Sunday, April 5, 2015


Synthetic Hormones Lose in Court


Court CaseSynthetic Hormones Lose in Court

Pfizer-Wyeth Loses Big Case
Prempro Causes Breast Cancer
112 Million in Punitive Damages
by Jeffrey Dach MD

A 112 million dollar punitive award is a very loud statement.  It states that the jury was outraged by the “wanton and reckless” conduct by Wyeth.   

112 Million Dollars in punitive damages was awarded to two breast cancer victims who took Wyeth’s synthetic hormone, Prempro, all the while thinking it safe. The jury was outraged that Wyeth ignored and suppressed evidence that Prempro causes breast cancer.  Wyeth paid consultants and ghostwriters of medical journal articles to play down concerns about breast cancer, and declined to study known risks. Once again, company profit was placed ahead of patient safety. This is the tip of the iceberg, as another ten thousand cases are waiting for their day in court.

Women’s Health Initiative Bombshell

Years ago, a bombshell appeared in the medical literature, and massive numbers of women switched from Prempro to safer bio-identical hormones. This was the 2002 WHI study which showed that PremPro causes breast cancer. This massive shift away from synthetic Prempro reduced breast cancer rates by 10,000 fewer cases per year. (NEJM Volume 356:1670-1674 April 19, 2007 Number 16)

The American Public Hoodwinked
progesteroneLeft image : Natural Progesterone   
MedroxyprogesteroneThis Prempro court case teaches us an important lesson. When a “Bad Drug” like Prempro gets FDA approval and placed on the market, what happens?  The public is hoodwinked, and the drug company profits handsomely. The wheels of justice turn slowly.  After 65 years and thousands of victims, our court system has finally ended a bad drug, in this case, a synthetic hormone called Prempro.

Altered PremPro



Left image show how to chemically alter a natural bioidentical hormone by adding  chemical groups. This is done in order to obtain a patent on the new chemical structure which protects profits for the drug company. This is a bad idea because any alteration of a hormone creates a MONSTER.  Left image medroxyprogesterone.

Another Important Lesson – Don’t Use Synthetic Hormones

Another important lesson from this case is that synthetic hormones like Prempro, which are chemically altered versions of human hormones, are all “Monster Hormones” which should never have been approved by the FDA in the first place. Any alteration in a chemical structure of a hormone creates a Monster, and in the case of Prempro, the result is increased cancer and heart disease.

Breast CancerChanged Chemical Structure Results in Monster Hormones
The drug companies changed the chemical structure of human hormones to obtain patent protection and maximize profits. Human bioidentical hormones cannot be patented because they are found naturally in the human body, therefore they are not profitable for the drug companies.  Left Image : Bright spot represents  breast cancer on PET mammogram combined imaging.

Just Another Round in the Medical Information War
Drug companies routinely use their influence to control information in the mainstream media and the medical journals. They downplay adverse side effects of their products in order to maximize profits. This is merely part of the Medical Information War played out in the media every day.

Bioidentical Hormones Are Safe and Effective
This case highlights another important lesson. While the chemically altered synthetic hormones like Prempro are dangerous, the original version from nature, called Bioidentical hormones are safe, effective and beneficial for health.

Addendum June 19 2012 from Bloomberg News:

June 19 (Bloomberg) by Jef Feeley — Pfizer Inc. has paid $896 million to resolve about 60 percent of the cases alleging its menopause drugs caused cancer in women.  Pfizer has now settled about 6,000 lawsuits that claim Prempro and other hormone-replacement drugs caused breast cancer, and it has set aside an additional $330 million to resolve the remaining 4,000 suits, according to a filing with the U.S. Securities and Exchange Commission.
The reserve means New York-based Pfizer has committed more than $1.2 billion to resolving claims that its Wyeth and Pharmacia & Upjohn units failed to properly warn women about the menopause drugs’ health risk. Based on the May 10 filing, the company is paying an average of about $150,000 a case.

Articles with related Interest:

The Importance of BioIdentical Hormones
The Safety Of Bio-Identical Hormones
Importance of Bioidentical Hormones

Here is an important article on HRT by Jonathan Wright MD, the originator of bioidentical hormones. Read it here:
FDA approved HRT- Prempro is Risky by Jonathan Wright MD written in 2003.
Links to Related Content:
Iodine Treats Breast Cancer, Overwhelming Evidence by Jeffrey Dach MD

Breast Cancer Prevention and Iodine Supplementation by Jeffrey Dach MD

Links and References

http://blog.legalbroadcastnetwork.com/
the-lbn-blog/2009/11/24/zoe-littlepage-discusses-112-million-wyeth-hrt-verdicts.html

Zoe Littlepage Discusses $112 Million Wyeth HRT Verdicts. Tuesday, November 24, BEST with video of Zoe Littlepage
http://menstruationresearch.org/2009/11/23/prempros-losing-streak-continues/
Blog of the Society for Menstrual Cycle Research.  PremPro’s Losing Streak Continues November 23rd, 2009 by Elizabeth Kissling
There are more than 10,000 lawsuits against Wyeth/Pfizer regarding the link between PremPro and breast cancer. There have been 12 verdicts so far, and juries have awarded money to the plaintiffs in ten of those cases. The latest was announced today, in Donna Kendall v. Wyeth (Phila. CCP, June Term, 2004, No. 0965). The jury awarded Ms. Kendall $6.3 million in compensatory damages, and $28 million in punitive damages. So far, thirteen women have settled their claims with Wyeth/Pfizer, but if awards like these continue, can we expect Pfizer soon to be offering to settle the rest?video here.
http://www.nytimes.com/2009/11/24/business/24wyeth.html
Another Loss for Pfizer in Drug Suits By DUFF WILSON November 23, 2009 NY Times.  Pfizer has been ordered to pay a total of $103 million in punitive damages to two women who were found to have breast cancer after they used hormonal drugs, state court officials in Philadelphia said Monday. Punitive damages in Pennsylvania require a finding of “wanton and reckless” conduct. The jurors heard testimony that Wyeth paid consultants and ghostwriters of medical journal articles to play down concerns about breast cancer, as well as testimony that Pharmacia did not study known risks. The punitive award was split $16 million for Wyeth and $12 million for Pharmacia.
http://www.philly.com/philly/business/homepage/
20091125_Prempro_plaintiffs__lawyers_sold_their_story_to_the_jury.html

Posted on Wed, Nov. 25, 2009 Prempro plaintiffs’ lawyers sold their story to the jury.  By Chris Mondics and Miriam Hill Inquirer Staff Writers The lawyers who won $103 million in two jury verdicts announced Monday against Pfizer Inc. relied as much on their storytelling ability as their knowledge of the law.
http://www.dailymail.com/ap/ApTopStories/200911230561
AP Featured News Monday November 23, 2009 $75M verdict unsealed in Prempro-cancer case PATRICK WALTERS Associated Press Writer
http://www.abajournal.com/news/
article/juries_award_103m_in_punitives_in_two_prempro_cases/

