Sea kelp

[Stormz17]

Does anyone take sea kelp along side levothyroxine?

I am on 25 now for 2 months. I was taking sea kelp before but stopped when I started on the levo. Would it be ok to go back on them?

Thanks in advance

[Lalatoot]

No. Sea kelp contains iodine which is not helpful unless you are deficient. Iodine deficiency is very rare in the UK.

[fuchsia-pink]

You need to be REALLY careful with Kelp because of the high iodine content. In the UK we get a lot of iodine in a normal diet, plus there's some in levo anyway - so you should ONLY add kelp under strict medical supervision having identified an iodine deficiency.

If you're only on 25 mcg of levo - this is half the standard starter dose - it's much more likely you need a dose increase. After 8 weeks it's usual to have more blood tests to see how things are doing and increase your dose - try and get free T4 at least alongside TSH. Really you also need free T3 testing and key nutrients - ferritin, folate, vit D and B12 - but the NHS won't often do the tests you need x

[greygoose]

Excess iodine is anti-thyroid. So, you could be making your thyroid worse by taking it.

[SlowDragon Administrator]

Standard starter dose of levothyroxine is 50mcg (unless you are over 60 years old)

Bloods should be retested 6-8 weeks after each dose increase and levothyroxine dose is increased slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase). Most people need to increase dose until on full replacement dose

As you have been 2 months on 25mcg have you had blood 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 and thyroid antibodies if not been tested yet

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)

Add results and ranges if you have any

Or come back with new post once you get results

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine 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...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.

RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Iodine or kelp is not recommended for anyone on levothyroxine

thyroidpharmacist.com/artic...

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