Iodine deficiency, elevated TSH

[Flyinghigh11]

Hi I'm new here in this forum.

I'm from the Netherlands and due to celiac gluten free for over 10 years. Bread and processed salt are the main sources of iodine here, both I don't eat.

A few months ago my TSH came back 6.9 and FT4 middle of the range, and the doctor wasn't helpful at all he was unreachable and spoke in my voicemail that if your FT4 is normal you should not feel bad from the thyroid and the complaints are psychological, and to just said wait and see if the FT4 is going to drop too in the next months. how dishearthening, nothing to prevent it.

Didn't ask me nothing about my diet.

I found studies online how Europe is getting increasingly more iodine deficient and 40% of the population is suffering from this. I believe it was in the Lancet, so not quackery.

I did a cronometer food analysis, just enter in everything you eat in a day for a significant period of time and it will calculate which vitamins and minerals you might be lacking. After entering my average diet for a week I was shocked to find out my iodine didn't surpass the 100mcg level. Despite eating salmon once a week, and yoghurt and eggs daily.

So for me the math seemed simple, lack of iodine for 10 years equals hypothyroidism.

For about 10 weeks I've been taking a kelp tablet of 200mcg iodine plus I added a multivitamin with 100mcg, plus the 100mcg from my average diet, so in total I get about 400mcg of iodine , which is well below the dangerous upper limit of 1100mcg. I would assume this is safe for the thyroid, but I am being my own guinnee pig.

Some improvements I've noticed so far, back acne gone, belly fat a lot less (I exericise) no more bleeding gums, healthier skin, less IBS pain, anxiety less. I seem to stay awake longer, not completely tired at 10 o'clock, I can stay awake until 12 more easily.

Not a complete panacea because I do still get cold easily, and general malaise feeling.

I have another doctor appointment planned in 6 weeks, I am curious if the thyroid improved or not. But the doctors are not very helpful or knowledgable about thyroid.

(Besides on Netflix my girlfriend loves watching Korean series, I know it's fiction, but I think there is some truth to it. The actors are constantly eating seaweed, big chunks of it, fish and sushi by the boatloads (apparently their regular diet), none of the actors are bald, grey, nor fat and look decades younger than their age on their IMDB profiles. So I don't believe Iodine really is the biggest poison there is. )

[seveneleven]

It's an interesting topic, one you might find a bit contentious, and there's a lot of disagreement about it. But, I think the fears around iodine and thyroid can mask cases where there is an actual deficiency exacerbating, if not causing, thyroid issues. Not enough can be as damaging as too much, same with any vitamin/mineral. I have Hashimoto's, and I have just started taking iodine daily after reading up on it. I used a rough calculator and realised that I get almost no iodine through my diet (and haven't for quite a few years) - around 5mcg a day, when the recommended amount is 120. This is because I don't eat wheat, dairy, or processed breads/cereals and only very rarely have eggs and fish, no iodised salt, not had seaweed for years. I think it's always best to test these things first if possible, but it's not widely available in the UK at least, so you can at least get a decent idea from your diet and any supplements as to whether you might be deficient.

[Flyinghigh11 in reply to seveneleven]

In the Netherlands the RDA for Iodine is 150mcg, in Germany its 200mcg. For pregnant and lactating women higher. I find it strange that the UK accepts 120mcg as an RDA and other countries significantly higher.

The problem is, from the 100 stories I read about people taking iodine, 99 report worsening of their levels.

This is the only thing making me a bit anxious about taking iodine. Almost no one reports improvements in their levels.

By I can hardly believe that improving a deficient diet to a middle of the range sufficient diet would be harmful for the thyroid.

Not only the thyroid needs iodine, all glands and skin need iodine. I've read somewhere that roughly 70% of the iodine is used by the thyroid to convert to thyroid hormones, the rest goes to the other organs and the immune cells.

So I hardly believe that an Iodine deficient diet, as some doctors like Christianson promote, could ever be healthy in the long run.

[seveneleven in reply to Flyinghigh11]

Yes it's all a bit of a minefield. From what I've read, there's a theory that worsening of symptoms can be due to not having enough co-factors, i.e. minerals like selenium, zinc, and copper, vitamin C, or from cortisol issues. I do have low cortisol, so I'm paying attention to minerals and watching closely for any changes. I see it as similar to something like vitamin A - an excess of it is very toxic, but not enough is also very damaging. If iodine deficiency weren't a risk to health, iodine wouldn't have been added to processed foods to try and prevent it. As you say, if you can see that your diet is deficient, there's unlikely to be harm from getting it to middle of the range.

