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The Gluten Intolerance Group of North America on Iodine and Dermatitis Herpetiformis

The the connection between iodine and Dermatitis Herpetiformis is briefly described by the following excerpt from a resource guide of the Gluten Intolerance Group of North America:

  • Iodine can trigger eruptions in some people (with dermatitis herpetiformis). However, iodine is a essential nutrient and should not be removed from the diet without a physicians supervision.
  • Iodine does not contain gluten. Iodine can worsen the symptoms of skin lesions in patients with dermatitis herpetiformis.
  • When the deposits of IgA have been cleared from the skin over time by following a gluten free diet, iodine should no longer present any problem for dermatitis herpetiformis patients.

As background, for those who are not familiar with Dermatitis Herpetiformis, the following description comes from a resource guide of the Gluten Intolerance Group of North America:

  • Dermatitis herpetiformis (dermatitis herpetiformis) is a chronic disease of the skin marked by groups of watery, itch blisters. The ingestion of gluten (the proteins gliadin and prolamines contained in wheat, rye, oats, and barley) triggers an immune system response that deposits a substance, IgA (immonuglobin A), under the top layer of skin. IgA is present in affected as well as unaffected skin. dermatitis herpetiformis is a hereditary autoimmune disease linked with celiac disease. If you have dermatitis herpetiformis, you always have celiac disease. With dermatitis herpetiformis the primary lesion is on the skin rather than the small intestine. The degree of damage to the small intestine is often less severe or more patchy then those with only celiac disease. Both diseases are permanent and symptoms/ damage will occur after comsuming gluten.

When my husband was diagnosed with dermatitis herpetiformis last November, he went to visit a expert in dermatitis herpetiformis, Dr. John J. Zone, at the University of Utah (USA). The written instructions Dr. Zone gave him included the following statement:

  • The mineral iodine is known to make the disease (dermatitis herpetiformis) worse. For this reason, foods and supplements high in iodine should be avoided. Table salt which is not iodized should be used. This can be found in most grocery stores with the other salts. Avoid kelp and other seaweed products, and do not use sea salt. If you take any nutritional supplements, examine them carefully to avoid any iodine containing ingredients.

It is not necessary for dermatitis herpetiformis patients to eliminate iodine completely from their diet, merely to avoid foods high in iodine as described above. Dr. Zone also explained that dermatitis herpetiformis patients need not avoid iodine indefinitely. Iodine is an important mineral for our bodies. dermatitis herpetiformis patients can stop avoiding iodine when their rash symptoms clear up which can take anywhere from a few months to a couple of years on a gluten-free diet.

More about iodine:

  • Intake of large amounts of inorgana iodide is known to exacerbate symptoms and a few patients have been reported to improve on low iodide diets. However, this is not a mainstay of treatment and need only be considered if patients are consuming excessive iodide in the form of vitamin pills, kelp, or seafood. Likewise, some patients have reported exacerbation with thyroid hormone replacement therapy and thyrotoxicosis. In such cases, excessive thyroid replacement should be avoided and thyrotoxicosis treated appropriately.
  • Dermatitis Herpetiformis, John J. Zone MD, Curr Probl Dermatol, Jan/Feb 1991, p36
  • Dermatitis Herpetiformis is considered a rare skin disease.
  • The true incidence and prevalence of dermatitis herpetiformis appears to vary in different areas of the world and may vary within the same country. During 1987, 158 cases of documented dermatitis herpetiformis were identified in the state of Utah out of a population of 1.6 million, a prevalence of 9.8 per 100,000.
  • Dermatitis Herpetiformis, John J. Zone MD, Curr Probl Dermatol, Jan/Feb 1991, p15

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34 Responses:

 
maria edh
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said this on
06 Dec 2007 9:04:39 AM PST
Having been recently diagnosed. I was unaware about Iodine's role, which makes me believe that staying away from shell fish (for 20 years) has played some role in this illness. Thank you

 
Sue
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said this on
09 Jan 2008 12:26:08 PM PST
An eye opener, no one ever told me about this link. I have used sea salt since diagnosis, found I have an intolerance to all seaweed products, and now I'm wondering if this is why I can't get my dermatitis to clear up. Thanks for starting this thought process!!

