Iodine is a necessary micronutrient with a key function in metabolism. It undergoes oxidation to create thyroid hormones that contain iodine. The regulation of development, metabolism, & numerous other bodily processes depend on thyroid hormones. They are essential for the development of fetal and newborn brains. Iodine deficiency has long been acknowledged as a global issue and continues to be a major contributor to avoidable prenatal brain damage.
Iodine shortage during pregnancy causes hypothyroidism and impairs the neurobehavioral growth of the unborn child. Iodine excess is more common than iodine insufficiency, despite the fact that the effects of iodine deficiency have long been known. The human body cannot produce iodine; therefore, it must be acquired via food, nutritional supplements, drugs, & iodinated contrast medium. The recommended daily amount (RDA) for grownups is 150 mg; for pregnant women, it is 220 – 250 mg, and for nursing mothers, it is 250 – 290 mg.
It is believed that most people can safely take up to 1 mg per day. Iodine can be consumed in excess from iodized salt, iodized milk, some seaweeds, drinking water, & iodine-containing nutritional supplements. Iodine intake above 1.1 mg daily may be detrimental and cause acute or chronic toxic effects. Patients with certain risk factors, such as those who have pre-existing thyroid illnesses, fetuses, the elderly, & newborns, might develop overt or subclinical thyroid dysfunction as a result of iodine overload.
The effects of excessive iodine vary from person to person and depend on the thyroid function at the individual level. Thyroiditis, hyperthyroidism, hypothyroidism, & thyroid papillary carcinoma can all be caused by iodine poisoning. Iodine overdose from oral consumption can have mild to serious clinical signs. Gastrointestinal discomfort, vomiting, nausea, & diarrhea are modest symptoms that might develop into stupor, delirium, & shock. It is not usually lethal.
Epidemiology
The National Poison Data System of the American Association of Poison Control Centers documented 1537 singular exposures to nutritional supplements in 2018, including 58 adverse events but no fatalities.
Moreover, 853 single external iodine exposures with 51 adverse reactions & no fatalities are listed. With 30,046 risks, electrolytes & minerals are among the top 25 kinds of compounds that are most commonly exposed to humans, according to the report.
Anatomy
Pathophysiology
Due to the uncovering of underlying thyroid dysfunction, there are to be individual variations in the thyroid’s reaction to excessive iodine intake. Iodine overload can result in overt or subclinical thyroid problems.
Etiology
The most frequent cause of iodine toxicity is excessive dietary supplement use. The toxic effects of iodine typically require ingesting numerous grams of the substance. Iodized salt, which has roughly 77 ug of iodine per gram, as well as water, milk, some shellfish, & seaweeds, are foods that contain iodine.
Iodine may also be present in some oral drugs, such as potassium supplements and amiodarone. The topical antiseptics tincture of betadine & iodine can result in a rash & blistering when administered externally & will cause more serious poisoning if unintentionally eaten.
Genetics
Prognostic Factors
The NPDS (National Poison Data System): 36th Annual Report of the American Association of Poison Control Centers states that there were no deaths attributed to iodine overdose in 2018. With the adoption of iodine supplement programs, populations lacking in iodine develop iodine-induced hyperthyroidism. TSH-resistant thyroid nodules are caused by their iodine shortage from birth.
In reaction to the sudden iodine influx, this nodule keeps producing hormone levels. Weight loss, muscle weakness, & tachycardia are symptoms of hyperthyroidism brought on by this illness. Those with preexisting heart problems may be at risk from iodine-induced hyperthyroidism. Iodine excess leads to increased levels of thyroid-stimulating hormone in people who consume enough iodine, which prevents the generation of thyroid hormone & causes hypothyroidism & goiter.
Despite the fact that iodine levels appear to be safe for the general population, people with iodine shortage and those who already have thyroid disease may be susceptible to it. Furthermore, those more vulnerable to iodine overload may include newborns, the elderly, & pregnant women.
