Iodine and Potassium Iodide
- Thread starter Gaby
- Start date
ka
Padawan Learner
Hi, all:
I have been supplementing with iodine for several years, now, and more than some other supplements I have used, I could tell pretty quickly that it really helped. Most noticeably, my metabolism is activated, and I actually felt more energetic. I had lived with symptoms of thyroid insufficiency since adolescence (I am now post-menopausal): cold hands and feet, susceptibility to chill, weight gain, also, symptoms associated with fibromyalgia-- but no abnormality ever showed in blood tests.
As soon as I started supplementing with iodine, those things got better. Then I started the keto diet, and it all got MUCH better. I watched a video about using iodine that said that women are especially vulnerable to iodine deficiency. This is something doctors were all aware of a hundred years ago. A woman who experiences problems associated with excess estrogen is that much more vulnerable. Breast tissue takes up an especially large amount of iodine—so the more you have there, the more iodine you need.
I started by taking Lugol’s. Then I tried a much less expensive form of iodide sold to be taken internally, that seems to work just as well.
But Do NOT ingest the kind sold as a wound treatment, for topical use only! It is said to be toxic when taken internally. But it is beneficial, when absorbed through the skin. How long the yellow-brown stain lasts will serve as a rough diagnosis of how deficient you are in iodine. If the stain disappears within a day, you are deficient. If the stain lasts several days, your body has enough that it doesn’t need to pull it from your skin so quickly. I was instructed to apply the tincture of iodine [the cheap kind sold as a wound treatment] to large areas of sensitive skin, such as the inside of the thighs—the skin is most absorbent there, and the stain won’t show when you wear street clothes.
I have been supplementing with iodine for several years, now, and more than some other supplements I have used, I could tell pretty quickly that it really helped. Most noticeably, my metabolism is activated, and I actually felt more energetic. I had lived with symptoms of thyroid insufficiency since adolescence (I am now post-menopausal): cold hands and feet, susceptibility to chill, weight gain, also, symptoms associated with fibromyalgia-- but no abnormality ever showed in blood tests.
As soon as I started supplementing with iodine, those things got better. Then I started the keto diet, and it all got MUCH better. I watched a video about using iodine that said that women are especially vulnerable to iodine deficiency. This is something doctors were all aware of a hundred years ago. A woman who experiences problems associated with excess estrogen is that much more vulnerable. Breast tissue takes up an especially large amount of iodine—so the more you have there, the more iodine you need.
I started by taking Lugol’s. Then I tried a much less expensive form of iodide sold to be taken internally, that seems to work just as well.
But Do NOT ingest the kind sold as a wound treatment, for topical use only! It is said to be toxic when taken internally. But it is beneficial, when absorbed through the skin. How long the yellow-brown stain lasts will serve as a rough diagnosis of how deficient you are in iodine. If the stain disappears within a day, you are deficient. If the stain lasts several days, your body has enough that it doesn’t need to pull it from your skin so quickly. I was instructed to apply the tincture of iodine [the cheap kind sold as a wound treatment] to large areas of sensitive skin, such as the inside of the thighs—the skin is most absorbent there, and the stain won’t show when you wear street clothes.
Just thought I post some of my symptoms which I am sure are iodine related. I did supplement with iodine many years ago, having read about the many benefits and then over time, forgot all about it (forgetfulness and brain fog being one of the symptoms!) 
I have been in ketosis for some time. Initially, after some minor hiccups (keto flu, muscle cramping etc) I felt great. The supplements I'm on are Blackmores Magnesium powder (ingredients are listed below), transdermal magnesium & sea salt:
Magnesium citrate (Magnesium 310 mg) 2 g
Taurine 500 mg
Glutamine 500 mg
Levocarnitine tartrate (Levocarnitine 100 mg) 147 mg
Calcium hydrogen phosphate anhydrous (Calcium 65 mg) 223.4 mg
Vitamin C (Ascorbic acid) 100 mg
Vitamin B1 (Thiamine nitrate) 25 mg
Vitamin B2 (Riboflavin) 5 mg
Nicotinamide 25 mg
Vitamin B5
(Pantothenic acid from calcium pantothenate 50 mg) 45.8 mg
Vitamin B6 (Pyridoxine hydrochloride) 50 mg
Vitamin B12 (Cyanocobalamin) 20 µg
Folic acid 150 µg
Selenomethionine (as Selenium 25 µg) 62.5 µg
Potassium aspartate (Potassium 75 mg) 362.3 mg
Chromium nicotinate (Chromium 50 µg)
However over the past few months, I have been feeling increasingly tired (exhausted mentally, emotionally and at times even spiritually), I felt depressed (and I'm not normally given to loss of faith and giving up: some thoughts running through my head were-why bother, it's not going to make any difference no matter what you do, so just give up), sore tender breasts premenstrually, brain fog, hair loss that seems to be getting worse, frequent headaches, bloated stomach & poor digestion, and weight gain. I have increased my carbs slightly, and while it helped with energy, it did nothing for my other symptoms. The most alarming had been the hair loss and the fibrocystic boobs. I tried progesterone cream which helped a bit, but did not address the issue.
During our Skype meeting the other day, it was suggested that maybe it is iodine deficiency (thank you nickelbleu!) and sure enough when I looked at iodine deficiency, all of the symptoms above are iodine deficiencies!
