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  • Scott Adams
    Scott Adams

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

    Reviewed and edited by a celiac disease expert.

    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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    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.

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    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.

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    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.

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    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.

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    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!

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    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.

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    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.

    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

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    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!

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    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.

    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.

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    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.

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    Celiac.com's Founder and CEO, Scott was diagnosed with celiac disease  in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. Scott launched the site that later became Celiac.com in 1995 "To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives."  In 1998 he founded The Gluten-Free Mall which he sold in 2014. He is co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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