Thyroid UK
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Low sodium. Related to hashimotos?

Hello all

On two blood tests 3 months apart, my sodium levels have both come back as 133 (range 136 - 145). On my previous test, my pottasium was 3.8 (range 3.6 - 4.9) and in the more recent one it was 4.6.

When I asked my dr about the low sodium level, they dismissed it as they said it wasn't low enough to worry about and the kidneys, etc showed good values. They said it could be due to drinking too much water and not enough salt (I hardly add any salt to food). I have hashimotos (anti - tpo 1,300+) but TSH fluctuates between 1.8 - 4.2 on the numerous tests I've had done. As such, drs aren't keen to start me on Levo yet.

My question is about the sodium, do any of you know whether this is related to hashimotos? Would you consider it concerning. I generally feel fine.

As a bit of extra info: i don't know if this is related, but I was a vegetarian and shortly after my first test I resumed eating meat.

10 Replies


I'm not aware of any association between low sodium and Hashimoto's. If you feel well there doesn't seem to be anything to worry about and low sodium can be due to drinking too much water.


As you have Hashimoto's then you may find adopting 100% gluten free diet can help reduce symptoms, and lower antibodies too.

I see on one of your previous posts you are already taking selenium, which is supposed to help lower antibodies and improve conversion

Have you checked levels of vitamin d, b12, folate and ferratin. These all need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells - common to be low in some or all of these with Hashimoto's

You do not need to have ANY obvious gut issues, to still have poor nutrient absorption or low stomach acid or gluten intolerance

Best advice is to read as much as you can. Vitamin and minerals levels are very important, but standard NHS thinking, doesn't at the moment seem to recognise this.

You will see, time and time again on here lots of information and advice about importance of good levels of B12, folate, ferritin and vitamin D, low stomach acid, leaky gut and gluten connection to autoimmune Hashimoto's (& Grave's) too.,

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Also meant to say.....upping your salt intake might be a good idea. Salt helps adrenals.

Lots on here also use Himalayan pink salt as has trace minerals in too.


Thanks ladies. What I'm concerned about now is having Addisons. I go through phases of worrying about different things - I don't know whether it's my mind trying to find an explanation tommy thyroid issues, or whether I'm becoming a hypochondriac.

Last time I had a full vitamin check (Jan this year), I got the following results:

Iron 19.8 (8.8 - 27.0)

Ferritin 25.5 (10.0 - 120.0)

Folate 24.66 (8.07 - 45.30)

Vitamin B12 224.0 (133.0 - 675.0)

Vitamin D 39.1 (18.1 - 70.6)

I haven't tested these after going back to eating meat.

I supplement with the following:

Centrum performance

200mg selenium

Two capsules turmeric daily (can't remember the dose - it's the holland and barret one).



Ferritin 25 is very low. Optimal is halfway through range. Eating meat will help raise ferritin level but if it doesn't make a difference you will need to supplement iron with 1,000mg vitamin C to aid absorption and minimise constipation.

B12 is low probably because of your previously vegetarian diet. You could supplement 1,000mcg methylcobalamin with a B Complex vitamin for 3 months to raise levels and if you continue eating meat may not need to supplement further.

Vitamin D 39nmol/L is insufficient. Most people need vitamin D around 100nmol/L to feel comfortable. I would supplement 5,000iu D3 daily for 8 weeks and then reduce to 5,000iu alternate days and retest in May. Very little vitaminD is obtained from food.


Many thanks for the info and sorry to be a pain, but from what I've told you thus far, you wouldn't consider the low sodium or adrenals to be an issue?



You've not included cortisol serum or cortisol saliva results so you've given members nothing to go on re adrenals.

I've already said that one low sodium result isn't likely to be an issue.


When you improve your vitamin levels, only add one supplement at a time.

You will see lots of advice on many posts about how & why to improve vit D, B12, folate and ferritin

Most multivitamins don't have enough of specific vitamins we need so are probably a waste of money. With Hashimoto's we absolutely should NOT take iodine either (often in multivitamin mixes) Iodine can make Hashimoto's flare up.

Very, very many of us find strict gluten free diet really beneficial. Would be a good idea to ask GP to do coeliac blood test first (though it is very unreliable test - wrong in about 40% of cases according to my gastroenterologist)


The Thyroid Pharmacist

Chris Kresser

Amy Myers

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Thanks for your replies. I've checked back to a year ago and found sodium was also low back then (135). So I now have 3 test results, all with marginally low sodium, yet the Drs pay no attention to this, I'm very confused. I will look into the vitamins, thanks.


Ladies, me again. I've purchased the supplements but just realised the vitamin b complex contains 600 mcg of biotin per pill. I've read biotin can skew blood tests. From what I've read, this seems to be the case on much high doses ~ 10mg. In your opinion would you consider a dose of 600mcg safe?

Out of interest, the Vit B pills cotain the following:

1). Vitamin C 40mg (I know this is very low and I am supplementing vit C separately)

2). Vit B1 (thiamin as hydrochloride) 60mg

3). Vit B2 (as riboflavin and riboflavin-5 phosphate) 75mg

4). Vit B3 (as niacin and niacinamide) 50mg

5). Vit B6 (as pyridoxine hydrochloride and pyridoxal-5 phosphate) 50mg

6). Folate (6S as MTHF and glucosamine salt from Quatrefolic) 400mcg

7). Vit B12 (as methylcobalamin) 1,000mcg

8). Biotin 600mcg

9). Pantothenic acid (as calcium pantothenate) 100mcg

Thanks for your help!!!


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