Iodine

[Rock_chick1]

I know there are discussions about the possibility of worsening Hashimotos but would there be a problem having a very low dose of it whilst on T3 and T4 meds if careful?

[greygoose]

Why would you want it? What do you think it's going to do for you? You're already getting iodine recycled from your levo and your T3 - 100 mcg T4 contains about 65 mcg iodine - and, of course, from your food. Why do you think you need more?

[Rock_chick1 in reply to greygoose]

Because I've been told that iodine is an essential nutrient not a medication. Medications help your thyroid but it only uses 15% of your total thyroid needs. And since I've gone through all levels of meds without improvement I thought it might be worth a cautious try

[Alanna012 in reply to Rock_chick1]

All the private doctors I've seen have recommended a small daily dose.

Whether you can tolerate it is another thing. You can try it and monitor your response and see.

[diogenes Remembering in reply to Rock_chick1]

If you haven't got any working thyroid then iodine is not going to help, because you can no longer make any T4 or T3 direct from the gland. Regarding medication, common salt is essential for life but too much is downright dangerous. Similarly, your proposed take-up of iodine is not wise if you can't use it usefully. It's not a medication in the multivitamin sense.

[greygoose in reply to Rock_chick1]

Yes, iodine is an essential nutrient, but like a lot of nutrients - iron, vit D, vit A, etc. - it is dangerous in excess. And, actually it used to be used as a medication for people with hyperthyroidism, because it is anti-thyroid - meaning that in excess it can make you more hypo.

By 'medications' I presume you mean levo? But I have no idea what you mean by it only uses 15% of your total thyroid needs. The thyroid doesn't need levo but the rest of your body does. And how well it meets those needs depends on how much you take. Unfortunately, doctors tend to keep their hypo patients under-medicated.

And since I've gone through all levels of meds without improvement I thought it might be worth a cautious try

That is rather a bold claim because although we know the lowest dose, we cannot know the maximum dose, it depends how much your body needs. Or, could be that you are a poor converter and need some T3.

Iodine is just one ingredient of thyroid hormone. On its own, it cannot replace levo or T3. And, even if you gave your thyroid lots of iodine, if it's not capable of making hormone the iodine won't help but could make things a lot worse.

I think the person you've been talking to is somewhat ill informed about how the thyroid works. And their advice is potentially dangerous. Be very careful from whom you take advice.

[helvella Administrator Thyroid UK in reply to Rock_chick1]

Something simply doesn't add up.

Standard daily requirement is usually said to be 150 micrograms of iodine.

If 15% of that went to the thyroid to create thyroid hormone, which would be about 22.5 micrograms, that would produce about 34 micrograms of T4.

Alternatively, if you work on the idea that your own thyroid might product about 100 micrograms of thyroid hormone, using 65 micrograms of iodine to do so, which is the 15%, that implies you need at least 450 micrograms of iodine.

Yet some have said they have noticed untoward effects from taking something like a multivitamin containing just 150 micrograms of iodine.

There are many difficulties, though. Our bodies try to hang onto iodine and there are processes which recycle iodine. The 150 micrograms a day standard daily requirement is really the amount required to replace losses.

Further, there appears to be a pronounced difference between those who have always had an iodine-rich diet (Japan often quoted) and those who have had low iodine intake - even if not absolute iodine deficiency.

[tattybogle]

lots to read here :

healthunlocked.com/thyroidu... iodine-a-collection-of-useful-information-because-the-search-facility-on-health-unlocked-is-totally-pants

[Hidden]

 Rock_chick1 I can see from your multiple previous posts spanning back many years that you’ve trialled many variations of thyroid hormone with little success, vits look good.

Have you considered your adrenal function?

Adrenals do not get enough recognition for their essential role in the effective metabolism of thyroid medication. For some people taking thyroid medication is enough to get adrenals working again, for others it isn’t.

If you are having problems raising/tolerating/having no benefit from/feeling worse from your thyroid meds consider cortisol.

