Selenium with iodine or not?

[Justiina]

Reading my copy of izabella wentz's book hashimoto's thyroiditis.

I had the impression selenium needs to be taken first before starting iodine or have I missed something?

I am low on both but been taking selenium all the time with or without iodine as I have difficulties to tolerate iodine.

I cannot be 100% sure if I am iodine deficient as 24 hour urine test does not tell the whole truth.

I am confused :S

[jimh111]

I had a look at one of your previous posts which showed very low iodine. I wonder if the assay is accurate? I would get the iodine level check by a doctor with a conventional test.

I'm not sure if you are taking thyroid hormone, if so you would need very little iodine as the iodine is already in the tablets. If you had insufficient iodine your fT4 would go down and your TSH be high. Your results don't show this which is why I question the accuracy of the test you ran.

Also selenium is required for converting T4 to T3 (deiodinase). The pituitary relies strongly on deiodinase. So, if you were deficient in selenium your TSH would again be high because the pituitary would not be able to respond to the fT4 in your blood. You would have high TSH, high fT4 and low fT3.

It's not good to supplement with iodine unless deficiency is confirmed by a trusted blood test, high iodine levels can cause hypothyroidism. As the test you ran reported low selenium and iodine it is important you get these checked at your doctors if you plan to get pregnant. In parts of central Africa there is concurrent selenium and iodine deficiency. Unusually, there is a much lower incidence of cretinism than would be expected. It's thought this is because the mother fails to convert some T4 to T3 thus preserving foetal T4 levels. In this particular case it is important to restore iodine levels first.

I don't want to disappoint you but I'd be very suspicious of the results you got back from your test, they need to be validated. I wouldn't take iodine supplements, you should get enough from a healthy diet.

[Justiina in reply to jimh111]

Exactly ! I have done the test twice. Before and after supplementing iodine. Both times result was low. But was said on the note from the lab that as my TSH is low it does not indicate chronic deficiency and 24 hour test only determines how much iodine have consumed during past few days. Was also said that chronic deficiency should be measured by other tests like 10 days urine and/or blood test.

Yet they stated low tt4 and high thyroglobulin indicates chronic iodine deficiency.

Unfortunately cannot get those other tests over here in Finland to figure out is there iodine deficiency or not.

Everyone else says selenium first and that is why I am confused as in this book it is said to do otherwise in case iodine deficient.

[Hidden in reply to Justiina]

Hello Justina

I am confused too as had previously thought to supplement selenium first & then iodine.

Following link supports what Izabella says

. ... [. .. In regions of combined severe iodine and selenium deficiency, normalization of iodine supply is mandatory before initiation of selenium supplementation in order to prevent hypothyroidism ..... ] ....

ncbi.nlm.nih.gov/pubmed/124...

Following link details jims excellent advice above.

ajcn.nutrition.org/content/...

Perhaps this situation arises in those who aren't medicating thyroid hormone replacement ..? ..? ...

I would advise lots & lots more research & wouldn't go down this route myself unless with an experienced practitioner. There are too many considerations & much scope for mess ups.

Flower

..........................................................................................................................

Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

..........................................................................................................................

[Justiina in reply to Hidden]

Thanks. Interesting information.

That second link arises some questions and I am not sure if I read it right, but in case of selenium and iodine deficiency TSH shoud be high and T4 should be low, like Jim already said, but T3 would be normal?