Clinical History
Clinical History
The clinical presentation of iodine toxicity varies depending on the severity and duration of exposure. Mild cases of iodine toxicity may present with gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. In moderate cases, patients may experience a metallic taste in the mouth, a burning sensation in the mouth and throat, sore throat, and dehydration. Severe iodine toxicity can result in a range of symptoms, including thyroid gland dysfunction, which can cause hyperthyroidism or hypothyroidism and can lead to the development of goiter.
Neurological symptoms can also occur, such as confusion, delirium, tremors, seizures, and even coma. Other clinical manifestations of iodine toxicity include skin lesions, such as acneiform eruptions, itching, and rash. Some patients may also experience respiratory symptoms, such as coughing, wheezing, and shortness of breath. Iodine toxicity is most commonly caused by the excessive consumption of iodine supplements or medications containing iodine, such as contrast agents used in diagnostic imaging.
Prolonged exposure to iodine-containing substances, such as topical antiseptics and disinfectants, can also lead to iodine toxicity. The treatment of iodine toxicity depends on the severity of the symptoms and the cause of exposure. Mild cases of iodine toxicity can be managed with supportive care and cessation of iodine-containing supplements or medications.
In severe cases, hospitalization may be necessary, and treatment may include the administration of intravenous fluids, medications to control symptoms, and measures to manage thyroid dysfunction. Preventing iodine toxicity involves avoiding unnecessary iodine supplementation and limiting exposure to iodine-containing substances. Patients with thyroid disorders or a history of iodine sensitivity should consult their healthcare provider before taking iodine supplements or undergoing procedures involving iodine-containing contrast agents.
Physical Examination
Physical examination
The physical examination of a patient with iodine toxicity may reveal various signs and symptoms depending on the severity and duration of the exposure. Here are some of the possible findings that a healthcare provider may observe during a physical exam:
Skin: The skin may show signs of iodine toxicity, such as rashes, itching, hives, or acneiform eruptions.
Respiratory system: The respiratory system may exhibit signs of iodine toxicity, such as wheezing, coughing, and shortness of breath.
Gastrointestinal system: The gastrointestinal system may show signs of iodine toxicity, such as nausea, vomiting, abdominal pain, and diarrhea.
Neurological system: The neurological system may exhibit signs of iodine toxicity, such as confusion, delirium, tremors, seizures, and coma.
Thyroid gland: The thyroid gland may show signs of hyperthyroidism or hypothyroidism, such as a palpable goiter, increased or decreased thyroid hormone levels, and abnormal thyroid function tests.
Other signs: Other possible signs of iodine toxicity may include fever, tachycardia, hypertension, and dehydration.
Overall, the physical exam findings will vary depending on the severity and duration of the iodine toxicity, and healthcare providers should perform a comprehensive evaluation to assess the patient’s condition thoroughly. Additionally, healthcare providers should take a detailed history of the patient’s exposure to iodine-containing substances to determine the potential cause of iodine toxicity.
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Differential diagnosis
The differential diagnosis is extensive when a patient exhibits minor GI discomfort, vomiting, nausea, & diarrhea. The process of gathering a thorough and comprehensive history is essential to reducing the range of possible diagnoses.
Medication, nutritional supplements, & other coingestants should all be considered, as well as any underlining medical issues. Priority number one is stabilization, followed by the patient’s supportive therapy. With additional testing and evaluation, the differential diagnosis can be trimmed down.
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Managing the airway, respiration, & circulation should be the first step in any therapeutic strategy. If the patient is in unstable condition, two large-bore IVs should be inserted, and they need to be put on a cardiac monitor with additional oxygen. If the patient’s depressed mental state prevents them from protecting their airway, endotracheal intubation is required.
Iodine poisoning has no specific treatment; thus, therapy is generally supportive. Activated charcoal must be given to clean the digestive tract if the individual is stable, awake, and guarding their airway. The patient might need to be admitted to the hospital or kept under close supervision in the ER until they are deemed to be medically stable.
