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What dose of daily iodine is recommended in hypothyroid?

rjb112 profile image
22 Replies

What dose of daily iodine is recommended in hypothyroid?

I have an iodine supplement that lists 150 mcg (micrograms) of iodine as 100% of the Daily Value but I have seen that some websites recommend much larger daily doses of iodine for hypothyroid patients.

Thanks very much

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rjb112
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Lalatoot profile image
Lalatoot

It is a big no to iodine unless you have been tested and told you are deficient.Then it needs to be taken as directed and levels monitored.

Iodine can really mess with thyroid.

Plus your levothyroxine already contains iodine.

helvella profile image
helvellaAdministrator

There have been numerous threads on iodine here.

This search will find many of the threads:

healthunlocked.com/thyroidu...

In general, it is advised you get a non-loading iodine test before considering any possible iodine supplementation.

Remember that a major use of iodine in our bodies is to make thyroid hormone. If we are taking thyroid hormone, it reduces the amount we need for that purpose.

radd profile image
radd

rjb112,

Your daily iodine dose should be the amount that is contained within your thyroid hormone replacement meds, and the little extra taken from foods & outside sources (ie cosmetics, etc) Therefore, unless you are deficient there should be no need to supplement extra iodine.

Also, be aware iodine levels needs to be balanced with that of selenium in order that neutralisation of the resulting hydrogen peroxide can take place or even small amounts of excess iodine can lead to oxidative damage.

rjb112 profile image
rjb112 in reply toradd

Lalatoot and helvella, thanks very much for those replies. I'm not sure I'm getting any iodine from my diet, as I don't consume any seafoods nor iodized salt. I wasn't aware of some of the important points you made.

radd, thanks. "and the little extra taken from foods & outside sources (ie cosmetics, etc)". My guess is that I'm not getting much if any iodine from foods, and none at all from outside sources. "Also, be aware iodine levels needs to be balanced with that of selenium".

Thanks. I'm eating one Brazil nut several times a week for selenium. Cronometer.com says that one Brazil nut, slighly less than 5 grams, has 165% of the Daily Value of selenium.

SeasideSusie profile image
SeasideSusieRemembering in reply torjb112

rjb112

I'm eating one Brazil nut several times a week for selenium. Cronometer.com says that one Brazil nut, slighly less than 5 grams, has 165% of the Daily Value of selenium.

I don't know anything about Cronometer.com and it looks like I have to sign up to gain any information which I'm not about to do. I am also very cynical about websites that invite people to "become an affiliate" and earn commission for generating leads and recruiting new users.

That said, does Cronometer.com also tell you that Brazil nuts have to be grown in selenium rich soil to contain any? And then you need to know which area they are grown in because some areas contain far less selenium than others?

Do they tell you to check the packaging of the nuts because if they are grown in selenium rich soil the packaging will say so, and some brands even tell you how much selenium is contained in XX grams of Brazil nuts.

Selenium content in Brazil Nuts:

honey-guide.com/2012/11/19/...

Cronometer.com says that one Brazil nut, slighly less than 5 grams, has 165% of the Daily Value of selenium.

I doubt that one nut has that amount of selenium. Here in the UK some brands put the amounts on the packaging and members have sent me the following information about some of our brands:

Sainsburys SO organic brazil nuts contain 50mcg selenium per 30g serving of nuts and their Fairtrade ones have 75mcg selenium per 30g serving

Aldi's "The Foodie Market" Brazil nuts, the packaging is said to show selenium content as 79mcg per 30g serving.

'My Garden of Eden' Brazil nuts from Home Bargains say"one serving (25g) gives 63ug of Selenium".

So unless Cronometer.com know where to get giant Brazil nuts that contain 5 grams per one nut [and here are 1,000,000 micrograms (mcg) in 1 gram (g)] then I would take what they say with a large pinch of salt.

tattybogle profile image
tattybogle in reply toSeasideSusie

Lol.. giant brazil nuts :)

i thought that too , but i think ? they mean "each nut weighs approx 5g." not "each nut contains 5g selenium"

But the "one nut = 165% RDA "is still higher that you'd think from what we read on nut packets.

(Unless i can't add up , my heads a shed this morning)

But it dose seem to fit with what this (randomly looked up) site says:

thehealthy.com/nutrition/br...

"One Brazil nut contains around 68 to 91 micrograms of selenium, says Malkoff-Cohen. The recommended daily allowance (RDA)—the estimated amount of nutrient necessary per day—for adults is 55 micrograms.

“Each Brazil nut contains 175 percent of the RDA for selenium,” says Dandrea-Russert. The amount of selenium varies depending on the soil and the water that the trees are grown in. The substantial amount of selenium in Brazil nuts means it outshines the other tree nuts in this department.

Most other nuts contain only one microgram of selenium.

Given that Brazil nuts are selenium all-stars, you don’t need to eat too many. “The maximum amount of Brazil nuts you should eat per day is three or you could be headed for selenium toxicity as the upper limit is 400 micrograms daily,” says Malkoff-Cohen"

Anyway i've confused myself now .. but i think it all depends on the size of your nuts.... has anybody got some scales .... and a brazil nut ?

SeasideSusie profile image
SeasideSusieRemembering in reply totattybogle

Tatty

has anybody got some scales .... and a brazil nut ?

It just so happens I'm mixing up some muesli today (I like mine nut and seed heavy so add extra to a basic mix) and have my scales and brazil nuts out 😊

I've weighed a few and they are all coming in at either 3 grams or 4 grams per nut. My Brazil nuts are from Lidl and there's no declared selenium content.

