Determining the End of the Iodine Loading Dose

How to ideally quit iodine loading.

What is iodine loading? An iodine loading dose is the amount of iodine needed to achieve saturation of your tissues with iodine. Typically, loading is done at 50mg per day but can go as high as 150mg per day under experienced supervision.

No one stays on the iodine loading dose forever, but you should stay on the maintenance dose once you reach your goals. The maintenance dose once saturation is achieved is 12-12.5mg per day.  So how do you know when you are done? Should you just quit after you feel better? How do I know when I've gotten the maximum benefit from the loading dose? Well the answer is to track and test.

Tracking

You will find this baseline check list on our How to Take Iodoral page. And it is worth repeating here for a number of reasons. Establishing baselines ensures you have everything you need to make good decisions now and into the future to determine when you have reached sustainable success and are ready for the maintenance program. If you are already into iodine therapy and didn't do this before you started, do your best to fill in the blanks with old lab work, typical oral temperature before you started, and so on.

Getting Started Baseline Check List

Name	Date	Date	Date	Date
TSH
Free T4
Free T3
Reverse T3
Home Temperature Test 3 day Average, High, & Low
Iodine Saturation*
Iodine Spot*
Journal all your symptoms and rate each one 1(mild) -10 (severe)

* optional at the beginning if you have met the symptomatic criteria.

When should you take the 24hour iodine saturation test after starting iodine therapy?

1. Test at 3 months from the day you reach the loading dose if you have mild symptoms or a moderately low initial test result of 60% or better.

2. Test at 6 months from the day you reach the loading dose if you have severe symptoms or an initial saturation test 59% or worse.

3. If your 3 or 6 month test comes back below 90%, test in 3 months if you are within 15 points of 90%. Test in 6 months if you are greater than 15 points from saturation.

4. It is HIGHLY recommended that you repeat the saturation test 3 months after starting the maintenance dose of 12.5mg daily. This will catch most cases that don't retain iodine well before any serious relapse in symptoms.

Why Testing? Testing is the only accurate measure to know when you are done with the iodine loading dose. It is also the best way to determine if you need a dose higher than 50mg. You have reached iodine saturation when the test comes back positive for 90% saturation. If you discontinue the loading dose before this point, symptoms may return and optimal results are not likely to be obtained. Many of your symptoms may resolve on the loading dose before you have actually reached saturation. It is not recommended to follow symptoms alone to determine the end of loading dose iodine therapy.

How we use this charting system and what to look for.

If during your program you run into side effects or an imbalance you need only to run a TSH test to determine if the imbalance is thyroid or adrenal. See “Transitioning off of thyroid medication with iodine” to learn more about how this is done.

To determine the end of the loading dose, we essentially are looking for your symptoms to improve in the presence of a stabilization of your numbers. Points 1-3 should be in range before you do the full thyroid panel blood tests again on number 4.

1. Normalization of symptom scores. Pretty simple, you're feeling better. But how much better are you? Look to your notes.

2. Iodine saturation of 90%

3. Average body temperature within 0.2°F over 3 days and no one reading lower than 98.4°F.

4. Two Stable Thyroid panel results 2 months apart that are within the functional range.

Remember, there is only a need to move on to number 4 once you achieve normalization for symptoms, saturation and temperature. Stable means that the two thyroid panel results are virtually the same. The values you get on these two final tests should be YOUR ideal blood values.

If you are having trouble making sense of this in your situation, we are here to help. Just schedule an appointment we can probably sort it out for you over the phone.

The maintenance dose

If you have reached this point and are ready to go to the maintenance dose, Congratulations! On a challenging job well done. Now don't screw it up by coming off the loading dose to fast. Yep. You got it right. Sudden reductions in iodine dosage can be just as big a shock as starting up to fast. Gradual titration is best.

Here is my recommended taper down schedule. It is basically my loading titration schedule in reverse.

Iodoral 12.5mg – Usual Discontinuation Schedule

Dose time	Week 1	Week 2	Week 3	Week 4	Week 5	Week 6	Week 7
Morning	2 tab	2 tab	1 ½ tab	1½ tab	1 tab	1 tab	1 tab
Noon - 3pm	2 tab	1 ½ tab	1 ½ tab	1 tab	1 tab	½ tab

Nascent Iodine 2% (0.4mg/drop) – Usual Discontinuation Schedule

Dose time	Week 1	Week 2	Week 3	Week 4	Week 5	Week 6	Week 7
Morning	62 drops (24.8mg)	62 drops (24.8mg)	46 drops (18.4mg)	46 drops (18.4mg)	30 drops (12mg)	30 drops (12mg)	15 drops (6mg)
Noon - 3pm	63 drops (25.2mg)	46 drops (18.4mg)	46 drops (18.4mg)	30 drops (12mg)	30 drops (12mg)	15 drops (6mg)	15 drops (6mg)

Slow Discontinuation – Stay 2 weeks at each dose level for a total of 16 weeks to reach 50mg daily.

Don't forget the maintenance dose for optimal daily iodine nutrition is 12-12.5mg. Many of my clients feel best and relapse less if taking a maintenance dose of adrenal support as well.

Cheers to your good health!