

In a mixed diet-not mixed with sand-only about 50 per cent of the iron is absorbed even by a healthy person; the remainder is lost in the feces. In experiments in which anemia was treated with single foods, liver was found to produce most hemoglobin, kidneys second, apricots third, and eggs forth. Many foods which contained as much or more iron failed to be good blood builders. Part of the iron in leafy vegetables is held in insoluble compounds which cannot be absorbed. The iron from most fruits reaches the blood stream. In general, the softer the texture of any food containing iron, the more complete the absorption. Much iron in meats is in the form of hemoglobin which is incompletely digested.

When iron-containing foods are digested, the freed iron must dissolve in hydrochloric acid from the stomach before it can pass through the intestinal wall into the blood. Since approximately two-thirds of all anemic persons lack this acid, much nutritional anemia cannot be overcome unless acid is supplied with adequate iron. Foods which contain acids, such as buttermilk, yogurt, sour fruits, and citrus juices, aid the absorption of iron. Even the drinking of sweet milk increases iron absorption because milk sugar is converted into lactic acid by intestinal bacteria. Conversely, refined carbohydrates decrease iron absorption both because they stimulate the flow of alkaline digestive juices and because they do not support the growth of valuable intestinal bacteria. Persons with stomach ulcers, anemic from loss of blood, cannot absorb iron while taking alkalinizing preparations.

Most inorganic iron is well absorbed, even iron rust. An old medical treatise entitled Self-help for People in Remote Places suggests for “the disease of pale ears” soaking rusty iron shavings in vinegar-water overnight and drinking the water. An ancient treatment of anemia was to stick rusty nails into a sour apple, allow it to stand overnight, remove the nails, and eat the apple. A rusty horseshoe would be an excellent toy for an anemic toddler who puts everything in his mouth. Ferrous chloride and ferrous sulfate are used medically in treating nutritional anemia. The body, however, needs only a limited amount; if more is absorbed than is needed, these drugs may be mildly toxic. I frequently find persons who are taking both an iron preparation and more than adequate amounts of vitamin C but who show multiple signs of vitamin-C deficiency; I suspect the vitamin is destroyed by the excess iron. I find liver, yeast, wheat germ, and eggs far more effective in correcting anemia than are iron salts.
A small excess of iron is stored in the liver, the bone marrow, and the spleen and is used at times when the diet is inadequate. The person suffering from an iron deficiency is anemic only because he lacks such a store.

The life span of red corpuscles is three to four months.

They are then withdrawn from circulation by the spleen and liver and are broken down by enzymes. The iron is used again and again in building other corpuscles. Most authorities believe that healthy women after menopause and adult men need no dietary iron. The non-iron parts of broken down hemoglobin are excreted by the liver as waste products. They are carried away in the bile and are known as bile pigments. These pigments give the color to the stools and urine.

Iron requirements are especially high during adolescence, when the blood volume increases rapidly, and during pregnancy. The needs of non-pregnant women vary with the losses during menstruation. Many women have excessive’ menstrual flow for years without realizing that it is excessive. Usually an adequate diet particularly high in protein, the B vitamins and especially vitamin E will correct excessive flow in a few weeks. Cumulative menstrual losses, pregnancies, and the long use of deficient diets cause anemia to be prevalent in women at and after the menopause. Besides causing needless fatigue, mental confusion, and depression, anemia can bring about such forgetfulness that these women often become convinced they are losing their minds.

So-called normal blood, arrived at by studying averages, has 4,500,000 red cells and 80 to 100 per cent hemoglobin for children and women and 5,500,000 cells and 100 per cent hemoglobin for men. When an adequate diet is given growing children, adolescent girls, and women of the reproductive age, hemoglobin of 100 per cent can be maintained, and the average blood count of 4,500,000 increases to 5,500,000. Such improvement shows that the standards for women are below normal. There are no age or sex differences in blood color or number of corpuscles in well-fed animals.

I cannot see how any intelligent person could let himself be deficient in either of the two nutrients, iron and iodine. The need for both has been known for decades. Iron is found in almost every natural food, whereas iodized salt has been sold at no extra cost for years. The fact that deficiencies of both iron and iodine are still widespread gives me a depressing you’re-butting-your-head-against-a-brick-wall feeling. But then I remind myself, more logically, that people will never apply sound nutrition until convinced it has personal value for them.

Not long ago a physician referred to me a man suffering from a fatal disease in which iron is held in the body in the form of a pigment. This man’s identical twin had already died of the disease. My problem, supposedly, was to plan a diet which could maintain maximum health but which supplied no iron, meaning no meat, eggs, fruit, vegetables, yeast, wheat germ, or whole-grain breads or cereals. If you can plan such a diet, let me know. I could not.

Anemia can result from inadequate protein, iodine, cobalt, copper, ascorbic acid, or ahnost anyone of the B vitamins, particularly folic acid, vitamin B12, niacin, or pyridoxin. Approximately half of all persons suffering from anemia have abnormal or sore tongues, indicating a lack of B vitamins. Probably every nutrient plays some role in building healthy blood. Much anemia does exist, however, which can be corrected by nothing more than iron.

Red blood cells, or corpuscles, are made in the bone marrow. It is estimated that approximately one billion per minute are produced by a healthy adult. In a cubic millimeter of blood, an imaginary cube about 0.04 inch on every side, there are normally about 5,000,000 red corpuscles. This number is spoken of as the blood count.

Each corpuscle must contain a certain amount of red coloring material, or hemoglobin, which carries oxygen by combining chemically with it. An easy method of estimating the amount of hemoglobin in the corpuscles is by comparing the color of blood with that of a standard series of colors. Blood which matches the brightest red of the standard is considered to have 100 per cent hemoglobin. If your blood matched the color marked 80 per cent, it would indicate that you have 80 per cent of the total amount of hemoglobin you should have.

Iron-deficiency anemia is a childish or feminine disease rare in men; the chief reason is that children grow and women menstruate. Men, however, may produce anemia in themselves through hemorrhage from stomach ulcers. Severe anemia often occurs in blood donors whose admirable generosity is not matched by an intelligent replacement of iron. Anemia in general means that the body does not produce enough red corpuscles or enough hemoglobin or enough of both. If the only deficiency is one of iron, the number of red blood cells is only slightly below normal; the hemoglobin, however, lacks color. The body of an anemic person cannot be supplied with sufficient oxygen; energy production is interfered with. The chief complaints are weakness, perhaps dizziness, shortness of breath on exertion and consciousness of a pounding heartbeat, or palpitation; fatigue amounts to a continuous dead-tiredness. The fingernails are often brittle and show longitudinal ridging. Such persons are literally and figuratively colorless, listlessly lacking in vitality. Since too little oxygen reaches the brain, they cannot think as clearly or quickly as is normal, and they forget easily. Yet when an adequate diet is adhered to and well absorbed, the amount of hemoglobin and the number of red corpuscles quickly become normal.

Aside from the iron needed for hemoglobin, iron is in the nuclei, or business center, of all body cells. It is part of substances known as cytochrome, important in energy production, and myohemoglobin, or hemoglobin of the muscles. During iron deficiency, iron for the production of cytochrome and myohemoglobin has priority over that of hemoglobin.