[SlowDragon Administrator in reply to seveneleven]

seveneleven you are on Levothyroxine which contains lots of iodine

As you have Hashimoto’s you need to be careful with iodine

[seveneleven in reply to SlowDragon]

Thanks SlowDragon - I'm on a very low dose of levo, 50mcg, because I'm also on T3, so coupled with long-term almost total lack of iodine in the diet, safe to say I've not got an excess, but am being careful with it, as you say, treating it like any supplement and not overdoing it very important, just watching symptoms and signs like HR as I go. I think 100mcg of levo has 40-50mcg of iodine in it.

[SlowDragon Administrator in reply to seveneleven]

Why such a low dose Levothyroxine with such small dose T3

Essential to dose by Ft4 and FT3 not TSH when taking T3

[seveneleven in reply to SlowDragon]

Yes, I always get full testing, and was started on 75mcg but T4 shot up to top of range, not converting, no improvement, so we reduced to 50 when I added the T3. T4 is upper-mid range now. I'm only on 25mcg T3 at the moment because it's only been a few months, and dire low cortisol means I have to raise very slowly alongside my hydrocortisone. Aim is to keep very slowly increasing that, but levo unlikely to need an increase.

[greygoose in reply to seveneleven]

65 mcg

[helvella in reply to greygoose]

Just adding detail. (The precise percentage depends on exactly which numbers are used. I'm NOT disagreeing!)

helvella's Vade Mecum document is available here:

helvella - Vade Mecum for Thyroid

The term vade mecum means:

1. A referential book such as a handbook or manual.

2. A useful object, constantly carried on one’s person.

helvella.blogspot.com/p/hel...

Screenshot of iodine content of T4

[greygoose in reply to helvella]

Well, it's more than 50, anyway.

The point is, that iodine is recycled in the body again and again and again, which is why we need such a low daily intake.

[DizzyD in reply to helvella]

Helvella do you have any idea if there is a antidote to remove excess iodine from cells in the body?

[helvella in reply to DizzyD]

I can't think that anyone, anywhere, has mentioned something that would do that.

Other than the extremely unhelpful answers relating to one halogen displacing anther - e.g. fluorine replacing chlorine, chlorine replacing bromine, bromine replacing iodine. And I'm not convinced that affects halogens within cells.

[DizzyD in reply to helvella]

Lol, helvella, took me quite sometime to work out that bromine might replace iodine. Odd but i have got a bottle of Bromine at hand, will try it regardless of it not affecting halogens in cells.

sincere thank you

[helvella in reply to DizzyD]

Don't! Bromine is seriously poisonous.

To the extent many bromine compounds have long been illegal in foods.

[Flyinghigh11 in reply to DizzyD]

Why would you want to remove excess iodine from the body, using a toxic antiganost?

If you think your iodine levels are too high, go on an iodine deficient diet for a while the body pees and sweats it out.

[helvella]

Modest, properly though out, iodine supplementation of some sort might indeed be needed by some.

But there are many ways things are not quite as simple as they seem. For example, there seems to be a significantly worse outcome in someone who has been long-term low in iodine who starts supplementing (at least, at higher levels than you are taking) than in someone who has only recently become iodine deficient.

One of the issues with kelp tablets (and many other seaweed/sea vegetable sources) is that the labelled iodine content is all too often based on tables of iodine content. Not measured by batch and adjusted accordingly.

Some of us have the crazy idea that everyone in Belgium and Netherlands is always consuming mussels so iodine deficiency isn't likely! Ill-informed stereotypes often fail us.

[Flyinghigh11 in reply to helvella]

I eat mussels some times, like 3 times a year, also gluten free sushi like 6 times a year. But these peaks in iodine consumption don't carry over to the average.

In the Netherlands, most iodine comes from fortified bread and processed salt. If you eat 4 slices of bread and a pinch of salt at dinner you should be sufficient.

But if you are gluten free, you have a lot of catching up to do, and I wasn't aware of this as of recently.

If you google population studies of iodine deficiency in Europe you will see that average populations of countries are either deficient, mildly deficient or just barely sufficient.

If you compare these data with Korean and Japanese and coastline China you see that they are tending to an Iodine excess.

