I thought I was recovering. After removing iodized salt from my diet and stepping back from fortified eggs, my thyroid numbers were coming down. I was eating better, sleeping more deeply, and starting to feel a flicker of hope.

But after discussing my situation with my PCP of my being able to eat eggs and fish but not take supplements nor eat other animal proteins, we made the decision for me to reintroduce iodine-rich foods into my diet, expecting for me to go back into mild hypothyroidism. Little did I know that a body in motion tends to stay in motion, just as one case study showed where a patient was on a roll down from iodine-deficiency hypothyroidism, moving rapidly toward the lower end of euthyroidism after taking an iodine supplement and started then introducing iodine-rich foods into his diet. He went into iodine-induced hyperthyroidism without guidance from his endocrinologists early to moderate his intake and to monitor him more frequently. 

Sure enough, a similar event happened for me. Within weeks of reintroducing the fortified eggs, my body began to shift again, only this time in the other direction. However, I didn’t realize that’s what was happening. As the shift intensified, I had feelings of panic and dizziness that were dismissed as mental health issues. Now I recognize that my free T4 was rapidly rising as my TSH sank.

The Symptoms Were Subtle at First

The first change I noticed was a burst of energy. At first, it felt good. I was finally able to complete tasks I’d put off for weeks. I felt sharp, focused, and energized. I could finally eat more.

But then came the nights where I couldn’t sleep, wakened around 3 AM with a rapid heart rate, pounding as if my heart were trying to break free. I would be drenched in sweat and overheating.

My heart would race when I laid down. I’d wake drenched in sweat. My skin began to dry out with dark patches, painfully, despite the sweating. I was peeing constantly during the day. 

I Knew Something Was Wrong Before the Lab Did

I knew something was wrong after a certain point as I stood outside, shaking, crying that I felt so overwhelmed like my thoughts were moving so fast that I was going to have a seizure with epilepsy to manage as well.

My baseline heart rate was creeping up steadily as I lay in bed. My brain was overstimulated, then fogged, like something had gone off-kilter and wouldn’t reset.

But because my last labs had shown euthyroid status, no one had scheduled more follow-ups. I had to fight to get new labs ordered—and when they came in, I was shocked. My free T4 was over 6 ng/dl and my TSH had dropped to a miniscule number.

Labs Don’t Catch It Fast Enough

I was officially hyperthyroid, but yet my PCP told me I shouldn't be symptomatic as I rapidly worsened as the ball gets rolling faster once it gets rolling. I was spending days crawling across the floor, screaming to my father in terror as I felt that I would die as my kidneys in my complete metabolic panel (CMP) showed signs of strain and difficulty eliminating potassium fast enough while I was rapidly dropping sodium, disrupting my potassium-sodium balance and causing cardiovascular events on top of adrenaline surges.

No one had warned me this could happen from reintroducing iodine—even though I had done so gradually. My doctor had told me to expect a return to subclinical hypothyroidism at most.

What I experienced was a slingshot.

The Medical System Still Didn’t Help

I reached out to my PCP. She dismissed my concerns and did not flag my lab results. When I kept pushing, she told my my lab results shouldn't produce significant symptoms as I still had a smidgen of TSH left, totally ignoring the fact that a > 6 ng/dl free T4 in the context of iodine-induced hyperthyroidism is very severe. 

If you look up hyperthyroidism parameters, there is an incorrect fixation on TSH with the Cleveland Clinic noting that severe hyperthyroidism is characterized by TSH levels significantly below the normal range, often below 0.1 mIU/L. Since I was at 0.15 mIU/L, I was told I should be fine. What was missing from my PCP's understanding of the larger context was that a rapidly rising free T4 was likely going to continue rising rapidly with this momentum with continued iodine intake without a mitigating element and that very soon my TSH would drop out completely. Sure enough, within three weeks, my TSH was no longer detectable. 

I was in a body that felt like it was sprinting in circles, unable to stop.

