Mid Jan I was tested for thyroid disorder, and my results came back as , TSH - 6.86 mU/L, Free T4 - 9.9 pmol/L
Doctor wanted to test again in 4 months to see if I needed treatment. During Feb and March I took iodine seaweed supplements and Nori, as well as 3 Brazil nuts everyday in an attempt to improve levels, I then paid for a blood test to monitor progress as 4 months felt too long. My results came back and the TSH level had spiked to 14 mU/L, FT4 showed a slight improvement - 11.8. pmol/L, FT3 and T4 are in range.
The spike in TSH over 2 months has terrified me, I am assuming its the iodine intake as that is the radical change to my diet. Has anyone else experienced this and how quickly did levels reduce after stopping the iodine?
thank you so much
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SunshineHPower
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There's no need to be terrified of a TSH reading. It doesn't do much whatever the level. But, you really shouldn't be taking iodine. In excess it is antithyroid, and it sounds like you were taking quite a lot. And it was never going to improve thyroid function because that's not how it works. It's just one of the ingredients of thyroid hormone, not a magic potion to 'cure' sluggish thyroids.
That said, if your FT4 rose, then it possibly wasn't the iodine responsible for the rise in TSH. Unless it had a negative effect on your conversion and your FT3 was low.
But, there's not knowing how long it will take your TSH to drop again - if it ever does. And, on the positive side, you're more likely to get a diagnosis of hypo with your TSH that high, than if it comes back at around six again - even though, with a TSH over 6 you are most definitely hypo.
But, you have to understand that once a thyroid starts to fail, there's nothing you can do about it except take thyroid hormone replacement. You cannot cure a sick thyroid, and thyroids do not regenerate if damaged.
When you go back for the next blood test for your doctor, make sure the blood draw is early morning - before 9 am - and have breakfast afterwards, not before. What time was the blood draw for that initial test?
And ask them to test your antibodies. It could have been autoimmune thyroiditis responsible for that rise in TSH.
thank you so much, I had no idea the seaweed and iodine would (if it has) cause such an issue. I have stopped, and am hoping I see some positive change. Fingers crossed. In the UK my doctor said they don't treat thyroid until its is over 10.
When I had my first bloods I wasn't tested for FT3 and T4 so its hard to gauge what has been going on. The first blood test was at 9.00 in the morning and I had only drank water before.
I was tested for a lot of other things and everything came back as optimal, and I am a pretty healthy vegetarian.
The second tests I paid for privately and its given a bigger picture. TgAB was within range, but TPOAb were completely out of range
If you're vegetarian and not supplementing, I very much doubt your B12 and iron are optimal. They may be 'in-range' but that is not the same as optimal, and they're probably too low.
If your TPOab were out of range, you have Autoimmune Thyroiditis - aka Hashi's. And if your second test comes back over-range, the GP should start treatment due to your high antibodies - even if the TSH is not over 10. I think that's in the NICE guidelines that they're so fond of!
both my B12 and iron are optimal, I am third generation vegetarian and approach each meal as a science experiment. 😀😀😀, doctors always tests for it as the assumption with vege's is that they are deficient but I never have been over the years - YET.
It's a postcode lottery. Your GP is so badly wrong to say they don't treat until a TSH of 10, but that's what some clueless buffoons do! If your TSH is over range then you are hypo and need treatment. The fact that you have high antibodies shows that you have autoimmune thyroid disease and your TSH will fluctuate. Do you have symptoms affecting your life? Tired, lethargic, cold, brain fog, lack of concentration? And many others besides?
If you do have symptoms and your TSH and antibodies are over range, you need to make another appointment with the GP and firmly but politely point these things out and request treatment commences immediately rather than leaving you to suffer.
Thank you. My Doctor wasn't the most proactive. I am generally feeling fine. I went to see him due to a numb index finger that hadn't improved. No other symptoms except
I do suffer from insomnia at times, but this is something I have always battled with and it comes and goes.
What you have, unfortunately, experienced is precisely why iodine supplementation is usually not a good idea.
Iodine is a complex area and there is much passionate argument.
You will find some people worry that the iodine in a few grains of sea salt might be too much. While others claim they take gargantuan doses like 50 milligrams a day.
Seaweed supplements are often problematical because their iodine content is uncertain. If they quote any numbers, they are usually based on iodine content looked up. Not the actual seaweed in the product in your hand. But their iodine potency can vary very significantly.
That makes it difficult to be sure how much you are taking (or were taking!), and whether the amount is consistent between batches of the same product.
We can't see where you are? It helps to add your country to your profile. Thus we cannot know if your standard salt is, or is not, iodised.
If you do end up taking levothyroxine, a common dose is around 100 micrograms. Of that, around 65 micrograms is iodine. (Not added, just the basic chemical composition.)
Looked at the other way round, in order for your own thyroid to make 100 micrograms of T4, it needs 65 micrograms of iodine. But some of that comes from recirculation of iodine.
Everywhere that T4 converts to T3, a single atom of iodine is freed and stands a good chance of being delivered to the thyroid to make more T4.
The amount of iodine we need is usually quoted as 150 micrograms. Some regard that as too low. Many quote Japan where average intake is around 3000 micrograms. That is, much more.
But Japan has a high incidence of Hashimoto disease. And there is a big difference between someone who has always consumed relatively large amounts of iodine and those who have been at the low end for years - possibly all their life. We adapt to our circumstances. We cannot go from barely enough to Japanese intake and expect all to be well. But we should not be overly concerned about maybe taking 150 one day, 200 the next, even 300 the day after - as in the normal variation based on our diets.
thank you so much for replying. I was really shocked by the spike in TSH and I'm glad I paid for a private test after 2 months to monitor it. I'm hopeful that stopping all the seaweed and iodine supplements will reactive positively on TSH levels (but it sounds like I'm chasing unicorns 😔) I was going to pay for a private test again in 2 weeks to make sure levels aren't getting worse, if they are go straight back to my doctor as it sounds like untreated thyroid is a problem.