I had some Lugols Iodine which has just expired. When I asked yesterday at both my local pharmacies, they looked at me like I was a total weirdo. For our Aussie peeps, it can be ordered online here. I'm checking out a few other pharmacies, will try a compounding pharmacy or just buy it online. You can only buy 1 bottle/2months here, 'cuz apparently it is used in the process of cooking up crystal meth. Even though mine has expired, I have started taking some in apple cider vinegar (2 drops). From some of the posts above, it appears that acidity helps absorption, and it also must be taken along with magnesium, selenium and potassium (which the powder I take has). There is a white form which can be used topically for skin ailments and on the scalp for hair regrowth.
Iodine is most essential for so many processes in the body (it's astounding really) and has been conveniently buried by vested interests, because why make it easy for people to be healthy and think clearly! Then they might start to think and act, and that can never be allowed to happen! I will post an update with my results. The magnesium board has been made a sticky post because it's so important, perhaps (if the mods see fit) we could do so with this thread too.
I have been in ketosis for some time. Initially, after some minor hiccups (keto flu, muscle cramping etc) I felt great. The supplements I'm on are Blackmores Magnesium powder (ingredients are listed below), transdermal magnesium & sea salt:
Magnesium citrate (Magnesium 310 mg) 2 g
Taurine 500 mg
Glutamine 500 mg
Levocarnitine tartrate (Levocarnitine 100 mg) 147 mg
Calcium hydrogen phosphate anhydrous (Calcium 65 mg) 223.4 mg
Vitamin C (Ascorbic acid) 100 mg
Vitamin B1 (Thiamine nitrate) 25 mg
Vitamin B2 (Riboflavin) 5 mg
Nicotinamide 25 mg
Vitamin B5
(Pantothenic acid from calcium pantothenate 50 mg) 45.8 mg
Vitamin B6 (Pyridoxine hydrochloride) 50 mg
Vitamin B12 (Cyanocobalamin) 20 µg
Folic acid 150 µg
Selenomethionine (as Selenium 25 µg) 62.5 µg
Potassium aspartate (Potassium 75 mg) 362.3 mg
Chromium nicotinate (Chromium 50 µg)
However over the past few months, I have been feeling increasingly tired (exhausted mentally, emotionally and at times even spiritually), I felt depressed (and I'm not normally given to loss of faith and giving up: some thoughts running through my head were-why bother, it's not going to make any difference no matter what you do, so just give up), sore tender breasts premenstrually, brain fog, hair loss that seems to be getting worse, frequent headaches, bloated stomach & poor digestion, and weight gain. I have increased my carbs slightly, and while it helped with energy, it did nothing for my other symptoms. The most alarming had been the hair loss and the fibrocystic boobs. I tried progesterone cream which helped a bit, but did not address the issue.
During our Skype meeting the other day, it was suggested that maybe it is iodine deficiency (thank you nickelbleu!) and sure enough when I looked at iodine deficiency, all of the symptoms above are iodine deficiencies!
I had some Lugols Iodine which has just expired. When I asked yesterday at both my local pharmacies, they looked at me like I was a total weirdo. For our Aussie peeps, it can be ordered online here. I'm checking out a few other pharmacies, will try a compounding pharmacy or just buy it online. You can only buy 1 bottle/2months here, 'cuz apparently it is used in the process of cooking up crystal meth. Even though mine has expired, I have started taking some in apple cider vinegar (2 drops). From some of the posts above, it appears that acidity helps absorption, and it also must be taken along with magnesium, selenium and potassium (which the powder I take has). There is a white form which can be used topically for skin ailments and on the scalp for hair regrowth.
Iodine is most essential for so many processes in the body (it's astounding really) and has been conveniently buried by vested interests, because why make it easy for people to be healthy and think clearly! Then they might start to think and act, and that can never be allowed to happen! I will post an update with my results. The magnesium board has been made a sticky post because it's so important, perhaps (if the mods see fit) we could do so with this thread too.
We just started to use Tincture of Iodine (Iodine 25mg/mL,Ethanol, Potassium Iodide 25mg/mL) in an attempt to treat the Psoriasis my girlfriend has. I'll keep you posted on that.
Simoncini's website is so interesting as I've never had been able to figure out what really is Psoriasis. In conjunction we are now heading to full ketosis and taking Probiotics so I guess Fungus ain't happy right now, but we do fell great and not hungry at all.
Thanks for the info on Iodine, I just stumbled onto that thread, makes a lot of sense.
Simoncini's website is so interesting as I've never had been able to figure out what really is Psoriasis. In conjunction we are now heading to full ketosis and taking Probiotics so I guess Fungus ain't happy right now, but we do fell great and not hungry at all.
Thanks for the info on Iodine, I just stumbled onto that thread, makes a lot of sense.
Mr. Premise
The Living Force
After reading Arwenn's post here I picked up some kelp capsules on Saturday and I can feel a real difference. Improved mood and energy. I Think what happened is that I normally travel at least twice a month for my job and when I'm on the road I eat regular commercial salt which has iodine added but when I'm home it's all sea or himalaya salt. And I haven't traveled for more than a month now so the lack of iodine may have caught up with me.
Arwenn said:Just thought I post some of my symptoms which I am sure are iodine related. I did supplement with iodine many years ago, having read about the many benefits and then over time, forgot all about it (forgetfulness and brain fog being one of the symptoms!)
