Iodine is the essential substrate for thyroid peroxidase (TPO), the enzyme that incorporates iodine into thyroglobulin to form T4 (thyroxine) and T3 (triiodothyronine). Without iodine, TPO has nothing to work with and thyroid hormone production stops. The thyroid gland actively concentrates iodine 20-50x above blood levels via the sodium-iodide symporter (NIS). In deficiency, the gland enlarges (goiter) trying to capture more iodine. In excess, the Wolff-Chaikoff effect temporarily halts hormone production, but chronic excess can permanently damage the gland, especially in those with anti-TPO antibodies (Hashimoto's).
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Not medical advice. Based on published clinical research and systematic reviews.