This is a post on the science on thyroid antibodies and symptoms. It was not until I had been thyroid sick for 7 years, that a doctor mentioned antibodies to me. That my high anti-TPO levels could affect my well being. This was in 2007. That is quite early for a doctor to be aware of this. Most doctors TODAY refuse to believe that antibodies can affect quality of life. At least here in Denmark. Many doctors won’t even test for antibodies. The Danish endocrinologists claim, antibodies are only important in terms of diagnosing. And they don’t even know, that some people with autoimmune thyroid disease (AITD) don’t have antibodies at all. You can read more about that here.
I have no doubts, that antibodies affect us. Our immune system is not in balance. It’s my conviction, that a lot of fatigue is caused by imbalances in our immune systems. I also believe, our gut health plays into it, and some people have what’s called a leaky gut. I am not going into that in this post though.
Everybody with AITD knows, we are not who we were. But it’s difficult to say what’s what. Is it all the years with mistreatment? All the years with too low FT3 even though we were on thyroid medication? Or can the antibodies also contribute to the fatigue we often feel?
It’s usually after years of being sick that we start understanding our disease. At that point we learn about optimal thyroid levels, which you can read about here, here.
And we get the right medication that will give us these levels. But we often still feel tired. It could be antibodies, though us with Ord’s atrophic have low antibody levels after our thyroid has shrunk. It is not my impression, we are feeling better than the people with true Hashimotos, who often have high antibody levels even after years of disease. It could be, it’s our compromised immune system that is the problem. I know for myself, after I started with Low dose naltroxene (LDN) link, the fatigue improved immensely. And what LDN does, is regulate the T regulator cells. Which play a big role in our AITD.
I will look at the science in this post. To wake people up to the fact, that it’s important. Here in Denmark, people have enormously high antibody levels. I am talking 20/30 000 IU/L. And they are being told by their doctors, it does not matter. It does matter!
You can show your doctor some of these studies, if he or she doesn’t let you test for antibodies.
I am very disappointed though, or I would have been were it not for the fact that I have reads heaps of studies on thyroid issues. The participants are very often low on their thyroid levels. And it is the same in most of these studies. So we can’t really say what’s what, hypothyroid or antibodies.
I almost didn’t bother writing this post after I had looked at the science. But even if we understand, the participants are hypo thyroid, your doctor won’t understand it. So to have a case for antibody testing, these studies work fine.
This is a post with more advanced info on iodine. It’s not the right post for you, if you just need some basic info on supplementing with iodine. I have a post for beginners, that I actually think everybody taking iodine should read, Iodine for beginners. That is on how to supplement iodine safely, and special precautions in terms of the thyroid and thyroid antibodies.
I have a post on the iodine protocol as well, that is, the protocol for taking high doses of iodine, The iodine protocol
This is long post, so I have put in some links. So that you can scroll to what might be of particular interest. This is a post I will probably revise and add to as time goes on. I haven’t included THAT much on iodine and cancer. But some. There are a lot of positive findings on iodine and cancer. But the post would just become too long. There is a lot of info on cancer in some of the studies I link to though.
Many believe, that TRAb is an antibody only people with Graves have. Many also call them Graves’ antibodies. And that high levels of TRAb is the same as hyper thyroid. This is not the case. As there are 3 types of TRAb, stimulating, blocking and cleavage. People with hypo thyroid can also have high levels of TRAb, So this antibody is of interest to all with thyroid disease.
There are 3 kinds of TRAb or TSHR abs, stimulating, blocking and cleavage; previously called neutral.
Both hypothyroid and hyper thyroid can have high levels of TRAb.
Some Graves’ patients have both blocking and stimulating TRAb. They will fluctuate between hyper thyroid and hypo thyroid.
One believed earlier, that the third kind of TRAb one had found, was neutral. But now one has realized, this third TRAb can actually cause cell death in the thyroid. That is, it kills thyrocytes.
People with atophic Ord’s (athropic AITD) have much higher levels of TRAb than people with Hashimotos. We mistakenly call both atropic AITD and AIDT that starts with a goiter, for Hashimotos. But these are two different diseases. You may not have been aware that you had a goiter, but the gland has been somewhat enlarged in true Hashimotos. And the gland keeps it’s size throughout the disease. But in Ord’s, the gland fades away, atrophies. This might be due in part to these cleavage TRAb s.
When the gland is gone or mostly gone, there will not be high TRAb levels anymore. As all thyroid antibodies are made in the gland.
There is also a section on iodine supplementation and Graves.
Thyroid patients are very focused on anti-TPO, but anti-TG is also important. If we have high levels, it can mean, that there is some damage to our thyroid. And did you know that 10% of Hashimotos patients don’t even have anti-TPO, only anti-TG?
