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					Low­Iodine Diet: Preparing to receive radioactive iodine

Why do I need to follow a low­iodine                How will I know which foods are high
diet?                                               in iodine so that I can avoid them?
Before you receive radioactive iodine (tracer or    Because the iodine content of food is not listed
therapy dose), you must follow a low­iodine diet    on food labels, nutrient counter books, or web­
for about 2 weeks to prepare.                       sites, you cannot track how much iodine you
By limiting iodine in your diet, you deplete your   consume.
body’s iodine supply. This makes your thyroid       The foods highest in iodine are dairy (milk and
gland ”hungry” for iodine so that it will absorb    milk­based products), egg yolks, fish, shellfish,
more radioactive iodine. Increased uptake of        seaweed, chocolate, and a few specific grains.
radioactive iodine will make your treatment         Beyond these foods, most iodine in the
more effective or your scan more accurate.          American diet comes from iodized salt used at
What is iodine?                                     the table and from a few food additives. The
Iodine is an essential mineral your body uses       document, Low­Iodine Diet Food List, will
to make thyroid hormones.                           help you choose wisely.
                                                    This list will tell you:
How much iodine can I consume on
                                                    o What foods to avoid
the low­iodine diet?
On the low­iodine diet, your intake must be less
                                                    o What foods you can consume, but in limited
than 50 micrograms of iodine per day. You do          amounts
this by limiting high iodine foods.                 o What foods you can eat in unlimited amounts
How much iodine do Americans                        Reading Ingredient Labels for Iodine
usually consume?
The Recommended Daily Allowance (or RDA,            Not­allowed Ingredients
the amount of iodine necessary for most             These ingredients are not allowed in any
adults), is 150 micrograms per day. The usual       amount. Check ingredient labels.
intake in the United States is about 150­550        o Bread conditioners: “Calcium iodate” or
micrograms. By comparison, the low­iodine diet        “potassium iodate”
is much lower in iodine than a person’s aver­         Avoid commercial breads and baked goods
age intake.                                           unless you can verify the type of bread
You must follow this diet for only a short time:      conditioner used.
2 weeks before treatment or testing with              Note: Home­made bread/baked goods are
radioactive iodine.                                   allowed.
                                                    o Sea salt

    Patient Education                         1             Low­Iodine Diet: Preparing to receive
                                                                               radioactive iodine
o Red Dye #3 (E127 in Europe), also              More about eating low­iodine
  called eryrythrosine                           Processed foods
  This is rare now, but check labels on          Many canned, packaged, or frozen foods
  foods dyed red or orange.                      contain added salt, and the label rarely
o Alginate, algin, agar­agar,                    says whether salt in a food is iodized or
  carrageenan, nori, algae, alginates,           not. At the time of this publication, most
  kelp, seaweed                                  large manufacturers use non­iodized salt
                                                 (See the list in this document, Food
  These are seaweed or seaweed­deriv­
                                                 brands using non­iodized salt, for spe­
  atives and should be avoided. Alginates
                                                 cific brand names.) Always check for not­
  thicken jellies, soup, ice cream, salad
                                                 allowed ingredients.
  dressings, and toothpaste. Sushi con­
  tains seaweed.                                 o Small manufacturers may use iodized
o Egg yolk (the yolk contains the                   salt or sea salt, so you should try to
  iodine)                                           avoid those products during the short
                                                    time you follow this diet.
Limited Ingredients                              o Non­iodized table salt is okay to use
The following foods are very high in                while on a low­iodine diet.
iodine and are not allowed as whole
foods. But because it may be difficult for       Restaurant foods
you to find products without these ingre­        Eating out on the low­iodine diet poses

dients, they are allowed as ingredients in       two challenges.

small amounts.                                   First, you will usually not know what type

o Cream or milk                                  of salt restaurants use, and most prepare

o Chocolate                                      foods with lots of added salt.

o Whole egg                                      Second, restaurants often make their own

o Cheese                                         marinades, spice mixes, dressings, and

                                                 sauces with iodized salt.

