Meta Information
ID:iodine
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/antithyroid-medications
Target name:
Antithyroid Medications (Methimazole, PTU)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Iodine supplementation directly counteracts the therapeutic mechanism of antithyroid drugs, which are designed to block iodine utilization by the thyroid gland, potentially worsening hyperthyroidism.
Actionable advice:
Iodine supplements should be strictly avoided while taking antithyroid medications unless specifically directed by an endocrinologist.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
Iodides (e.g., potassium iodide, strong iodine solution) are given to inhibit the release of thyroid hormone from the gland but may subsequently be used as a substrate for thyroid hormone synthesis; therefore, treatment with a thioamide antithyroid agent is usually initiated before iodide therapy.
Label source:
Primary literature: https://www.medcentral.com/drugs/monograph/7251-382464/methimazole-oral
Action type:
avoid
Target id:
/intervention/amiodarone
Target name:
Amiodarone
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Amiodarone contains a very large amount of iodine, and adding more from supplements significantly increases the risk of iodine-induced thyroid dysfunction (hyperthyroidism or hypothyroidism).
Actionable advice:
Iodine supplements should not be taken while on amiodarone due to the high risk of thyroid toxicity.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Amiodarone is a class III antiarrhythmic drug containing 37% iodine by weight, with a structure similar to that of thyroid hormones. Deiodination of amiodarone releases large amounts of iodine that can impair thyroid function, causing either hypothyroidism or thyrotoxicosis in susceptible individuals reflecting ~20% of patients administered the drug.
Label source:
PubMed: Amiodarone (PMID 29999620)
Action type:
avoid
Target id:
/class/potassium-sparing-diuretics
Target name:
Potassium-Sparing Diuretics
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining potassium iodide supplements with potassium-sparing diuretics can lead to dangerously high levels of potassium in the blood (hyperkalemia), which can cause serious heart problems.
Actionable advice:
Potassium iodide supplements should not be used when taking a potassium-sparing diuretic (e.g., spironolactone, amiloride).
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
the risk of hyperkalaemia was also increased in the interaction group (9.9 vs. 5.9%, RR 1.7, 95% CI 1.3–2.1). The combination of potassium-sparing diuretics plus a potassium supplement, start of the PID within the hospital and hospitalisation in non-internal medicine departments was associated with higher relative risk estimates for hyperkalaemia.
Label source:
Primary literature: https://pmc.ncbi.nlm.nih.gov/articles/PMC3154285/
Action type:
avoid
Target id:
/condition/thyroid-disorders
Target name:
Thyroid Disorders (Hashimoto's, Graves', Nodules)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
In individuals with pre-existing autoimmune thyroid disease or nodules, supplemental iodine can trigger or worsen hyperthyroidism or hypothyroidism, a phenomenon known as the Jod-Basedow or Wolff-Chaikoff effect.
Actionable advice:
Iodine should not be supplemented with a known thyroid disorder, except under the direct supervision of a physician.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Although excessive iodine intake or exposure is generally well tolerated, an acute iodine load may result in thyroid dysfunction (hypothyroidism or hyperthyroidism) in certain susceptible individuals due to the failure to escape from the Wolff-Chaikoff effect and to the Jod-Basedow phenomenon, respectively.
Label source:
PubMed: Endocrine reviews (2024)
Source url:
Exact phrase from label:
Excess iodine is generally well tolerated, but individuals with underlying thyroid disease or other risk factors may be susceptible to iodine-induced thyroid dysfunction following acute or chronic exposure.
Label source:
PubMed: Current opinion in endocrinology, diabetes, and obesity (2012)
Source url:
Exact phrase from label:
However, in a few apparently normal individuals, in newborns and fetuses, in some patients with chronic systemic diseases, euthyroid patients with autoimmune thyroiditis, and Graves' disease patients previously treated with radioimmunoassay (RAI), surgery or antithyroid drugs, the escape from the inhibitory effect of large doses of iodides is not achieved and clinical or subclinical hypothyroidism ensues.
Label source:
PubMed: Thyroid : official journal of the American Thyroid Association (2001)
Action type:
informational_none
Target id:
/procedure/radioactive-iodine-uptake-test
Target name:
Radioactive Iodine Uptake (RAIU) Test
Severity:
major
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
672
Hours after target:
0
Description:
Recent iodine intake saturates the thyroid gland, preventing it from taking up the radioactive tracer and causing a falsely low (and therefore inaccurate) test result.
Actionable advice:
All iodine supplements should be discontinued for at least 2-4 weeks before a scheduled RAIU test or thyroid scan.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Failure to follow the prescribed diet can alter RAIU results, thyroid scan findings, and poststudy management.
