II. Indications: Medical Uses
- Topical Antiseptic (Povidone-Iodine)
- Water Disinfection via Halogenation (Tincture of Iodine)
- Colposcopy (Lugol's Solution may better highlight lesions)
- Expectorant in COPD (SSKI)
-
Hyperthyroidism
- Radioiodine (I-131) for Thyroid radioablation
- Radioactive Iodine Uptake Scan (I-123) for Hyperthyroidism diagnostic evaluation
- Thyroid Storm (Potassium Iodide/SSKI given after Beta Blocker and Thionamide)
III. Physiology
- Iodine
- Iodine (I) is an element with atomic number 53 and atomic weight 126.90
- Non-metal mineral in the halogen group
- Essential for Thyroid Hormone synthesis (but must be converted to the Iodide state)
- Iodine also has anti-infective properties allowing for use as an Topical Antiseptic and water disinfectant
- Potassium Iodide (SSKI) is given in Thyroid Storm
- Must be given after Thionamides (Methimazole, PTU), or increases T4 synthesis, worsening storm
- Iodine blocks release of stored T4 and decreases Iodine transport (Wolff-Chaikoff Effect)
- Effects are limited to 2 weeks (after which T4 secretion resumes again)
- Iodide
- Iodine Anion (I-) or salt
- In vivo synthesis of Thyroid Hormone (T4) requires Iodide
- Enzyme Thyroid peroxidase generates Iodide from Iodine
- Thionamides (Methimazole, PTU) block Thyroid peroxidase, thereby blocking T4 synthesis
IV. Medications
- See Povidone-Iodine (Betadine)
- See Radioiodine
- See Radioactive Iodine Uptake Scan
- Lugol's Solution
- Lugol's is a Iodine and Potassium Iodide solution used as a diagnostic agent in Colposcopy, as well as an antiseptic
- Iodine binds the alpha-1,4 glucans in Polysaccharides (e.g. glycogen)
- Glycogen is present in normal cells, but absent in dysplastic and cancer cells
- In Colposcopy, Lugol's stains normal cells brown
- Dysplastic and cancer cellsremain unstained, highlighted regions for biopsy
- Saturated Solution Potassium iodide (SSKI)
- Used in Thyroid Storm AFTER giving Beta Blocker and at least one hour after Thionamide (Methimazole or PTU)
- Dose: 5 drops (50 mg Iodide/drop) mixed in fluid or food every 6 hours for at least 2 days
- May be used as an expectorant in COPD
- Used in Thyroid Storm AFTER giving Beta Blocker and at least one hour after Thionamide (Methimazole or PTU)
- Tincture of Iodine
- Used for histopathology stains
- Used historically as a Topical Antiseptic (replaced by products such as Povidone-Iodine)
- May be used for Water Disinfection of water by Halogenation (5-10 drops added to quart water)
- Found in some emergency survival kits for purification of water with high load of organic solute
- Available in 2-3% and 7% (strong) solutions
-
Multivitamins
- Many Prenatal Vitamins contain 150 mcg Iodine
V. Dosing: Recommended Daily Allowance (RDA)
- Men and women: 150 mcg daily
- Pregnancy: 220 mcg daily
- Lactation: 290 mcg daily
VI. Precautions
- Iodine intake >500 mcg daily offers no benefit
- Iodine intake >1100 mcg daily may result in toxicity (inhibits Thyroid Hormone synthesis)
VII. Sources: Dietary
-
Iodized Salt (400 mcg per 1 tsp)
- Not all salt is iodized (check labeling)
- Dairy
- Cows Milk (60 mcg per 8 oz)
- Soy Milk
- Cheese
- Yogurt
- Ice Cream
- Seafood
- Pregnant women should avoid excessive fish (see Mercury Content in Fish)
- Saltwater Fish (e.g. Cod contains 100 mcg per 3 oz)
- Shellfish
- Miscellaneous
- Eggs
- Seaweed (e.g. kelp)
- Soy sauce
VIII. Resources
- Thyroid.org
- Wikipedia
- Saturated Solution Potassium iodide (DailyMed)
- Potassium Iodide (DailyMed)
- Tincture of Iodine (DailyMed)
IX. References
- (2015) Presc Lett 22(5): 25-6
Images: Related links to external sites (from Bing)
Related Studies