The NHS says the RDA of selenium is 75mcg for men and 60mcg for women.

I tested my selenium recently and I'm actually a little above the reference range of 67-135ug/L at 185. I was taking 100mcg selenium which I've stopped for now although I didn't have any symptoms of too much.

tattybogle profile image
tattybogle in reply toSeasideSusie

Super speedy research :)

tattybogle profile image
tattybogle in reply toSeasideSusie

So those packets 'declared content' seem to say the RDA amount is contained in 5/6/7 ish nuts , depending on size ?

SeasideSusie profile image
SeasideSusieRemembering in reply totattybogle

Yep. Weigh your nuts 🤣

a supplement might be more accurate.

userotc profile image
userotc in reply totattybogle

All this is driving me nuts(!) but I think 2 brazils/day is generally OK newhealthadvisor.org/brazil...

rjb112 profile image
rjb112 in reply toSeasideSusie

Here's some decent information on selenium:

ods.od.nih.gov/factsheets/S...

rjb112 profile image
rjb112 in reply totattybogle

Thanks tattybogle

That's good information

rjb112 profile image
rjb112 in reply totattybogle

Hi tattybogle,

This site concurs with what you posted, and says that "Brazil nuts, for example, contain very high amounts of selenium (68–91 mcg per nut)"

ods.od.nih.gov/factsheets/S...

rjb112 profile image
rjb112 in reply toSeasideSusie

Hi SeasideSusie,

cronometer.com lets you enter the amount you are consuming in various ways, for example, grams, ounces, etc etc.

They had an entry for one Brazil nut, which they selected to be 4.73 grams for the size of Brazil nut they had in mind.

Of course another way is to just weigh the Brazil nuts you are going to eat and then enter your serving size in grams.

It listed the 4.73 grams of Brazil nuts as having 90.6 micrograms of selenium, which they listed as 165% of the RDA.

I purchase the Brazil nuts in the shell.

The package I am looking at does not say anything about the selenium content of the soil they were grown in.

Thanks for the good information

SlowDragon profile image
SlowDragonAdministrator

Looking at previous posts you are male and only on 75mcg levothyroxine

Likely under medicated unless you’re extremely under weight

Dose levothyroxine is increased SLOWLY Upwards

(retesting 6-8 weeks after each increase) until eventually on, or near 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.

Also here

cks.nice.org.uk/topics/hypo...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

rjb112 profile image
rjb112 in reply toSlowDragon

Thanks SlowDragon. You and this website in general were very instrumental in me getting my dose raised from 50 mcg Levothyroxine to 75 mcg, and it has helped a lot. I feel MUCH better on 75 mcg than I did on 50 mcg.

"Likely under medicated unless you’re extremely under weight"

I'm happy to say that recently I've been taking 75 mcg levothyroxine one day followed by 100 mcg levothyroxine the next day. So recently my dose has averaged 87.5 mcg levothyroxine. But it has not yet been 8 weeks and I don't want to get TSH, free T4 and free T3 tested yet.

Thanks for the great references......

greygoose profile image
greygoose

How much levo are you taking? 100 mcg levo contains about 65 mcg iodine. And, if you're taking levo, it means that your thyroid is no-longer making thyroid hormone so you need less iodine that euthyroid people, not more. Iodine is just one of the ingredients of thyroid hormone, it isn't some magical substance that makes your thyroid work better - adding extra flour to the cake won't make the oven work any better if it's on the blink.

Pretty certain you are getting some iodine from your diet - quite enough for someone who doesn't need to make thyroid hormones anymore. Eggs are a very good source of iodine, and dairy and some fruit and veg. It's rare to be deficient in iodine in the western world.

rjb112 profile image
rjb112 in reply togreygoose

Thanks very much greygoose. I had been taking 75 mcg levothyroxine for a long time. Then just recently I have been taking 75 mcg levothyroxine one day followed by 100 mcg levothyroxine the next day. So an average of 87.5 mcg. I haven't tested TSH, free T4 and free T3 yet on the new dose of 87.5 mcg, as I have not been on this dose long enough.

"And, if you're taking levo, it means that your thyroid is no-longer making thyroid hormone so you need less iodine that euthyroid people, not more"

I didn't know that my thyroid was no longer making thyroid hormone. I thought I needed iodine so my thyroid could make thyroid hormone, whatever amount it was able to make even though it is not functioning normally. Thanks for that information.

Unfortunately, cronometer.com does not list iodine content.

I just found this source, which does not give me confidence that I'm getting iodine from my diet: ods.od.nih.gov/factsheets/I...

I don't consume eggs, dairy or any sea foods.

Of course, I have no way to know if the foods that I eat were grown in iodine sufficient or iodine poor soils.

Thanks for all this excellent information.

And I really enjoy reading your articles on the website!

Best,

rjb112

greygoose profile image
greygoose in reply torjb112

Of course, I have no way to know if the foods that I eat were grown in iodine sufficient or iodine poor soils.

Same goes for the selenium content of the Brazils you're eating. Only, now, they're supposed to tell you on the packet if they're grown in selenium-rich soils. If they don't say so, then the nuts will contain very little selenium.

SlowDragon profile image
SlowDragonAdministrator in reply torjb112

As soon as we start taking replacement thyroid hormones, the feedback mechanism means as TSH reduces, your own thyroid reduces and eventually virtually stops working …..that’s why it’s virtually universal that everyone eventually needs to be on full replacement dose of levothyroxine

rjb112 profile image
rjb112 in reply toSlowDragon

Thanks. Good information

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