Thyroglobulin is a large molecule. It’s involved in the manufacturing and storage of thyroid hormones. It’s supposed to stay primarily INSIDE the thyroid. But it’s normal to have tiny amounts floating around in the circulation. We can get anti bodies to the thyro-globulin when levels become high, anti-TG.
Thyroglobulin can release into the circulation in various ways:
When the thyroid is being destroyed.
When the thyroglobulin contains very little iodine.
When they suddenly contain much more iodine (when one has been iodine deficient and suddenly increase iodine intake by a lot).
And lastly, in thyroid cancer, TG can get released in connection with the synthetization of hormone.
One did think, that anti-TG was pretty harmless in terms of damage to the thyroid. But this is changing. It looks to be potentially more harmful than anti-TPO.
It’s important to test anti-TG when one suspects AITD, because some people have only elevated levels of anti-TG, and not anti-TPO. I don’t think many doctors are aware of that fact.
This is a post for you who maybe know, or suspect, you suffer from iodine deficiency. But at the same time, you may be scared of supplementing with iodine. In this post, I won’t be referring to heaps of studies, as I want to keep it easy and assessible. But everything I write, I have read in books or studies. Except when I write “I believe” or “I think”.
A lot of people suffer from iodine deficiency. And even more so us with thyroid disorders. Iodine deficiency is the number one reason for thyroid disease. I am not saying it’s the only reason. There is an almost phobia of iodine in the world, you can read more about that here
At the same time as we often get too little iodine, we have big issues with other halogens occupying the iodine receptors. Iodine is a halogen, and toxins like fluoride, bromide and chloride can occupy the iodine receptors. This happens less if we have ample iodine in our bodies.
We get a lot of fluoride in our tooth paste. Bromide from our furniture as flame retardant. In the US, they apparently even add bromide to bread! Which is very difficult to understand. In some countries, chloride is added to drinking water, and of course, it’s in our pools.
Of course, many of these symptoms are symptoms of low thyroid levels, and will disappear as we become euthyroid, have good thyroid levels. You can read more about that here, For the thyroid newbie and here, Optimal thyroid levels. BUT far from all. Many with thyroid disease still have many of these symptoms DESPITE good thyroid levels. Many believe, even doctors, that the thyroid is the only organ in the body in need of iodine. This is not the case. ALL glands in the body need iodine to function. Breast glands, ovaries, the prostate, the little glands excreting stomach acid, tear film and so on.
So even if you now get thyroid hormones, if you are taking that, all these other glands in the body are not getting the iodine they need.
NB! If you have a hot nodule in your gland, do NOT take iodine. The nodule might absorb the iodine and make even more thyroid hormone. And you will become more hyper. If you are hyperthyroid and you are not sure, whether you have a hot nodule or not, you need to be careful as well. A hot nodule needs to be surgically removed.
This is the most common comment, that iodine is dangerous for those suffering from Hashimotos. One of Norway’s better known endocrinologists, Ingrid Norheim, told me in 2007 that I should avoid ALL iodine , even the 150 mcg in multivitamins. I listened to her, unfortunately. I understand now, I was severely iodine deficient at that time, and had been for years. I believe she has become wiser. I hope so at least.
There are two kinds of Hashimotos, the one that starts with goiter and the one without goiter. The latter is in reality Ord’s disease or Ord’s anthropic. It was a doctor named Ord that diagnosed it, years before Hashimotos named the AIDT with goiter. Why do I mention this?
It’s because, with Ord’s, the gland atrophies. After some years, one has little or no gland. I belong to this group myself. While those with “real” Hashimotos can have a full size gland after years of disease. And it’s not the case either, as many say, that anti-TPO “eats” our gland. One can have high levels of anti-TPO for years without the gland decreasing in size. But it doesn’t function, it’s infiltrated by t- and b lymphocytes. And the TPO enzyme is damaged, you can read more about that here.
Why does this matter in terms of iodine supplementation? It’s because all thyroid anti bodies are produced inside the thyroid itself.
So if you have little or no thyroid tissue, you don’t have to worry about increase in antibodies when taking iodine. There will be no antibody flares. You might have a little antibodies even if you have an atrophied gland. I have a little anti-TPO still. But then I have some thyroid tissue left.
When you have a gland, it’s wise to be a bit more careful. It’s not so much increase in anti-TPO one needs to worry about, but more anti-TG and TRAb. Especially the first. According to a scientist called Michael Zimmermann, we don’t know if the increase in anti-TG is transitory or more chronic. I recommend him as a serious investigator of iodine. He realizes the importance of iodine.