Label source:
PubMed: Clinical nuclear medicine (2008)
Source url:
Exact phrase from label:
LIDs reduce urinary iodine measurements and appear to increase I-131 uptake or lesional radiation compared to regular diets.
Label source:
PubMed: Thyroid : official journal of the American Thyroid Association (2010)
Action type:
monitor
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Iodine requirements increase significantly during pregnancy to support maternal thyroid function and fetal neurodevelopment; deficiency can cause severe and irreversible harm.
Actionable advice:
Adequate, but not excessive, iodine intake should be maintained throughout pregnancy as recommended by an obstetrician.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
Conditions such as hypothyroidism, hyperthyroidism, and their subclinical variants arise from disruptions in thyroid hormone balance, which is vital for fetal neurodevelopment and maternal well-being.
Label source:
Anecdotal: StatPearls
Action type:
informational_none
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Adequate iodine intake is critical during lactation to ensure sufficient iodine content in breast milk for the infant's brain development.
Actionable advice:
Continue to ensure adequate, but not excessive, iodine intake while breastfeeding as recommended by your physician.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
Babies receive all their iodine (for making their own thyroid hormone) from their diet, including breast milk.
Label source:
Anecdotal: MotherToBaby
Action type:
informational_none
Target id:
/class/ace-inhibitors
Target name:
ACE Inhibitors
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
ACE inhibitors can increase blood potassium levels. Taking them with potassium iodide increases the risk of developing hyperkalemia (high potassium).
Actionable advice:
Caution is warranted, and potassium levels should be monitored, when combining potassium iodide with ACE inhibitors.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
ACE inhibitors have been associated
with a higher rate of angioedema in black than in non-black patients.
Label source:
Action type:
monitor
Target id:
/class/arbs
Target name:
Angiotensin II Receptor Blockers (ARBs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
ARBs can increase blood potassium levels. Taking them with potassium iodide increases the risk of developing hyperkalemia (high potassium).
Actionable advice:
Caution is warranted, and potassium levels should be monitored, when combining potassium iodide with ARBs.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Closely observe neonates with histories of in utero exposure to losartan potassium for hypotension, oliguria, and hyperkalemia.
Label source:
Action type:
monitor
Target id:
/intervention/lithium
Target name:
Lithium
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Both lithium and iodine can suppress thyroid function; using them together synergistically increases the risk of developing hypothyroidism (an underactive thyroid).
Actionable advice:
Iodine supplements are best avoided while taking lithium unless thyroid function is closely monitored by a doctor.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Lithium salts may cause the development of goiter, hypothyroidism, or rarely hyperthyroidism.
Label source:
PubMed: Journal of physiology and pharmacology : an official journal of the Polish Physiological Society (2020)
Source url:
Exact phrase from label:
It increases intrathyroid iodine content or compete for iodine transport, resulting in low iodine uptake by the thyroid. It also inhibits the coupling of iodotyrosine residues to form iodothyronines and inhibits the release of T4 and T3.
Label source:
PubMed: Medicina (2022)
Source url:
Exact phrase from label:
Lithium therapy causes overt hypothyroidism in 5 to 15% of patients, and goitre in up to 37%. Thyroid function tests should be performed prior to initiating lithium therapy, and at 6-monthly intervals thereafter. Iodine and iodine-containing drugs (e.g. radiographic contrast media, iodinated glycerol and amiodarone) can have profound and variable effects on thyroid function.
Label source:
PubMed: Drug safety (1995)
Action type:
avoid
Target id:
/intervention/levothyroxine
Target name:
Levothyroxine
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Excess iodine can interfere with thyroid hormone production and conversion, potentially disrupting the stability of levothyroxine therapy and exacerbating underlying autoimmune thyroiditis.
Actionable advice:
High-dose iodine supplements are best avoided while on levothyroxine; it is important to talk to an endocrinologist before taking any iodine.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Excess of iodine may interfere with thyroid function.
Label source:
PubMed: Auto regulatory capacity of the thyroid gland after numerous iodinated contrast media investigations. (PMID 31990217)
Action type:
avoid
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Impaired kidney function reduces the body's ability to excrete excess iodine, increasing the risk of accumulation and toxicity.
Actionable advice:
Iodine supplements are best used with caution and at lower doses in those with kidney disease, under medical supervision.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
Imbalance of essential trace elements is a common complication of CKD and a risk factor for CKD progression, cardiovascular events, and death.
