KimberlyHello – That’s great to hear that your endo was so thorough in answering your questions. And it’s definitely smart to test levels prior to adding any sort of supplementation regimen!
In terms of getting patients stabilized on anti-thyroid drugs before RAI, this is one area (of many!) where doctors don’t always agree. Some don’t believe it’s necessary. The latest medical guidance does recommend getting patients stable first if they have very high T4 levels or if they have other co-existing conditions (heart issues, kidney issues, poorly controlled diabetes etc.).
Prior to thyroid surgery (or *any( type of surgery) getting levels stable prior to the procedure is definitely very important to reduce the risk of thyroid storm.
As you noted, there is conflicting information on diet, but patients who are hypER are generally advised to avoid foods/supplements that have lots of iodine, like the seaweed wrap that comes with sushi. The thyroid uses iodine to manufacture thyroid hormone…which is like throwing gasoline on a fire for those who are hyper!
Take care!