 
Rebecca Johnson
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said this on
10 Jan 2008 11:23:43 AM PST
I never heard about iodine before and now I will talk to my doctor about it. Thanks !!!

 
ellis
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said this on
25 Jun 2016 7:00:21 AM PST
If your doctor didn't talk to you about it in the first place, you should change your doctor!

 
Laura H.
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said this on
01 Mar 2008 12:11:20 PM PST
I made the connection between my Dermatitis Herpetiformis and iodine 16 years ago and was able to clear up the blisters by avoiding sources of iodine. However, even after I found out I had celiac five years ago, I didn't connect the blister outbreaks to celiac until I read Dr. Green's book. When he stated that iodine was the trigger, I almost jumped out of my chair. Now everything was clear-- celiac was actually the cause, while iodine was merely the trigger. Unfortunately, because I avoided iodine for 16 years, my thyroid essentially 'died' last year, and since all thyroid meds contain iodine, I break out in blisters at the slightest gluten contamination. My back is also covered with an itchy rash, my throat is sore, and my thyroid is inflamed. My doctors seem at a loss at treating this sensitivity to iodine. So, I would like to reiterate Dr. Green's advice to not completely avoid iodine--your thyroid needs it to be healthy.

 
Ursula

said this on
14 Mar 2008 7:37:56 AM PST
Thank you for this insightful information. I have always found that my eczema gets worse when I eat prawns and now I know why. I will definitely be on the look-out for foods high in iodine in the future so as to avoid them.

 
Carol Z.
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said this on
11 Jun 2008 8:23:28 AM PST
Really helpful. Since so many of us have thyroid problems too and must take supplements, this is a big issue. There is not much clear information out there and doctors don't seem so well informed.

 
Julie M.
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said this on
10 Aug 2008 11:09:52 AM PST
My son Andrew is 15 years old now, he was diagnosis with Dermatitis Herpetaformis at 8, has been rash-free for 5 years by being on a Gluten Free diet continuously and Iodine free diet for approximately 6 months after his initial diagnosis). He has recently relapsed, I believe he has been eating more fast foods, going through puberty, and has been in the ocean 3-4 times a week for several months now possibly absorbing iodine through his skin. I am unsure if puberty and the absorption through the skin can trigger Dermatitis Herpetaformis. He is looking and feeling terrible, so frustrating for him and me as a mother.

 
Michelle E
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said this on
19 Jan 2009 1:02:35 PM PST
At 33 years old I finally got diagnosed with celiac this year with a simple blood test (after 3 years of gut pain). To make up for my lack of vitamins - I was taking a fantastic, all inclusive vitamin religiously in addition to a gluten free diet. My gut was great, but I got wicked cases of 'poison ivy' 3 times in one summer - a record even for me. THANK YOU for this article. I switched off the vitamin, which was high in iodine and haven't had a major outbreak since. I did get a prescription for Fluocinonide .05% a topical steroid that helped before I knew to cut back on iodine. Now it seems that I can usually just cut back on shrimp intake (had a flare up on vacation when eating lots of shrimp) and that stops the rash from spreading and turning into the big bumps.

 
Kathy
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said this on
05 Feb 2009 11:25:49 AM PST
Usually going in the ocean soothes skin rashes. Does anyone know if it's bad for a person with Dermatitis Herpetiformis to go into the ocean?

 
Jeannie
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said this on
09 May 2010 2:59:48 AM PST
Live in Hawaii and our ocean is like a medicine for lots of ailments. BUT, nowadays, if you have an open cut, it's advised not to go into the ocean. There are "new unknown" bacteria or particles in the ocean more than ever. Your little cut can become infected so quickly. In my days, it was good to go into the waters and have nature's ocean clean the cut and heal it.
I'd say, with an inflamed case of dermatitis herpetiformis, don't go in the waters. When my son's skin looks better I'll take him to the beach. He'll even tell me when his skin feels better.