How small is a small amount?
There is not an easy answer to this ques­        So, if you eat out in a restaurant,

tion. Less is better since you must limit        follow these tips:

your iodine intake. Think in terms of tea­       o Choose plainly prepared foods that are
spoons not measuring cups.                         allowed on your low­iodine diet.
Also know that ingredients are listed on         o Make special requests that food be
the label from largest to smallest                 prepared without added salt, mari­
amounts by weight. This means that if              nades, or sauces.
one of these appears at the end of a long
                                                 o Use simple oil and vinegar instead of
list of ingredients, it most likely is present
                                                   dressing on a salad, or bring your own.
in only small amounts.

Patient Education                           2             Low­Iodine Diet: Preparing to receive
                                                                             radioactive iodine
o Spices and herbs without salt are              Medications
  allowed to flavor food.                          Some medications contain iodine (most
                                                   notably levothyroxine and triiodothyroi­
o Home preparation: Similar to eating in           nine). Check with your doctor to learn
  restaurants.                                     whether any of your medicines contain
                                                   iodine or should be stopped. Do not stop
Other iodine­containing products                   any medication without speaking with
to avoid                                           your doctor first.
Red Dye: Red Dye #3 (E127 in Europe),              Some people use Betadine or other
erythrosine                                        iodine­containing products on their skin
Red Dye # 40 is okay. With this in mind,           as an antiseptic. Avoid using this product
check about any pills or capsules                  while on the low­iodine diet. Instead
artificially dyed red, orange, or brown.           choose hydrogen peroxide for cleansing
                                                   and an antibiotic cream if necessary.
                                                 Creams, lotions
o Calcium supplements made from                    Avoid creams or lotions made from
  oyster shells may be high in iodine              seaweeds (including kelp and spirulina)
  and should be avoided.                           while on the low­iodine diet.
o Fish oil is also likely to be high in iodine   Water purification
  and should be avoided. (Omacor brand             Avoid using iodine tablets while on this
  is one exception and is allowed.)                diet.
o Multi­vitamins also may contain iodine
  and should be stopped while following
  the low­iodine diet.
o Selenium supplements should also be
  Some toothpastes contain alginates.
  Check the label to find an acceptable
  product for brushing your teeth.

Patient Education                           3             Low­Iodine Diet: Preparing to receive
                                                                             radioactive iodine
 Food brands using                              Reddi­Whip
 non­iodized salt                               Slim Jim
 The following manufacturers report using
 non­iodized salt in their food production      Kraft Brands
 (as of this publication). You may safely use   http://www.kraft.com/Brands/
 foods prepared by these manufacturers          A1
 if they are on the “allowed” food list.        Alpen Gold
 Each manufacturer typically produces many      Breakstone’s
 brands, and many appear below. If you          CapriSun
 want a more comprehensive list, you can        CarteNoir
 always check the company’s website.            CheezWhiz
 Campbell Soup Brands                           Chips Ahoy
 http://www.campbellsoupcompany.com/our_        Club Social
 brands.asp                                     Cool Whip
 Campbell Soup                                  Cote D’Or
 Campbell                                       California Pizza Kitchen
 Pepperidge Farm                                Cracker Barrel
 V8                                             Crystal Light
 Pace sauces                                    Deluxe
 Prego                                          DiGiorno
 Swanson broths                                 Estrella
                                                General Foods ­ International
 Conagra                                        Gevalia
 http://www.conagrafoods.com/                   Grand Mere
 Chef Boyardee                                  Handi­snacks
 David Seeds                                    Honey Maid
 Egg Beaters                                    Jack’s
 Healthy Choice                                 Jacobs
 Hebrew National                                Jell­O
 Hunt’s                                         Kenco
 Kid Cuisine                                    Kool­Aid
 Marie Callender’s                              Kraft
 Orville Redenbacher’s                          Marabou