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References
https://www.ncbi.nlm.nih.gov/books/NBK560770/
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Iodine is a necessary micronutrient with a key function in metabolism. It undergoes oxidation to create thyroid hormones that contain iodine. The regulation of development, metabolism, & numerous other bodily processes depend on thyroid hormones. They are essential for the development of fetal and newborn brains. Iodine deficiency has long been acknowledged as a global issue and continues to be a major contributor to avoidable prenatal brain damage.
Iodine shortage during pregnancy causes hypothyroidism and impairs the neurobehavioral growth of the unborn child. Iodine excess is more common than iodine insufficiency, despite the fact that the effects of iodine deficiency have long been known. The human body cannot produce iodine; therefore, it must be acquired via food, nutritional supplements, drugs, & iodinated contrast medium. The recommended daily amount (RDA) for grownups is 150 mg; for pregnant women, it is 220 – 250 mg, and for nursing mothers, it is 250 – 290 mg.
It is believed that most people can safely take up to 1 mg per day. Iodine can be consumed in excess from iodized salt, iodized milk, some seaweeds, drinking water, & iodine-containing nutritional supplements. Iodine intake above 1.1 mg daily may be detrimental and cause acute or chronic toxic effects. Patients with certain risk factors, such as those who have pre-existing thyroid illnesses, fetuses, the elderly, & newborns, might develop overt or subclinical thyroid dysfunction as a result of iodine overload.
The effects of excessive iodine vary from person to person and depend on the thyroid function at the individual level. Thyroiditis, hyperthyroidism, hypothyroidism, & thyroid papillary carcinoma can all be caused by iodine poisoning. Iodine overdose from oral consumption can have mild to serious clinical signs. Gastrointestinal discomfort, vomiting, nausea, & diarrhea are modest symptoms that might develop into stupor, delirium, & shock. It is not usually lethal.
The National Poison Data System of the American Association of Poison Control Centers documented 1537 singular exposures to nutritional supplements in 2018, including 58 adverse events but no fatalities.
Moreover, 853 single external iodine exposures with 51 adverse reactions & no fatalities are listed. With 30,046 risks, electrolytes & minerals are among the top 25 kinds of compounds that are most commonly exposed to humans, according to the report.
Due to the uncovering of underlying thyroid dysfunction, there are to be individual variations in the thyroid’s reaction to excessive iodine intake. Iodine overload can result in overt or subclinical thyroid problems.
The most frequent cause of iodine toxicity is excessive dietary supplement use. The toxic effects of iodine typically require ingesting numerous grams of the substance. Iodized salt, which has roughly 77 ug of iodine per gram, as well as water, milk, some shellfish, & seaweeds, are foods that contain iodine.
Iodine may also be present in some oral drugs, such as potassium supplements and amiodarone. The topical antiseptics tincture of betadine & iodine can result in a rash & blistering when administered externally & will cause more serious poisoning if unintentionally eaten.
The NPDS (National Poison Data System): 36th Annual Report of the American Association of Poison Control Centers states that there were no deaths attributed to iodine overdose in 2018. With the adoption of iodine supplement programs, populations lacking in iodine develop iodine-induced hyperthyroidism. TSH-resistant thyroid nodules are caused by their iodine shortage from birth.
In reaction to the sudden iodine influx, this nodule keeps producing hormone levels. Weight loss, muscle weakness, & tachycardia are symptoms of hyperthyroidism brought on by this illness. Those with preexisting heart problems may be at risk from iodine-induced hyperthyroidism. Iodine excess leads to increased levels of thyroid-stimulating hormone in people who consume enough iodine, which prevents the generation of thyroid hormone & causes hypothyroidism & goiter.
Despite the fact that iodine levels appear to be safe for the general population, people with iodine shortage and those who already have thyroid disease may be susceptible to it. Furthermore, those more vulnerable to iodine overload may include newborns, the elderly, & pregnant women.