I have been in ketosis for some time. Initially, after some minor hiccups (keto flu, muscle cramping etc) I felt great. The supplements I'm on are Blackmores Magnesium powder (ingredients are listed below), transdermal magnesium & sea salt:
Magnesium citrate (Magnesium 310 mg) 2 g
Taurine 500 mg
Glutamine 500 mg
Levocarnitine tartrate (Levocarnitine 100 mg) 147 mg
Calcium hydrogen phosphate anhydrous (Calcium 65 mg) 223.4 mg
Vitamin C (Ascorbic acid) 100 mg
Vitamin B1 (Thiamine nitrate) 25 mg
Vitamin B2 (Riboflavin) 5 mg
Nicotinamide 25 mg
Vitamin B5
(Pantothenic acid from calcium pantothenate 50 mg) 45.8 mg
Vitamin B6 (Pyridoxine hydrochloride) 50 mg
Vitamin B12 (Cyanocobalamin) 20 µg
Folic acid 150 µg
Selenomethionine (as Selenium 25 µg) 62.5 µg
Potassium aspartate (Potassium 75 mg) 362.3 mg
Chromium nicotinate (Chromium 50 µg)
However over the past few months, I have been feeling increasingly tired (exhausted mentally, emotionally and at times even spiritually), I felt depressed (and I'm not normally given to loss of faith and giving up: some thoughts running through my head were-why bother, it's not going to make any difference no matter what you do, so just give up), sore tender breasts premenstrually, brain fog, hair loss that seems to be getting worse, frequent headaches, bloated stomach & poor digestion, and weight gain. I have increased my carbs slightly, and while it helped with energy, it did nothing for my other symptoms. The most alarming had been the hair loss and the fibrocystic boobs. I tried progesterone cream which helped a bit, but did not address the issue.
During our Skype meeting the other day, it was suggested that maybe it is iodine deficiency (thank you nickelbleu!) and sure enough when I looked at iodine deficiency, all of the symptoms above are iodine deficiencies!
I had some Lugols Iodine which has just expired. When I asked yesterday at both my local pharmacies, they looked at me like I was a total weirdo. For our Aussie peeps, it can be ordered online here. I'm checking out a few other pharmacies, will try a compounding pharmacy or just buy it online. You can only buy 1 bottle/2months here, 'cuz apparently it is used in the process of cooking up crystal meth. Even though mine has expired, I have started taking some in apple cider vinegar (2 drops). From some of the posts above, it appears that acidity helps absorption, and it also must be taken along with magnesium, selenium and potassium (which the powder I take has). There is a white form which can be used topically for skin ailments and on the scalp for hair regrowth.
Iodine is most essential for so many processes in the body (it's astounding really) and has been conveniently buried by vested interests, because why make it easy for people to be healthy and think clearly! Then they might start to think and act, and that can never be allowed to happen! I will post an update with my results. The magnesium board has been made a sticky post because it's so important, perhaps (if the mods see fit) we could do so with this thread too.
Hi Arwenn, you mentioned exhaustion / depression, but I did not see in your listing of supplements any thing on vitamin D.
You may be lacking Vit D. Sunshine is free, you don't have to order it in. Twenty minutes in early morning or late afternoon should do it.
Don't worry. Be Happy. Hmm, could be a song in that..
Thanks MusicMan, don't think sunshine is an issue. I'm on the Mid-North Coast of NSW & I daresay we get a wee bit more sun that you guys in the ACT ;D I do make sure to get some daily exposure to sun, although I must admit to not liking spending hours in the sun like I used to. It seems more harsh or something, and this was commented on on another thread.
I'm trying a colloidal iodine (aka Nascent or Atomic iodine). So far, I've my energy back (yay!!) & sleeping better too. I will post my results after a few weeks with regards to headaches, mood and my other pre-iodine symptoms.
I'm trying a colloidal iodine (aka Nascent or Atomic iodine). So far, I've my energy back (yay!!) & sleeping better too. I will post my results after a few weeks with regards to headaches, mood and my other pre-iodine symptoms.
OneFielder
A Disturbance in the Force
Hi,
I did a search for Rutin. Nothing came up. For those of you worried about iodine not affecting the body well you should look into it. It increases iodine uptake for use. If your thyroid is willing, it may be beneficial. It also appears to help regulation,
I did a search for Rutin. Nothing came up. For those of you worried about iodine not affecting the body well you should look into it. It increases iodine uptake for use. If your thyroid is willing, it may be beneficial. It also appears to help regulation,
The Benefits of Potassium Iodide
Contributes to overall healthy thyroid function:
Potassium iodide is known as the thyroid mineral. It helps in keeping iodine levels in the thyroid in proper balance. When iodine levels are not optimal, it can lead to both hyper or hypothyroidism, two conditions whereby the thyroid gland produces too much or too little iodine. For this reason, potassium iodide acts as a powerful treatment and preventative mechanism for both forms of thyroid disorder through a mechanism of counteracting any less-than-optimal iodine levels due to dietary deficiencies. Potassium iodide also boosts colloid accumulation in the thyroid follicles, contributing to more healthy functioning in the important gland.
Surgical preparation:
This mineral is also used prior to thyroid surgery as a preparatory mineral for the gland by reducing thyroid vascularity.
Arthritis:
Iodine deficiency may be related to arthritis, and potassium iodide may help prevent this. [1]
Hormone balance:
Iodine deficiency has also been related to emotional disorders and malfunctioning glandular systems, and weight gain associated with hormonal imbalance. Dr. David Brownstein also believes that iodine deficiency may be linked to breast, ovarian, uterus and prostate cancers and cysts.
Acts as an overall expectorant:
This form of potassium stimulates the salivary glands, creating a moisturizing expectorant for treating coughs. It acts as a treatment for most respiratory tract conditions like asthma, bronchitis and emphysema, through a mechanism of reducing mucus viscosity and through augmenting respiratory tract secretions.