Low cortisol symptoms (these are not exclusive to low cortisol):

Negative or no response to thyroid medication

Chest pains

Nausea

Fatigue

Insomnia

Waking through the night

Anxiety

Depression

Abdominal fat

Poor stress tolerance

Weight gain or loss

Tinnitus

Low blood pressure

Dizziness on standing

Sensitivity to light

Palpitations

Thumping heart beat

Menstrual irregularities

Hypoglycemia

High or low appetite

Headaches / head pressure

Pigmentation / melasma

Burn in the sun instead of tan

"At least 50% of hypothyroid patients may have an adrenal problem and without discovering and treating that problem you will be unable to benefit from thyroid treatment." (Stop The Thyroid Madness, Janie Bowthorpe)

"Low cortisol causes T3 to work less effectively within the cells. This is because T3 and cortisol are partners within our cells. High cortisol also causes problems and can reduce the effectiveness of T3 within the cells, hence thyroid patients with high cortisol often complain of feeling hypothyroid even when they appear to have reasonable or low FT3 levels. When patients try to raise T3 levels in the presence of low cortisol, they may find that the body compensates for low cortisol by producing more adrenaline. This can cause anxiety, rapid heart rate, the feeling of heart palpitations etc. This is usually the adrenaline response rather than a direct issue with the T3. Very often, it is the low cortisol that is at the root." (Paul Robinson website)

"Whatever you may be told, adrenal insufficiency in thyroid disorders is very common indeed and should always be considered at the onset of treatment. Failure to respond to thyroid supplementation, or actually feeling less well, is likely more often than not to involve the low adrenal reserve syndrome." (Peatfield “how to look after your thyroid”)

"If, upon starting NDT [or T3], you experience symptoms, including anxiety, insomnia, shakiness, sweating, dizziness, feeling spaced out it's a strong sign that you may need adrenal support." (Tpauk website)

Adrenal testing: 4 point saliva test from Regenerus Labs is good if you suspect moderately low cortisol.

If you think you have a more profound cortisol issue then you need to ask your GP for -

SYNACTHEN

ALDOSTERONE

RENIN

ELECTROLYES

ADRENAL ANTIBODIES

Blood tests are inferior to saliva tests because bloods show what is total, saliva shows free and therefore available. But bloods are still valuable and a very important step in ruling out anything more serious than adrenal fatigue.

Interpreting saliva results: Morning sample must be the number at the top of the range, midday must be 75% through the range, afternoon must be 50% through range and evening must be below the top part of the range. If anything comes up lower than this, then this indicates low cortisol. (If cortisol is high then this can be lowered through Phosphorylated Serine)

Interpreting blood results:

A 9am morning cortisol results needs to be in the top 1/4 of the range at least, anything less can be indicative of adrenal insufficiency and needs to be followed up by your GP.

A synacthen test is where the adrenals are artificially stimulated by ACTH (the signal that comes from the pituitary to the adrenals) to see what adrenal hormone you can produce. This test will show you whether you have a primary (with the adrenals) adrenal issue, or a secondary (with the pituitary - therefore the signal that is sent to the adrenals and not the adrenals themselves) adrenal issue. If ACTH is low this is indicative of a pituitary issue (secondary adrenal issue), this can often be rectified by incorporating T3 in your treatment as the pituitary is particularly T3 reliant. If your response to the synacthen is below 420 and/or does not double from the previous result then we can assume a primary adrenal issue.

Aldosterone is a steroid created in a different part of the adrenal cortex. If this comes up low and renin high in conjunction with low sodium then this is further suggestive of a primary adrenal issue (so the adrenals themselves).

Low Cortisol Treatment (after testing):

If you fail a synacthen test this is indicative of adrenal insufficiency and steroid replacement of hydrocortisone will be warranted. This is usually in the realm of 20mg-40mg a day, if Addison’s antibodies are present this replacement will be for life. Sometimes Fludrocortisone is also needed, this is usually around 0.1mg. If you are placed on Fludrocortisone you will need to watch potassium levels, and ask your doctor for extended release potassium if your potassium drops too low. It is also important to invest in high quality salt and liberally use it.