Verdicts & Settlements Juries Award $103M in Punitives in Two Prempro CasesPosted Nov 24, 2009 By Debra Cassens Weiss Philadelphia juries have awarded two breast-cancer victims $103 million in punitive damages in two separate cases against Pfizer Inc. involving the marketing of the hormone replacement drug Prempro.
Jurors had heard testimony that Wyeth, the maker of Premarin and Prempro, paid consultants to write medical journal articles to play down the risks of breast cancer, and evidence that another drug maker, Pharmacia, didn’t study known risks of its replacement drug, Provera, the New York Times reports. Both companies have been acquired by Pfizer. Yesterday jurors awarded $28 million in punitives to Donna Kendall of Decatur, Ill., in addition to $6 million in compensatory damages already awarded, the Legal Intelligencer reports.
After the verdict, the court unsealed an award of $75 million in punitives in a case filed by Connie Barton of Peoria, Ill. She had already been awarded $3.5 million in compensatory damages. Fordham University law professor Howard Erichson told the Philadelphia Inquirer that the $75 million punitive award will likely be reduced because it is so much larger than compensatory damages.
At least 1,500 cases over the hormone drugs have been filed in Philadelphia, the location of Wyeth, the Times says. Across the country, more than 10,000 cases have been filed. Esther Berezofsky, a lawyer for one of the plaintiffs, told the Times that women with breast cancer have won awards in 10 of 12 hormone drug cases. Pfizer counters that out of 34 hormone replacement cases that have been tried, all but four of the plaintiffs’ verdicts were set aside, according to the Intelligencer.
Jeffrey Dach MD

http://www.drdach.com
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The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician — patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.
Link to this article:http://wp.me/p3gFbV-2Hm
Copyright (c) 2009- 2015 Jeffrey Dach MD All Rights Reserved. This article may be reproduced on the internet without permission, provided there is a link to this page and proper credit is given.
FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of issues of significance. We believe this constitutes a ‘fair use’ of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.

Testosterone Prevents Heart Attacks 

in Older Men

90-Year-Old-Weight-LifterNew Study Shows Testosterone Therapy Not a Risk For Heart Attacks, and Actually Prevents Heart Attacks in High Risk Older Men.


A new study published in Annal of Pharmacotherapy by Dr Baillargeon shows that “Older men who were treated with intramuscular testosterone did not appear to have an increased risk of Myocardial Infarction (MI). For men with high Myocardial Infarction (MI) risk, testosterone use was modestly protective against Myocardial Infarction (MI).”  Note: Heart Attack = Myocardial Infarction (MI).


To read this paper here is the link to the pdf: Testosterone_No_Increased_Risk_Baillargeon_Ann_Pharmacother_2014

Left Image 90 year old weight lifter courtesy of Photography Heat.
Articles With Related Interest:
Testosterone Erythrocytosis Thrombophilia and Heart Attack
Testosterone and the Heart Part One
Testosterone and the Heart Part Two
Low Tesostosterione Diagnosis and Treatment
Testosterone Beneficial in Diabetes

Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663

Links and References:

1) http://www.ncbi.nlm.nih.gov/pubmed/24989174  Ann Pharmacother. 2014 Jul 2;48(9):1138-1144. Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy.Baillargeon J1, Urban RJ2, Kuo YF2, Ottenbacher KJ2, Raji MA2, Du F2, Lin YL2, Goodwin JS2.
Testosterone therapy for older men has increased substantially over the past decade. Research on the effects of testosterone therapy on cardiovascular outcomes has yielded inconsistent results.
OBJECTIVE:  To examine the risk of myocardial infarction (MI) in a population-based cohort of older men receiving intramuscular testosterone.
METHOD:  Using a 5% national sample of Medicare beneficiaries, we identified 6355 patients treated with at least 1 injection of testosterone between January 1, 1997, and December 31, 2005. We matched this cohort to 19 065 testosterone nonusers at a 1:3 ratio based on a composite MI prognostic score. Patients were followed until December 31, 2005, or until they lost coverage from Medicare, enrolled in a health maintenance organization, experienced a MI, or died.
RESULT:  In a Cox regression analysis adjusting for demographic and clinical characteristics, receipt of testosterone therapy was not associated with an increased risk of MI (hazard ratio [HR] = 0.84; 95% CI = 0.69-1.02). In this analysis, there was an interaction between receipt of testosterone and quartile of risk of MI (P = 0.023). For men in the highest quartile of the MI prognostic score, testosterone therapy was associated with a reduced risk of MI (HR = 0.69; 95% CI = 0.53-0.92), whereas there was no difference in risk for the first (HR = 1.20; 95% CI = 0.88-1.67), second (HR = 0.94; 95% CI = 0.69-1.30), and third quartiles (HR = 0.78; 95% CI = 0.59-1.01).
CONCLUSION:  Older men who were treated with intramuscular testosterone did not appear to have an increased risk of MI. For men with high MI risk, testosterone use was modestly protective against MI.
Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663
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The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician — patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.

Link to this article:http://wp.me/p3gFbV-2BH

Copyright (c) 2012-13 Jeffrey Dach MD All Rights Reserved. This article may be reproduced on the internet without permission, provided there is a link to this page and proper credit is given.
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James A Shapiro Natural Genetic Engineering and Evolution Part Two

Elysia-Chlorotica-Credit-Patrick-KrugJames A Shapiro Natural Genetic Engineering and Evolution Part Two
In part one we discussed how advances in science had rendered portions of Darwin’s Original 1859 theory antiquated and obsolete. In addition, a later revision of Darwin, neo-Darwinism updated with new knowledge of genetics, has also been rendered obsolete by new scientific understandings in molecular biology and cytogenetics.


Evolution: A View From the 21st Century

Jams A Shapiro Evolution View From the 21st CenturyJames A. Shapiro, author of
Evolution: A View from the 21st Century , and Professor of Microbiology, professor of genetics at the University of Chicago has written extensively about this topic.  His blog at Huffington Post provides the public with non-technical explanations of these new advances in science.
In Part Two, we will rely on Dr Shapiro’s prose and wit to bring us up to speed on the new Non-Darwinian thinking about evolution.




Middle Ages and Suppression of Science


Anatomy Lesson REmbrandtFirstly a little historical perspective on science.  Through much of the Middle Ages, the prevailing culture prohibited the study of human anatomy, or any medical science for the alleviation of disease.  These people were found guilty of witchcraft and burned at the stake.  Needless to say, this provided a powerful disincentive to study human anatomy, medicine or even science for that matter.  Things turned around in the 1600’s with the “Enlightenment” . The study of human anatomy could now be done in the open, and was celebrated with group portraits by leading artists. See left image: the Anatomy Lesson Nicolas Tulp 1632 by Rembrandt courtesy of Museum.
Beat The Swords Into Plowshares
Schwerter_zu_Pflugscharen_-_Bronze_-_Jewgeni_Wutschetitsch_-_Geschenk_der_Sowjetunion_an_die_UNO_-_1959Science involves examining the natural world and coming up with a rational explanation for the observations.  Various analytic tools, such as microscopes, telescopes, and computers etc. proved immensely useful in increasing our knowledge of mastery of the natural world.  The first atomic bomb was detonated in August 1945, representing a milestone in human achievement.  This event marked a turning point in human history.  We now had gained enough knowledge and mastery of the natural world to transform our lively planet into a lifeless cinder heap. Here, we repeat the old lesson that science can be used for peace or war, for making swords or for making plowshares. (See left image:  

Let Us Beat Swords into Plowshares, a sculpture at the UN in New York, by Evgeniy Vuchetich donated by the Soviet Union to the United Nations in 1959; courtesy of wikimedia commons)
Race Horse Breeding Darwinian EvolutionAbove image: race horses are subject to artificial breeding techniques to create faster horses. courtesy of Guardian.


