Iron and Levothyroxine: what the published research says
PubMed indexes 6 records that name Iron and Levothyroxine together, either in the title or in an interaction, co-administration, or pharmacokinetic context. Each one is listed below with its study design and, where the abstract states one, the authors’ own conclusion, quoted and linked. This page reports that literature. It does not tell you whether to combine them.
Every statement below is attributed to a named, dated, linked source.
This page lists published research relevant to Iron and Levothyroxine. It deliberately does not state whether the combination is safe, whether it interacts, in which direction, at what dose, or how far apart to take them.
A study appearing here is not proof that an interaction exists. Two substances can be named together in a paper that never tested them in combination, and a source listed as background may cover only one of them.
Findings are quoted from each abstract as the authors wrote them. NutriStack has not re-analysed, pooled, or reconciled them, and they may disagree with each other.
NutriStack’s own interaction assessment for this pair is not published here. It has not completed qualified-human clinical review, so it is withheld from search. See the publication gate.
Nothing here is medical advice. Decisions about prescription medication and supplements belong with your prescriber or pharmacist, who can see your full regimen.
The research
6 studies naming Iron and Levothyroxine.
Strongest relevance first: papers naming both substances in the title, then human trials and systematic reviews.
“This case highlights that a clinically significant iron-levothyroxine interaction may persist despite appropriate dose separation. Clinicians should maintain a high index of suspicion for pharmacological interference in patients with refractory hypothyroidism.”
The Journal of clinical endocrinology and metabolism · 2009 · PMID 18984662
Randomized Controlled Trial
“Subclinical hypothyroidism should be treated in iron-deficiency anemia patients when both conditions coexist. This would provide a desired therapeutic response to oral iron replacement and prevent ineffective iron therapy.”
“Liquid levothyroxine is resistant to the sequestration by calcium or iron. The high rate of thyroid-stimulating hormone normalization already at the first check (6-8 weeks) should avoid frequent adjustments in levothyroxine doses and assays of thyroid-stimulating hormone, with consequent financial savings.”
Clinical and translational science · 2025 · PMID 41221788
Randomized Controlled Trial
“Hypothyroid patients should nonetheless take levothyroxine separated from magnesium-containing formulations, especially if TSH levels are desired to be within a narrow range. If taken together, magnesium citrate may be a better option than magnesium aspartate.”
Names Iron and Levothyroxine together in an interaction, co-administration, or pharmacokinetic context.
Names Iron and Levothyroxine together in an interaction, co-administration, or pharmacokinetic context.
Limitations
What this evidence cannot tell you.
Search-based evidence indexes have real limits, and it is worth being explicit about them:
Selection. These records were found by searching PubMed titles and abstracts for both substance names alongside interaction and pharmacokinetic terms. Relevant work that phrases things differently, or is not indexed in PubMed, will be missing.
No effect size. The quoted conclusions are the authors’ words about their own study. We have not extracted effect direction or magnitude, and a single study’s conclusion is not a consensus.
Population mismatch. Findings in healthy volunteers, animals, or a specific patient group may not transfer to you, your dose, or your formulation.
Absence is not safety. Few published studies means the combination is under-studied, which is not the same as established as safe.
Nearby evidence
Other pairs with published research.
Pages covering Iron or Levothyroxine alongside a different substance.
NutriStack is a free iPhone app for organising a supplement routine: what you take, when, and what the published record says about it. Its exploratory interaction checker covers Iron, Levothyroxine, and several hundred other substances.
The checker is a research and organisation tool, not a clinical decision aid, and its per-pair assessments are excluded from search until they pass claim-level review.
NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.