Acts as a protector against harmful radiation exposure:
Significant studies show that potassium iodide offers a clear protective mechanism against radiation. It does this through its ability to prevent the thyroid gland from absorbing the harmful radioactive isotopes of iodine that are released through radiation. In the event of a nuclear event, the use of potassium iodide as a deterrent is crucial, as it can reduce the risk of thyroid cancer and other future diseases associated with the thyroid.
Reduces chances of developmental problems:
Many developing countries use potassium iodide supplements to reduce the occurrence of growth and development problems, such as goiters, Hashimoto’s Disease, miscarriage, Graves’ Disease, generalized fatigue and impaired immune system function. In fact, The World Health Organization has stated that iodine deficiency is the biggest cause of mental retardation on a global scale.
Detoxification properties:
Potassium iodine also aids the body in detoxification, filtering out harmful mercury, fluorides, chlorides, and bromides from our tissues and cells.
Acts as an anti-fungal:
Saturated solutions of potassium iodide have been shown to be effective in treating external forms of cutaneous sporotrichosis, a fungal infection that leads to lesions on the skin.
Recommended Iodine Supplement
References:
Charles Weber, MS. Potassium in foods, to treat rheumatoid arthritis, gout, high blood pressure, and heart disease. 2011 May.
_http://www.globalhealingcenter.com/natural-health/potassium-iodide/
Contributes to overall healthy thyroid function:
Potassium iodide is known as the thyroid mineral. It helps in keeping iodine levels in the thyroid in proper balance. When iodine levels are not optimal, it can lead to both hyper or hypothyroidism, two conditions whereby the thyroid gland produces too much or too little iodine. For this reason, potassium iodide acts as a powerful treatment and preventative mechanism for both forms of thyroid disorder through a mechanism of counteracting any less-than-optimal iodine levels due to dietary deficiencies. Potassium iodide also boosts colloid accumulation in the thyroid follicles, contributing to more healthy functioning in the important gland.
Surgical preparation:
This mineral is also used prior to thyroid surgery as a preparatory mineral for the gland by reducing thyroid vascularity.
Arthritis:
Iodine deficiency may be related to arthritis, and potassium iodide may help prevent this. [1]
Hormone balance:
Iodine deficiency has also been related to emotional disorders and malfunctioning glandular systems, and weight gain associated with hormonal imbalance. Dr. David Brownstein also believes that iodine deficiency may be linked to breast, ovarian, uterus and prostate cancers and cysts.
Acts as an overall expectorant:
This form of potassium stimulates the salivary glands, creating a moisturizing expectorant for treating coughs. It acts as a treatment for most respiratory tract conditions like asthma, bronchitis and emphysema, through a mechanism of reducing mucus viscosity and through augmenting respiratory tract secretions.
Acts as a protector against harmful radiation exposure:
Significant studies show that potassium iodide offers a clear protective mechanism against radiation. It does this through its ability to prevent the thyroid gland from absorbing the harmful radioactive isotopes of iodine that are released through radiation. In the event of a nuclear event, the use of potassium iodide as a deterrent is crucial, as it can reduce the risk of thyroid cancer and other future diseases associated with the thyroid.
Reduces chances of developmental problems:
Many developing countries use potassium iodide supplements to reduce the occurrence of growth and development problems, such as goiters, Hashimoto’s Disease, miscarriage, Graves’ Disease, generalized fatigue and impaired immune system function. In fact, The World Health Organization has stated that iodine deficiency is the biggest cause of mental retardation on a global scale.
Detoxification properties:
Potassium iodine also aids the body in detoxification, filtering out harmful mercury, fluorides, chlorides, and bromides from our tissues and cells.
Acts as an anti-fungal:
Saturated solutions of potassium iodide have been shown to be effective in treating external forms of cutaneous sporotrichosis, a fungal infection that leads to lesions on the skin.
Recommended Iodine Supplement
References:
Charles Weber, MS. Potassium in foods, to treat rheumatoid arthritis, gout, high blood pressure, and heart disease. 2011 May.
_http://www.globalhealingcenter.com/natural-health/potassium-iodide/
PHARMACOLOGICAL ASPECTS AND MECHANISM OF ACTION
Potassium iodide (KI) is a salt composed of 76% of iodine and 23% of potassium which presents itself as transparent or white hexahedral crystals.1,4 "It is photosensitive and has slightly hygroscopic properties, being highly soluble in water."4 Its solubility limit varies depending on the solvent used. One gram (1 g) of the solute is soluble in 0.7 mL of water, 0.5 mL of boiling water, 22 mL of alcohol and 2 mL of glycerol. The solution has neutral to alkaline properties.4,5
"Iodine is poorly absorbed when applied to the skin. By the oral route, solutions of iodide salts are converted into iodine, which is transported and concentrated in the thyroid gland. The remainder is eliminated in the urine, and a small amount appears in the feces, saliva and sweat. It is excreted in breast milk and goes through the placenta."4
The various hypotheses regarding its mechanism of action justify the therapeutic versatility of iodide, which helps to protect the thyroid gland in nuclear accidents or gland disorders, in interactions with cells of the immune system and in direct action against infectious agents. Some of them are exemplified below.
Diseases whose pathogenesis involves the action of neutrophils respond well to iodide. It has been demonstrated that iodine, as well as dapsone, has the ability to suppress the production of toxic oxygen intermediates by polymorphonuclear cells and thus exert its anti-inflammatory effect.6 It also inhibits neutrophil chemotaxis, which is observed in vivo in peripheral blood when KI is taken by the oral route at a dose of 15 mg/kg/day for three days.7 It is speculated that iodine participates in halogenation reactions by myeloperoxidases, which are fundamental for the action of phagocytes.8 This mechanism also helps to understand, in part, the usefulness of this medicine against infectious diseases.