Charles Darwin 1859  – Artificial Selection by Animal Breeders

Darwin’s work followed this emancipation from the mental shackles of the past.  The idea was to apply science to answer the questions about the origin of man, animals and other life on the planet.  The original 1859 Darwin’s Theory of evolution was based on observations that animal breeders could artificially breed into their herd traits they considered desirable or useful.  This was accomplished by allowing animals with desired traits to reproduce, and prohibiting those with undesirable traits from doing so.  This was called “artificial selection”.


Modern Eugenics in Indiana 1907

Indiana Eugenics Law 1907During a sad chapter in our history, modern eugenics argued for and actually practiced “Artificial Selection ” on our fellow humans by weeding out the “unfit”.
The state of Indiana passed a Eugenics inspired sterilization law in 1907.  The law was struck down in 1921 by the Indiana Supreme Court after 2500 people had been involuntarily sterilized by the state. Sterilization of institutionalized patients continued to the mid-1970’s in 33 states. In all, about  60,000 Americans were involuntarily sterilized.   The topic of Eugenics is still active, as this article on the Huff Post demonstrates.
Natural Selection – What is it ?

The idea here is that mother nature replaces the animal breeder.  Animals having traits more adapted to their environment will survive and reproduce, continuing those traits in the offspring. Those animals having undesirable or less adapted traits would usually not survive and therefore not reproduce.

Dr Shapiro explains Natural Selection in his article (2):

james_shapiro_genetic_engineering“Variants fittest (best able) to survive the Malthusian struggle for existence and reproduction in a world of limited resources would progressively become different and dominant. Eventually, differences would accumulate to the point that new species would form.”
Dr Shapiro points out the Darwin’s artificial selection has never actually produced a new body plan or new species, so it is ironic that Darwin would use “Natural Selection” as a proposed mechanism for evolution of simple to more complex life forms. Shapiro points out that :
Darwin “ignored the inconvenient fact that human selection for altered traits has never generated a truly new organismal feature (e.g., a limb or an organ) or formed a new species. Selection only modifies existing characters.“


Evolution – Gradual or Sudden ?
Evolution from Monkey ViewPointAnother feature of Darwin’s Theory was that variation was “continual and small”.  Change occurred in small steps. “Evolutionary innovation had to be gradual”
From Dr Shapiro:
“Darwin was correct in believing that natural selection could only play a creative role if variation was continual and small. Based on the “Uniformitarian” idea that change had to occur in the small steps we observe under normal conditions, he originally insisted that evolutionary innovation had to be gradual. “If it could be demonstrated that any complex organ existed, which could not possibly have been formed by numerous, successive, slight modifications, my theory would absolutely break down. But I can find out no such case” 
Sudden Changes Outside of Natural Selection
Darwin acknowledged that sudden changes in evolution could occur independently of natural selection  .  He wrote

“… variations which seem to us in our ignorance to arise spontaneously. It appears that I formerly underrated the frequency and value of these latter forms of variation, as leading to permanent modifications of structure independently of natural selection“ (Origin of Species, 6th edition, Chapter XV, p. 395, emphasis added by Dr James A Shapiro).

Dr Shapiro points out that the modern science of cytogenetics and molecular genetics has provided insight into biological novelties arising “independently of natural selection — hybridization, genome duplication, symbiogenesis, chromosome restructuring, horizontal DNA transfer, mobile genetic elements, epigenetic switches, and natural genetic engineering (the ability of all cells to cut, splice, copy, and modify their DNA in non-random ways). ” (2)

“The genome sequence record tells us that these processes have accompanied rapid changes in all kinds of organisms. We know that many of them are activated by stress under extraordinary circumstances.”(2)


Natural Genetic Engineering (NGE) and Evolution

GMO BacteriaNatural Genetic Engineering is defined as the “ability of all cells to cut, splice, copy, and modify their DNA in non-random ways”.  Dr. James A Shapiro goes on to explain NGE in this article on the Huffington post.(8)
“NGE is shorthand to summarize all the biochemical mechanisms cells have to cut, splice, copy, polymerize and otherwise manipulate the structure of internal DNA molecules, transport DNA from one cell to another, or acquire DNA from the environment. Totally novel sequences can result from de novo untemplated polymerization or reverse transcription of processed RNA molecules.

Tool BoxNGE describes a toolbox of cell processes capable of generating a virtually endless set of DNA sequence structures in a way that can be compared to erector sets, LEGOs, carpentry, architecture or computer programming.”(8)
While we can now relegate Natural Selection and Random Mutation to the dustbin of history, declare NGE as the new mechanism for evolution, the details are yet to be uncovered.
“While NGE can help in understanding the molecular details of rapid and widespread genome change, it does not tell us what makes genomic novelties come out to be useful. How natural genetic engineering leads to major new inventions of adaptive use remains a central problem in evolution science.”(8)
 
Random Mutation and Evolution – Proofreading and Error Correction


ProofReadingAnother dogma of Neo-Darwinism is the idea of random mutation as a necessary component of the mechanism of evolution.  Random mutation was thought to produce the variation and diversity in a gradual way.
Science has shown that the genome has “proof reading and repair systems“.  These are elaborate self correcting  and self repairing mechanisms which correct random mutations.  These repair mechanisms are also components of “natural genetic engineering” in the cell.  If mutations are not repaired by cell machinery and persist, they are harmful, leading to genetic disease.  These harmful mutations create “monsters”, not new adaptive traits, nor new species.(10)

From Dr Shapiro (10):
“Before we learned about biochemical systems for DNA reorganization, physical damage from radiation, radiation, chemical damage from alkylating agents and other reactive substances, spontaneous chemical changes, and inevitable errors in the fidelity of replication were thought to be the main agents of genetic change. It is very important to recognize that living cells resemble man-made systems for information processing and communication in their use of mechanisms for error detection and correction. These mechanisms minimize the degradation of information through accidents which are inevitable in all complex systems. Cells illustrate the application of this principle with multiple genomic proofreading and repair systems that anticipate a wide range of accidental genetic changes, including replication errors, chemical changes and radiation damage.”(10)

antibiotic _resistance_bacteria_evolution_James_shapiroThe Rapid Evolution of Antibiotic Resistant Bacteria

Left Image Caption: “Bacteria acquire resistance by exchanging conjugative plasmids (circular units of DNA), by acquiring DNA released from dead cells, and by transferring resistance genes packaged in viruses.”
The case of rapidly acquired antibiotic resistance in pathogenic bacteria is a highly studied example of evolution which again supports the theory of natural genetic engineering, not random mutations as the mechanism for evolutionary change. (10)   Left Image courtesy of: Antibiotic_Resist_Carol_Potera_2013 
This discussion by Dr James A Shapiro comes from his articles in the Huff Post:  The Distinct Roles of Selection, Horizontal Transfer and Natural Genetic Engineering in Dangerous Superbug Evolution  and this article by Dr Shapiro on Evolutionary Lessons From SuperBugs.

Conjugation_Plasmid_DNA_Genetic_Enginering
Above Image: Schematic Representation of Conjugation, a Plasmid (Blue Circle) transfers from one bacterial cell to another, courtesy of science prof online. 

Enter the Plasmid, a Circular Strand of DNA

Plasmid_electron_microscopy_Circular_DNAIn a form of HGT, Horizontal Gene Transfer, Plasmids, little circular molecules of portable DNA, transmit the antibiotic resistant coding sequence to the new bacteria.
Left Image electron microscope image of Plasmid, cover courtesy of PNAS.
The plasmid’s job is to distribute the antibiotic resistant genes throughout an unselected population of bacteria. To make matters even worse, the plasmids may encode resistance to many different antibiotics, conferring “multiple antibiotic resistance” to the bacterial population.  The antibiotic resistant bacteria “acquired new biochemical activities that could destroy or inactivate the antibiotics, chemically alter their targets, or remove them from the bacterial cell”.
“Faced with such a powerful bacterial toolbox for accumulating and spreading antibiotic resistance, it is no wonder that we have been caught off guard underestimating the capacity of these small cells to evolve high levels of resistance quickly.”
“Many questions remain to be clarified, such as where the resistance sequences themselves arose”.


