Supplementing with iodine if on T3 ONLY and testing low for iodine

[Nutripea1220]

Dear all,

I'm hoping GreyGoose will chime in here.

For past 6 months (3 blood tests), my iodine levels have been untraceable (so low, they can't give a number). Before that I have no idea we never tested. I just took another test, so will know next week, but it seems three tests over six months are pretty definitive. I eat seaweed, sushi, table salt etc...

I take 125mg T3 Cytomel a day. I know Levo provides iodine but don't believe cytomel (t3) does since there is no conversion??

I realize my dose is unusually high. It's not a typo.

I'm going to post full results next week from all bloodwork. Need advice since I am off in a number of areas... but starting with iodine as my doctor (who I love) suggested I start supplementing.

I do not have hashimotos. Antibodies not elevated. Just do not tolerate t4 at all, and t3 makes me feel much better. Doctor goes by how I feel and increased it accordingly. He's a saint.

Thoughts on iodine supps in these circumstances?

[jimh111]

L-T3 has thee iodine atoms, so you are getting plenty of iodine. You are also supplementing. So, either the iodine assay is rubbish or you have some condition that is causing deficiency.

How are you having your iodine levels checked? If it is by a proper blood test from your family doctor then they should be finding out why your levels are low.

[Justiina]

You should have urine test to see how much you excrete iodine as you clearly get iodine. Not loading test, just 24 hour urine test on normal diet.

Basically undetectable serum iodine doesn't sound good, but the test can fail. It's possible to use up all iodine storages which could then show up as low serum iodine as your body is using all iodine fast.

I think that should be properly investigated before supplementing and only supplement under supervision of a doctor who truly understand how iodine works. That might be tricky as most doesn't have a clue.

Thyroglobulin is another marker , if antibodies are not present, elevated thyroglobulin can indicate iodine deficiency.

[shaws]

I shall add greygoose in.

[greygoose]

I can only agree with jimh111. T3 does have to convert, it converts to T2, and T2 converts to T1. So you are getting iodine recycled from there. Plus the seaweed, etc. Seems to me you're getting plenty of iodine! So, the question is : why isn't it showing up in the tests. I really don't think you should be considering taking more. I suppose none of those tests were done before you started taking T3? So, you don't have a base line?

You don't say what kind of test you're doing : blood? Urine? Have you tried testing in different laboratories? Or is it always the same one? Blood tests for iodine are notoriously inaccurate. I don't know what else I can say.

[Olissima in reply to greygoose]

I agree, yes, you should definitely retest your Io levels before you supplement with Io. If you are still low you need to supplement- seeweed cannot correct severe deficiency. Agree that blood tests for Io are inaccurate , the best is loading 24h urine test (including bromide levels if offered).

[Nutripea1220]

Thank you all sooooo much. I've been taking this T3 for almost a year now (was progressively falling apart on levo with another doctor prior). No tests prior of course....grrr. It's a blood test so, very likeLy inaccurate it sounds. Plus, I really had no idea about the conversion. Seems like if I'm getting iodine then... why worry?

failed to mention I'm taking a very low dose of accutane ( I'm 43, but it does amazing things for my skin)... it's a strong dose of vitamin a though and I read somewhere that can lower iodine levels (can also mess with liver). I admit I'm so bad about taking my meds away from vitamins (and swallow my morning pill with coffee and almond milk) so I probably need to clean up my act. I just don't know when or how I'd take it away from food and vit D, if I take it 3 times a day and eat pretty often all day.

My doctor told me not to worry and that if I always take it with coffee, it's ok, because even if I need more, I'll always need the same amount more. But people here seem quite adamant to take it on an empty stomach (and probably not with accutane/hefty doses of A)... could this be my problem?

[jimh111 in reply to Nutripea1220]

If you are saying you take thyroid medication with coffee this is not a good idea. Coffee has a big effect on thyroid hormone absorption (40%) and it will be a bit inconsistent from day to day, especially as you are taking L-T3 which has a short half life. Other food has much less effect and so I don't worry about it and take my L-T3 just before breakfast. The problem with coffee and L-T3 is the combined effects of a big effect on absorption and short half life of T3.

[humanbean]

You'll often read that the best way of testing iodine is an iodine loading test with urine.

According to this link it almost always returns a result which is low :

townsendletter.com/Jan2013/...

If you are considering testing in some other way, you might want to avoid the loading test.

[Olissima in reply to humanbean]

The reason that the loading test "almost always returns a result that is low" is probably because the people who are tested are suspected to have low Iodine based on their symptoms and diagnosis...

The loading test gives the most accurate results for evaluation of the body reserves of Io.