When topical, iodide acts as a disinfectant and an antiseptic.4 The ability of potassium iodide to directly destroy microorganisms continues to be speculated. Although the pharmacological literature states that potassium iodide has no antifungal activity in vitro, a study shows that cell lysis occurs when Sporothrix schenckii yeast is exposed to increasing concentrations of the drug through the release of lysosomal enzymes.4,9 Also, considering the immunological action of iodide in vivo, it is possible that it has some direct effect on the infectious agent. However, more studies are needed to confirm these mechanisms of action.
The immunomodulatory characteristic of the drug justifies its mechanism of action in relation to other inflammatory and immune-mediated disorders. However, the exact target of the complex immunological pathway on which iodide acts in each of these diseases is unknown. The lack of scientific investigations in this area could be justified by the lack of interest from the pharmaceutical industry in this old and unprofitable drug.
Potassium iodide (KI) is a salt composed of 76% of iodine and 23% of potassium which presents itself as transparent or white hexahedral crystals.1,4 "It is photosensitive and has slightly hygroscopic properties, being highly soluble in water."4 Its solubility limit varies depending on the solvent used. One gram (1 g) of the solute is soluble in 0.7 mL of water, 0.5 mL of boiling water, 22 mL of alcohol and 2 mL of glycerol. The solution has neutral to alkaline properties.4,5
"Iodine is poorly absorbed when applied to the skin. By the oral route, solutions of iodide salts are converted into iodine, which is transported and concentrated in the thyroid gland. The remainder is eliminated in the urine, and a small amount appears in the feces, saliva and sweat. It is excreted in breast milk and goes through the placenta."4
The various hypotheses regarding its mechanism of action justify the therapeutic versatility of iodide, which helps to protect the thyroid gland in nuclear accidents or gland disorders, in interactions with cells of the immune system and in direct action against infectious agents. Some of them are exemplified below.
Diseases whose pathogenesis involves the action of neutrophils respond well to iodide. It has been demonstrated that iodine, as well as dapsone, has the ability to suppress the production of toxic oxygen intermediates by polymorphonuclear cells and thus exert its anti-inflammatory effect.6 It also inhibits neutrophil chemotaxis, which is observed in vivo in peripheral blood when KI is taken by the oral route at a dose of 15 mg/kg/day for three days.7 It is speculated that iodine participates in halogenation reactions by myeloperoxidases, which are fundamental for the action of phagocytes.8 This mechanism also helps to understand, in part, the usefulness of this medicine against infectious diseases.
When topical, iodide acts as a disinfectant and an antiseptic.4 The ability of potassium iodide to directly destroy microorganisms continues to be speculated. Although the pharmacological literature states that potassium iodide has no antifungal activity in vitro, a study shows that cell lysis occurs when Sporothrix schenckii yeast is exposed to increasing concentrations of the drug through the release of lysosomal enzymes.4,9 Also, considering the immunological action of iodide in vivo, it is possible that it has some direct effect on the infectious agent. However, more studies are needed to confirm these mechanisms of action.
The immunomodulatory characteristic of the drug justifies its mechanism of action in relation to other inflammatory and immune-mediated disorders. However, the exact target of the complex immunological pathway on which iodide acts in each of these diseases is unknown. The lack of scientific investigations in this area could be justified by the lack of interest from the pharmaceutical industry in this old and unprofitable drug.
Respiratory tract diseases
Potassium iodide can be used as expectorant syrup at a concentration of 2% (20mg/mL) in cases of infectious diseases of the respiratory tract or in cases of pulmonary diseases in which anatomical changes impair expectoration, such as emphysema and cystic fibrosis. It acts as an "irritating" expectorant whose mechanism of action will occur by direct irritation of the glands of the respiratory mucosa.
Potassium iodide can be used as expectorant syrup at a concentration of 2% (20mg/mL) in cases of infectious diseases of the respiratory tract or in cases of pulmonary diseases in which anatomical changes impair expectoration, such as emphysema and cystic fibrosis. It acts as an "irritating" expectorant whose mechanism of action will occur by direct irritation of the glands of the respiratory mucosa.
Sporotrichosis
The saturated solution of potassium iodide (SSKI) has been the first choice for the treatment of lymphocutaneous and fixed cutaneous forms of sporotrichosis since 1900.1,15,16,17 Its efficacy and low cost allowed this drug to be safely used for a long period of time. However, the ease of dosage of itraconazole, which was introduced in the 1990s, caused it to be considered the first-line drug in some centers, although it is more expensive and not different from SSKI in terms of efficacy. In the main international guidelines on the treatment of this disease, the authors classify the different therapeutic options according to levels of evidence and scientific quality. SSKI and itraconazole are at the same level, that is, IIA. Therefore, they are equally effective and indicated as a therapeutic option for the treatment of lymphocutaneous and fixed cutaneous forms of sporotrichosis.
Entomophthoromycoses
Entomophthoromycoses are subcutaneous mycoses caused by zygomycetes of the genus Basiodiobolus and Conidiobolus. They can be treated with SSKI, which is considered the gold standard treatment even when compared to the most recent antifungal drugs. Case reports show satisfactory results even in exuberant cases, with good cure rates.
Other
The use of SSKI has been described in the literature as a therapeutic alternative for the treatment of some infections, especially when it is impossible to use other medications. Surgical procedures such as electrocoagulation, exeresis, surgical drainage, thermotherapy or cryotherapy may often be associated. Here are some indications: chromomycosis, mycetoma, cutaneous nocardiosis, cutaneous cryptococcosis and human pythiosis. Therapeutic success is directly linked to the size and duration of the lesion and to the immunological status of the host.