Clinical History
The clinical presentation of iodine toxicity varies depending on the severity and duration of exposure. Mild cases of iodine toxicity may present with gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. In moderate cases, patients may experience a metallic taste in the mouth, a burning sensation in the mouth and throat, sore throat, and dehydration. Severe iodine toxicity can result in a range of symptoms, including thyroid gland dysfunction, which can cause hyperthyroidism or hypothyroidism and can lead to the development of goiter.
Neurological symptoms can also occur, such as confusion, delirium, tremors, seizures, and even coma. Other clinical manifestations of iodine toxicity include skin lesions, such as acneiform eruptions, itching, and rash. Some patients may also experience respiratory symptoms, such as coughing, wheezing, and shortness of breath. Iodine toxicity is most commonly caused by the excessive consumption of iodine supplements or medications containing iodine, such as contrast agents used in diagnostic imaging.
Prolonged exposure to iodine-containing substances, such as topical antiseptics and disinfectants, can also lead to iodine toxicity. The treatment of iodine toxicity depends on the severity of the symptoms and the cause of exposure. Mild cases of iodine toxicity can be managed with supportive care and cessation of iodine-containing supplements or medications.
In severe cases, hospitalization may be necessary, and treatment may include the administration of intravenous fluids, medications to control symptoms, and measures to manage thyroid dysfunction. Preventing iodine toxicity involves avoiding unnecessary iodine supplementation and limiting exposure to iodine-containing substances. Patients with thyroid disorders or a history of iodine sensitivity should consult their healthcare provider before taking iodine supplements or undergoing procedures involving iodine-containing contrast agents.
Physical examination
The physical examination of a patient with iodine toxicity may reveal various signs and symptoms depending on the severity and duration of the exposure. Here are some of the possible findings that a healthcare provider may observe during a physical exam:
Skin: The skin may show signs of iodine toxicity, such as rashes, itching, hives, or acneiform eruptions.
Respiratory system: The respiratory system may exhibit signs of iodine toxicity, such as wheezing, coughing, and shortness of breath.
Gastrointestinal system: The gastrointestinal system may show signs of iodine toxicity, such as nausea, vomiting, abdominal pain, and diarrhea.
Neurological system: The neurological system may exhibit signs of iodine toxicity, such as confusion, delirium, tremors, seizures, and coma.
Thyroid gland: The thyroid gland may show signs of hyperthyroidism or hypothyroidism, such as a palpable goiter, increased or decreased thyroid hormone levels, and abnormal thyroid function tests.
Other signs: Other possible signs of iodine toxicity may include fever, tachycardia, hypertension, and dehydration.
Overall, the physical exam findings will vary depending on the severity and duration of the iodine toxicity, and healthcare providers should perform a comprehensive evaluation to assess the patient’s condition thoroughly. Additionally, healthcare providers should take a detailed history of the patient’s exposure to iodine-containing substances to determine the potential cause of iodine toxicity.
Differential diagnosis
The differential diagnosis is extensive when a patient exhibits minor GI discomfort, vomiting, nausea, & diarrhea. The process of gathering a thorough and comprehensive history is essential to reducing the range of possible diagnoses.
Medication, nutritional supplements, & other coingestants should all be considered, as well as any underlining medical issues. Priority number one is stabilization, followed by the patient’s supportive therapy. With additional testing and evaluation, the differential diagnosis can be trimmed down.
Managing the airway, respiration, & circulation should be the first step in any therapeutic strategy. If the patient is in unstable condition, two large-bore IVs should be inserted, and they need to be put on a cardiac monitor with additional oxygen. If the patient’s depressed mental state prevents them from protecting their airway, endotracheal intubation is required.
