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Urine Iodine test question

Hello, I've done a urine Iodine test recently.
My results are not clear to me, I am not asking for an interpretation of the results, merely an opinion as for whether they even make sense.

test - Iodine urine
result - 0.00
units - %MCG
reference range - 00.0 - 10.0

The first strange thing is the units of measurement: mcg%.
What is mcg%? I was not able to find info on this anywhere.
I know what mcg means, but never seen a unit of measurement in conjunction with a percent sign.

Second thing is whether it makes sense that someone has 0 Iodine in their urine and beyond that, that the reference range contains a result of 0.

Thank you.
33 Responses
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649848 tn?1534633700
COMMUNITY LEADER
In my opinion, it would be a random fluctuation, but your levels aren't horrible, though your FT4 is only at 27% of its range (rule of thumb is mid range, 50%).   As you know Total T3 is obsolete and doesn't tell  much; however, I wouldn't let that FT4 get much lower... you have very little to convert to T3 now, so when FT3 starts going down, it will probably go pretty fast.  TSH will then rise, quickly, as well.

Stopping soy might have helped, since soy is known to inhibit thyroid hormone metabolism.

I'm happy to hear that you didn't continue with the iodine.  

Make sure your iron and vitamin D levels are both well up in the ranges... both are necessary for proper metabolism of thyroid hormones.

Best to you.
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Avatar universal
Hey Barb, thank you very much for your comments, they are very helpful.

In the end I only took Potassium Iodide for like a couple of days and I stopped as I received new results from a test done on 28/12/2014.

So that was about two and a half weeks after the test where my TSH was 8.85 mlu/l.

The results of this test show a further decrease in my TSH. I stopped eating soy between these two tests, not sure if the decrease is related.
The results are (reference range in parantheses):

FT4: 1.1 ng/dl (0.8 - 1.9)
T3: 135 ng/dl (72 - 170). Apparently they've done T3 and not FT3, not sure why
TSH: 3.45 mUI/ml (0.35 - 4.70). Suddenly within range

Not sure if these are random fluctuations or there really has been a decrease in TSH.

It has been about two months since this test, so I'll do another test soon.
For now I haven't started thyroid hormone replacement and I feel fine.
I am also not taking Iodine. Once I saw the results above and the improvement I decided not to try Iodine. So I ended up taking it for like 2-3 days and stopping.

Any idea if these are random fluctuations or could be a real improvement for some reason?

Cheers


Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Sorry - you aren't nagging; you slipped by me again... don't wait so long to bump me, next time, if I don't respond, okay?

It's good to cut out the soy - that's a known thyroid inhibitor.

I'm still not a big fan of using iodine and I don't think it's going to work for you.  I think you need to be on thyroid hormone replacement, no matter what the cause of your hypothyroidism is.  

It appears, however, that you're going to do the potassium iodide anyway, so I must caution to be careful with that, as too much potassium can cause an electrolyte imbalance in your body, which, again, can cause all types of issues.
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Avatar universal
Any thoughts on this? don't want to nag but the answers are very helpful so far :)
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Avatar universal
Hi Barb,

Thank you for the answer.

The doctor indeed ordered the Thyroglobulin battery because apparently that's the only way she could get the Thyroglobulin antibody test.

So I got the results for this test (reference ranges in parantheses):
TSH: 8.85 mlu/l (0.5 - 4.8)
FT4: 13.2 pmol/l (10.3 - 19.7)
FT3: 5.38 pmol/L (3.5 - 6.5)
Thyroid peroxidase Ab: 12.4 IU/ml (0 - 35)
Thryglobulin Ab: less than 20 IU/ml (no reference range specified)

So better than last time. The only thing I did diffrently between the two tests is to cut off soy (which I used to eat every day quite a lot of.)
Though perhaps it could be a natural fluctutation.
He said that the Iodine urine test I took was most probably an erronous result, as he has never seen anyone with a measurement of 0. In the new Iodine test I took I collected urine for a whole day, so I assume it would be more accurate.
I also done TSH, FT4 and FT3 again in this new test.

I agree with you about the salt, at the moment I intend to try Iodien tablets (Potassium Iodide) instead of salt, and Selenium as well.
So my current plan is to try Iodine + Selenium for 2-3 months and get tested again, and if I don't see an improvement and results are still bad then probably start taking Thyroid medication.

What do you think?
Also, I'll post up the results for the new test once thye are available, which should be in the next week or so.

Cheers


Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Sorry, I didn't respond to your last post, not sure how I missed it.  

Your FT4 is actually below range and your TSH is way too high, indicating that your are really hypothyroid, at this time.  You should be on thyroid replacement medication.

From what I can find out, the Thyroglobulin TM battery your doctor ordered may or may not include the thyroglobulin antibodies, depending on your lab.  Thyroglobulin is a protein used entirely (and only) by the thyroid to produce thyroid hormones.  Testing it is often used as a tumor marker and there's no reason to believe you have any tumors, so I have no idea why your doctor ordered that test when she really only need to order Thyroglobulin Antibodies.  You should contact your lab and make the test battery includes the antibody test.  IMO, that's an indication that she knows very little about thyroid.

