Objective: To investigate whether iron supplementation can improve thyroid hormone function in iron-deficient adolescent girls. Design: A double-blind randomized intervention study. Setting: The study was performed from 2002 through 2003 in the Islamic Republic of Iran. Subjects: 103 iron-deficient non-anaemic girls who fulfilled all inclusion criteria were included, and 94 subjects successfully completed the study. Interventions: Patients were randomly assigned to one of four groups and treated with a single oral dose of 190 mg iodine plus 300 mg ferrous sulphate 5 times/week (n ¼ 24), 300 mg ferrous sulphate 5 times/week (n ¼ 23), a single oral dose of 190 mg iodine (n ¼ 25), or a placebo (n ¼ 22) for 12 weeks. Results: All groups were comparable at baseline. After the intervention, there was a significant increase in ferritin and transferrin saturation in the iron þ iodine group (17.6 vs 8.7 mg/dl, and 18.8 vs 7.2%, respectively, Po0.001 for both) and in the iron group (Po0.001 for both). Urinary iodine doubled in the iron þ iodine group and in the iodine group (Po0.001 for both). Thyroid indices tT4, tT3 and T3RU increased and reverse RT3 decreased in the iron þ iodine group (10 vs 8.9 mg/dl, Po 0.001; 143 vs 138 mg/dl, Po0.05; 32.3 vs 28.4%, Po0.001 and 24.8 vs 44.2 ng/dl, Po0.001, respectively) and in the iron group. These two groups did not differ for any of the four indices, but both differed significantly from the iodine and placebo groups. Conclusions: Our results indicate that improvement of iron status was accompanied by an improvement in some indices of thyroid hormones.