What Zimmermann also writes, and which is important, is that one sees a sharp increase in anti-TG especially when someone has been iodine deficient for a long time, and then suddenly gets a lot of iodine. One sees this when a country starts iodizing the salt. In the countries where they have started on a high addition from the get go, one has seen a big increase in anti-TG. Whereas in the countries where one has added iodine a little at the time, there has been less increase in anti-TG.
One used to say, high levels of anti-TG didn’t matter that much. But now there are some studies saying, that anti-TG is more dangerous than one used to believe. It has a greater ability to kill thyrocytes than anti-TPO. I write about this here.
This is why I advice starting low and increasing over time if you have a thyroid. And especially if you have functioning thyroid. If you have had Hashimotos for years, your thyroid does not function anymore. Which is why you need thyroid hormones. The gland will be infiltrated, and it will never be healthy again, I don’t think. In that case, there is no danger of further damage to the gland by ingesting Iodine. The gland is already destroyed, more or less. After many years of thyroid disease, I think everybody deserves an ultra sound of their gland. It’s the only way of truly seeing the state of the gland.
If this is the case with you, you have to decide if an increase in antibodies would worry you or not. High levels of antibodies are connected to symptom load. High dose iodine can clear up thyroid antibodies as well. But you never know which way it will go.
If you are just in the beginning of thyroid disease, you have anti-TPO and/or anti-TG over range. Or your FT4 is becoming too low, under 40% of range, then I think “low and slow” is the safe way to go. If your thyroid is healthy, and you don’t have thyroid antibodies over range, then it’s much safer to start high dose iodine. As long as you take selenium. IT’S WHEN YOU ARE IN THE BEGINNING PHASES OF THYROID DISEASE THAT YOU REALLY NEED TO BE CAREFUL.
The problem is, that’s it at this stage many start high dose iodine. In the hopes of fixing their beginning thyroid issues. And we often know very little about thyroid disease at this stage. Things can go wrong, and I see it happening in iodine groups. People damage themselves with iodine. I hope my warning voice reaches someone. And remember, I love iodine and take it every day. I am not an iodine phobic. But better safe than sorry!
Those with a functioning gland should start with 2 to 300 mcg. I see, Kris Kresser starts his patients up on 325 mcg. Test antibodies BEFORE you start. then follow up with frequent thyroid testing including for antibodies in the first months. Then you can’t go wrong. Increase dose when you feel safe about it. See under for safe max doses.
Lots of people with a functioning thyroid gland can do high dose iodine. But if you want to make sure, you don’t damage your gland, then starting low is the wise choice.
Those without a functioning gland can start on higher doses. You can do the Iodine protocol if you feel like it. If you feel safer supplementing lower doses, start with 3 to 500 mcg, and increase over time. I think one can safely take up to at least 2 mg without issues, see below. When one does the Iodine protocol, one can get detox symptoms. It can also be hard on the kidneys with all that iodine And one needs to really study before starting on large doses. You can read more about the Protocol here.
Take a supplement where you can see the exact content. If you take a sea weed supplement, take one where the amount of iodine is listed. I see in American iodine groups, that many consider sea weed to be full of toxins. I believe this fear is exaggerated. We get so many toxins, I don’t think small amounts of sea weed is the biggest culprit. Some swear by nascent iodine. Others by Lugol’s. Taking a supplement with little iodide is safer for the thyroid, iodine is less absorbed by the thyroid. I write about that on my nerd’s post here.
Lugol’s contain both iodide and iodine, 2/3 iodide and 1/3 iodine. It’s high dose iodine, but one can dilute it to smaller doses. I guess it’s difficult to get an accurate, small dose. Seaweed contains both iodide and iodine. i don’t think one should take iodide only, potassium iodide, I-. Iodine is also more antioxidant.
Selenium is the most important thing when taking iodine. Do not take iodine with poor selenium levels. Selenium protects the thyroid. All enzymes involved in the production of thyroid hormones and hormone conversion, are selenium enzymes. I read an article in The journal of the Norwegian physicians, written by 3 doctors, the current reference range for selenium is way too low. They argued, that we need to have as high as 3 umol/L in serum. Reference often goes to 1.8 or 1.9 umol/L today. And that it is levels over 3.5 umol/L that can be toxic. You can convert these numbers to your units in an online units converter, https://unitslab.com/node/210. These doctors wrote, one needs to take 300 mcg/day to achieve such levels.
Many have been worried about overdosing on selenium, but maybe we can stop worrying about that at least. I have increased my selenium intake after reading this.