However, in Okinawa, Japan, where the highest concentration of 100+ year olds live, they eat the most seaweed in the world. They get insane Iodine intakes well in the double digit milligrams.

This is a paradox that's been puzzling my mind.

[WitchingHour2point0 in reply to Flyinghigh11]

But countries have evolved over hundreds of years to eat their diets.

I think it's disingenuous to compare diets of different cultures because they're simply not comparable to my mind.

Some Inuit cultures thrive on almost exclusively eating whale and seals and they are healthy. Doesn't mean you or I will be healthy or thrive switching to that diet.

[Flyinghigh11 in reply to WitchingHour2point0]

Hundreds of years no.

If you check this huge population study of iodine intake in the 1970ies compared to the 1990ies (I wonder what it is compared to 2020ies) you can see a graph see that Iodine intake in the US has crashed, because it used to be added in gigantic amounts to the milk.

Urine levels went from 320mcg/l to 145mcg/l if I read it correctly, so the urine iodine levels more than halved from the 70ies to the 90ies.

I wasn't born in that time, but from pictures it seemed almost every American in the 70ies was skinny, full eyebrows and full heads of hair.

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

[WitchingHour2point0 in reply to Flyinghigh11]

But we're not talking about America. You were talking about Japan eating vast quantities of iodine.

In the 70's people ate next to no ultra processed foods. Maybe that's why they're all slim with good hair. 🤷🏻‍♀️

[Flyinghigh11 in reply to WitchingHour2point0]

Haha True, McDonalds, lots of processed foods.

In Japan, I just found a study that the average intake of iodine is between 850-1000mcg and that is not considering those coastal islands where they eat tons of seaweed daily. Where many live up to a 100 and obesity and diseases are rare.

The iodine rabbit hole is confusing as hell. You would expect everyone in Japan would look like a bald sumo wrestler severely hypothyroid. But most of them look 10 years younger than us westerners who also eat healthy.

[WitchingHour2point0 in reply to Flyinghigh11]

But that's what I was saying; we've evolved to do well on our local, native diets. Comparing diets of different countries is pointless.Western food and UPFs have colonised the world and we're all suffering for it.

[Jazzw in reply to WitchingHour2point0]

There was a fair amount of mass produced white bread in the 1970s. Very ultra processed.

[WitchingHour2point0 in reply to Jazzw]

Of course, but majority of food was still food.

[Jazzw in reply to WitchingHour2point0]

I’m going to beg to differ. I was brought up on a diet of mass produced beef burgers, fishfingers… margarine was in vogue rather than butter. Pretty grim, looking back on it!

[WitchingHour2point0 in reply to Jazzw]

That's fair enough.

But ultimately OP was talking about iodine intake on Japan and suddenly switched to USA! 🤷🏻‍♀️

I think we're at risk of being sidetracked by UPFs. 😂

[humanbean in reply to Flyinghigh11]

you can see a graph see that Iodine intake in the US has crashed, because it used to be added in gigantic amounts to the milk.

Iodine wasn't added to milk deliberately in years gone by. Instead, milk used to have lots of iodine in it because the udders of milking cows were disinfected with iodine before being milked. Inevitably some of it ended up in the milk itself. It was when the use of iodine as a disinfectant was discontinued and something artificial was used that iodine levels started to drop in some populations which had traditionally drunk milk.

I did read some time ago that the UK as a whole is likely to be iodine deficient. There are lots of papers on the subject here :

scholar.google.co.uk/schola...

[helvella in reply to humanbean]

Last I looked, teat disinfection is nowadays more often done with a chlorine-based solution rather than iodine-based. Apparently, whatever else, it is gentler on the teats.

[helvella in reply to Flyinghigh11]

Iodised salt has long been a questionable approach - especially as salt consumption is being pushed down on the basis of the impact of sodium.

So, too, do we see things like bread being used as a vehicle for iodine and folic acid supplementation. Against a background of both voluntary wheat/bread avoidance - and forced, as in coeliac.

Some of the reports about Japan have later been reported to be wrong. (Not all, I hastily add!) With the typical intake across the adult population in the last paper I looked at actually being around 3 milligrams.

[GlowCoach Administrator]

Its usually recommended to test your iodine level before supplementing.

Have you had your thyroid antibodies checked as iodine isnt recommended in autoimmune hypothyroidism. There are 2 types of antibody - TPO & Tg.

