<<Disclaimer: Verify this information before applying it to your situation.>>

>but now we have discovered that iodine in salt is also a problem

Iodine and iodized salt can be a problem for people with Dermatitis
Herpetiformis (DH), but not for celiac patients in general.  If you would
like to know more about DH (and iodine), read on.

---------

The the connection between iodine and Dermatitis Herpatiformis (DH) is
briefly described by the following excerpt from a resourse guide of the
Gluten Intolerance Group of North America:

     "Iodine can trigger eruptions in some people (with DH).  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
lessions in patients with DH.  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 DH patients.

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

     "Dermatitis herpetiformis (DH) is a chronic disease of the skin marked
by groups of watery, itch blisters.  The ingestion of gluten (the proteins
gliadin and prolamin contained in wheat, rye, oats, and barley) triggers an
immune system reponse that deposits a substance, IgA (immonuglobin A), under
the top layer of skin.  IgA is present in affected as well as unaffected
skin.  DH is a hereditary autoimmune disease linked with celiac disease.  If
you have DH, you always have celiac disease.  With DH 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 DH last November, he went to visit a
expert in DH, 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 (DH) 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 DH patients to eliminate iodine completely from
their diet, merely to avoid foods high in iodine as discribed above.  Dr.
Zone also explained that DH patients need not avoid iodine indefinately.
Iodine is an important mineral for our bodies.  DH 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 pations 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)

Dermititis Herpetiformis is considered a rare skin disease.

     "The true incidence and prevalence of DH appears to vary in different
areas of the world and may vary within the same country.  During 1987, 158
cases of documented DH 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)


Now you probably know more than you wanted to about DH and iodine :)

Amber Lee
American Fork, Utah
USA