On the iodine protocol, people take several other supplements. Large doses of niacin (B3) and riboflavin (B2). B3 can give temporary flushing. One needs to buy the no-flush kind. Even then one can get a flush if the dose is high. These two vitamins are important for the ATP function in the mitochondria. I think it’s good for all hypo thyroid to have good levels of these two, as we have a metabolism dysfunction. But I don’t really know how important it is when doing small dose iodine.
People also take magnesium and sea salt. Sea salt is important for detoxing bromide. When we take iodine, we can start detoxing the other, toxic halogens, fluoride and bromide. Which is a very good thing, but one can get detox symptoms. I don’t know to what extent this happens on low dose iodine. But just keep it in mind.
Please take care to test your anti-bodies if you still have a thyroid. Anti-TPO, anti-TG and TRAb. You also need to keep an eye on your thyroid levels. they can both increase and decrease. Your thyroid can start producing again, and you can become hyper. In that case you will need to decrease your thyroid meds. And that is just great I have read some people saying, if you go hyper, that is a sign you take too much iodine. NO, it’s not. It’s a sign you take too much medicine. If you are not taking thyroid meds, then of course, you should not go hyper and need to have your TRAb tested asap. You could have gotten Graves. And again, if you have a hot nodule, do not supplement iodine.
If your TSH should go up, but FT4 and FT3 stay normal, that is nothing to worry about. The TSH is not actually just a signal hormone. It is also involved in making new symporters, the channels whereby iodine is channeled into the cells. The TSH can rise for a few months in this process.
Your levels can also go down. My FT3 went down, I am sorry to say. I have to increase my dose. I have seen this also with other people in iodine groups. I was very puzzled by this, shocked even. But I read on Kris Kresser’s blog, that large doses of iodine can inhibit all selenium enzymes, like TPO and all the conversion enzymes (deiodinases). That is, the enzymes converting T4 to T3. I guess that makes sense in my case. I don’t have much TPO enzyme, but I do hopefully have D1, D2 and D3 deiodinase. And these can have become inhibited. But at the same time, I take NDT and get a lot of T3 in my meds. And I certainly don’t convert well. But maybe there is conversion going on.
Maybe this become a bit complicated for you. The point is, keep an eye on your levels.
The best thing is always to follow pulse and temperature. There is a difference between morning- and evening temperature. Some say, our temperature is individual. I don’t believe that. I think our evening temperature needs to be 37 to 37,2 ° C/ 98,6-98,9 ° F. Taken inside the body, vaginal or rectal. Concerning pulse, so many hypothyroid live with too low pulse. I did myself for years. I personally am good when morning pulse is around 68, and daytime pulse around 78/80. Morning pulse at 60 or under is in my view hypo thyroid. Unless you are an athlete 😉
Iodine needs to be tested in urine. In serum is no good. There are various ways to do it. The best test, is the 24 hours iodine loading test. In the US you can get it from a couple of labs, Hakala is one of them. It’s quite expensive. We can get the Hakala test here in Europe as well, from Biochorence.eu. It costs a lot. Many labs offer 24 hours test where you just collect the urine for 24 hours, and include the morning urine. then send off a sample. And there is urine spot tests, which is the morning urine. I think the 24 hours is better. Some say no iodine testing is accurate. I am the kind who like to test things. I have only taken the Hakala test so far. But if I took a 24 hours test, I would want to lie high in range. Excessive even.
Here is a table of 24 hours testing from Zimmermann, link
|Iodine intake||Iodine nutrition|
|School-aged children and adults|
|<20 μg/L||Insufficient||Severe iodine deficiency|
|20–49 μg/L||Insufficient||Moderate iodine deficiency|
|50–99 μg/L||Insufficient||Mild iodine deficiency|
|≥300 μg/L||Excessive||Risk of iodine-induced hyperthyroidism and autoimmune thyroid disease|
|250–499 μg/L||More than adequate||..|
I believe that those without a thyroid can safely take at least 800 mcg. As you see from the table under, the highest recommended intake in the US is 1100 mcg. The European scientific committee says 600 mcg, whereas WHO says 40 mcg pr kg body weight for pregnant and lactating women. That means a pregnant woman weighing 70 kg can take 2800 mcg. They don’t say anything about other adults. But they give very high levels for babies and infants. In Japan the upper limit is set at 3000 mcg.
|Age group||IOM (μg/day)||SCF (μg/day)||WHO (μg/kg/day)|
|4−6 years||300 (4−8 years)||250|
|7−10 years||600 (9−13 years)||300||50 (7−12 years)|
|11−14 years||450||30 (>13 years)|
|15−17 years||900 (14−18 years)||500|
|Pregnant and lactating women||1100||600||40|
This table is from this study. It also says further down
The lowest observed adverse effect level (LOAEL) proposed for iodine intakes based on these studies is 1700−1800 μg/day, based on a mild increase in thyroid‐stimulating hormone (TSH) that was not associated with clinical adverse effects
And as you remember, one can have an increase in the TSH for the first few months of iodine supplementation. And that this is a positive thing.