My 7 year old son just got diagnosed with dermatitis herpetiformis. With the help of a new dermatologist, my son's mystery skin has a name. Our doctor was so nice to explain to me about dermatitis herpetiformis and its nickname "suicidal itch".

After 5 years of 3 dermatologists, 1 allergist, and pediatricians all saying that he just has an extreme eczema or dyshidrosis or some severe mystery skin. Though I had pictures of his "angry skin", no one went outside the "box" of eczema. I knew something was different. Every one would tell me that they knew what we were going through, Yet none of them could understand or relate to me and my son when I told them that there has been lots of staph infections and ER nights and just no sleeping.
Even my son's school staff has been challenging.

Sorry, just so happy with this new world of dermatitis herpetiformis and trying to go gluten-free 100% (or as much as possible) yet a little perturbed with professionals that are closed minded to "outside of the box" learning something new.

 
Katey
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said this on
01 Apr 2009 8:49:31 PM PST
Thank you! I recently started taking kelp, and the watery blisters I got from gluten intolerance multiplied and became worse. I had no idea about the relationship between the two until now.

 
Anna Mae Schroeder
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said this on
09 Mar 2010 9:18:55 PM PST
Very informative, thank you very much for this. Research keeps bringing us new information.

 
Darren
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said this on
23 Jul 2010 9:19:40 AM PST
Did I read that right? If you have dermatitis herpetiformis you have celiac. I made the mistake of going off gluten prior to testing, and all my tests with the exception of the "visual" results from my endoscopy, were all negative. I had this rash last year when I went to mayo clinic and they said they had no idea what it was and gave me hydro cream. Well it came back again and is still there now. Thank you for the information on iodine. I had been snacking on cashews with salt but have stopped thinking they may have been exposed to gluten. My rash isn't as red now. Eating gluten made it itch like the devil. And when the blisters open up they sting like mad. I have so many of these symptoms but nothing indicates it in my tests. The doctor who did the endoscopy came in afterward and said it "looked" like celiac but the labs said otherwise. Any ideas what I should do next. Eating gluten causes cramps, bloating, and severe diarrhea and back pain within hours.

 
Joe Eustis
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said this on
19 Oct 2010 8:31:01 AM PST
I have celiac (no tummy issues) and DH and started the gluten free diet 18 months. I have made no progress in clearing up the rash / itch. Have been on iodine free salt and vitamins at home with no help. Six months ago I started levothyroxine for newly diagnosed Hashimotos and noticed itch slowly got worse. Stopped for a while, seemed to get better, then took Armour and it flared up. I stopped Armour and started a very low iodine diet - bought only no salt or low sodium packaged items from grocery (canned, boxed, frozen). It made a big difference so far. Culprit seems to be all the iodized salt in the processed foods we all buy. Never the less I have an appointment to see Dr. John Zone (expert) at Salt Lake City University Hospital next month to understand / get help on the "iodine connection. It will be a long trip from New Orleans, but worth it to get real answers.

 
Joe Eustis
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said this on
25 Oct 2010 6:21:28 PM PST
Follow up - upon reviewing the foods I recently eliminated in going on a low iodine diet (which makes a big difference) I think the dairy products, i.e., milk, cheese, and in particular Weight Watchers fudge bars and Wendy's Frosties which have carregeenen - an iodine rich food thickener could be the smoking gun.

 
Johan
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said this on
14 Apr 2014 8:52:10 AM PST
Yea, dairy products IS the smoking gun, since iodine is added into the food concentrate given to feed cows and chicken, dairy products contains often large amounts of iodine. Having DH and still IgA rest inside your skin you should get clear of dairy products and products containing dairy products, just like chocolate and other mixed products.