Mid Jan I was tested for thyroid disorder, and my results came back as , TSH - 6.86 mU/L, Free T4 - 9.9 pmol/L
My results came back and the TSH level had spiked to 14 mU/L, FT4 showed a slight improvement - 11.8
That’s a reasonably significant increase (in the region of 15-20% depending on ref range). How likely is it that the rise in FT4 is in response to the rising TSH, irrespective of the cause of rising TSH
Very difficult to know anything like that without also having FT3. Even then, difficult and lots of speculation.
But for TSH to rise despite increasing FT4 seems to me to say the feedback mechanism is not working properly.
If the 6.86 TSH (already over reference interval) is not sufficient to raise thyroid hormone production, then it suggests that the thyroid is incapable of increasing thyroid hormone output sufficiently. Hence TSH continued to increase. We cannot know whether the TSH at 6.86 is making the thyroid produce at the greatest rate it can. If so, the increase to 11.8 is, in itself, irrelevant. It indicates hypo that is not being compensated by increased thyroid hormone output.
But if thyroid hormone levels did rise, then the expected consequent drop in TSH will take longer if TSH has risen higher.
Imagine a car accelerator which has the traditional steel wire connection. Once you get to flat out, there is an elastic band. So you can press on it but instead of getting to "foot on the floor", it keeps going. And, because the car is not accelerating as expected, that is exactly what you do. Continuing to press harder does nothing but you would still likely do so!
thank you, that its a very clear, visual description and has helped me a lot. here are my other results. I appreciate its a lot of speculation to join dots.
FT3 - 4 pmol/L
T4 - 82. nmol/L
TgAB - 58.1. kU/L
also at my first blood test in Jan everything looked great, no deficiencies BUT my white blood cells were low (I did have a fever a bad cold a few weeks before and Doctor thought it might be due to that), and creatine was the bottom of the in-range bracket. But Creatine has been like that for a long time and doctor said it was nothing to worry about. ?🙃
I have no idea, its just that on day 1 of getting my first bloods results, I started taking a seaweed supplement for thyroid every day, not knowing I have Hashimoto, and when did a test 2 months later these were the results, hunting around the web I've come across quiet a few people whose TSH spiked quickly after taking iodine with Hashimoto's. now I know I likely have Hashimoto, seaweed supplement are in the bin.
thank you. I took the supplements as a response to my first ever thyroid blood test and the TSH being 6. I had been eating nori a fair amount the 2 months before my blood test, a small Itsu packet a day. But I often go through phases of eating them. The iodine supplements were seaweed based and promoted as a thyroid balancer - so.... I thought thats what I need.
Uh Oh.
my second blood tests after 2months of taking them, my TSH had sky rocketed.the only change to my diet was the supplements and Brazil nuts which I feel has positively affected the FT4 level.
I am clinging on to the hope that the TSH levels will go down to 'near' where they were - but from what everyone else is saying, it sounds unlikely. I will test privately in 2 weeks to make sure its not worsening and will go to the doctors straight away if it is.
One more thing, the day after I had my second blood test I came down with really bad flu, could this have affected the results?
I think you'll find that a huge proportion of "thyroid support" and similar descriptions are effectively codes for "iodine". Even if they have some other things in as well.
Thyroid issues require the patience of a church full of saints.
Some nori is relatively low in iodine. Does your state its content?
"When iodine supplementation first begins, it’s not uncommon for TSH levels to rise. This is the body’s response to an increased supply of iodine - it increases TSH in order to stimulate more NIS transporters, which are plasma membrane glycoproteins that mediate the uptake of iodine into the thyroid. The more iodine the body has to process, the more NIS needed. Raised TSH levels are an appropriate response, and these TSH levels may stay elevated until the body adapts to its new normal of iodine. "
Is it in any sense official or simply an opinion? We do ask:
15. Members posting on Thyroid UK must only post information which is true and correct to their knowledge. If relevant, please provide references to health or medical information.
In addition to warnings about iodine you have already received…….A word of caution regarding selenium; doses of above 400ug per day have been shown to be toxic.
In the past, I have supplemented with 200ug when diagnosed with active Thyroid Eye Disease (as studies have shown it can help mild/ moderate cases if taken for 6 months). I then reduced to 100ug. Selenium supplementation did reduce my antibody levels (however, they still remain over range).
As Brazils can contain 50-90ug selenium each (depending on selenium content of soil where grown) it’s not advisable to take a selenium supplement AND eat a couple of Brazils a day.
Thank you, I do not take Selenium supplements and due to having a severe nut allergy in the home (kids), I haven't had nuts for approx 9 years. But, due to Jan blood results,I have reintroduced Brazil nuts cautiously - 1-2 a day.
the only supplements I take are Vitamin C from natural sources Amla, or Acai, and omega from algae source (no iodine). Everything else comes from food. - so apart from my trial with the iodine/seaweed supplement which has had a majorly negative impact - it has shown that I most probably have hashimoto's and need to talk to the doctor.
whether I wait 2 weeks, do a test, to see if the TSH levels come down at all, due to stopping the supplements I am undecided.
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
Important to also get coeliac blood test with autoimmune thyroid disease Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten. Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
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Hypothyroid symptoms while on Levothyroxine
Can you comment on Full Thyroid Function test, please?
are these normal levels
TSH going up, normal T3
Do these Monitor my health results seem ok