| iodine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| IODINE 2% MILD TINCTURE | Generic OTC | $0.07 per ml |
| iodide (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| IODIDES TINCTURE | Generic OTC | $0.07 per ml |
Ontology: Iodides (C0021966)
| Definition (NCI_CRCH) | Iodine ion requiring removal of one electron to return to its elemental state. |
| Definition (NCI) | A salt or ester of mineral iodine. Iodide salts are mild reducing agents and many react with oxygen to give iodine. |
| Definition (MSH) | Inorganic binary compounds of iodine or the I- ion. |
| Concepts | Inorganic Chemical (T197) |
| MSH | D007454 |
| SnomedCT | 42146005 |
| LNC | LP36777-8, MTHU020182 |
| French | Iodures |
| Swedish | Jodider |
| Czech | jodidy |
| Finnish | Jodidit |
| Russian | IODISTOVODORODNOI KISLOTY SOLI, IODIDY, ИОДИДЫ, ИОДИСТОВОДОРОДНОЙ КИСЛОТЫ СОЛИ |
| English | iodides, Iodides, Iodides [Chemical/Ingredient], iodide, Iodine-, I-, I - Iodide, Iodide, Iodide salt (substance), Iodide salt, Iodide salt, NOS, Iodide, NOS |
| Latvian | Jodīdi |
| Polish | Jodki |
| Norwegian | Joditter |
| Spanish | sal yoduro, yoduro (sustancia), yoduro, Yoduros |
| German | Iodide |
| Italian | Ioduri |
| Portuguese | Iodetos |
Ontology: Iodine (C0021968)
| Definition (NCI_NCI-GLOSS) | An element that is necessary for the body to make thyroid hormone. It is found in shellfish and iodized salt. |
| Definition (NCI) | An element with atomic symbol I, atomic number 53, and atomic weight of 126.90. |
| Definition (MSH) | A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. |
| Definition (CSP) | nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90; it is a nutritionally essential element and is especially important in thyroid hormone synthesis; in solution, it has anti-infective properties and is used topically. |
| Concepts | Pharmacologic Substance (T121) , Element, Ion, or Isotope (T196) |
| MSH | D007455 |
| SnomedCT | 325330005, 44588005 |
| LNC | LP15157-8, MTHU009375 |
| English | Iodine, Jodum, I, iodine, iodine (vaginal) (medication), iodine (medication), vaginal preparations iodine vaginal, iodine (vaginal), IODINE, Iodine [Chemical/Ingredient], iodine product, iodines, iodine products, I element, I- element, Iodine product, Iodine (substance), Iodine product (product), Iodine, NOS, Iodine product (substance) |
| Swedish | Jod |
| Czech | jod, jód |
| Finnish | Jodi |
| Russian | IOD, ИОД, ЙОД |
| Spanish | producto con yodo (producto), yodo (producto), producto con yodo, ioduro, producto (producto), ioduro, producto (sustancia), ioduro, producto, yodo (sustancia), yodo, Yodo |
| Croatian | JOD |
| Latvian | Jods |
| Polish | Jod |
| Norwegian | Jod |
| French | Iode |
| German | Iod |
| Italian | Iodio |
| Portuguese | Iodo |
Ontology: Potassium Iodide (C0032831)
| Definition (NCI) | A metal halide composed of potassium and iodide with thyroid protecting and expectorant properties. Potassium iodide can block absorption of radioactive iodine by the thyroid gland through flooding the thyroid with non-radioactive iodine and preventing intake of radioactive molecules, thereby protecting the thyroid from cancer causing radiation. In addition, this agent acts as an expectorant by increasing secretion of respiratory fluids resulting in decreased mucus viscosity. |
| Definition (MSH) | An inorganic compound that is used as a source of iodine in thyrotoxic crisis and in the preparation of thyrotoxic patients for thyroidectomy. (From Dorland, 27th ed) |
| Concepts | Pharmacologic Substance (T121) , Inorganic Chemical (T197) |
| MSH | D011193 |
| SnomedCT | 400389005, 89351005 |