I certainly would not recommend that anyone increase their intake of table salt simply to get  more iodine, as salt contains sodium, which can cause multiple other problems, such as fluid retention that contributes to other health issues.

We have known of people being diagnosed with Hashimoto's, in spite of  testing negative for thyroid antibodies.  
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Avatar universal
Any opinions? :)
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Avatar universal
Barb thank you so much for replying here, it's a blessing. This seems to be the only forum with someone to talk to.

Here are the exact results with reference ranges in parantheses:
Free Thyroxine (FT4): 9.4pmol/l (10.3 - 19.7)
Thyroid Peroxidase Ab: 13.7 IU/ml (0-35)
TSH: 14.36 mlu/l (0.5 - 4.8)

I also got a Thyroid Ultrasound this week, everything was well in the Ultrasound except lymph nodes were slightly swolen.
Also had a Thyroid Ultrasound 10 months ago where everything was well.

Was as the endocrinologist's office today. She told me I look well and my thyroid feels well (She felt my neck with her hands.) She told me I look euthyroid to her and I told her I feel well.
Diagnoisis is for now Hypothyroidism UNS - mild-subclinical.
UNS I think stands for "Unspecified." So not diagnosed as Hashimoto's at the moment.

By the way your previous answers helped me realize I need to check for other antibodies as well and I asked her to do such tests.

She gave me a reference to the following blood tests (that I'll take Monday):
FT4 Free Thyroxine
Triiodothyronine Free FT3
Thyroid Peroxidase (TOP) Ab
TSH
Thyroglobulin TM Battery

I understand checking for Thyroglobulin antibodies is included in the last test mentioned.
I also told her I suspect I am low on Iodine. I showed her my urine test where I had 0 Iodine. She said she never encountered such a test but that probably my Iodine is low.
She said since it is not that urgent at the moment for me to start thryoid hormone replacement treatment. It is acceptable that I'll test my theory and try to supplement Iodine (low doses, she recommended I consume Iodized salt) and see it 2-3 months if there are changed for the better and update her.
She didn't specify a specific dose of Iodine and it does not seem she has experience with the issue. I believe I'll just start slow at ~ 50% the daily intake and up the dose every week to two weeks as long as I feel well and get to ~100-150% of the recommended daily intake in around 2 months and get another test at around the 3 month mark. That is assuming I am not diagnosed with Hashimoto's after the next blood test where I am testing the Thyroglublin antibodies.
About the swollen lymph nodes, she said it is not significant and can happen for many reasons.

Feel free to comment about any of this. Also, I have a question.

If my thyrodlobulin antibodies are within range, considering that my TPO antibodies are within range. Is it quite safe to assume I don't have Hashimoto's?

About the Iodine Urine test. As I said she didn't seem to know much about it. The lab is not giving me much information either so far unfortunately. You said previously that Iodine is present in the body as Iodide and is probably present in the urine in that form. That is something I should check as well, to make sure that the test really does measure nutritional Iodine and not something else.
What I can say is that on the webpage for the lab where I took the Iodine test (which is a well known lab) it is written that this test CAN be used to answer the question "does the patient have an adequate intake of Iodine in their nutrition?" so I think I can be quite certain that it does measure nutritional Iodine. Anyhow I'll send an e-mail to the lab about this Iodide issue, although they are not very responsive unfortrunately.
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649848 tn?1534633700
COMMUNITY LEADER
What's the reference range for the T4 and is it Free T4?  Also the range for the TPOab?  
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Avatar universal
I have neglected the issue unfortunately and got another blood test several days ago.
Now my TSH is much higher (14.36 mlu/l)
And my T4 much lower (9.4 pmol/l)
TPO antibodies are 13.7 IU/ml

I still have a desire to try to treat this naturally. I don't know if it's Hasimoto's or not. I have a meeting with an endocrinologist tomorrow. This time I'll ask about the urine test and whether I could try Iodine supplementation.
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649848 tn?1534633700
COMMUNITY LEADER
Your levels are all within the reference ranges and would not, normally, indicate a thyroid condition.  Under some circumstances, however, your FT4 and FT3 levels could be considered somewhat low in their ranges.  

Do you have symptoms of a thyroid condition?  Are you currently taking a thyroid replacement medication?  If so, which one, at what dosage and for how long have you been on it?
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Avatar universal
Dear All,

Please help with the interpretation for the results below:

FT4: 15.34 pmol/l (12.0 - 22.0pmol/L)
FT3: 4.86 pmol/L (3.1 - 6.8pmol/L)
TSH: 1.61 mlu/l (0.27 - 4.2)

Thanks
Everlyn
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649848 tn?1534633700
COMMUNITY LEADER
Hashimoto's is the most common cause of hypothyroidism in the developed world, so we often tend to think that's what you have unless proved otherwise.  The next step is to get your antibody levels tested, as I mentioned early on in this thread.  Your thyroid might not have been swollen/inflamed at the time of your ultrasound, which would cause your doctor to think you don't have Hashimoto's.