Inflammatory and immune-mediated dermatoses
The two best indications in this group are neutrophilic dermatoses and panniculitis.1,2 The pathophysiology of pyoderma gangrenosum, Sweet's syndrome and Behçet's disease involves the action of neutrophils. 1 These cells are especially present in early stages, when the intense attraction and toxicity of polymorphonuclear cells produce an exuberant inflammatory response and sterile purulent discharge. Behçet's disease exhibits clear manifestations of this mechanism, such as acne, hypopyon and aseptic meningitis. Potassium iodide has an inhibitory effect on the chemotaxis of neutrophils and on the production of toxic radicals by these cells, which justifies its use in this group of disorders.
It is possible to assume that potassium iodide has an important anti-inflammatory role in panniculitis, since the patients that show better response also present systemic symptoms and increased C-reactive protein. It usually improves fast, with fever, pain and erythema reduction in two days and complete remission in up to two weeks. The main indications are the following: erythema nodosum, nodular vasculitis and subacute nodular migratory panniculitis.
Miscellaneous
Potassium iodide has been successfully used for the treatment of erythema multiforme, even when associated with infection with herpes simplex; granuloma annulare, including reports of good response to widespread cases of the disease; Erythema annulare centrifugum; and Wegener's granulomatosis.
The recommended dose of potassium iodide to treat infectious diseases varies from 4 to 6g/day or 6 to 7.5 g/day for adults, depending on the scientific reference. The pediatric dose is about half or a third of the adult dose.
However, the recommended dose for inflammatory dermatoses is lower. It is approximately 1g/day for adults, taken in three doses.1,27,28
As an expectorant, the syrup is formulated at 2% (20mg/mL) and administered at a dose of 5 mL, 34x /day. 4
To make its use more convenient, potassium iodide is administered in the form of a saturated solution (SSKI).1 A saturated solution should be understood as one in which the addition of any solute will result in its precipitation. Considering the solubility limit for distilled water, which is the vehicle usually used, we found that 1g of the salt to a volume of 0.7 mL of this solvent results in a solution of approximately 1.42 g/mL.4
A discrepancy regarding the dosage of SSKI to be administered is observed in the scientific literature. This can be evidenced in the formulations recommended by WHO or even by some reference books and scientific articles on pharmacology, which define the concentration of the saturated solution of potassium iodide as 1g/mL.4,17,26-31 They probably use already prepared saturated solutions and dilute them to obtain a concentrated solution (not saturated) of 1g/mL. In Brazil, we typically use the pure potassium iodide salt (PA) in the therapeutic formulations.
It is important to have all these considerations in mind before administering the drug to a patient so that the actual dose can be known. Toxicity or absence of therapeutic response is often due to inadequate dosage. Most studies address the number of drops to be administered in the treatment, without even mentioning the characteristics of the solution and the volume of drops used, that is, the amount in grams that is being administered to the patient.
For these reasons, it can be inferred that the knowledge and standardization of the proper use of SSKI are important so that treatment can be tolerable, safe and correct.
When using pure potassium iodide crystals (PA), the correct formula for a final volume of 100 mL is 100 g of salt to 70 mL of distilled water or 50 g of salt to 35 mL of water if the desired final volume is 50 mL.
Considering a standard dropper in which each drop has a volume of 0.05 mL, there will be 0.07 g of KI per drop (1.42 g/mL) in the solution. Thus, by administering 20 drops of the solution 3x/day, the daily intake of potassium iodide is approximately 4g. It is also possible to use the concentrated solution, in which there is 1g of potassium iodide in each mL of water. However, if we consider the same drop volume of 0.05 mL, the daily dose taken by administering 20 drops 3x/day will be 3g.
The studies on dosage recommendation are based on the most classic indication, that is, on the treatment of sporotrichosis. According to the official publication of IDSA (Infectious Diseases Society of America), the recommendation for the treatment of lymphocutaneous or fixed cutaneous sporotrichosis is 40-50 drops 3x/day of a saturated solution, but they do not say how the solution is prepared.18 If it were saturated, the daily total dose would be unbearable, between 8.4 and 10.5 g/day. It is possible that they have considered the concentrated solution, even though the daily dose of 6-7.5g is not always well tolerated.
Another standardization to be reviewed is related to drop volume. A standard dropper usually has 0.05 mL/drop, but there are variations.32 In Brazil, we usually administer 4-6g/day in the treatment of sporotrichosis, which is taken in three doses (Table 2).1,17,26-28 In summary, no matter whether the solution is concentrated or saturated, it is important to know the formulation being used so that the daily dose for inflammatory, infectious or immune-mediated diseases can be adjusted.