Another Example of Non-Darwinian Evolution

Elysia-Chlorotica-Credit-Patrick-KrugThanks and credit goes to Scott Baker, managing editor of Op Ed News sending me  this fascinating example of the sea slug that has acquired a novel function, photosynthesis by horizontal gene transfer from ingested algae.  Image at left: Rich green color of the photosynthesizing sea slug, Elysia chlorotica by Patrick Krug courtesy of Science Daily.
This is a beautiful example of non-Darwinian “rapid evolution” using HGT, one of the tools in the “Natural Genetic Engineering” toolbox.   Author of the paper, Sidney K. Pierce says:
“When a successful transfer of genes between species occurs, evolution can basically happen from one generation to the next, he notes, rather than over an evolutionary timescale of thousands of years.”

Addendum: Lynn Margulis says thet random mutation is never enough for novelty in evolution. 2004 interview:

For part one of this series see: Part One.
Jeffrey Dach MD
7450 Griffin Road Suite 190
Davie, Fl 33314
954-792-4663

LINKS and References

1) Reply to Laurence A Morans review of Evolution A View From 21st Century James A Shapiro
My argument is that molecular research over the past sixty years on DNA change processes has taught us that virtually all genetic variation results from the action of regulated cell biochemistry, including a wide array of cutting, splicing and polymerizing functions that I summarize under the term “natural genetic engineering”. I assert that this realization represents a fundamental shift from the conventional view that genetic change is a random, accidental process.
2) http://www.huffingtonpost.com/james-a-shapiro/does-natural-selection-evolution_b_1769524.html
James A. Shapiro Does Natural Selection Really Explain What Makes Evolution Succeed?
Have we learned since 1859 about processes that can lead to organism change “independently of natural selection?” The answer is overwhelmingly positive.
Two fields principally illuminated the basic mechanisms of heredity and variation:
cytogenetics (the study of chromosome behavior in heredity using both genetic and microscopic methods) and molecular genetics (using DNA analysis to identify the nature of genome change).
In combination, cytogenetics and molecular genetics have taught us about many processes that lead to biological novelties “independently of natural selection” — hybridization, genome duplication, symbiogenesis, chromosome restructuring, horizontal DNA transfer, mobile genetic elements, epigenetic switches, and natural genetic engineering (the ability of all cells to cut, splice, copy, and modify their DNA in non-random ways). As previous blogs document and as future blogs will discuss, the genome sequence record tells us that these processes have accompanied rapid changes in all kinds of organisms. We know that many of them are activated by stress under extraordinary circumstances.
3)  http://www.counterpunch.org/2012/05/07/the-evolution-paradigm-shift/
May 07, 2012 An Interview With James Shapiro  The Evolution Paradigm Shift by SUZAN MAZUR
Dawkins and his ill-conceived atheist crusade hurts science education and hurts evolutionary science. Both Coyne and Dawkins have been characterized as having a neo-atheist agenda in attacking religion.
Both Coyne and Dawkins are doing well for themselves by being vitriolic and vehement in their campaign against religious belief and against some of the more foolish things that religious fundamentalists do.  But I suspect ego gratification is the major driver more than financial gain. Obviously it’s nice if you make money at the same time.
back in the late 60s and 70s and since then we’ve learned about a wide variety of biochemical systems that cells use to restructure their  genomes as an active process.  Genome change is not the result of accidents. If you have accidents and they’re not fixed, the cells die. It’s in the course of fixing damage or responding to damage or responding to other inputs — in the case I studied, it was starvation — that cells turn on the systems they have for restructuring their genomes. So what we have is something different from accidents and mistakes as a source of genetic change.  We have what I call “natural genetic engineering.” Cells are acting on their own genomes in a large variety of well- defined non-random ways to bring about change.
So if genetic change is not a series of accidents and not a series of necessarily small changes, then how does it work out in evolution?
That’s where the DNA record from genome sequencing comes in and confirms what many of us had argued for a long time:  namely, all of these systems of genetic change, of natural genetic engineering, have played a major role in evolutionary change. We have a new view of how cells operate in evolution, which is much more information technology friendly.
4)  http://www.huffingtonpost.com/james-a-shapiro/evolution-debate_b_1425133.html
James A. Shapiro What Is the Best Way to Deal With Supernaturalists in Science and Evolution?
The conventional approach has been to circle the wagons around mid-19th and mid-20th century ideas (Darwinism and neo-Darwinism). This approach has not been successful. One reason Darwinism has failed to convince skeptics may be that it ignores over 60 years of molecular science.
Thirty years ago, I was at a conference in Cambridge, England, to celebrate the centennial of Darwin’s death. There, Richard Dawkins began his lecture by saying, “I will not only explain that Darwin had the right answer, but I will show that he had the only possible right answer.”
Hearing this (and knowing that alternative explanations inevitably arise in science), I said to myself that the Creationists have a point. They are dealing with a form of religious belief on the “evolution” side. Dawkins’ transformation into an aggressive proselytizer for his undoubting and absolutist version of atheism confirms this conclusion.
One of the Creationists’ main tools is the argument that evolutionists are simply militant atheists in drag, who care more about dissing religion than about understanding evolution. Dawkins’ ill-considered crusade just bolsters their position.
Rather than accept that evolution science is always a tentative work in progress, conventional evolutionists make absolutist statements like “all the facts are on my side.” Making obviously inflated and unrealistic assertions is hardly likely to convince anyone who has serious questions.
5) http://www.huffingtonpost.com/james-a-shapiro/inconvenient-truths-why-a_b_2228277.html
James A. Shapiro Author, ‘Evolution: A View from the 21st Century'; Professor of Microbiology, University of Chicago
Inconvenient Truths: Why Are Self-Styled Defenders of Evolution so Resistant to Lessons From Molecular Genetics?
6) http://www.huffingtonpost.com/james-a-shapiro/natural-genetic-engineeri_b_1442309.html
James A. Shapiro Natural Genetic Engineering and Natural Selection: Perplexing Delusions of Certain Neo-Darwinist Advocates
7) pdf The_Read_Write_genome_Physics_of_life_James_A_Shapiro_2013
Shapiro, James A. “How life changes itself: The Read–Write (RW) genome.” Physics of life reviews 10.3 (2013): 287-323.

