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Supplement · Grade A

Iodine and medications.

Every documented pair, every citation. Below: 5 documented pairs grouped by mechanism.

Iodine is in the Distil supplement database, evidence Grade A. The page below lists every medication we have explicitly assessed it against.

Iodine is the raw material for thyroid hormone, which in turn sets metabolic rate and supports cognition. Mild shortfall is becoming more common in the UK as dairy intake drops, and vegans are at higher risk because they miss the seaweed and dairy sources. The evidence for its role in thyroid function is Grade A, with Zimmermann 2009 and Bath 2013 among the key references. Potassium iodide at 150 to 300mcg covers most needs; the NHS recommends 140mcg a day in pregnancy, where iodine is critical for fetal brain development. The interactions are worth respecting. Iodine works with selenium for thyroid synthesis, but it can interfere with thyroid medication dosing, so your GP needs to know you are taking it. In Hashimoto's thyroiditis, high-dose iodine can worsen the autoimmune picture, so keep to physiological doses and monitor. The main risk at either extreme is thyroid disruption, so matching the dose to actual need matters more than taking more.

Below are the 5 documented pairs we have explicitly assessed for Iodine: 1 red and 4 amber. The pairs cluster around 4 mechanisms: Additive iodine load (thyroid toxicity), Additive thyroid suppression, Antithyroid drug interference, and Thyroid status destabilisation. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.

Documented interactions

Additive iodine load (thyroid toxicity)

Amiodarone is itself an enormous iodine load, and around one in five people taking it develop a thyroid problem because of that. Adding an iodine supplement on top increases that risk and is not advised. Do not take iodine while you are on amiodarone unless a specialist has specifically told you to.

PMID 33159436 · PMID 6428291 · BNF: Amiodarone

Additive thyroid suppression

Lithium can affect the thyroid and commonly causes an underactive thyroid or goitre over time. Iodine intake interacts with that effect, so taking an iodine supplement on top of lithium can add to the risk of thyroid problems. If you take lithium, do not start an iodine supplement without discussing it with your GP, and make sure your thyroid is being monitored.

PMID 23391071 · PMID 9827658 · BNF: Lithium

Antithyroid drug interference

Amber Carbimazole

Carbimazole is used to calm an overactive thyroid. Taking an iodine supplement at the same time can work against it by giving the thyroid more raw material to make hormone, which may make your overactive thyroid harder to control. Iodine supplements are generally not advised while you are being treated for an overactive thyroid unless a specialist has told you otherwise.

PMID 12213665 · PMID 12927435 · BNF: Carbimazole

Propylthiouracil is used to calm an overactive thyroid. Taking an iodine supplement at the same time can work against it by giving the thyroid more raw material to make hormone, which may make your overactive thyroid harder to control. Iodine supplements are generally not advised while you are being treated for an overactive thyroid unless a specialist has told you otherwise.

PMID 12213665 · PMID 36740774 · BNF: Propylthiouracil

Thyroid status destabilisation

Taking extra iodine while you are on levothyroxine can shift your thyroid status and may change how much levothyroxine you need. Most people on a stable dose do not need an iodine supplement, and large doses are best avoided unless your GP has advised one. If you do start iodine, ask your GP to recheck your TSH so your dose can be adjusted if needed.

PMID 26203098 · PMID 28290237 · PMID 17598973 · BNF: Levothyroxine

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.