Under-active thyroid: Hi. Two years ago, It has... - Thyroid UK

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Under-active thyroid

Nott-Hi
Nott-Hi

Hi. Two years ago, It has been diagnosed indirectly by blood test that my thyroid is under-activate and the TSH was 11. May be I have this condition but I have not notice that. I took Thyroxine 25 mg for two monhs but I did not retest my blood to check TSH again until one year later. The second test was 10 which is still high. My doctor advicsed me to increase the thyroxine dosage to 50 or even 100 mg with iodine tablet (Kelp) and Omega 369. I sarted thyroxine at high dose of 50 mg but I could not continue because I feld not very well with it. Meanwhile, I kept taking Iodine and Omega tablets for a month and the result was TSH was reduced to 7.4. I stopped iodine for a while while keeping Omega until finished around 40 tablets. The final TSH was two days ago and it was 8.4. The doctor advised me to take 5 mg Prednisolone but I am not sure to what extent it can affect the thyroid. I was careful with taking Iodine dosage because I know high dosage can negatively impact and cause opposite condition (hyper). On the Kelp's box is written "three tablets for adults daily" but the doctor told me one tablet each 48 hrs. My question is can I continue taking iodine as a single treatment in my case and what is the normal iodine dosage for effective results?

9 Replies

You should not take iodine supplements unless a blood test has shown you are deficient. Too much iodine can make hypothyroidism worse. Indeed in the old days high dose iodine was the only treatment for hyperthyroidism. Levothyroxine tablets contain iodine (four atoms in each thyroxine molecule) so your iodine requirements are reduced when taking thyroid hormones. Your doctor doesn't seem to know what they are doing. You really need your TSH, fT3 and fT4 levels tested to get a good idea of your thyroid status.

Your TSH is high which suggests you need a higher dose of levothyroxine, to bring your TSH down to around 1 or 2. Some doctors believe in 'adrenal support' which involves giving very low doses of adrenal hormones such as prednisolone or natural adrenal extract. I'm not in favour of this unless the patient has clear signs of adrenal insufficiency. However, the doses used are tiny, probably do no harm so it's not worth arguing about.

I wouldn't worry about your TSH varying between 7.4 and 10.0, this is a small fluctuation that can happen due to 'time of the month' (if relevant to you), time of day, effects of thyroid autoimmunity and other factors. I would try increasing your dose again and see how you go, having discontinued the iodine.

Nott-Hi
Nott-Hi in reply to jimh111

Thank you for your appreciable guidance and advice. I did the tests you mentioned and they as follows:

FT3: 6.13 (3.8-6) pmol/L

FT4: 0.6 (0.61-1.12) pmol/L

In addition to my TSH: 8.4

Also, I did these tests:

TPO: 679 IU/ml

a-TG: 1.7 (<4) IU/ml

S-Tg: 12.12 (1.59-50) Ng/ml

Folic acid: 11 (5-25) ng/ml

B12 :224 (180-914) Pg/ml

D3: 28 (30-100) Ng/ml

May be my TPO is high due to taken iodine!. But I think my dose was little, just one tablet of Kelp. It was written on the box 450 microgram iodine-average, 300 (% NRV).

How do you see my current thyroid status

What is your suggestions according to these results, please?

I have a question that I have not find the answer up to now.

In case of levothyroxine is the only solution, do we treat the thyroid or supply artificial hormone into the body as a hormone defficiency substitution to come the balace back?. What I mean by treat, "To what extent the thyroid can naturaly properly work after a while of levo treatment?". Or in case of hormone supplying, do we neglect the thyroid gland role?. Can we stimulat the gland to work properly? I thought by using iodine, we can do that. But unfortunately may I am wrong.

jimh111
jimh111 in reply to Nott-Hi

To answer your last question first. You have high TPO antibodies. This is the most common cause of hypothyroidism, it sets up an autoimmune process that attacks the thyroid and destroys it over time. Once the thyroid tissue has been destroyed it will not recover. If you treat with levothyroxine and you find it isn't needed then a healthy thyroid will recover once the levothyroxine is tapered off.

