Dosage Guidelines



Which category are you in?


Let’s assume that you have already read this website and taken the online questionnaire. Further assume that you are experiencing symptoms of hypothyroidism.

At this point you are in one of two categories:

  • You are not taking any prescription thyroid hormones, OR
  •  
  • You are already taking a prescription thyroid hormone



If you are not taking any prescription thyroid hormones than start reading here and you can skip the discussion about folks taking prescriptions. Life is much simpler in your group.

If you are taking prescription thyroid hormones, you can read what the rest of the world is doing, but you will need to pay special attention to the section “Already taking prescription thyroid hormones”. Your group is more complex.


Category 1 – Not taking prescription thyroid hormones


How do you know how much to take? The scientific way is to measure your iodine levels in a 24 hour urine collection AFTER a 50 mg iodine/iodide challenge the night before.

The non-scientific way is to start low and work your way up on dosages. Starting doses of iodine supplementation are a single 12.5 mg tablet of a combination of iodine with iodide. Then, depending on the severity of your symptoms, you add an additional tablet each month until your symptoms go away. 

Unless you have a Health & Wellness physician guiding you, I recommend that your upper limit is 4 tablets (50 mg) of the recommended iodine supplement per day. (Although 12 tablets (150 mg) can be safely taken – but only under a doctor’s guidance)


The thyroid is SLOOOOOOOOOW


Physicians already know this. Thyroid hormones can circulate around in your bloodstream for a week or two. This is unlike virtually all other pills that come and go within a matter of hours. Thyroid is SLOW. Think in terms of weeks, not hours or days.

Any dosage changes affecting the thyroid should be done in monthly intervals. In other words, anytime you do anything that might affect the output of the thyroid gland, allow a full month for a response. Don’t change anything for a month.

Even though iodine is completely harmless, even in huge doses, we still allow a month to see what the effects will be before you start increasing the dose. Why? It is not because it can harm you (it can’t). But the actions are soooooo slow that it takes that long to observe a response.


When one iodine tablet is not enough?


Take the Online Questionnaire and determine which category you fit in. These are the categories:

  • Mild hypothyroidism
  •  
  • Moderate hypothyroidism
  •  
  • Profound hypothyroidism
  •  
  • Severe hypothyroidism
  •  
  • Hypothyroidism so bad that blood tests may be abnormal



Our experience is roughly adding the equivalent of 1 iodine tablet for each level of hypothyroidism. Even though there are five levels, we tend to max out at 4 tablets daily.

So you could potentially work your way up to this schedule:

  • Mild hypothyroidism – suggest 1 tablet
  •  
  • Moderate hypothyroidism – suggest 2 tablets
  •  
  • Profound hypothyroidism – suggest 2- 3 tablets
  •  
  • Severe hypothyroidism – suggest 2 - 4 tablets
  •  
  • Hypothyroidism so bad that blood tests may be abnormal – maximum 4 tablets



Keep in mind that some people may require more or less than the above suggestions. Also, let me remind you to start out at one tablet and add no more than one iodine tablet per month. So if you are a level 3 (profound hypothyroidism), it will be your third month before you get to 3 tablets.

Also notice that we are quite happy with two tablets for most conditions.

One more thing: It is impossible to induce hyperthyroidism even with massive iodine supplementation. Why? Because your body can only use so much iodine for its needs. Anything above that and your body merely washes it away and out it goes via your urine.

So with iodine supplementation you are better off taking too much than not enough.



Category 2 – Already taking prescription thyroid hormones



Already taking prescription thyroid hormone?


Are you taking Synthroid, Levothroid, Thyrolar, Levoxyl, Unithroid, Cytomel, Armour Thyoid, NatureThroid?

None of the above thyroid hormone prescriptions are bio-identical or in correct human proportions. Doctors don’t know this. Synthroid, by far the most popular prescription, is T4 – but the wrong dimer. It is a backwards molecule to the real T4 that you are supposed to have. Think of it as a mirror image (and backwards) to the real human T4.

This is why Synthroid fails so often. If you are taking Synthroid and reading this article – now you know why.

Even my favorite, Armour Thyroid (and its cousin NatureThroid), are indeed the exact same human T4 and T3 hormones, but the proportions are wrong. Human T4 to T3 ratio is 10:1 (or 15:1 depending on your source of information). Pig thyroid (the source of Armour and Nature) is 4:1.


Go slow with iodine increases


Slow changes are even more critical if you are already taking a prescription thyroid hormone. Because now you are looking at TWO items: the iodine and the prescription hormone at the same time. The iodine can’t hurt you but the prescription hormone sure can.

Almost always, people who are already taking prescription thyroid hormones will need to reduce those prescription amounts when their thyroid gland starts seeing iodine.


How do you know when to reduce your thyroid prescription?


Don’t do this alone. Get your physician involved on tapering your thyroid prescription doses once you get on iodine. There are certain signs to look for if your prescription dose is too high.

  • When your heart rate is too high when at rest (like over 85 beats per minute and you are doing nothing). (Your resting heart rate should be around 70 – 80 beats per minute).



An elevated resting heart rate is probably the first indicator that your prescription thyroid hormone dose is too high. You have about 3 weeks to take action here before you get in trouble.