 
Kara Larocco
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said this on
03 Nov 2010 5:34:49 PM PST
I am hypothyroid. I do take kelp too. I got my thyroid levels correct first and then I did a few iodine patch tests to see if it picked up a deficiency. It showed I was deficient, so I started the kelp. Many people do fine with a little bit of iodine, then there are others that don't. I started out by taking powdered kelp, but the problem with powdered kelp is that there are no dosages. Plus, iodine deficiency is a symptom, not a cause. There are other, more pressing headaches associated with hypothyroidism. Metabolism, for starters, which can play hell with your immune system, and also your mental health. If you look at a nurses' guide, you'll see that thyroid issues can lead to some chemical difficulties in brain/body day-to-day functioning.

 
Julie
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said this on
27 Mar 2011 4:46:51 PM PST
Thank you for this article, it has pretty much changed my life. I have been dealing with intermittent flare-ups of this type of dermatitis for the past year having no idea what was causing it or how to address it. Having been diagnosed with extreme gluten intolerance within the past two weeks with IgA readings off the charts (and incidentally, plenty of iodine in my diet), it all makes sense now. I found this article after eating some kelp and having the worst flare-up ever immediately after. Now that I've finally identified the correlation, I believe I will finally be able to beat this by avoiding iodine rich foods and switching to a strict gluten-free diet. Thanks again!

 
Cara
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said this on
28 Jul 2011 9:19:40 PM PST
Thank you so much for this information. My inability to clear up the DH rash for over 3 years on a gluten free diet has been so frustrating. One question I have never seen answered is whether there is a treatment or topical product which will calm the intense inching? Any information on palliative treatment would certainly be very welcome.

 
Linda Cabaniss
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said this on
06 Nov 2011 9:37:22 AM PST
I have had success with cold pressed/processed castor oil soaked bandages along with applied heat at bedtime. This usually clears up the DH within a week. This is an old Edgar Cayce remedy for many ailments including internal

 
Tammy Price
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said this on
12 Jun 2013 9:26:12 PM PST
I have found that the only thing that comes close to helping the rash is thayers alcohol witch hazel (with cucumber/ rose water) to clean and calm the burn... Let it dry... Then i put some white pine salve on it. I order the salve on line from some nice herbal lady. But i have found it at some health food stores. Wise ways herbals. It helps cut the time in half. And helps it a lot in general.

 
Craig
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said this on
08 Dec 2013 8:00:04 AM PST
I take Dapsone for the DH... it works well...

 
Annie C
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said this on
30 May 2014 6:24:52 PM PST
I have been using PanAway oil from Gary Young Living Oils; you need to coat your skin with olive oil/ or aloe vera oil and then apply the PanAway oil. I suffered so much from the crazy itch, and when I tried the PanAway - it worked. It burns a little, but the burning is better than the intense itchy that was driving me crazy. I haven't been diagnosed with anything yet, but I believe I have dermatitis herpetiformis, which is from eating gluten, plus the iodized salt was making the itching worse. I am finally, after three years, getting better. Thank God; I thought I was going crazy from lack of sleep.

 
pete
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said this on
29 Jul 2012 4:59:31 AM PST
Thank you for this information.

 
Rupa
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said this on
18 Sep 2012 10:10:33 PM PST
I was wondering why my skin gets those hives when I eat salty food and this link explains it. Thank you for sharing this.

 
Brenda
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said this on
15 May 2013 5:24:00 PM PST
I am just now self-diagnosing (no health insurance) my 30 year intestinal problem and associating gluten to it all... But I have a suspicion that MSG in most the foods I eat in Asia (every 4 months of the year) are the trigger to the miserable DH skin rash that occurs while in warm tropical areas, eating Asian food plus added nervous system problems (ie: stress). I rarely have DH in the states. If anyone has similar thoughts, please share. Thank you all for your comments!