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8) http://www.huffingtonpost.com/james-a-shapiro/what-natural-genetic-engi_b_2783419.html
James A. Shapiro What Natural Genetic Engineering Does and Does Not Mean
For me, NGE is shorthand to summarize all the biochemical mechanisms cells have to cut, splice, copy, polymerize and otherwise manipulate the structure of internal DNA molecules, transport DNA from one cell to another, or acquire DNA from the environment. Totally novel sequences can result from de novo untemplated polymerization or reverse transcription of processed RNA molecules. NGE describes a toolbox of cell processes capable of generating a virtually endless set of DNA sequence structures in a way that can be compared to erector sets, LEGOs, carpentry, architecture or computer programming.
NGE operations are not random. Each biochemical process has a set of predictable outcomes and may produce characteristic DNA sequence structures. The cases with precisely determined outcomes are rare and utilized for recurring operations, such as generating proper DNA copies for distribution to daughter cells.
It is essential to keep in mind that “non-random” does not mean “strictly deterministic.” We clearly see this distinction in the highly targeted NGE processes that generate virtually endless antibody diversity.
In summary, NGE encompasses a set of empirically demonstrated cell functions for generating novel DNA structures. These functions operate repeatedly during normal organism life cycles and also in generating evolutionary novelties, as abundantly documented in the genome sequence
Some NGE functions help us to understand the mechanistic details of rapid evolutionary changes. Rapid changes include the evolution of novel proteins by reorganization of existing functional domains to generate new combinations of biochemical activities and the distribution of regulatory signals to multiple sites in the genome.
@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@
While NGE can help in understanding the molecular details of rapid and widespread genome change, it does not tell us what makes genomic novelties come out to be useful. How natural genetic engineering leads to major new inventions of adaptive use remains a central problem in evolution science. To address this problem experimentally, we need to do more ambitious laboratory evolution research looking for complex coordinated changes in the genome.
___________________
9) http://www.huffingtonpost.com/james-a-shapiro/does-natural-selection-evolution_b_1769524.html
James A. Shapiro Does Natural Selection Really Explain What Makes Evolution Succeed?
Unlike most followers, Darwin acknowledged later that significant, sudden changes could occur in a fundamentally different way. He wrote about “… variations which seem to us in our ignorance to arise spontaneously. It appears that I formerly underrated the frequency and value of these latter forms of variation, as leading to permanent modifications of structure independently of natural selection” (Origin of Species, 6th edition, Chapter XV, p. 395, emphasis added).
So a way to rephrase my question is to ask: Have we learned since 1859 about processes that can lead to organism change “independently of natural selection?” The answer is overwhelmingly positive.
Two fields principally illuminated the basic mechanisms of heredity and variation:
cytogenetics (the study of chromosome behavior in heredity using both genetic and microscopic methods) and
molecular genetics (using DNA analysis to identify the nature of genome change).
In combination, cytogenetics and molecular genetics have taught us about many processes that lead to biological novelties “independently of natural selection” — hybridization, genome duplication, symbiogenesis, chromosome restructuring, horizontal DNA transfer, mobile genetic elements, epigenetic switches, and natural genetic engineering (the ability of all cells to cut, splice, copy, and modify their DNA in non-random ways). As previous blogs document and as future blogs will discuss, the genome sequence record tells us that these processes have accompanied rapid changes in all kinds of organisms. We know that many of them are activated by stress under extraordinary circumstances.
Fortunately for evolution science and science education, 20th century studies of inheritance at the cellular and molecular level have freed us from the intellectual straightjacket of gradual random change and natural selection. In the 21st century, we can think open-mindedly about the cellular and molecular processes that lead to biological diversity. Today, we can investigate how they work to achieve evolutionary success, particularly in crisis situations, when novelty is most necessary.
10) pdf
Natural_genetic_engineering_evolution_James_A_Shapiro_Transposable Elements_1993
Shapiro, James A. “Natural genetic engineering in evolution.” Transposable Elements and Evolution. Springer Netherlands, 1993. 325-347.
The objective of this paper is to discuss certain kinds of molecular genetic data which, in the author’s opinion, raise serious questions about the prevailing evolutionary wisdom based on notions of piecemeal, stochastic genetic change due to replication errors and physico-chemical instabilities.
1) evolutionary novelty often does not reside in the invention of new biochemical processes by the continual modification and selection of individual proteins. Instead, evolution appears to proceed by the utilization of basic biochemical routines in different combinations indifferent organisms.
With few exceptions, the structural proteins of all mammals, for example, are probably interchangeable; what makes a mouse different from an elephant is when and how those molecules are synthesized and assembled during development.
2) Mosaic structure of genome.
Protein coding regions.
Transcriptional regulatory regions.
Repetitive sequence elements.
repetitive sequences show a high degree of taxonomic specificity (Dover, 1982). For example, a very good primate taxonomy can be
constructed on the basis of restriction site polymorphisms in alphoid DNA (Donehower & Gillespie, 1979), and various groups of mammals are identifiable by their characteristic dispersed retroposons (Rogers, 1985; Weiner et al., 1986). Indeed, the
abundance and distribution of repetitive elements are often among the best available genomic characters for species identification. This is true both of prokaryotes and eukaryotes.
taxonomically-specific repetitive DNA sequences help define the ‘system architecture’ of each species, perhaps serving a role in hierarchical organization of different genomic regions.
In other words, it can be argued that much of genome change in evolution results from a genetic engineering process utilizing the biochemical systems for mobilizing and reorganizing DNA structures present in living cells.
#############################################
One major tenet of conventional evolutionary theory is that genetic changes arise sporadically without reference to the needs
of the organism. As we shall see, the molecular genetic data suggest a different point of view. Examples are accumulating of systems where DNA rearrangements occur in a predictable, biologically significant manner. Moreover, there are several
systems where coordinated genome-wide rearrangements
are integrated into developmental cycles. Thus, one of the fundamental genetic facts underlying any modern evolutionary theory will have to be cellular capacity for specific and widespread genomic change.
One generalization which can be based on the study of genetic variation is that there exist a wide array of elaborate biochemical systems for replicating, correcting, repairing, packaging, rearranging and transporting DNA molecules. In other words, living cells have many mechanisms at their disposal for processing DNA according to their needs.
Retooling for a new model: the capacity for genome-wide changes
One of the major issues in evolutionary theory is the question of the relative importance of accumulated micromutations versus systemic macromutations. The conventional wisdom is that mutational
events are sporadic, undirected and independent, and a tacit assumption is generally made that each new mutation arises in a single individual or single gamete. Nonetheless, a closer consideration of the P-M system of hybrid dysgenesis in Drosophila
and of macronuclear development in ciliates will show that multiple mutations can occur in clusters of gametes and that thousands of coordinated genome-wide changes can occur in a single cell
generation.