Iodine poisoning has no specific treatment; thus, therapy is generally supportive. Activated charcoal must be given to clean the digestive tract if the individual is stable, awake, and guarding their airway. The patient might need to be admitted to the hospital or kept under close supervision in the ER until they are deemed to be medically stable.
https://www.ncbi.nlm.nih.gov/books/NBK560770/
medtigo
Iodine Toxicity
Updated :
September 5, 2023
Iodine is a necessary micronutrient with a key function in metabolism. It undergoes oxidation to create thyroid hormones that contain iodine. The regulation of development, metabolism, & numerous other bodily processes depend on thyroid hormones. They are essential for the development of fetal and newborn brains. Iodine deficiency has long been acknowledged as a global issue and continues to be a major contributor to avoidable prenatal brain damage.
Iodine shortage during pregnancy causes hypothyroidism and impairs the neurobehavioral growth of the unborn child. Iodine excess is more common than iodine insufficiency, despite the fact that the effects of iodine deficiency have long been known. The human body cannot produce iodine; therefore, it must be acquired via food, nutritional supplements, drugs, & iodinated contrast medium. The recommended daily amount (RDA) for grownups is 150 mg; for pregnant women, it is 220 – 250 mg, and for nursing mothers, it is 250 – 290 mg.
It is believed that most people can safely take up to 1 mg per day. Iodine can be consumed in excess from iodized salt, iodized milk, some seaweeds, drinking water, & iodine-containing nutritional supplements. Iodine intake above 1.1 mg daily may be detrimental and cause acute or chronic toxic effects. Patients with certain risk factors, such as those who have pre-existing thyroid illnesses, fetuses, the elderly, & newborns, might develop overt or subclinical thyroid dysfunction as a result of iodine overload.
The effects of excessive iodine vary from person to person and depend on the thyroid function at the individual level. Thyroiditis, hyperthyroidism, hypothyroidism, & thyroid papillary carcinoma can all be caused by iodine poisoning. Iodine overdose from oral consumption can have mild to serious clinical signs. Gastrointestinal discomfort, vomiting, nausea, & diarrhea are modest symptoms that might develop into stupor, delirium, & shock. It is not usually lethal.
The National Poison Data System of the American Association of Poison Control Centers documented 1537 singular exposures to nutritional supplements in 2018, including 58 adverse events but no fatalities.
Moreover, 853 single external iodine exposures with 51 adverse reactions & no fatalities are listed. With 30,046 risks, electrolytes & minerals are among the top 25 kinds of compounds that are most commonly exposed to humans, according to the report.
Due to the uncovering of underlying thyroid dysfunction, there are to be individual variations in the thyroid’s reaction to excessive iodine intake. Iodine overload can result in overt or subclinical thyroid problems.
The most frequent cause of iodine toxicity is excessive dietary supplement use. The toxic effects of iodine typically require ingesting numerous grams of the substance. Iodized salt, which has roughly 77 ug of iodine per gram, as well as water, milk, some shellfish, & seaweeds, are foods that contain iodine.
Iodine may also be present in some oral drugs, such as potassium supplements and amiodarone. The topical antiseptics tincture of betadine & iodine can result in a rash & blistering when administered externally & will cause more serious poisoning if unintentionally eaten.
The NPDS (National Poison Data System): 36th Annual Report of the American Association of Poison Control Centers states that there were no deaths attributed to iodine overdose in 2018. With the adoption of iodine supplement programs, populations lacking in iodine develop iodine-induced hyperthyroidism. TSH-resistant thyroid nodules are caused by their iodine shortage from birth.
In reaction to the sudden iodine influx, this nodule keeps producing hormone levels. Weight loss, muscle weakness, & tachycardia are symptoms of hyperthyroidism brought on by this illness. Those with preexisting heart problems may be at risk from iodine-induced hyperthyroidism. Iodine excess leads to increased levels of thyroid-stimulating hormone in people who consume enough iodine, which prevents the generation of thyroid hormone & causes hypothyroidism & goiter.
Despite the fact that iodine levels appear to be safe for the general population, people with iodine shortage and those who already have thyroid disease may be susceptible to it. Furthermore, those more vulnerable to iodine overload may include newborns, the elderly, & pregnant women.