Don’t be afraid of iodine. I have been taking large doses of 25 to 50 mg, as I wanted to detox fluoride and bromide. As well as achieving a good iodine status. I have been iodine deficient for a very long time. And it has certainly contributed to my Hashimotos. It’s a long time since I stopped sweating.
But as I have said maybe too many times, high doses are not for everyone. Small doses ARE for everyone, except those with hot nodules. It’s safer to take it low and slow. But don’t be so afraid of iodine that you don’t try supplementing. If you read this, you have a feeling that you need it.
I feel much better after taking iodine for about 11/2 years. More awake, improved memory, warmer, my back is straighter, my skin is less dry, my eyes are less dry, sweating better. Right now, in February 2022, I take 5 mg nascent iodine/day.
I see many in a Norwegian thyroid group I am in, who also feel better for taking iodine.
This is part 1 in a series on anti bodies and auto immune thyreoditis. In this first part I will take a look at anti bodies in general and Anti-TPO in particular. I think you will be a little surprised at some of the findings. It’s maybe a little nerdy for some. But the main points are listed in the summary.
This is a complex topic, and there is a lot of research going on. I will probably revise these posts as I learn more.
All anti bodies look the same, Y shaped. They differ only on the tips of the Y. That is where they bind onto specific anti genes. People without thyroid disease can also have low levels of anti bodies, particularly Anti-TPO and Anti-TG. But whether they GET a thyroid disease later, we don’t know. A study showed, that many women had anti bodies up to 7 years before they got symptoms (1).
All antibodies are produced within the thyroid itself by B lymphocytes. So if on has little or no thyroid, one does not have high levels of anti bodies.
TPO is an enzyme that takes part in the process where Iodide gets converted into Iodine. Iodine is the form the thyroid uses in it’s hormone production. TPO can get damaged by oxidative stress. Anti-TPO then gets produced against the damaged enzyme. Oxidative stress can start as a result of Iodine deficiency. The process has started.
Anti-TPO is not what causes the greatest damage to the thyroid. It’s B and T lymphocytes that do that. Plus a form of the TRAb anti body, the cleavage TRAb. That can cause cell death as well. I will write about that in part 3.
One can have high levels of Anti-TPO without the thyroid decreasing in size. We call everything Hashimotos, but that is not correct. Hashimotos is the AIDT that starts with a goiter. The thyroid gets infiltrated by B and T lymphocytes, and cannot function as it should. But it doesn’t atrophy. Whereas Ord’s does not start with a goiter, and the thyroid atrophies. I will write more about that in a later part in the series.
Some people will think, what has this post to do with thyroid issues? It has a lot to do with it. The body is only for a little while, the soul is for ever. And how we feel impacts our bodies in a major way.
Also, AIDT has to do with trauma in many people. I am not saying all. I will get back to this in a future post.
But anyway, I write on my home page, I will share things that have helped or help me. Mother Meera has helped me A LOT. She has helped heal some deep wounds in me. I had a dream many years ago, in the beginning when I first started visiting her in Germany.
I dreamt I was in an enormous crater that had been dug out. Big enough for a sky scraper. There were these huge construction vehicles. In the middle, in a car on top of a mound sat Mother Meera giving me darshan through the window. That says something about the scope of my process.
I am writing this now, in February 2021. I am thinking maybe you are a little down, maybe you feel lonely. Maybe you have had a hard time in these Covid times? I was thinking, maybe you need some comfort. Maybe Mother can help you as she as helped me.
Trykk på “Meny” for norsk
Welcome to my blog on everything thyroid. I want to write about things I think can help us feel good. Yes, we can feel good even though we are not totally well. But it takes becoming optimal on our thyroid levels and on the medicine that is best for us. Everybody doesn’t have this option. I will do what I can to change this. I will give my take on things like optimal levels, reverse T3, NDT and much more. As well as present studies, and maybe make them easier to understand for those not so familiar with scientific publications. I will also write on other things to do with our health and well being. We are so much more than our thyroid disease. We need to be in good shape on many other parameters, not just our thyroid levels.
The blog is meant for inspiration. I hope you find something of interest, something that you together with your doctor can implement. And hopefully, feel better.
This is a fixed post where I comment on things I read or observe. Where I share some thoughts and maybe recommend some things I like.