The use of KI is contraindicated in cases of previous thyroid diseases such as hypo or hyperthyroidism, presence of nodules and thyroid cancer. Family history of thyroid disease is a relative contraindication. However, positivity for autoantibodies such as anti-TPO antibodies (anti-thyroid peroxidase) and TRAb (TSH receptor antibodies) show a predisposition to autoimmune thyroid diseases that can be triggered by exposure to iodine.1,33
KI is also contraindicated in patients with any type of allergy to iodine.4,28,29,30 Its use should be avoided in patients with chronic renal failure because of the presence of potassium in its formulation and is proscribed in those whose renal function is greatly impaired. Similarly, those using potassium-sparing diuretics or angiotensin-converting-enzyme inhibitors should be closely monitored.1,4,28
It is prudent to avoid the concomitant use of other medications such as lithium, because of its drug interaction, and of medications containing iodine in its formulation such as amiodarone.4,28
Transplant patients and patients with cancer, a history of alcoholic disease, poorly controlled diabetes mellitus and insulin-dependency, autoimmune diseases and immunosuppressive characteristics such as AIDS, and patients who use corticosteroids and immunosuppressive medications should not use this medicine, for its mechanism of action affects the immune system. Active tuberculosis is also included in this group.30
It should not be used by pregnant and lactating women, for it causes neonatal hypothyroidism, thyromegaly, fetal airway obstruction and prolonged labor, being among the category D drugs.1,4,28,30
It should also not be administered to patients with Addison's disease, since they do not only present an autoimmune condition but also changes similar to those that occur with the use of angiotensin-converting-enzyme inhibitors.28
Regarding infectious diseases, KI is not recommended in cases of extensive disease or in cases of involvement of internal organs such as systemic or disseminated cutaneous forms of sporotrichosis, because it is believed that these patients' immune system is impaired.18
Adverse effects, usually mild to moderate, may occur due to the high doses administered, especially for the treatment of infectious skin disorders. They are often related to the digestive system, with a predominance of gastrointestinal intolerance and a metallic or bitter taste in the mouth.1,30
To relieve these symptoms, it is recommended to start the treatment with low doses of the drug, usually five drops of 1.42 mg/mL (0.35 g) three times a day, with daily increases of a drop every time the medicine is taken until the target dosage is reached, for both adults and children.1,4,17,18,29,30 Another recommendation is to take the medicine after meals, with the intake of juice or milk soon afterwards.29 Some pharmacological references recommend mixing the medicine with these drinks.1,17,30 Reducing the dose every time the medicine is taken often eliminates the gastrointestinal complaint without reducing its efficacy.
Due to the presence of large amounts of iodine in the drug, it is possible that it has some effects on the metabolism of the thyroid. There is a physiological mechanism of autoregulation in the human body that aims to keep the pool of stored iodine balanced. Thus, an excess of iodine causes an acute inhibitory effect with a temporary increase in TSH called adaptive block. However, there are escape mechanisms that help maintain the normal function of the gland.1,10
The Wolff-Chaikoff phenomenon is described as an interruption in the thyroid hormone synthesis due to the inability of the thyroid to overcome the acute inhibitory effect resulting from inefficient escape mechanisms in individuals with underlying thyroid disorders, especially Hashimoto's thyroiditis. In these cases, there is axis suppression and increased TSH levels, with consequent hypothyroidism (decreased free T4).1,33
On the other hand, if the patient presents autonomous hormone production in toxic multinodular goiter or in Graves' disease, there may be hyperthyroidism or thyrotoxicosis, which is called Jod-Basedow.1,33
Other adverse effects are occasionally found in the scientific literature, such as acneiform eruption, dermatitis herpetiformis, pustular psoriasis, bullous pemphigoid and iododerma, possibly related to the action on the chemotaxis of polymorphonuclear cells, with iododerma being the most frequent condition in patients with underlying systemic diseases. The syndrome caused by iodine poisoning is called iodism. It is characterized by conjunctival hyperemia, lacrimation, blurred vision, rhinorrhea and sialorrhea.1,28,30
As with any drug, allergic reactions such as urticaria and angioedema should be considered.1,29 Cases of congestive heart failure with pulmonary edema and cases of toxicity related to potassium iodine, such as renal dysfunction, cardiac arrhythmia and metabolic acidosis, have been described.30,34,35 Headaches, arthralgia and prolonged fever have also been reported.1,30
CONCLUSION
Despite being used in Medicine for over a century, potassium iodine remains a good therapeutic option for the treatment of several dermatoses as a drug of first or second choice and may be part of the dermatologist's therapeutic arsenal. When treatment with potassium iodide is considered, it is important to know the exact dose being administered, since the toxicity is directly related to dosage and not to the drug. This involves knowing the formulation being used and the effective dose per drop (in grams) for each individual and therapeutic indication. The toxicity of a drug alone does not constitute a reason to abandon its use, since deeper knowledge of the drug may generate benefits to the patient who does not have access or cannot use other medications due to high cost, adverse effects, drug interactions or even therapeutic failure, in case adverse effects can be controlled, of course. Simply recommending the number of drops may lead to misuse and undue dose administration with risks for the patient.
* Work conducted at the Mycology Laboratory of the Dermatology Service, Hospital Universitário Pedro Ernesto (Pedro Hernesto University Hospital), Universidade do Estado do Rio de Janeiro (Rio de Janeiro State University) - HUPE-UERJ - Rio de Janeiro (RJ), Brazil.
Conflict of interest: None
Financial Support: None
The saturated solution of potassium iodide (SSKI) has been the first choice for the treatment of lymphocutaneous and fixed cutaneous forms of sporotrichosis since 1900.1,15,16,17 Its efficacy and low cost allowed this drug to be safely used for a long period of time. However, the ease of dosage of itraconazole, which was introduced in the 1990s, caused it to be considered the first-line drug in some centers, although it is more expensive and not different from SSKI in terms of efficacy. In the main international guidelines on the treatment of this disease, the authors classify the different therapeutic options according to levels of evidence and scientific quality. SSKI and itraconazole are at the same level, that is, IIA. Therefore, they are equally effective and indicated as a therapeutic option for the treatment of lymphocutaneous and fixed cutaneous forms of sporotrichosis.
Entomophthoromycoses
Entomophthoromycoses are subcutaneous mycoses caused by zygomycetes of the genus Basiodiobolus and Conidiobolus. They can be treated with SSKI, which is considered the gold standard treatment even when compared to the most recent antifungal drugs. Case reports show satisfactory results even in exuberant cases, with good cure rates.