Patient Education                        4             Low­Iodine Diet: Preparing to receive
                                                                          radioactive iodine
 Maxwell House                     General Mills
 Milka                             http://www.generalmills.com/brands.aspx
 Miracle Whip                      Betty Crocker
 Nabisco                           Bisquick
 Newtons                           Bugles
 Nilla                             Cascadian Farm
 Nutter Butter                     Cheerios
 Onko                              Chex
 Oreo                              Forno de Minas
 Oscar Mayer                       Frescarini
 Philadelphia (cream cheese)       Fruit by the Foot
 Planters                          Fruit Gushers
 Polly­O                           Fruit Roll­Ups
 Post                              Fruit Shapes
 Premium                           Gardetto’s
 Prince                            Gold Medal
 Ritz                              Green Giant
 Royal                             Haagen­Dazs
 Simmenthal                        Latina
 South Beach                       Muir Glen
 Stove Top                         Nature Valley
 Tang                              Pillsbury
 Tassimo                           Pop Secret
 Toblerone                         Progresso
 Tombstone                         Totino’s/Jeno’s
 Trakinas                          Trix
 Triscuits                         Wheaties
 Velveeta                          Yoplait/Columbo
 Wheat Thins                       8th Continent (soy)

Patient Education              5         Low­Iodine Diet: Preparing to receive
                                                            radioactive iodine
 Heinz                                            FritoLay
 http://www.heinz.com/                            http://www.fritolay.com/index.html
 Bagel Bites                                      Baken­ets
 Boston Market                                    Chester’s
 Delimax                                          Cracker Jack
 Guloso                                           Cheetos
 Heinz                                            Doritos
 Jack Daniel’s Sauces                             El Isleno
 Mr. Yoshida’s Sauces                             Flat Earth
 Nancy’s                                          Fritos
 Ore­Ida                                          Funyuns
 Smart Ones                                       Gamesa Cookies
 T.G.I. Friday’s                                  Grandma’s Cookies
 Weight Watchers                                  Lay’s
 Wyler’s                                          Maui Style Potato Chips
 Hormel                                           O’Keeley’s
 http://www.hormelfoods.com/brands/default.aspx   Quacker Snack mix
 Chi­Chis                                         Rold Gold
 Dinty Moore                                      Ruffles
 Farmer John                                      Sabritones
 Jennie­O                                         Santitas
 HerbOx                                           Smartfood
 Lloyds                                           Stacy’s brand
 Stagg Chili                                      Sun Chips
 World Food                                       Tostitos


Patient Education                           6            Low­Iodine Diet: Preparing to receive
                                                                            radioactive iodine
 Quaker                                       Unilever
 http://www.quakeroats.com/home.aspx          http://www.unilever.com/brands/
 Aunt Jemima                                  Bertolli
 Cap’n Crunch                                 Blue Band
 Kretschmer Wheat Germ                        Country Crock
 Life                                         Heartbrand
 Mother’s Natural Foods                       Hellman’s
 Near East                                    Knorr
 Quaker                                       Lipton
 Quisp                                        Slim­Fast
 Pasta Roni                                   Wish­Bone

 PepsiCo                                      What if the brand of the food I
 (also owns Frito Lay and Quaker, previous­   want to eat is not on this list?
 ly listed): http://www.pepsico.com/          This list does not name all food companies
 Gatorade                                     or their brands. By including a company on
 Propel                                       this list, NIH is in no way endorsing them.
 Pepsi                                        If you know of a brand not listed here, use
 Tropicana                                    your best judgment to decide whether to
                                              include the food.
                                              The guideline is that foods by large
                                              manufacturers/ companies are generally
                                              prepared with non­iodized salt. Foods
                                              prepared by smaller companies have a
                                              greater risk for containing iodized salt and
                                              being high in iodine.

Patient Education                      7             Low­Iodine Diet: Preparing to receive
                                                                        radioactive iodine
 Is this information up­to­date?
 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
 up­to­date information. We will make every
 attempt to confirm the use of non­iodized
 salt by these manufacturers once a year.
 We can also provide references if you ask
 for them.

                                             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?

                                             NIH...Turning Discovery Into Health

Patient Education                        8                  Low­Iodine Diet: Preparing to receive
                                                                               radioactive iodine

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