The next series of signs that indicate too high of a prescription dose are:

  • Heart rate over 90 at rest
  •  
  • Blood pressure goes up
  •  
  • Feeling “shaky”
  •  
  • Feeling weak
  •  
  • Tremors in hands
  •  
  • Irritability, excitability
  •  
  • Can’t sleep
  •  
  • Feeling hot (warm body temperature)



If in doubt, just stop taking the prescription thyroid hormone and consult your doctor. The thyroid hormone will wash out in a week. It is a lot easier to start low and work up than the other way around.

Don’t stop your iodine, however. You may be finding out that iodine is all your thyroid really needed - not prescription thyroid hormones.

Your doctor will probably start checking frequent blood tests. Unfortunately, blood tests are just not a good indicator of your thyroid state. This is why most doctors are confused on thyroid dosing to begin with. The good news is that most doctors tend to underdose rather than overdose.

Expect your doctor to try to talk you out of taking iodine supplementation. Mainstream medicine is fairly clueless on supplements in general and knows nothing about iodine supplementation.

In fact, your doctor was probably fed erroneous information about iodine safety decades ago that turned out to be completely wrong. Nevertheless, mainstream medicine continues its bias against iodine.

Hold your ground. Your iodine is not negotiable. But prescription drugs that can cause harm need to be reduced or removed if you don’t need them.

Too much iodine can’t harm you. But too much prescription thyroid hormone sure can.


Iodine dosing for Category 2:


Just like we did for the Category 1 group, your iodine dosing follows the same logic.

How do you know how much to take? The scientific way is to measure your iodine levels in a 24 hour urine collection AFTER a 50 mg iodine/iodide challenge the night before.

The non-scientific way is to start low and work your way up on dosages. Starting doses of iodine supplementation are a single 12.5 mg tablet of a combination of iodine with iodide. Then, depending on the severity of your symptoms, you add an additional tablet each month until your symptoms go away. 

Unless you have a Health & Wellness physician guiding you, I recommend that your upper limit is 4 tablets (50 mg) of the recommended iodine supplement per day. (Although 12 tablets (150 mg) can be safely taken – but only under a doctor’s guidance)


The thyroid is SLOOOOOOOOOW


Physicians already know this. Thyroid hormones can circulate around in your bloodstream for a week or two. This is unlike virtually all other pills that come and go within a matter of hours. Thyroid is SLOW. Think in terms of weeks, not hours or days.

Any dosage changes affecting the thyroid should be done in monthly intervals. In other words, anytime you do anything that might affect the output of the thyroid gland, allow a full month for a response. Don’t change anything for a month.

Even though iodine is completely harmless, even in huge doses, we still allow a month to see what the effects will be before you start increasing the dose. Why? It is not because it can harm you (it can’t). But the actions are soooooo slow that it takes that long to observe a response.


When one iodine tablet is not enough?


Take the Online Questionnaire and determine which category you fit in. These are the categories:

  • Mild hypothyroidism
  •  
  • Moderate hypothyroidism
  •  
  • Profound hypothyroidism
  •  
  • Severe hypothyroidism
  •  
  • Hypothyroidism so bad that blood tests may be abnormal



Our experience is roughly adding the equivalent of 1 iodine tablet for each level of hypothyroidism. Even though there are five levels, we tend to max out at 4 tablets daily.

So you could potentially work your way up to this schedule:

  • Mild hypothyroidism – suggest 1 tablet
  •  
  • Moderate hypothyroidism – suggest 2 tablets
  •  
  • Profound hypothyroidism – suggest 2- 3 tablets
  •  
  • Severe hypothyroidism – suggest 2 - 4 tablets
  •  
  • Hypothyroidism so bad that blood tests may be abnormal – maximum 4 tablets



Keep in mind that some people may require more or less than the above suggestions. Also, let me remind you to start out at one tablet and add no more than one iodine tablet per month. So if you are a level 3 (profound hypothyroidism), it will be your third month before you get to 3 tablets.

Also notice that we are quite happy with two tablets for most conditions.

One more thing: It is impossible to induce hyperthyroidism even with massive iodine supplementation. Why? Because your body can only use so much iodine for its needs. Anything above that and your body merely washes it away and out it goes via your urine.

So with iodine supplementation you are better off taking too much than not enough.


Side effects of Iodine?


The following are some side effects of iodine supplementation that can occur in 1-3% of patients.

  • Metallic taste in mouth
  •  
  • Increased salivation
  •  
  • Sneezing
  •  
  • Coryza (runny nose)
  •  
  • Frontal sinus headache
  •  
  • Acne



These are found in people taking the maximum doses and are easily rectified by adding magnesium, Vitamin C, Vitamin B2, Vitamin B3 or just lowering the dose. This is not an allergy. These are not life threatening.


Another thought about “iodine allergies”:


Many people have been told by their doctors that they are “allergic to iodine” when they got some reaction from eating shellfish or received a medical imaging procedure that had contrast dye in it.

It is virtually impossible to be “allergic” to iodine in reality. This is like being “allergic” to magnesium or copper or any other essential element. Every cell in your body processes iodine. If there was a true allergic reaction to iodine you would not survive one day.

It is my belief that allergies to shellfish are allergies to something in shellfish that is not iodine. How many thousands of different compounds are in a shellfish? How many other ingredients (none of them natural) are in radiological contrast dye?

You are not allergic to iodine. And never will be.


Andrew Jones, M.D

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