An evolutionary case history: bacterial resistance to antibiotic chemotherapy
Since World War II, a major evolutionary event has taken place – the emergence of multiply drug resistant bacteria in response to widespread antibiotic use for chemotherapy and prophylaxis. Since the molecular details of this process have been extensively
characterized, we have a unique opportunity to examine how well the facts fit with different theoretical perspectives.
Resistance determinants did not arise (as predicted) by gradual modifications of pre-existing cellular machinery but appeared as
complete systems that could spread rapidly between distinct clones and species.
Work on the physiology of resistance has revealed a variety of sophisticated biochemical mechanisms for dealing with antibiotics (Foster,1983):
• inactivation by hydrolysis, acetylation, adenylylation,
and phosphorylation;
• removal from the cytoplasm by efflux pumps
and volatilization;
• covalent modification of target molecules to render them drug-insensitive without altering their
activities;
• substitution of drug-insensitive enzymes for
their normal (sensitive) analogues.
How these different resistance determinants originally arose is itself an intriguing evolutionary question.
For the present discussion, however, what is important is the observation that evolving bacterial cells incorporated DNA sequences encoding novel biochemical systems; they did not use the slower and less efficient process of accumulating mutations
altering basic cellular functions.
Quality control:  preventing accidental genetic change by proofreading and repair systems Before we learned about biochemical systems for DNA reorganization, physical damage from radiation, radiation, chemical damage from alkylating agents and other reactive substances, spontaneous chemical changes, and inevitable errors in the fidelity of replication were thought to be the main agents of genetic change. It is very important to recognize that living cells resemble man-made systems for information processing and communication in their use of mechanisms for error detection and correction. These mechanisms minimize the degradation of information through accidents which are inevitable in all complex systems. Cells illustrate the application of this principle with multiple genomic proofreading and repair systems that anticipate a wide range of accidental genetic changes, including replication errors, chemical changes and radiation damage.
pdf
Mobile_DNA_evolution_21st_century_James_A_Shapiro_2010
Shapiro, James A. “Mobile DNA and evolution in the 21st century.” Mobile DNA 1.4 (2010): 1-14.
Scientific history has had a profound effect on the theories of evolution. At the beginning of the 21st century, molecular cell biology has revealed a dense structure of information-processing networks that use the genome as an interactive read-write (RW) memory system rather than an organism blueprint. Genome sequencing has documented the importance of mobile DNA activities and major genome restructuring events at key junctures in evolution:
exon shuffling, changes in cis-regulatory sites, horizontal transfer, cell fusions and whole genome doublings (WGDs).
The natural genetic engineering functions that mediate genome restructuring are activated by multiple stimuli, in particular by events similar to those found in the DNA record: microbial infection and interspecific hybridization leading to the formation of allotetraploids. These molecular genetic discoveries, plus a consideration of how
mobile DNA rearrangements increase the efficiency of generating functional genomic novelties, make it possible to formulate a 21st century view of interactive evolutionary processes. This view integrates contemporary knowledge of the molecular basis of genetic change, major genome events in evolution, and stimuli that activate DNA restructuring with classical cytogenetic understanding about the role of hybridization in species diversification.

Physiology_RW_Genome_James _A_Shapiro_2014
The Journal of Physiology Vol 592, Issue 11, pages 2319–2341, 1 June 2014. Physiology of the read–write genome  James A. Shapiro
Discoveries in cytogenetics, molecular biology, and genomics have revealed that genome change is an active cell-mediated physiological process. This is distinctly at variance with the pre-DNA assumption that genetic changes arise accidentally and sporadically. The discovery that DNA changes arise as the result of regulated cell biochemistry means that the genome is best modelled as a read–write (RW) data storage system rather than a read-only memory (ROM). The evidence behind this change in thinking and a consideration of some of its implications are the subjects of this article. Specific points include the following: cells protect themselves from accidental genome change with proofreading and DNA damage repair systems; localized point mutations result from the action of specialized trans-lesion mutator DNA polymerases; cells can join broken chromosomes and generate genome rearrangements by non-homologous end-joining (NHEJ) processes in specialized subnuclear repair centres; cells have a broad variety of natural genetic engineering (NGE) functions for transporting, diversifying and reorganizing DNA sequences in ways that generate many classes of genomic novelties; natural genetic engineering functions are regulated and subject to activation by a range of challenging life history events; cells can target the action of natural genetic engineering functions to particular genome locations by a range of well-established molecular interactions, including protein binding with regulatory factors and linkage to transcription; and genome changes in cancer can usefully be considered as consequences of the loss of homeostatic control over natural genetic engineering functions.
http://voicesfromoxford.com/video/how-life-changes-itself/412
The Read-Write (RW) Genome
Lecturer: James Shapiro Institution: University of Chicago, USA
Talk: The Read-Write (RW) genome
Symposia: Physiology and Evolution: Has physiology become relevant again to evolutionary biology This talk was given at the International Union of Physiological Sciences (IUPS) held in Birmingham, UK in July 2013.
Revisiting the central dogma in 21st century James A Shapiro 2009
Shapiro, James A. “Revisiting the central dogma in the 21st century.” Annals of the New York Academy of Sciences 1178.1 (2009): 6-28.
Bacteria are small but not stupid Cognition 2006 James A Shapiro Shapiro, James A. “Bacteria are small but not stupid: Cognition, natural genetic engineering, and sociobacteriology.” 2006
Thinking about evolution cellular computing Natural Computing James A Shapiro 2005 Natl Computing
Shapiro, James A. “Thinking about evolution in terms of cellular computing.” Natural Computing 4.4 (2005): 297-324.
Shapiro, James A. “Transposable elements as the key to a 21st century view of evolution.” Transposable Elements and Genome Evolution. Springer Netherlands, 2000. 171-179.
__________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23406696
Phys Biol. 2013 Apr;10(2):026001.
Stress-induced hypermutation as a physical property of life, a force of natural selection and its role in four thought experiments.
Hilbert L1.
The independence of genetic mutation rate from selection is central to neo-Darwinian evolutionary theory. However, it has been continuously challenged for more than 30 years by experimental evidence of genetic mutation rate transiently increasing in response to stress (stress- induced hypermutation, SIH). The prominent concept of evolved evolvability (EE) explains that natural selection for strategies more competitive at evolutionary adaptation itself gives rise to mechanisms dynamically adjusting mutation rates to environmental stress. Here, we theoretically investigate the alternative (not mutually exclusive) hypothesis that SIH is an inherent physical property of all genetically reproducing life. We define stress as any condition lowering the capability of utilizing metabolic resources for genome storage and replication. This thermodynamical analysis indicates stress-induced increases in the genetic mutation rate in genome storage and in genome replication as inherent physical properties of genetically reproducing life. Further integrating SIH into an overall organismic thermodynamic budget identifies SIH as a force of natural selection, alongside death rate, replication rate and constitutive mutation rate differences. We execute four thought experiments with a non-recombinant lesion mutant strain to predict experimental observations due to SIH in response to different stresses and stress combinations. We find (1) acceleration of adaptation over models without SIH, (2) possibility of adaptation at high stresses which are not explicable by mutation in genome replication alone and (3) different adaptive potential under high growth-inhibiting versus high lethal stresses. The predictions are directly comparable to culture experiments (colony size time courses, antibacterial resistance assay and occurrence of lesion-reversion mutant colonies) and genome sequence analysis. Considering suggestions of drug-mediated disruption of SIH and attempts to target mutation-associated sites with chemotherapeutic agents to prevent resistance, our findings seem to be relevant knowledge for resistance-averse drug development and administration.
——-
Mae-Wan Ho
Dr Mae Wan Ho  Cut and splice vs random accidents
http://www.i-sis.org.uk/paris.php?printing=yes
The End of Bad Science and Beginning Again with Life
Mae-Wan Ho Institute of Science in Society and Department of Biological Sciences, Open University, Walton Hall, Milton Keynes, MK7 6AA, UK
This is a public Lecture for Conference on “The Limit of Natural Selection”, French Senate, Paris, March 18, 2000
Recently, molecular geneticist James Shapiro has joined the debate. He is critical of neo-Darwinians like Richard Dawkins and John Maynard Smith who are still clinging to the discredited paradigm. “Localized random mutation, selection operating “one gene at a time” (John Maynard Smith’s formulation), and gradual modification of individual functions are unable to provide satisfactory explanation for the molecular data, no matter how much time for change is assumed. There are simply too many potential degrees of freedom for random variability and too many interconnections to account for.”11
And yet, the variations are far from random. The processes responsible for the fluidity of the genome form a highly sophisticated regulatory system, which can provide hyper-variability or stability for genes or genomes as required. All organisms, from bacteria to human beings, possess a wide range of repair and proof-reading functions to remove accidental changes to DNA sequences and correct errors resulting from physiological and physical insults. The same cells also possess numerous biochemical mechanisms for changing and reorganizing DNA through ‘natural genetic engineering’ – processes that include cutting and splicing of DNA molecules into new sequence arrangements (like the immunoglobulin genes). Most frequently, natural genetic engineering involves mobile genetic elements, found in all genomes, which can move from one position to another, enabling organisms to respond to environmental challenges.
The ability to activate those mechanisms under stress can significantly accelerate evolutionary change in times of crisis without threatening genetic stability under ordinary circumstances. Shapiro12 suggests that further studies of transposable elements and DNA rearrangements may throw light on directed mutations. Just as signal-transduction systems of the cell can direct the transcriptional apparatus to specific genes, so there might be mutational apparatus(es) that can be similarly directed to mutate specific genes. In other words, the natural genetic engineering done by organisms themselves is quite precise, even though we don’t yet know how they manage it.
http://www.i-sis.org.uk/Evolution_by_Natural_Genetic_Engineering.php
New Genetics and Evolution
Evolution by Natural Genetic Engineering
New findings in genetics show that evolution happens by precisely targeted natural genetic engineering and not by the natural selection of random mutations, says leading molecular biologist James Shapiro, but what are the implications for the safety of GMOs and social policies?
NDM-1-gene-superbug Wear, U. K. “Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study.” (2010).
Yoon, Young Geol, Michael D Koob, and Young Hyun Yoo.
“Re-Engineering the Mitochondrial Genomes in Mammalian Cells.” Anatomy & Cell Biology 43.2 (2010): 97–109. PMC. Web. 6 Feb. 2015.
Horizontally_Transferred_Algal_Gene_Sea_Slug_Sidney_Pierce_Biol_Bull_2014
Julie A. Schwartz, Nicholas E. Curtis, and Sidney K. Pierce. FISH Labeling Reveals a Horizontally Transferred Algal (Vaucheria litorea) Nuclear Gene on a Sea Slug (Elysia chlorotica) Chromosome. Biol Bull, 2014 227:300-312
 Fantastically Wrong: What Darwin Really Screwed Up About Evolution  BY MATT SIMON

