Rachel: And sometimes emails from practitioners provide me with both the question and their own answer to their question even!
Cameron Barker’s (Ex-student long-term learner & mentee) email arrives titled: Unexpected Source of Iodine in Placenta Caps?!
A 32 yo female with a 12-week-old daughter came to me as she was not feeling well, in particular, she reports fatigue, racing heartbeat, anxiety and loss of appetite. Previously, 2 years ago, I had helped her with her Hashimoto’s. I did not hear from her for a year or so and she fell pregnant and was recommended to take a well-known iodine-containing pregnancy multi.
When she represented in this early postnatal period, she provided me with TSH, free T4 and free T3 results which include her cumulative historical gestation values. I could see that her TSH has dropped from 2.28 late in pregnancy to now 0.17mUI/L. Additionally, her free T4 went from 10.1 to 21.9 pmol/L and her postnatal T3 was 7.0 pmol/L! I wrote to her GP advising, “I am concerned that she has transitioned into hyperthyroidism and has to wait for 3-6 months to see an endocrinologist.:
I told her to stop any source of Iodine in the meantime and at this time I was unaware she was taking placenta caps.
In response to my letter, her GP organised some testing and with some guidance from me, we ensured that she followed the best collection conditions protocols e.g fasting etc. Check out the Random urinary iodine results for someone “not taking any iodine”
Random Urine Iodine
R-U-Creatinine 2.2 mmol/L
Urine iodine 100 L ( >100 ) ug/L
Creat Corr. Iodine 377 ( >100 ) ug/L
Thyroid Peroxidase Ab 416.9 H ( <5.6 ) IU/mL
Thyroglobulin Ab 23.8 H ( <4.1 ) IU/mL
TSH Receptor Antibodies <0.9 ( <1.8 ) IU/L
Thyroid Stimulating Immunoglobulins 0.13 ( <0.55 ) IU/L
Thyroid Function Tests
Free T4 21.4 H ( 9.0 – 19.0 ) pmol/L
Free T3 8.4 H ( 2.6 – 6.0 ) pmol/L
TSH 0.01 L ( 0.3 – 3.5 ) mIU/L
I could not work out why her Iodine levels were so high and as soon as she sent me all these results I called her straight away and told her to not take the multi anymore but apparently, she was taking her own placenta capsules and did not think to tell me… I came across this study: https://pubmed.ncbi.nlm.nih.gov/21417918/#:~:text=Iodine%20content%20of%20tissue%20samples,1037%20ng%2Fg%20thyroid%20tissue I am guessing placenta is a good source of Iodine. Have you come across this before? I will definitely keep this in the back of my mind from now on.
Rachel’s reply: OH MY LORDY Cameron this is extraordinary!!🤯 Thank goodness she came to see you – I really hope she’s getting some relief from her hyperthyroid sx now…because that’s an awful thing to deal with on top of a new baby!
And thanks for the tip-off – placental capsules as a potential source of iodine is now firmly on my radar too for all these new mums with wobbly TFTs and potential PPT and….the Jod-Basedow effect to boot!!!🤓
Cameron: The patient is feeling a lot better already and her symptoms were quite mild compared to what I expected. I think I caught it just in time!! As always, thanks for the great content and for being a fantastic silent mentor for me.
Me? Silent? Well, that’s a first….😂
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