If you have low cortisol and low ACTH but pass the synacthen test this is indicative of a secondary adrenal issue - an issue with the pituitary. This can often be rectified by T3, it is worth trying Paul Robinson’s CT3M for this.

For mildly low cortisol -

According to STTM:

Adrenal Cortex Extract (not whole adrenal gland): On waking 150mg, 100mg at noon, 50mg afternoon, 50mg evening. After 5 days on those doses you can do DATS (Daily Average Temperatures) - Measure BBT 3 times; 3 hrs after waking, 3 hrs after that, 3 hrs after that and add them up to make an average, do this 5 days in a row avoiding ovulation & menstruation. If there is more than 0.2 degrees fluctuation between the temps then Adrenal Cortex Extract needs to be increased. Increase Adrenal Cortex Extract until DATs become stable. If DATs do not ever become stable then Hydrocortisone may be needed. STTM states 25mg/day is a starting dose, broken down as: 10mg on waking, 7.5mg at noon, 5.5mg in afternoon, 2mg before bed. If DATs still won't stabilise then this could indicate an Aldosterone issue.

According to Peatfield:

Adrenal Cortex Extract: Anywhere from 150mg to 600mg in the morning and nothing after midday. He also recommends 20mg of Hydrocortisone for those who are not improved by Adrenal Cortex Extract.

According to Paul Robinson:

Research CT3M (Nb. Many do not find this effective).

Nb. Initially cortisol presence can increase thyroid hormone uptake so much that you may feel over stimulated/strange. Some advise to lower thyroid hormone dosing to let thyroid hormones run down a few days before starting ACE to avoid this.

Adrenal Cortex Extract brands: Adrenavive, Thorne, Klaire Labs

[SeasideSusie Remembering]

Rock_chick1

First of all, are you optimally medicated thyroid-wise?

What thyroid meds are you curretly on?

In March 2022 you were taking 87mcg Levo and 15mcg Lio according to this post:

healthunlocked.com/thyroidu...

which achieved levels of

FT3: 6.3 (3.1-6.8) = 86.49% through range

FT4: 15.1 (12-22) = 31% through range

We don't know if you followed our testing protocol of last dose of Levo 24 hours before test and last dose of Lio 8-12 hours (splitting dose day before) but have you changed your dose and retested since then? If so please tell us doses and new results and whether you left the correct time gaps.

If you're not optimally medicated then of course the first thing to do would be to address that.

Secondly, are your key nutrients optimal -Vit D, B12, Folate and Ferritin? Have they been tested recently? If so what are the results/ranges? If not tested recently it's advised to do so.

Thirdly, have you tested iodine with a non-loading urine test from Genova Diagnostics:

thyroiduk.org/help-and-supp...

Click on LIST OF AVAILABLE TESTS then on page 3 of the pdf you will see:

Urine Iodine Test:

Specimen requirements: Urine

Cost: £76.00

Order Code: END25

Turnaround time: 5 - 10 days

Iodine is an essential trace element, vital for healthy thyroid function. Adequate levels are required to enable the production of T3 and T4 thyroid hormones, whilst also being required in other areas of health.

Deficiencies can lead to impaired heat and energy production, mental function and slow metabolism. Urine iodine is one of the best measures of iodine status. This test is not performed as a loading test, but can be used to establish existing levels or to monitor iodine supplementation.

This will tell you if you need to supplement. Obviously if you have an adequate level you wouldn't want to supplement, but if your level is low then you would know that it's worth trying under the supervision of a practioner experienced in the iodine protocol.

Besides getting iodine from your Levo and Lio, a normal UK diet provides a good amount of iodine, this can be obtained from milk, yogurt, cod, haddock, scampi, etc. The normal RDA amount of iodine is approx 150mcg for an adult. British Dietetic Association list of iodine in food:

bda.uk.com/resource/iodine....