 Link to this article:http://wp.me/p3gFbV-2A2

Jeffrey Dach MD
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Davie, Fl 33314
954-792-4663
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Making Smarter Children With Maternal Iodine Supplements

A Young Mom WIth Hashimotos Thyroiditis


Christina is a 32 year old mom with Hashimotos Thyroiditis.

Unfortunately, the autoimmune thyroid disease has damaged her thyroid gland and slowed thyroid function. Her lab panel revealed elevated TPO antibodies and low Free T3 levels.  When first seen a year ago, Christina complained of chronic fatigue, weight gain, a “puffy” appearance of the eyes and face, dry skin and hair loss.  Thankfully, these symptoms all resolved over time on a treatment program with Nature-Throid (RLC Labs) 2 grains per day, selenium supplement,  200 mcg per day and iodine supplement, Iodoral half tablet (6.25 mg) daily.  Christina takes Celtic sea salt daily as well, to avoid Dermo-Bromism. Above left image woman on telephone courtesy of wikimedia commons.

Low Iodine Levels in Mom
Christina had low iodine levels. Her baseline urinary iodine excretion was 49 mcg/L indicating moderate iodine deficiency based on WHO Guidelines.(1)  Iodine supplements were given to correct this.

A Happy Mom Calls to Share the News !


After six months on our treatment program which includes iodine supplementation and prenatal vitamins containing methyl folate, Christina calls to share the good news. She is expecting !!
A_smiling_baby 
Why is Iodine So Important?
Raising Baby IQ with Iodized Salt

In 1924 iodized salt was introduced in the US, and average IQ increased by 15 points in iodine deficient areas of the country according to studies on military recruits.  Global programs to eliminate iodine deficiency have also improved IQ in other countries.  See universal salt iodization by Sullivan 1995.

Iodine Deficient Moms Cause Mental Retardation in Babies
Maternal iodine deficiency is the single most common cause of preventable mental retardation in children, and is a global health problem addressed by the World Health Organization.(5-7)

Low Maternal Iodine is Still a Problem

In spite of Iodized salt in the US, one third of young women have low iodine levels placing the baby at risk for neuro-developmental delay (2-4).  Low maternal iodine level is a preventable cause of mental retardation.(2)  As noted above, low maternal iodine levels have a deleterious effect on the baby’s brain development and IQ scores.  In many countries, screening programs have been instituted to detect Congenital Hypothyroidism caused by iodine deficiency so the babies can be treated immediately.  Left Image Smiling Baby courtesy of Wikimedia Commons.

How Much Iodine ?

Our office program for the expectant mom with Hashimoto’s Thyroiditis is 225-450 mcg of Potassium Iodide daily.  We monitor the spot urinary iodine excretion.  We also monitor thyroid labs, TSH, Free T3, Free T4 and antibody levels.  As the pregnancy progresses, we typically note declining TPO antibody levels related to “immune tolerance” of pregnancy as reported by Balucan et al.(8-9)

Excess Maternal Iodine May Raise TSH in Newborn

Although Iodine deficiency is the topic of this article, we will now discuss the other side of the coin, “Maternal Iodine Excess” causing “Transient Congenital Hypothyroidism in the newborn” reported in the pediatric literature. (15)  For this reason, for maternal iodine intake, we recommend the range of 225-450 mcg/day,  well below the 1,100 mcg per day upper limit set by the Food and Nutrition Board (FNB) of the Institute of Medicine. 

Asian Cultures Have High Dietary Iodine Intake

Asian cultures such as Japan and Korea, mothers consume kombu soups containing sea weed with high iodine content, (2000-3000 mcg per day), and elevated TSH levels suggesting hypothyroidism may be discovered  in the newborn baby during congenital hypothyroidism screening. (16-18)  These cultural practices have been followed for centuries, while only recently the newborn thyroid screening programs been established. (16-18)

Iodine Is a Supplement Available at the Health Food Store

Don’t Go It Alone.

For anyone thinking of supplementing with Iodine, I would recommend seeking out and working closely with a knowledgeable physician who can  monitor iodine levels, thyroid function, and supervise your  program.  For a list of iodine-literate practitioners click here.'

Conclusion:
Making sure our moms-to-be have healthy Iodine levels will produce more intelligent babies with higher IQ.

Articles with Related Interest:
Iodine and Hashimoto’s Autoimmune Thyroid Disease
Hashimotos, Selenium and Iodine, Part Two
Iodine and Bromine Detox With Unrefined Salt

Iodine Induced Hyperthyroidism 
David Brownstein on Thyroid Health and  Iodine

Jeffrey Dach MD
7450 Griffin Road Suite 190
Davie, Florida, 33314
954-792-4663

Links and references
1) Iodine Guidelines: WHO_Urinary Excretion 2013 World Health Organization  World Health Organization Urinary Iodine Excretion Guidelines:
50-99 mcg/L indicates mild deficiency,
20-49 mcg/L indicates moderate deficiency,
and less than 20 mcg/L indicates severe deficiency.
2) 2012_Leung_iodine_intake_during_pregnancy_Thyroid
http://www.ncbi.nlm.nih.gov/pubmed/23134529