The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  You need them both, because some of us have one or the other, some have both.  Elevated levels of either are the basis for a diagnosis of Hashimoto's.
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Avatar universal
It is probably also important to add that I hav enot been diagnosed with Hashimoto's. I do have a family history of Hashimoto's. But the latest ultrasound test did not cause my doctor to believe I have Hashimoto's
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Avatar universal
Okay, thank you for the comments guys. I didn't talk to a doctor about the urine test yet. I guess that's my next step.
Helpful - 0
4274823 tn?1388529098
Brazil nuts are supposedly a good source of selenium. I eat one per day.

Please note I know first--hand that one needs to be careful with iodine intake. My system was flooded with iodine by a naturopathic doctor in 2012 and it worsened my hypothyroidism. Needless to say I stopped the medication and didn't go back to the ND.
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649848 tn?1534633700
COMMUNITY LEADER
While most of us don't do it, all the time, it's recommended that you consult a physician, every time you add a new supplement.  Some supplements can be toxic if too much is taken; others can have adverse side effects or cause reactions with other meds, etc.  It's a matter of opinion whether or not adding  iodine would constitute self-medication; in my opinion, it would be, since it's contra indicated with Hashimoto's.  Whether I would, necessarily, let that keep me from trying it if I thought it might help, is another matter.

Did you talk to this last doctor about the iodine test?  If so, what was his reaction?

For other health reasons, I have to limit my salt intake, therefore, I get very little iodine, as well.  I do have Hashimoto's and I take thyroid hormone replacements.

I know you don't want to take thyroid medication, but when the thyroid stops producing enough hormones, there's really no other other choice.  At some point, you will have to, and it's usually better to get started on a small dose before symptoms become uncontrollable.  I'd keep trying different doctors.

Your last blood work was done over a month ago; might no hurt to repeat it and see what your levels are now.  When the thyroid is failing, labs can change quickly.  



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Avatar universal
I have been to a doctor and he has not recommended I take a thyroid replacement pill at this stage.
Would you really call this self-medication?
The fact is that salt is iodized in many countries, so I would just as well get iodine if I consume salt. But I just don't want to increase my salt intake.
I also don't eat fish. I simply do not consume anything with substantial amounts of iodine which the average person probably would.
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649848 tn?1534633700
COMMUNITY LEADER
I never recommend self medication, especially, with something like iodine.

Consulting with a doctor about the iodine test would be a good idea, but better yet, would be to find a doctor who will start you on thyroid medication to alleviate your symptoms.  I've never understood tossing back a handful of supplements every day, yet being reluctant to take a single thyroid replacement pill.
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Avatar universal
No, the last time I went to the doctor he said that there is no need for treatment for now, but that I should check my levels periodically.
The doctors I saw did not know much about Iodine and did not seem to think it is the reason, but I haven't seen a doctor since this Iodine urine test I took.
I never took any Thyroid medication and really don't want to get to the stage where I need to.
Right now I think my courses of action are:
1. See a doctor again about the Iodine test results and see what he thinks
2. Try to take small doses of Iodine + Selenium and see how I feel, I know it may exacerbate Hashimoto's but if I never try I'll never know, if I start feeling worse then I'll stop.

My feeling is that most doctors don't know much about Iodine, this has been impresion so far, and they will only treat anything once my thyroid fails and T4/T3 levels go too low.

Do you think that's a wise decision?
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649848 tn?1534633700
COMMUNITY LEADER
Sorry I didn't respond to your previous post; guess I missed it.  

As I noted in my previous post, FT3 should be higher in its range, than FT4 in its... Your results are opposite, with FT4 higher in the range than FT3 in its.  That's what I meant by your number being upside down.

If you were on a thyroid medication, we'd probably conclude that you aren't converting FT4 to FT3 adequately.  People not on replacement hormones, may not need levels as high; however, your elevated TSH and lower level of FT3 indicates that your thyroid is starting to fail.  

Has your doctor mentioned starting you on a replacement hormone?
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Avatar universal
Do you have any interpretation of what it means that "my numbers are upside down"? is this good/bad? is this caused by something specifc?
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Avatar universal
I don't think I really have symptoms.
Fatigue is the only thing I think i may have of the list of symptoms. It is really hard to say whether I am currently more fatigued then I was several months ago. So I would say if I am the difference is not big.

Do you have any interpretation of what it means that "my numbers are upside down"? is this good/bad? is this caused by something specifc?

Thank you a lot for all your answers, I feel you r helping
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Many doctors will test only TPOab and if that's negative will declare that your don't have Hashimoto's; that's often why people end up not getting a proper diagnosis: because the doctor didn't run all the tests.  

Rule of thumb, for those on thyroid replacement, is that FT4 be at/near the mid range point; your FT4 is at 56%, which is totally adequate.  Rule of thumb is for FT3 to in the upper half to upper third of its range; yours is at 39%.  FT3 should be higher in its range than FT4 in its, so your numbers are upside down.

Because TSH can vary so much over the course of a day and is affected by many variables, I don't place a lot of importance on it, unless it's extremely high/low.  That said, if your lab were using the new range, your TSH would be further out of range than it is.

Do you have symptoms of under active thyroid?  
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