There is a complication with autoimmune thyroid disease in that as the thyroid is being attacked it can release extra hormone time to time until it finally packs in. Thus, you can get irratic secretion from the thyroid. This might be happening in your case because your fT3 is high and the excess secretion is often T3 rather than T4. Also taking iodine supplements is likely to make things worse. Don't take any more iodine, it only helps if someone is iodine deficient.

Given your unusual blood test results (high fT3, low fT4) I would ask for a referral to an endocrinologist. They can scan your thyroid and monitor your TSH, fT3, fT4 to see if your thyroid is stable or irratic.

Have you got any blood results for Vit B12, folate, iron, Vit D? All are relevant when dealing with hypothyroidism. If you have raised antibodies, TPO and TgAb that is also relevant when looking at treatment or whether you should adopt a gluten free diet.

Nott-Hi
Nott-Hi in reply to crimple

Thank you for your appreciable guidance and advice. I did the tests you mentioned and they as follows:

FT3: 6.13 (3.8-6) pmol/L

FT4: 0.6 (0.61-1.12) pmol/L

In addition to my TSH: 8.4

Also, I did these tests:

TPO: 679 IU/ml

a-TG: 1.7 (<4) IU/ml

S-Tg: 12.12 (1.59-50) Ng/ml

Folic acid: 11 (5-25) ng/ml

B12 :224 (180-914) Pg/ml

D3: 28 (30-100) Ng/ml

May be my TPO is high due to taken iodine!. But I think my dose was little, just one tablet of Kelp. It was written on the box 450 microgram iodine-average, 300 (% NRV).

How do you see my current thyroid status

What is your suggestions according to these results, please?

I have a question that I have not find the answer up to now.

In case of levothyroxine is the only solution, do we treat the thyroid or supply artificial hormone into the body as a hormone defficiency substitution to come the balace back?. What I mean by treat, "To what extent the thyroid can naturaly properly work after a while of levo treatment?". Or in case of hormone supplying, do we neglect the thyroid gland role?. Can we stimulat the gland to work properly? I thought by using iodine, we can do that. But unfortunately may I am wrong.

SlowDragon
SlowDragonAdministrator

Are you in the UK?

Most hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's diagnosed by high thyroid antibodies

Iodine is best avoided.

drknews.com/iodine-and-hash...

50mcg Levothyroxine is only a starter dose. Bloods should be retested 6-8 weeks after each dose increase

Dose is increased slowly in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine. Most common is probably 100mcg or 125mcg

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common and often need supplementing

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Nott-Hi
Nott-Hi in reply to SlowDragon

Thank you for your appreciable guidance and advice. I did the tests you mentioned and they as follows:

FT3: 6.13 (3.8-6) pmol/L

FT4: 0.6 (0.61-1.12) pmol/L

In addition to my TSH: 8.4

Also, I did these tests:

TPO: 679 IU/ml

a-TG: 1.7 (<4) IU/ml

S-Tg: 12.12 (1.59-50) Ng/ml

Folic acid: 11 (5-25) ng/ml

B12 :224 (180-914) Pg/ml

D3: 28 (30-100) Ng/ml

May be my TPO is high due to taken iodine!. But I think my dose was little, just one tablet of Kelp. It was written on the box 450 microgram iodine-average, 300 (% NRV).

How do you see my current thyroid status

What is your suggestions according to these results, please?

I have a question that I have not find the answer up to now.

In case of levothyroxine is the only solution, do we treat the thyroid or supply artificial hormone into the body as a hormone defficiency substitution to come the balace back?. What I mean by treat, "To what extent the thyroid can naturaly properly work after a while of levo treatment?". Or in case of hormone supplying, do we neglect the thyroid gland role?. Can we stimulat the gland to work properly? I thought by using iodine, we can do that. But unfortunately may I am wrong.

SlowDragon
SlowDragonAdministrator in reply to Nott-Hi

So you have Hashimoto's confirmed by high TPO antibodies

Low vitamins are extremely common with Hashimoto's

Vitamin D too low

B12 too low, ask GP to test for Pernicious Anaemia before starting any B12 or B complex supplements

Folate only average

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

Thank you all for your guidance and advice. I will do the tests you mentioned and let you know as soon as possible. Actually, I have been in the UK during my studying MSc degree for one year and a half. Now I am in my country. Yours Sincerely.

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