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Serious risks

• High biotin intakes, possibly even intakes above the AI, may pose a health risk tied to lab testing.
• Biotin beyond recommended intakes can cause clinically significant falsely high or falsely low lab results, depending on the test.
• In a small study of six healthy adults taking 10 mg/day for 1 week, biotin falsely lowered N-terminal pro-brain natriuretic peptide, which could result in a failure to identify congestive heart failure. Thyroid stimulating hormone was also falsely lowered.
• Case reports describe findings falsely indicating Graves' disease and severe hyperthyroidism in patients taking 10–300 mg biotin per day.
• A single 10 mg dose of biotin has interfered with thyroid function tests given within 24 hours.
• Per FDA, a patient with a high intake of supplemental biotin died after a troponin test gave a falsely low result because of biotin interference.

Medication interactions

• Biotin can interact with certain medications, and some medications can have an adverse effect on biotin levels.

Serious risks

• Isolated case reports link chromium supplements to several problems, including liver dysfunction and renal failure.
• The FNB said caution may be warranted because data are limited, and high intakes could have adverse effects.

Avoid or ask a doctor first if

• People with renal or liver disease might be susceptible to adverse effects from high chromium intakes.

Medication interactions

• Several types of medications have the potential to interact with chromium supplements.
• People taking medications regularly should talk with their health care providers about their chromium intakes.

Possible side effects

• High iodine intakes can cause goiter, elevated TSH levels, and hypothyroidism, some of the same symptoms as iodine deficiency.

Serious risks

• Iodine-induced hyperthyroidism can result from high iodine intakes, including when iodine is given to treat iodine deficiency.
• Studies have shown that excessive iodine intakes cause thyroiditis and thyroid papillary cancer.
• Acute iodine poisoning is rare and is usually caused by doses of many grams. Symptoms include burning of the mouth, throat, and stomach, fever, abdominal pain, nausea, vomiting, diarrhea, weak pulse, and coma.
• Long-term intakes above the UL increase the risk of adverse health effects.

Avoid or ask a doctor first if

• People with autoimmune thyroid disease or iodine deficiency may have adverse effects at iodine intakes considered safe for the general population.
• The ULs do not apply to people receiving iodine for medical treatment, who should be under a physician's care.

Medication interactions

• Iodine supplements have the potential to interact with several types of medications. People taking these medications on a regular basis should discuss their iodine intakes with their health care providers.

Possible side effects

• High doses from supplements or medications can cause diarrhea, nausea, and abdominal cramping.
• Magnesium carbonate, chloride, gluconate, and oxide are the forms most commonly reported to cause diarrhea.

Serious risks

• Very high doses can lead to magnesium toxicity, with low blood pressure, vomiting, difficulty breathing, irregular heartbeat, cardiac arrest and other signs.
• A few cases of fatal hypermagnesemia have been reported.
• Very large doses of magnesium-containing laxatives and antacids have been associated with magnesium toxicity.
• The risk of toxicity increases with impaired kidney function or kidney failure.

Avoid or ask a doctor first if

• People with impaired kidney function or kidney failure face higher risk of magnesium toxicity.
• People taking medications regularly should discuss their magnesium intake with their health care providers.

Medication interactions

• Magnesium may interact with oral bisphosphonates, tetracyclines, and quinolone antibiotics.
• Some medications, including diuretics and proton pump inhibitors, can affect magnesium status.

Possible side effects

• High-dose iron supplements can cause stomach upset, constipation, nausea, abdominal pain, vomiting, and diarrhea.
• Supplements with 25 mg iron or more can reduce zinc absorption and plasma zinc concentrations.

Serious risks

• Large acute intakes from supplements or medicines can lead to corrosive necrosis of the intestine, which might lead to fluid and blood loss, shock, tissue damage, and organ failure.
• In severe cases, iron overdoses can lead to multisystem organ failure, coma, convulsions, and even death.
• Case reports suggest some people develop more serious gastrointestinal effects, including gastritis and gastric lesions.
• At least 43 U.S. children died between 1983 and 2000 from ingesting high-dose iron supplements.
• Without treatment, people with hereditary hemochromatosis typically develop signs of iron toxicity by their 30s.
• Iron toxicity effects in hemochromatosis can include liver cirrhosis, hepatocellular carcinoma, heart disease, and impaired pancreatic function.

Avoid or ask a doctor first if

• People with hemochromatosis: treatment guidance includes avoiding iron and vitamin C supplements.
• The required FDA label on solid iron supplements says accidental overdose is a leading cause of fatal poisoning in children under 6, and to keep the product out of children's reach.

Medication interactions

• Iron supplements may interact with levodopa and levothyroxine.
• Proton pump inhibitors can potentially reduce iron absorption.