[humanbean in reply to Olissima]

The loading test gives the most accurate results for evaluation of the body reserves of Io.

Not according to the link I gave. The loading test assumes the body eliminates as much iodine as it is going to in 24 hours. But this is not always the case. For some people it takes longer than that. So their bodies do eliminate the iodine, suggesting that their results are not indicating deficiency, but since the loading test only looks at the first 24 hours it assumes that some of the iodine is retained, when in fact it just takes some people longer to eliminate it.

[Olissima in reply to humanbean]

Yes, it is not the "perfect" test but I am not aware of a better one... The article offers "Extending the iodine loading test's collection period past 24 hours and including analysis of iodine in feces would provide a better picture of iodine retention after consumption of 50 mg iodine/iodide" - but is that realistic and is there such test available? Regarding the excretion of urine after the first 24h, the article says that the excretion continues after the first 24 h (which is known and expected) and the graphs clearly show the same kinetics and the same shape for the participants. Also, the article has tested 10 healthy people (one participant dropped). In comparison, the data from the 24h urine loading test is from >1000s tests with clinical correlation...

[Nutripea1220]

Jim thank you for shaking sense into me. I ALWAYS wake up to pee a few hours before I have to get up. I will take it then. As for second dose is a 2 hr gap ok? (2 hours after coffee?) I somehow convinced myself the coffee thing was only for synthroid. 😤

[jimh111 in reply to Nutripea1220]

The research only looks at levothyroxine and coffee, so it's just a guess that there would be a problem with liothyronine also but it makes sense to play safe. Liothyronine is very well absorbed and takes about one hour to be fully absorbed. So, another guess, you would probably be OK taking it two hours after coffee.

[Olissima]

You should take the loading 24 h urine test- it is the most accurate since it checks your body reserves of Io. Although T3 has 3 Io molecules, it is not enough to supply Io if you are deficient. If you are deficient you should supplement with Io - oral or Lugols drops on the skin. Which lab you are using? You should also check your bromide levels with the same test- high bromide can mask Io deficiency. Also, it is good to know your Selenium levels (necessary for T4-to-T3 conversion).

[greygoose in reply to Olissima]

'Although T3 has 3 Io molecules, it is not enough to supply Io if you are deficient'

So, you've worked out how much she's getting from her dose of T3, have you, to be able to make a bald statement like that? (And, actually, it doesn't have 3 Io molecules, it has 3 Io atoms.) Plus what she's getting from her - seemingly - high iodine diet? Are you absolutely certain she's not getting enough?

[helvella in reply to Olissima]

"You should also check your bromide levels with the same test- high bromide can mask Io deficiency."

Are you saying that a 24 hour iodine loading urine test can be used to check bromide levels? Care to explain what you'd be looking for?

[Olissima in reply to helvella]

The Io lab test I took - 24h urine with Io loading , offers option to add bromide levels. Dr. Brownstein in his book about the Io role (highly recommend the book, but not sure if I can cite the name due to advertising), explains in details the bromide /bromine toxicity. In summary, bromine (found in bakery in the US, disinfectants, some medications and other sources), as well as fluoride, and chloride, compete with Io within the body due to having similar chemical structure. Bromide may interfere with utilization of Io in the body and further exacerbate already existing Io deficiency. The reason I recommend it tested to get with Io, is because of the convenience- the collected 24h urine is used to test for both Io and bromide. Hope this clarifies somewhat my previous post

[helvella in reply to Olissima]

The only such test I could readily find in the UK is from Regenerus.

Unfortunately, they seem to have carried over their promotional copy from the USA and go on about bromide in baked goods - not legal in Europe. Which is rather misleading. Also, a pretty expensive test at £175. Perhaps the lower likelihood of getting bromide in the diet explains why Europe seems generally less concerned about bromide than the USA?

[Olissima in reply to helvella]

Lucky you, one less chemical in the food in the UK! In that case , there is no need for bromide test!

[Olissima in reply to helvella]

How about the drinking water - is it fluoridated in the U.K.?

[helvella in reply to Olissima]

It varies. Not where I am! Some areas do. And some areas have significant natural fluoride levels.

Our own local average fluoride level is 0.031 mg/l (the limit is 1.50).

[Olissima]

No, I am suggesting that she should retest (cannot assume she is getting enough from the diet and T3).

[Nutripea1220]

Thank you all for your thoughtful replies. I just googled accutane and iodine and it appears it DOES seriously affect iodine. So, that's it - Im going to stop taking that - might explain a LOT. Thank you all for taking so much time for giving such thoughtful replies - I'm so grateful - I am also going to start taking my medicine properly - away from coffee! You all rock