| English | Iodide, Potassium, Potassium Iodide, Potassium iodide (KI), Antistrumin, Kalium Jodatum, Potassium Iod (Obsolete), Potassium Salt of Hydriodic Acid, potassium iodide (medication), POTASSIUM IODIDE, Potassium Iodide [Chemical/Ingredient], iodide potassium, potassium iodide, Potassium iodide, Potassium iodide (product), Potassium iodide (substance), IODINE (AS POTASSIUM IODIDE) |
| French | Iodure de potassium |
| Swedish | Kaliumjodid |
| Czech | jodid draselný |
| Finnish | Kaliumjodidi |
| Russian | KALII IODISTYI, KALIIA IODID, КАЛИЙ ИОДИСТЫЙ, КАЛИЯ ИОДИД |
| Polish | Jodek potasowy |
| Japanese | ヨードカリ, ヨウ化カリウム, よう化カリウム, 沃化カリウム |
| Norwegian | Kaliumjodid |
| Spanish | yoduro de potasio (producto), yoduro de potasio (sustancia), yoduro de potasio, Yoduro de Potasio |
| German | Kaliumiodid |
| Italian | Ioduro di potassio |
| Portuguese | Iodeto de Potássio |
Ontology: Lugol's solution (C0065234)
| Definition (NCI) | A solution composed of iodine and potassium iodide, which can be used as a reagent and antiseptic, with potential use in cancer diagnosis. The iodine in Lugol's solution selectively binds to alpha-1,4 glucans found in polysaccharides, such as glycogen. Lugol's solution reacts with glycogen in normal, healthy non-keratinized, squamous epithelium and the iodine-glucan complex stains the glycogen-containing cells dark brown. Cancer cells are devoid of glycogen, so these cells will stay unstained. The presence of cancer cells can be detected by the degree of staining and the neoplastic cells can be surgically removed. High-grade intraepitheial neoplasia has almost no glycogen-containing epithelium. |
| Definition (SPN) | A general purpose reagent is a chemical reagent that has general laboratory application, that is used to collect, prepare, and examine specimens from the human body for diagnostic histopathology, cytology, and hematology, and that is not labeled or otherwise intended for a specific diagnostic application. General purpose reagents include cytological preservatives, decalcifying reagents, fixatives and adhesives, tissue processing reagents, isotonic solutions, and pH buffers. |
| Concepts | Pharmacologic Substance (T121) , Inorganic Chemical (T197) , Indicator, Reagent, or Diagnostic Aid (T130) |
| MSH | C010389 |
| SnomedCT | 325331009, 100988006 |
| English | Lugol's iodine, potassium triiodide, Lugols Iodine, Lugol's, SOLUTION, LUGOL'S, Lugols Solution, lugols solution, lugols iodine, iodine lugol, lugol iodine, lugol solution, lugol's iodine, lugol's solution, Lugol's solution, LUGOL'S SOLUTION, LUGOL'S SOLUTION (product), Lugol's Iodine, LUGOL'S SOLUTION (substance), Lugol's Solution |
| Spanish | LUGOL'S SOLUTION, solución de lugol, LUGOL'S SOLUTION (producto), LUGOL'S SOLUTION (sustancia) |
Ontology: Iodine tincture (C1261556)
| Definition (SPN) | A general purpose reagent is a chemical reagent that has general laboratory application, that is used to collect, prepare, and examine specimens from the human body for diagnostic histopathology, cytology, and hematology, and that is not labeled or otherwise intended for a specific diagnostic application. General purpose reagents include cytological preservatives, decalcifying reagents, fixatives and adhesives, tissue processing reagents, isotonic solutions, and pH buffers. |
| Concepts | Indicator, Reagent, or Diagnostic Aid (T130) |
| SnomedCT | 34654009 |
| English | IODINE (TINCTURE), Iodine Tincture, tincture iodine, iodine tincture, Iodine tincture |
| Spanish | tintura de yodo |
Ontology: SSKI (C1564085)
| Concepts | Inorganic Chemical (T197) , Pharmacologic Substance (T121) |
| MSH | D011193 |
| English | potassium iodide (SSKI), potassium iodide (SSKI) (medication), SSKI, Upsher-Smith Brand of Potassium Iodide |