If you do have hypothyroidism then likely you have other low vitamin levels due to the low stomach acid caused by being hypo. I'd recommend testing ferritin, folate, B12 & D3. Post results here when you have them.

[Flyinghigh11 in reply to GlowCoach]

I have tpo positive antibodies, I basically had to beg my doctor to test this. Never have been offered an iodine test or any other specific vitamin or mineral test deviating from the protocol. Actually in the waiting room there was a poster saying "multivitamins are not necessary and just expensive urine" to give you an idea of how the place operates.

Healthcare in the Netherlands is very bad a 5 minute consult and you're kicked out the office with come back in 6 months and we will re-evaluate if your thyroid is destroyed enough to give you prescription pills.

Sorry for the cynicism.

My only source for treating the subclinical thyroid disease is what I can do at home researching from behind my computer.

[SlowDragon Administrator in reply to Flyinghigh11]

High TPO antibodies confirms autoimmune thyroid disease also called hashimoto’s

Get vitamin D, folate, B12 and ferritin levels tested

[GlowCoach Administrator in reply to Flyinghigh11]

There is a really good collection of information about iodine in this link: healthunlocked.com/thyroidu...

So your thyroid issue is autoimmune of you have positive thyroid antobodies and iodine won't help. You have Hashimoto's if you have a goitre or Ords disease with no goitre.

The thyroid is slowly destroyed resulting in hypothyroidism.

If you can ask your GP for the vitamin tests I mentioned or get labs run at a private lab. We have quite a few private labs in the UK and likely you have them also in the Netherlands.

In a way your doctor isnt wrong about multivitamins. We dont recommend them in this group as they tend to be low quality vitamins in low amounts and not enough to help raise thre levels you really need to optimal. Its better to test and see wht levels are low then supplement individually with active type vitamins that the body finds easier to use.

If you can push for getting your thyroid retested sooner, say 3-4 months from now. Always book test for 9am or earlier when TSH is highest. Faast that morning until after the blood draw and stop any biotin containing supplements 3-5 days before the test.

[Flyinghigh11 in reply to GlowCoach]

Thank you very much, I'll check out the link and private clinics.

[greygoose in reply to Flyinghigh11]

So, your hypothyroidism is caused by autoimmune thyroiditis - i.e. the immune system slowly destroying your thyroid - not iodine deficiency.

[Hidden in reply to Flyinghigh11]

Hi Flyinghigh11

Regarding your comment on healthcare in the Netherlands: think it has become universal from the US to the UK and downunder in NZ and Australia.

Constant complaints on here from all those countries, and others.

[jrbarnes]

At the age of 24, before I knew that I had thyroid problems, I worked on a cruise ship in Hawaii for two years, spending several hours per day under the sun, swimming in the ocean and walking several miles. The average temperature is 29.4 and it's never cold. My diet consisted of a lot of sushi with seaweed. For those two years I had no signs of hypothyroidism and was the healthiest I'd ever been. Once I left Hawaii and came back to mainland North America I swiftly developed overt hypothyroidism. There's definitely something there but iodine supplements make me feel terrible, however eating seaweed on sushi does not.

[Flyinghigh11]

mdpi.com/2072-6643/14/19/3886

An interesting study here in which they are determining the optimal intake of iodine.

Too low iodine levels can cause autoimmunity, excess iodine as well increases thyroid autoimmunity.

Apparently the sweet spot is 200-300mcg/l daily for the lowest anti thyroid antibodies. Remember, this is urine output, so intake has to be higher than that.

optimal iodine intake graph

[Flyinghigh11]

Just did another cronometer food analysis of what I ate yesterday:

breakfast:

Goat yoghurt 200gram, 100gram gluten free cereal, 1 banana, 2 coffee.

Lunch:

5 slices of ham, 3 eggs, 2 slices of cheese, 2 slices of gluten free bread, spoon of butter, sea salt 2 coffee

Dinner:

Potatoes 300gram, 200 gram broccoli caulifower mix, butter, 150 gram hamburger meat, sea salt, 1 coffee

Snacks:

50 gram of chocolate, 1.5 liter of water.

I thought this was a great day of eating, food analysis says, iodine too low 110mcg, folate too low, B6 too low, vitamin A too low, vitamin C way too low. Eventhough I felt that yesterday I ate a lot and healthy several vitamins and minerals are lacking.

I can imagine people who don't take any vitamins and don't eat as much or have malabsorption issues are walking around with severe nutrient depletions.