 
Tammy Price
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said this on
12 Jun 2013 9:36:22 PM PST
Sad... I just flared up a week ago... Just a little. It is just calming some and I think I just ate some sea noodles with some iodine. Eeek! I had about 9 noodles.

 
Angela

said this on
29 Jul 2013 6:45:41 AM PST
I was diagnosed with celiac disease 4 years ago after being really sick for about 6 years. I have DH as well. It was tons of fun trying to figure out what that was. I have had it under control, but occasionally I will have an outbreak. Potato chips seem to be a big culprit. I found that benedryl at night helps the itching and with sleeping. It seems to lessen the length of the outbreak. Also, watch ALL hair products. I was losing handfuls a day until I looked at my mousse. Hydrolized wheat protein was one of the first ingredients.

 
Gil
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said this on
30 Sep 2013 11:14:59 PM PST
Hey guys.
Great article, and very informative.
Recently I found out I'm mildly allergic to iodine.
I like working out and have a few supplements that do have iodine. Now I now ask this, is there any type of ingredient or item that will help counter the iodine allergic reaction?
I just bought a whole tub, I want to know if there is a possibility it can be saved.
Thanks for reading, and will greatly appreciate for any responses.

 
Kari

said this on
04 Dec 2013 4:11:01 PM PST
I have a very itchy rash that is all over my body. Everything I read says its is a hereditary autoimmune disease linked with celiac disease. No one in my family has either, my blood tests came back normal and my dermatologist wont do a skin biopsy. How do I know I really have this disease? I have never been sick or have any other issues. How do I find an expert in Colorado?

 
Diane
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said this on
08 Apr 2014 9:55:00 PM PST
I have DH and react to iodine after exposure to gluten. We use un-iodized table salt in our home, and it is my understanding that the use of iodine in salt for processed food is voluntary, so very few processors add it. Food products from animals are likely to contain some iodine from their feed, and most commercially baked breads have iodine added. We live in Hawaii, so I generally avoid locally grown fruits and veggies because of the high iodine count. BUT, if I haven't had exposure to gluten, iodine is not a problem. Interesting sidebar: prior to being diagnosed, I had no intestinal issues that I was aware of. My symptoms were confined to rash and inflammation in various body systems. Since adhering to a GF diet, my digestive system has begun to react severely to the ingestion of gluten. My intestines must swell completely shut, because within 30 minutes vomiting begins. It continues until I'm depleted & throwing up bile (about 2 hours of hell). The good thing is that I'm in no way tempted to cheat on my diet, so other than an occasional mistake, and my recent attempt to eat "certified gluten-free oats" I've been virtually rash free for many years. Hope this info is helpful to someone!

 
pearl
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said this on
23 Jun 2015 2:19:16 AM PST
Reading this makes me think the thyroid support supplement I take is preventing the DH from healing. I am doing the SCDiet for celiac and think it is helping my esophagitis and hopefully gastritis.

 
Ben
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said this on
07 Oct 2015 2:03:03 AM PST
Really interesting article and comments too.

I've suffered from colitis, a host of food intolerances, skin complaints including DH (which I'm not rid of yet) and all the associated ailments that come with auto-immune disease like aches, low energy, dislike of the cold etc.

I don't mean to dissect what's already been written above and by the author but my thinking was that iodine is acting as a chelate and helping your body to detox. Therefore my take would be that we have to go through a certain amount of pain i.e. experiencing exacerbated symptoms before ridding our bodies of toxins and ultimately getting better.

IMHO it's about being gentle with any detox so that as individuals we can find a comfortable sweet spot that allows us to detox without being driven to distraction, not an easy balance to achieve but ultimately very rewarding.

I'm still on this journey but I'm following my instinct and experiencing significant health improvements to the point that I've almost forgotten about my colitis and I'm now focusing on improving my skin as I see this as a window to my health. This is all with a diet that is mostly pescetarian, gluten, nut and dairy free to minimize inflammation in my body.




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