Label source:
Primary literature: https://pmc.ncbi.nlm.nih.gov/articles/PMC9843383/
Action type:
informational_none
Target id:
/biomarker/thyroid-panel
Target name:
Thyroid Function Tests (TSH, T3, T4)
Severity:
moderate
Interaction type:
assay_interference
Nature:
temporal
Temporal spacing:
Hours before target:
72
Hours after target:
0
Description:
Large doses of iodine can temporarily alter thyroid hormone levels, particularly suppressing TSH, which may lead to misinterpretation of test results.
Actionable advice:
Consider pausing high-dose iodine supplements for several days before having your thyroid levels checked for the most accurate baseline reading.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
LID babies from birth on had large goiters, high thyroid labeled MIT/DIT ratios and radioiodine uptakes, high plasma TSH and low plasma T4 in comparison to HID controls.
Label source:
PubMed: (PMID 1196133)
Action type:
monitor
Target id:
/intervention/selenium
Target name:
Selenium
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Selenium is an essential cofactor for deiodinase enzymes that convert T4 to the active T3 thyroid hormone and for glutathione peroxidases that protect the thyroid from oxidative stress during hormone synthesis.
Actionable advice:
Adequate selenium intake (from diet or supplements) is a good idea when supplementing with iodine to support proper thyroid function.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
OBJECTIVE: Selenium (Se) in the form of selenocysteine is an essential component of the family of the detoxifying enzymes glutathione peroxidase (Gpx) and of the iodothyronine selenodeiodinases that catalyse the extrathyroidal production of tri-iodothyronine (T(3)).
Label source:
PubMed: Effects of a six month treatment with selenomethionine in patients with autoimmune thyroiditis. (PMID 12656658)
Action type:
informational_none
Target id:
/dietary/goitrogenic-foods
Target name:
Goitrogenic Foods (Raw Cruciferous Vegetables, Soy)
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Goitrogens are compounds in certain foods that can interfere with the thyroid gland's ability to absorb and utilize iodine, though this effect is significantly reduced by cooking.
Actionable advice:
If you have borderline iodine status, consider cooking goitrogenic vegetables and spacing their intake from your iodine supplement.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
Goitrogens compete with iodine for thyroid absorption, which can interfere with normal thyroid function. Foods that contain goitrogens are able to disrupt thyroid function by inhibiting your body's ability to use iodine. More specifically, goitrogens can block the process by which iodine is incorporated into the key thyroid hormones thyroxine (T4) and triiodothyronine (T3).
Label source:
Primary literature: https://www.verywellhealth.com/thyroid-disease-goitrogens-diet-3233164
Action type:
separate
Target id:
/intervention/iron-supplements
Target name:
Iron
Severity:
minor
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Iron deficiency can impair the function of thyroid peroxidase, an enzyme critical for producing thyroid hormones, thereby reducing the effectiveness of iodine.
Actionable advice:
Adequate iron status is generally best maintained for optimal utilization of iodine by the thyroid gland.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Iron deficiency impairs thyroid hormone synthesis by reducing activity of heme-dependent thyroid peroxidase. Iron-deficiency anemia blunts and iron supplementation improves the efficacy of iodine supplementation.
Label source:
Primary literature: https://pubmed.ncbi.nlm.nih.gov/12487769/
Action type:
informational_none
Target id:
/intervention/vitamin-a
Target name:
Vitamin A
Severity:
minor
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin A is necessary for regulating thyroid hormone metabolism and inhibiting TSH secretion, making it a co-factor for proper iodine function.
Actionable advice:
Sufficient Vitamin A levels are generally best maintained to ensure proper thyroid-stimulating hormone (TSH) regulation and iodine utilization.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
VA status modulates thyroid gland metabolism, peripheral metabolism of thyroid hormone, and production of thyrotropin (TSH) by the pituitary.
Label source:
PubMed: International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition (2007)
Source url:
Exact phrase from label:
At baseline, increasing VAD severity was a predictor of greater thyroid volume and higher concentrations of TSH and thyroglobulin (P < 0.001). In children with VAD, the odds ratio for goiter was 6.51 (95% confidence interval, 2.94, 14.41).
Label source:
PubMed: The Journal of clinical endocrinology and metabolism (2004)
Source url:
Exact phrase from label:
VA supplements are effective in treating VAD in areas of mild ID and have an additional benefit-through suppression of the pituitary TSHbeta gene, VAS can decrease excess TSH stimulation of the thyroid and thereby reduce the risk of goiter and its sequelae.
Label source:
PubMed: The American journal of clinical nutrition (2007)
Action type:
monitor