Supplements with Levothyroxine

[Steve88]

Can I take Sea Kelp with iodine and L-Tyrosine 2000mg supplements

with Levothyroxine?

[SeasideSusie Remembering]

Steve88

It's not recommended to take iodine unless tested and found to be deficient.

In the UK it's not common to be iodine deficient, we can get the iodine we need from our diet - milk, yogurt, white fish, scampi, etc.

Also, levothyroxine contains iodine (not as an ingredient - T4 contains 4 iodine atoms, one iodine atom is released when it's converted to T3. ). 100 mcg levo contains 65 mcg iodine which is recycled in the body.

[Steve88 in reply to SeasideSusie]

Aw thanks Seaside Susie!

Patrick Holford Optimum Nutrition Bible suggests:

Vit C - 2000mg

Multi vitamin/mineral x 2

Manganese 10mg

Kelp, iodine with L-Tyrosine 2000mg

I’m on 125mcg LevoThyroxine only

I was hoping to boost/support my health.. any thoughts welcome

[SeasideSusie Remembering in reply to Steve88]

Steve88

I don't know anything about Patrick Holford but I can tell you that multivitamins aren't a good idea. They tend to contain too little of anything to help low levels, often contain the cheapest, the wrong form and least absorbable of active ingredients, and also tend to contain things we shouldn't take unless tested and found found to be deficient, eg calcium, iron, iodine. If they contain iron then that affects the absorption of everything else because iron needs to be taken 2 hours away from any other supplements (and 4 hours away from thyroid meds).

We always advise here to test the core nutrients and address any problems that may show up:

Vit D

B12

Folate

Ferritin

[Steve88 in reply to SeasideSusie]

Thanks again!

You bring me back to a big hole in my knowledge. I had hoped to understand it better and make healthy improvements.

I’m sick of being overweight and not at my optimum self. There must be a key 🔑 that heals this condition. What am I doing wrong?

So what would be good to take?

Vit D

B12

Folate

Ferritin

[SeasideSusie Remembering in reply to Steve88]

Steve88

So what would be good to take?

Nothing until you've tested to see if you need to supplement, then the dose depends on your result.

Weight loss will be difficult if FT3 is low. What are your current results for

TSH

FT4

FT3

If you can post them, along with their reference ranges (these vary from lab to lab so we need your lab's ranges to interpret your results) then we can help further.

If you can't get all these tests with your GP then we have recommended private labs that do home fingerprick tests (or venous blood draw at extra cost) which covers the full thyroid/vitamin panel. Please ask if you need details.

[Steve88 in reply to SeasideSusie]

Ah cool 😎

I hadn’t thought it would be so technical. I’ll ask my GP first to see what they can tell me.

You’re a gem!

Thatnks

[Steve88 in reply to Steve88]

Seaside Susie

Is there a private lab in Scarborough?

What should I ask for?

Steve88

[SeasideSusie Remembering in reply to Steve88]

Steve

Here is a list of the private labs from ThyroidUK's main website:

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

They send you the kit, you get the test done and post back to the lab.

Some can be done by fingerprick, some need venous blood draw which you can either arrange yourself of use one of their partner clinics or arrange home phlebotomy.

Most popular companies are

Medichecks

Blue Horizon

Monitor My Health

I have used all of the above and have been happy with all of them.

There is also Thriva which some members use but I've not used them.

Cheapest is the fingerprick test, some people find these easy to do, others can't do it. If you want to try that then I have some tips I can list for you at the time.

If you have a nurse friend you could maybe get a freebie blood draw.

Some members ask their GP surgery to draw the blood, some oblige, some don't.

If you can't get a freebie blood draw then the cost charged by the partner clinics needs to be taken into account.

If you want to do the full thyroid/vitamin panel then these are the tests to go for:

Blue Horizon Thyroid Premium Gold - can be done by fingerprick.

Medichecks Thyroid Check Ultravit with Folate - needs venous blood draw.

Basic TSH/FT4/FT3 - cheapest is MonitorMyHealth - can be done by fingerprick.

[Steve88 in reply to SeasideSusie]

Thank you. This is the most information I’ve had since starting ten years ago.

Crazy, I know but It never occurred to me to ask and the doctors have never shared any insights. I’d say that it’s quite remiss of them.

[SlowDragon Administrator]

How much levothyroxine are you currently taking?

Do you always get same brand of levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Teva and Aristo are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

On levothyroxine it’s extremely common to need to supplement virtually continuously to maintain optimal vitamin levels

First step is to get FULL Thyroid and vitamin testing

Essential to test 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....or had Graves’ disease

Ask GP to test vitamin levels or test privately

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)

Is this how you do your tests?

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 vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

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

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

Please add any results and ranges if you have any

Or come back with new post once you get results

Examples of private test results

healthunlocked.com/search/p...

healthunlocked.com/search/p...

[Steve88 in reply to SlowDragon]

Thank you. This is the most information I’ve had since starting ten years ago.

It never occurred to me to ask and the doctors have never shared any insights. I’d say that it’s quite remiss of them.

[SlowDragon Administrator in reply to Steve88]

Took me almost 25 years to question what medics were telling me .....you are far from alone

First step is to get hold of all your previous results (and ranges)

Test anything that’s missing

Extremely important to test thyroid levels early morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Median TSH graph

healthunlocked.com/thyroidu...

TSH daily variation

healthunlocked.com/thyroidu...

Time of day important when you test TSH ....

researchgate.net/publicatio...

“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”

“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”

ncbi.nlm.nih.gov/pubmed/252...

TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.

[humanbean]

Personal anecdote : I tried L-Tyrosine at one time. I also take Levothyroxine.

The addition of the L-Tyrosine gave me the headaches from hell, so I would never take it again.

[Kimvw1]

Hi Steve,

I did a urine test and was low on iodine. I was put on iodoral 12.5mg. It changed my life. My body temp was 35.9 consistently on waking. It went up immediately to 36.7. I took it for two years. I stopped for unrelated reasons (I had a shellfish allergy but at the time I stopped I didn’t know what was causing my reaction. It took three months to work it out). I have to ask the dr next time if I should go back on it

[SlowDragon Administrator in reply to Kimvw1]

Never supplement iodine or kelp if also on levothyroxine or any other thyroid replacement hormones, especially if cause of hypothyroidism is autoimmune thyroid disease (About 90% of hypothyroidism is autoimmune)

nhs.uk/medicines/levothyrox...

Kelp (a type of seaweed) can contain high levels of iodine, which sometimes makes an underactive thyroid worse. Do not take supplements containing kelp if you're taking levothyroxine.

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

[Kimvw1 in reply to SlowDragon]

I have hashimoto. 1.5 NDT tablets per day.

[Steve88]

Thank you all. This is the most information I’ve had since starting ten years ago.

It never occurred to me to ask and the doctors have never shared any insights. I’d say that it’s quite remiss of them.

[Kimvw1]

I went to a functional medical dr for the iodine and told my endocrinologist. I also did a good intolerance test and cut out a heap of triggers. I feel fantastic.

[Cleopatra73]

Hello I learned that Selenium is a really important nutrient for the thyroid and, like many micronutrients, can be in short supply in modern diets. You can take it as a supplement or eat a handful of Brazil nuts every day as they are a good source. There's a lot of research on this and you can get plenty of detailed information online (as with everything!!)