Levothroxine, thyroid & Sea Kelp : Hi I am new on... - Thyroid UK

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Levothroxine, thyroid & Sea Kelp

Runner9 profile image
6 Replies

Hi I am new on here I am a 48 year old peri menopausal... Doctor put me on sertraline for insomnia then mood changes kept increasing dosage until I was a zombie I’ve now got down to 50mg a day .

I currently take 50mg if levothyroxine I’ve never had an issue with weight before the last 18 months need to lose a Stone to fit in my clothes comfortably.

A friend suggested sea kelp and selenium

I take Vit d as have low levels I also low in Calcium

I have purchased selenium, sea kelp and calcium to help with things but since then have read I shouldn’t take with Levo

I need some help

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Runner9 profile image
Runner9
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6 Replies
fuchsia-pink profile image
fuchsia-pink

Welcome to the forum.

Kelp is generally a bad idea because of the iodine content.

If you're on levo then you are under-active (hypo). If you don't feel well and are putting on weight it's more than likely you are n the wrong dose. Do you have any recent blood results to share? Ideally not just TSH and free T4 .... really we also need to see free T3 (taken at the same time as free T4) and key nutrients - ferritin, folate, vit D and B12. Your levo works best when these are nice and high. You should have your blood taken as early in the morning as you can get, on an empty stomach, and 24 hours after taking your previous dose of levo to get the best reading.

You should also take your levo on an empty stomach, just with water, 2 hours after / one hour before any food or other drink, and away from supplements for it to work properly.

Good luck x

Runner9 profile image
Runner9 in reply to fuchsia-pink

I have my bloods done once a year to check my levels and they normally only contact me if I need a dose change. I have no idea what these T's & F's are .

I have purchased some sea kelp and selenium and calcium to boost myself so I guess this is a bad idea? I am so confused :-(

fuchsia-pink profile image
fuchsia-pink in reply to Runner9

Going back a few steps.

Lots of people have under-active thyroids - levo is the third most prescribed medication in the UK. Most of them trundle on quite happily - as you have been - with their doctor testing their TSH once a year and telling them if it's "out of range". If that's what you have been doing, and you feel fit and well - that's great [but still don't touch the kelp!]

Other people struggle. They have their annual bloods but don't feel great. They put on weight; they lost their hair; their hands and feet are always cold; they have "brain fog" - whatever.

They come to forums like this and decide they want to take control of their health. If that is you, may I suggest

(a) you look at helvella 's excellent glossary [pinned on the right] - there is jargon to get to grips with

(b) you treat yourself to full blood testing - see SlowDragon below - and see exactly where you are now - and post the results here for help and advice. Maybe get a refund on that kelp to help with the cost?

Doctors start with TSH and seldom get any further. This is a message from the pituitary to the thyroid to tell it to work harder if it's struggling - hence the more hypo you are, the higher your TSH goes (and the more ill you feel). It's not a thyroid hormone.

Doctors occasionally test your free T4 - this is a thyroid hormone, but inactive. It needs to convert to the active T3 hormone - needed in every cell in your body - and your free T3 level will tell you how well that is going. Hence, you need your free T3 and T4 to be nice and high to feel well. Doctors seldom test free T3.

Your blood results come with a reference range - this varies from lab o lab, so when you post your results, you need to post the range. Eg free T4 might be 10 - 22. Your doctor saying you are "in range" is not the same as saying "good" or "enough". With free T4 of 11 your would feel dreadful - and at 20 probably really good. But both are "in range".

It takes time and patience to build up to the "right" level of medication for you, increasing slowly and re-testing every 6 - 8 weeks.

Good luck x

SlowDragon profile image
SlowDragonAdministrator

50mcg levothyroxine is only a starter dose

Bloods should be retested 6-8 weeks after each dose increase

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Have you had thyroid levels retested ?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Do NOT take kelp when on levothyroxine

greygoose profile image
greygoose

Do you also take vit K2-MK7? Taking vit D will increase absorption of calcium from food, but you do need vit K2 to make sure it gets into the teeth and bones, and doesn't build up in the soft tissues.

You also need to take magnesium with vit D, as they work together.

When did you last have your calcium tested? I really, really wouldn't take calcium supplements. It's like swallowing rocks, as they're very badly absorbed. Far better to get it from food.

As for iodine (kelp) it's a common misconception that taking iodine will improve your thyroid function. This comes about because iodine is one of the ingredients of thyroid hormone. But, as you are taking thyroid hormone replacement, your thyroid needs less iodine, not more. So, you should never take it without first getting tested to see if you need it - and then only supplement under the supervision of an experienced practitioner.

Your friend is giving very dangerous advice because excess iodine can cause all sorts of problems - even thyroid cancer. What people don't seem to realise is that, although iodine is one of the ingredients of thyroid hormone, taken in excess it is anti-thyroid, and can make hypothyroidism worse.

Iodine is recycled in the body, so you will already be getting 34 mcg iodine from your daily 50 mcg levo. Plus what you get from your food. It's easy to over-dose.

As for CFS, on only 50 mcg levo - a starter dose - it's far more likely that you're just under-medicated.

But, you can take the selenium you've bought. It is necessary for conversion of T4 to T3. But not to be taken consistently for long periods. :)

SlowDragon profile image
SlowDragonAdministrator

How long ago was your annual blood test?

How long have you been left on just 50mcg levothyroxine

Bloods should be retested regularly until we are stable on correct dose. Levothyroxine doesn’t “top up” a failing thyroid....the thyroid hormones replaces your own thyroid hormones...so we need to take high enough dose

Far, far too frequently GP doesn’t understand this, even though the guidelines are clear and they frequently only test TSH which is completely inadequate

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

Come back with new post once you get results

Then you can either see GP for further testing or get more comprehensive private testing done

Even if we frequently don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

gp-update.co.uk/Latest-Upda...

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

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