I have Hashimoto's thyroiditis which has left me hypothyroid. First, I do think it's important to know if you have antibodies although few doctors care(because they say it doesn't alter the course of treatment which of course is Synthroid). Using thyroid meds of any kind does treat the antibodies but that is just because it shuts down the gland. I have often wondered the same thing as you about whether the damage is too severe for the thyroid to function anymore. My thoughts are since I am no longer on thyroid meds (nothing seemed to help dessicated or not), that I would give Iodine a try first to see if it resolved most of my symptoms and that if this was not enough that I would then consider adding back in some meds to see if there is a synergistic effect between the meds and iodine. I have read of others that believe the combination is what has been most helpful to them. Once things seem to stabilize somewhat for me, I will probably have my antibodies retested to make sure the Iodine isn't aggravating them. I worry about this as I have been having a lot of irritation in my thyroid gland recently. One thing for sure I found very helpful for the antibodies is going gluten free. So, there are no hard and fast rules, some people say if you think you need it that badly go on the meds and still continue with Iodine anyway. However, there has been suggestion by the iodine docs that thyroid meds can interfere with the absorption of iodine. Look up Flechas interview on this board-he addresses this.