Clinical History
The clinical presentation of iodine toxicity varies depending on the severity and duration of exposure. Mild cases of iodine toxicity may present with gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. In moderate cases, patients may experience a metallic taste in the mouth, a burning sensation in the mouth and throat, sore throat, and dehydration. Severe iodine toxicity can result in a range of symptoms, including thyroid gland dysfunction, which can cause hyperthyroidism or hypothyroidism and can lead to the development of goiter.
Neurological symptoms can also occur, such as confusion, delirium, tremors, seizures, and even coma. Other clinical manifestations of iodine toxicity include skin lesions, such as acneiform eruptions, itching, and rash. Some patients may also experience respiratory symptoms, such as coughing, wheezing, and shortness of breath. Iodine toxicity is most commonly caused by the excessive consumption of iodine supplements or medications containing iodine, such as contrast agents used in diagnostic imaging.
Prolonged exposure to iodine-containing substances, such as topical antiseptics and disinfectants, can also lead to iodine toxicity. The treatment of iodine toxicity depends on the severity of the symptoms and the cause of exposure. Mild cases of iodine toxicity can be managed with supportive care and cessation of iodine-containing supplements or medications.
In severe cases, hospitalization may be necessary, and treatment may include the administration of intravenous fluids, medications to control symptoms, and measures to manage thyroid dysfunction. Preventing iodine toxicity involves avoiding unnecessary iodine supplementation and limiting exposure to iodine-containing substances. Patients with thyroid disorders or a history of iodine sensitivity should consult their healthcare provider before taking iodine supplements or undergoing procedures involving iodine-containing contrast agents.
Physical examination
The physical examination of a patient with iodine toxicity may reveal various signs and symptoms depending on the severity and duration of the exposure. Here are some of the possible findings that a healthcare provider may observe during a physical exam:
Skin: The skin may show signs of iodine toxicity, such as rashes, itching, hives, or acneiform eruptions.
Respiratory system: The respiratory system may exhibit signs of iodine toxicity, such as wheezing, coughing, and shortness of breath.
Gastrointestinal system: The gastrointestinal system may show signs of iodine toxicity, such as nausea, vomiting, abdominal pain, and diarrhea.
Neurological system: The neurological system may exhibit signs of iodine toxicity, such as confusion, delirium, tremors, seizures, and coma.
Thyroid gland: The thyroid gland may show signs of hyperthyroidism or hypothyroidism, such as a palpable goiter, increased or decreased thyroid hormone levels, and abnormal thyroid function tests.
Other signs: Other possible signs of iodine toxicity may include fever, tachycardia, hypertension, and dehydration.
Overall, the physical exam findings will vary depending on the severity and duration of the iodine toxicity, and healthcare providers should perform a comprehensive evaluation to assess the patient’s condition thoroughly. Additionally, healthcare providers should take a detailed history of the patient’s exposure to iodine-containing substances to determine the potential cause of iodine toxicity.
Differential diagnosis
The differential diagnosis is extensive when a patient exhibits minor GI discomfort, vomiting, nausea, & diarrhea. The process of gathering a thorough and comprehensive history is essential to reducing the range of possible diagnoses.
Medication, nutritional supplements, & other coingestants should all be considered, as well as any underlining medical issues. Priority number one is stabilization, followed by the patient’s supportive therapy. With additional testing and evaluation, the differential diagnosis can be trimmed down.
Managing the airway, respiration, & circulation should be the first step in any therapeutic strategy. If the patient is in unstable condition, two large-bore IVs should be inserted, and they need to be put on a cardiac monitor with additional oxygen. If the patient’s depressed mental state prevents them from protecting their airway, endotracheal intubation is required.
Iodine poisoning has no specific treatment; thus, therapy is generally supportive. Activated charcoal must be given to clean the digestive tract if the individual is stable, awake, and guarding their airway. The patient might need to be admitted to the hospital or kept under close supervision in the ER until they are deemed to be medically stable.
https://www.ncbi.nlm.nih.gov/books/NBK560770/
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