I Turned to Data, Not Doctors

Once again, I had to figure things out myself. I began reducing iodine again, but slowly. I tracked symptoms daily. I wrote down my food, how much I sweated, my body weight fluctuations, and how my body felt overall. I noted that I no longer smelled iodine as a sign I'd had of too much iodine in my daily diet back when I was euthyroid or hypothyroid or even slightly hyperthyroid with some TSH still and hypothesized that this was connected with the presence of TSH and that I no longer had the ability to dump iodine I didn't need.

I tracked everything I could.

I Found Stories Like Mine

Eventually I came across the earlier-mentioned research case of a man who had been hypothyroid due to iodine deficiency from avoiding iodine-rich food and recovered rapidly with iodine supplementation. A little too rapidly, he was shifting fast and not being tested often enough. He was so relieved, he started eating seafood again—only to slingshot into hyperthyroidism. His endocrinology team had not warned him.

Like me, he thought he was safe once he felt better. Like me, he found that recovery can come with consequences when physicians assume that a patient entering euthyroidism (normal range) means that they'll hang out there instead of recognizing hormonal kinetics. The body doesn't just say "oh, good, we're here! Resume as normal." The body is in motion and will remain in motion, and the approach needs to be adjusted accordingly to not overshoot the target. 

Two and a Half Months of Hell

For two and a half months of hell, I fought each day to survive, drinking salt water where needed, running downstairs to my father, texting my neurologist whenever I needed to temporarily up my dose of medication to manage my seizures which were heavily impacted by all of these fluctuations. Multiple times, the ambulance had to come out to my house to run an EKG on me as I stayed in tachycardia at 140 BPM and needed to make sure I wasn't having arrythmias at that speed. 

I was so hungry but I felt like collapsing after eating as my post-prandial heart rate would increase drastically. Your heart rate naturally increases when you eat within a normal range, but in hyperthyroidism there essentially is no cap on things. If you are anxious, your adrenaline releases in unchecked amounts. If you try to eat, your heart rate soars. 

I was terrified of dying every single day as I still worked and held meetings, lying under my computer table and breathing carefully for each moment that I had a break in speaking as the act of speaking was pushing my heart rate up even higher. 

Throughout it all, my PCP stuck her head in the sand and ignored me as she didn't know what to do if I simply reported symptoms and asked for feedback on symptom management. I realized that I had to give her action items for her not to be overwhelmed. I continued to order complete metabolic panels and T4/TSH checks every three weeks as I lowered iodine to check both how strained my metabolic system was as well as whether my T4 was coming down. At one point, I started poaching my eggs rather than scrambling them as I had always done and realized based on my T4 near-plateau that this cooking method was preserving more iodine and thus had to drop another egg before my T4 kept dropping. 

I was in my distress. My father was in distress watching me go through distress. He would tell every mobile phlebotomist and EMT that my PCP was incompetent.

This was one of the hardest times of my life to have iodine-induced hyperthyroidism on top of secondary epilepsy, secondary POTS, secondary MCAS with limited dietary options for nutrition, and a spinal CSF leak. 

Next week, I will cover my self-guided progress in getting my free T4 back into normal range and what the recovery process looked like for me as my TSH started coming back as I could not find any information on this when I looked online and even posted in Facebook groups. My endocrinologist likewise told me she had no idea what this would look like and that none of her patients had ever recovered from hyperthyroidism and typically just crashed into a hypo-rebound until they were medicated with levothyroxine and then often flipped back into hyperthyroidism in a constant back-and-forth. This seemed to be a common theme in the Facebook groups as well too. 

What I’m Doing Now

Recently, I had the opportunity to speak at a continuing education event for registered dietitians in North America. One dietitian immediately recognized that her patient’s symptoms might be from a spinal CSF leak. She used the research I shared and created a meal plan that took iodine sensitivity into account.

I’ve also had the chance to collaborate with Vincci Tsui, RD, the founder of Weight-Inclusive Dietitians in Canada. Together, we’re co-hosting a webinar.

🎟️ Join us live on June 19 at 7:00 PM EDT for a one-hour, evidence-based presentation and discussion with real-life experience on iodine and thyroid health. You’ll leave with practical tools to understand your own dietary iodine intake.

Can’t make it live? Subscribe to our email list and stay tuned to get the recording for $20 once it’s released. We’ll email you as soon as it’s ready.