Tool · Kymata Health
Supplement interaction checker
Pick your medicine to see which common supplements, foods and drinks have a documented interaction with it, how serious it is, how strong the evidence is, and the PubMed studies behind each entry.
Medical review pending
Check your medicine
3 entries for Semaglutide, most serious first.
Oral semaglutide absorbs less when other tablets are swallowed with it
Applies to semaglutide tablets (Rybelsus and other oral forms), not injections. In healthy volunteers, taking five extra (placebo) tablets with oral semaglutide cut semaglutide exposure by about a third (34%). Taking it after a meal left little or no measurable drug in the blood.
- Why:
- Oral semaglutide relies on an absorption enhancer (SNAC) and reaches useful levels only when taken fasting, with up to 120 mL of water and at least 30 minutes before food, the conditions used in its trials and on its label.
- What to do:
- Follow the tablet’s dosing instructions: take it on an empty stomach with a small sip of water, and wait before eating, drinking or taking other pills. Ask your prescriber or pharmacist where your supplements fit in the day.
Oral semaglutide raises thyroxine exposure from levothyroxine
In a crossover trial in 45 healthy adults, taking levothyroxine with oral semaglutide raised total thyroxine (T4) exposure by 33%. The study tested semaglutide tablets, not injections.
- Why:
- Both medicines have similar fasting dosing instructions. The trial did not pin down the cause; the absorption enhancer alone (SNAC) did not raise T4 exposure.
- What to do:
- If you take both, the trial authors advise considering thyroid blood tests. Ask your prescriber whether to recheck TSH.
Berberine adds a second glucose-lowering effect
We found no study of berberine together with semaglutide or tirzepatide. Berberine lowered blood glucose in trials in type 2 diabetes, and adding it to diabetes tablets gave stronger glucose control than the tablets alone, so it may add to a GLP-1 medicine’s effect (inferred).
- Why:
- Two glucose-lowering agents together. The trials were small and of low methodological quality, and reported no serious side effects from berberine.
- What to do:
- Tell your prescriber before adding berberine, especially if you also take insulin or a sulfonylurea, where low blood sugar is a bigger concern (inferred).
Not listed? This is a short, curated list, not a full drug-interaction database. A supplement that is missing here may still interact with Semaglutide. Check with your pharmacist or prescriber.
How to read an entry
Severity. Major: avoid the combination unless your prescriber advises otherwise. Moderate: can change how well a medicine works or what a lab test shows; worth a conversation and sometimes a dose or timing change. Minor: small or theoretical effect.
Evidence grade.A: controlled human studies, with the finding built into the product's dosing instructions. B: at least one controlled human study, often small. C: case reports, observational data, or mechanism only. The grade rates the cited studies; a step beyond them is marked “(inferred)” instead.
(inferred).Where an entry goes beyond what the cited studies tested, for example applying a birth-control-pill study to estradiol for menopause, that sentence is marked “(inferred)” and the card says “Partly inferred”.
Methodology
Scope. 11 medicines (Semaglutide, Tirzepatide, Levothyroxine, Testosterone (TRT), Estradiol / estrogen, Sertraline, Fluoxetine, Escitalopram, Citalopram, Paroxetine, Fluvoxamine) and the supplements, foods and drinks people most often ask about with them. It is a curated list of 19 entries, not a complete interaction database.
Sources.Every entry cites at least one PubMed record. Each record was looked up with the National Library of Medicine's E-utilities on October 10, 2026, its abstract read, and its notices checked for retractions and corrections. No cited record is retracted; one carries a published correction of a unit of measure, noted under the entry.
What it does not cover. Doses, timing and individual risk vary. Interactions with other prescription drugs, alcohol and medical conditions are mostly outside this list.