Thyroid. January 2013, 23(1): 7-8. Sufficient Iodine Intake During Pregnancy: Just Do It.  Angela M. Leung, Elizabeth N. Pearce, Lewis E. Braverman
According to data from the National Health and Nutrition
Examination Survey (NHANES), the median urinary iodine
concentration in U.S. adults decreased by over 50% from the
early 1970s to the late 1990s (10). Of particular concern in the
NHANES data is that the prevalence of urinary iodine
values < 50 lg/L among women of childbearing age increased
by almost fourfold, from 4% to 15%, during this period.
The most recent NHANES survey (2005–2008)
demonstrated that 35.3% of pregnant women had urinary
iodine levels below 100 lg/L (11), which suggests mild iodine
deficiency (12).
Reductions in U.S. dietary iodine have been variously ascribed to a possible reduction in the iodine content of dairy products, the removal of iodate dough conditioners in commercially produced bread, new recommendations for reduced salt intake for blood pressure control, the recent increased use of Kosher and sea salts (which contain no iodine), and the increasing use of noniodized salt in manufactured or ‘‘pre-made’’ convenience foods (13).
NHANES Survey showing 50% decline in Iodine levels
3) http://www.ncbi.nlm.nih.gov/pubmed/9768638
Hollowell JG, Staehling NW, Hannon WH, Flanders DW,
Gunter EW, Maberly GF, Braverman LE, Pino S, Miller DT,
Garbe PL, DeLozier DM, Jackson RJ 1998 Iodine nutrition in
the United States. Trends and public health implications:
iodine excretion data from National Health and Nutrition
Examination Surveys I and III (1971–1974 and 1988–1994). J
Clin Endocrinol Metab 83:3401–3408.
4) http://www.ncbi.nlm.nih.gov/pubmed/21323596
Thyroid. 2011 Apr;21(4):419-27.
Iodine status of the U.S. population, National Health and Nutrition Examination Survey, 2005–2006 and 2007–2008.
Caldwell KL, Makhmudov A, Ely E, Jones RL, Wang RY.
This report presents urinary iodine (UI) concentrations for the general U.S. population during 2005-2006 and 2007-2008.
The median UI concentrations for the general U.S. population in 2005-2006 and 2007-2008 were 164 mg/L (95% confidence interval [CI] 154-174) and 164 mg/L (95% CI 154-173), respectively. Also, the proportions of the population with a UI concentration of < 50 mg/L during these survey periods were 9.8% ± 1.3% and 8.8% ± 0.4%, respectively. The median UI concentration and prevalence of ≥ 200 mg/L appeared to be higher in children and persons ≥ 70 years than in other age groups. (ii) In both surveys, children aged 6-11 years had median UI concentrations of ≥ 200 mg/L, and about 5% of them had a UI concentration of < 50 mg/L. (iii) All pregnant women (sample size 184) surveyed during 2005-2008 had a median UI concentration of 125 mg/L (95% CI 86-198), and 56.9% ± 7.9% of this group had a UI concentration of < 150 mg/L. UI concentrations were lower among non-Hispanic black survey participants than non-Hispanic white and Mexican-American participants.
5) http://blogs.discovermagazine.com/crux/2013/07/23/how-adding-iodine-to-salt-boosted-americans-iq/#.VMt8xiy6b2I
How Adding Iodine to Salt Boosted Americans’ IQ
By Lisa Raffensperger | July 23, 2013 3:00 pm
The economists found that in the lowest-iodine areas—the bottom quarter of the study population—the introduction of iodized salt had stark effects. Men from these regions born in 1924 or later were significantly more likely to get into the Air Force and had an average IQ that was 15 points higher than their predecessors.
6) COGNITIVE_EFFECTS_SALT_IODIZATION_Feyrer_July_2013
http://www.nber.org/papers/w19233
Feyrer, James, Dimitra Politi, and David N. Weil. The Cognitive Effects of Micronutrient Deficiency: Evidence from Salt Iodization in the United States. No. w19233. National Bureau of Economic Research, 2013.
Iodine deficiency is the leading cause of preventable mental retardation in the world today. The condition, which was common in the developed world until the introduction of iodized salt in the 1920s, is connected to low iodine levels in the soil and water. We examine the impact of salt iodization on cognitive outcomes in the US by taking advantage of this natural geographic variation. Salt was iodized over a very short period of time beginning in 1924. We use military data collected during WWI and WWII to compare
outcomes of cohorts born before and after iodization, in localities  that were naturally poor and rich in iodine. We ˝find that for the one quarter of the population most deficient in iodine this intervention
raised IQ by approximately one standard deviation. Our results can explain roughly one decade’s worth of the upwardtrend in IQ in the US (the Flynn Effect). We also document a large increase in thyroid
related deaths following the countrywide adoption of iodized salt, which affected mostly older individuals in localities with high prevalence of iodine deficiency.
Interpreting our measure in terms of IQ, our nding is that in iodine-de cient regions, iodization raised IQ scores by roughly one standard deviation, or 15 points. Given that one-quarter of the population lived in such regions, this implies a nationwide increase in average IQ of 3.5 points.
7) Salt_Iodization_American_Worker_Adhvaryu_2013
Adhvaryu, Achyuta, et al. “Salt Iodization and the Enfranchisement of the American Worker.” (2013).
In 1924, The Morton Salt Company, the largest salt producer in the United States, began nationwide distribution of iodine-fortified salt. Access to iodine, a key determinant of cognitive ability, rose considerably, leading to increased intelligence quotients particularly in places where deficiency was previously rampant. We compare outcomes for cohorts exposed in utero to iodized salt to slightly older, unexposed cohorts, across individuals born in states with previously high versus low iodine deficiency rates. We document substantial impacts of salt iodization. High school completion rose by nearly 6 percentage points, and labor force participation went up by 1 point. Analysis of income transitions by quantile shows that new
labor force joiners entered at the bottom of  the wage distribution and took up blue collar jobs, pulling down average wage income conditional on employment. Our results inform the ongoing debate on salt iodization in many low-income countries. We show that blanket
iodized salt distribution in fact had a very targeted impact, benefiting the worker on the margin of employment, and generating sizeable economic returns at low cost.
8) Maternal thyroid deficiency during pregnancy Haddow New Eng J Med 1999
Haddow, James E., et al. “Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child.” New England Journal of Medicine 341.8 (1999): 549-555.
9) Balucan, Francis S., Syed A. Morshed, and Terry F. Davies. “Thyroid autoantibodies in pregnancy: their role, regulation and clinical relevance.” Journal of thyroid research 2013 (2013).
10) Iodine: Its Role In Health and Disease  Some New Exciting Concepts  Michael B. Schachter, M.D.
11) An Iodine Primer By Dr. Davis | July 9, 2012
12) Iodine to the Rescue Dr Sircus on June 11, 2012
13) Iodine—Are You Getting Enough? Many Americans Aren’t
2012  Dr. J. E. Williams
14) Safe Uses of Iodine Blog Alexander Haskell
15) Connelly, Kara J., et al. “Congenital hypothyroidism caused by excess prenatal maternal iodine ingestion.” The Journal of pediatrics 161.4 (2012): 760-762.
16) Nishiyama, Soroku, et al. “Transient hypothyroidism or persistent hyperthyrotropinemia in neonates born to mothers with excessive iodine intake.” Thyroid 14.12 (2004): 1077-1083.
17) Iodine_induced_neonatal_hypothyroidism_Emder_2011_JPCH  Emder, Phillip John, and Michelle Marion Jack.”Iodine‐induced neonatal hypothyroidism secondary to maternal seaweed consumption: A common practice in some Asian cultures to promote breast milk supply.” Journal of paediatrics and child health 47.10 (2011): 750-752.
18) Chen, Wen, et al. “Neonatal thyroid function born to mothers living with long‐term excessive iodine intake from drinking water.” Clinical endocrinology (2014).
Jeffrey Dach MD
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Davie, Fl 33314
954-792-4663
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