Other
The use of SSKI has been described in the literature as a therapeutic alternative for the treatment of some infections, especially when it is impossible to use other medications. Surgical procedures such as electrocoagulation, exeresis, surgical drainage, thermotherapy or cryotherapy may often be associated. Here are some indications: chromomycosis, mycetoma, cutaneous nocardiosis, cutaneous cryptococcosis and human pythiosis. Therapeutic success is directly linked to the size and duration of the lesion and to the immunological status of the host.
Inflammatory and immune-mediated dermatoses
The two best indications in this group are neutrophilic dermatoses and panniculitis.1,2 The pathophysiology of pyoderma gangrenosum, Sweet's syndrome and Behçet's disease involves the action of neutrophils. 1 These cells are especially present in early stages, when the intense attraction and toxicity of polymorphonuclear cells produce an exuberant inflammatory response and sterile purulent discharge. Behçet's disease exhibits clear manifestations of this mechanism, such as acne, hypopyon and aseptic meningitis. Potassium iodide has an inhibitory effect on the chemotaxis of neutrophils and on the production of toxic radicals by these cells, which justifies its use in this group of disorders.
It is possible to assume that potassium iodide has an important anti-inflammatory role in panniculitis, since the patients that show better response also present systemic symptoms and increased C-reactive protein. It usually improves fast, with fever, pain and erythema reduction in two days and complete remission in up to two weeks. The main indications are the following: erythema nodosum, nodular vasculitis and subacute nodular migratory panniculitis.
Miscellaneous
Potassium iodide has been successfully used for the treatment of erythema multiforme, even when associated with infection with herpes simplex; granuloma annulare, including reports of good response to widespread cases of the disease; Erythema annulare centrifugum; and Wegener's granulomatosis.
The recommended dose of potassium iodide to treat infectious diseases varies from 4 to 6g/day or 6 to 7.5 g/day for adults, depending on the scientific reference. The pediatric dose is about half or a third of the adult dose.
However, the recommended dose for inflammatory dermatoses is lower. It is approximately 1g/day for adults, taken in three doses.1,27,28
As an expectorant, the syrup is formulated at 2% (20mg/mL) and administered at a dose of 5 mL, 34x /day. 4
To make its use more convenient, potassium iodide is administered in the form of a saturated solution (SSKI).1 A saturated solution should be understood as one in which the addition of any solute will result in its precipitation. Considering the solubility limit for distilled water, which is the vehicle usually used, we found that 1g of the salt to a volume of 0.7 mL of this solvent results in a solution of approximately 1.42 g/mL.4
A discrepancy regarding the dosage of SSKI to be administered is observed in the scientific literature. This can be evidenced in the formulations recommended by WHO or even by some reference books and scientific articles on pharmacology, which define the concentration of the saturated solution of potassium iodide as 1g/mL.4,17,26-31 They probably use already prepared saturated solutions and dilute them to obtain a concentrated solution (not saturated) of 1g/mL. In Brazil, we typically use the pure potassium iodide salt (PA) in the therapeutic formulations.
It is important to have all these considerations in mind before administering the drug to a patient so that the actual dose can be known. Toxicity or absence of therapeutic response is often due to inadequate dosage. Most studies address the number of drops to be administered in the treatment, without even mentioning the characteristics of the solution and the volume of drops used, that is, the amount in grams that is being administered to the patient.
For these reasons, it can be inferred that the knowledge and standardization of the proper use of SSKI are important so that treatment can be tolerable, safe and correct.
When using pure potassium iodide crystals (PA), the correct formula for a final volume of 100 mL is 100 g of salt to 70 mL of distilled water or 50 g of salt to 35 mL of water if the desired final volume is 50 mL.
Considering a standard dropper in which each drop has a volume of 0.05 mL, there will be 0.07 g of KI per drop (1.42 g/mL) in the solution. Thus, by administering 20 drops of the solution 3x/day, the daily intake of potassium iodide is approximately 4g. It is also possible to use the concentrated solution, in which there is 1g of potassium iodide in each mL of water. However, if we consider the same drop volume of 0.05 mL, the daily dose taken by administering 20 drops 3x/day will be 3g.
The studies on dosage recommendation are based on the most classic indication, that is, on the treatment of sporotrichosis. According to the official publication of IDSA (Infectious Diseases Society of America), the recommendation for the treatment of lymphocutaneous or fixed cutaneous sporotrichosis is 40-50 drops 3x/day of a saturated solution, but they do not say how the solution is prepared.18 If it were saturated, the daily total dose would be unbearable, between 8.4 and 10.5 g/day. It is possible that they have considered the concentrated solution, even though the daily dose of 6-7.5g is not always well tolerated.
Another standardization to be reviewed is related to drop volume. A standard dropper usually has 0.05 mL/drop, but there are variations.32 In Brazil, we usually administer 4-6g/day in the treatment of sporotrichosis, which is taken in three doses (Table 2).1,17,26-28 In summary, no matter whether the solution is concentrated or saturated, it is important to know the formulation being used so that the daily dose for inflammatory, infectious or immune-mediated diseases can be adjusted.
The use of KI is contraindicated in cases of previous thyroid diseases such as hypo or hyperthyroidism, presence of nodules and thyroid cancer. Family history of thyroid disease is a relative contraindication. However, positivity for autoantibodies such as anti-TPO antibodies (anti-thyroid peroxidase) and TRAb (TSH receptor antibodies) show a predisposition to autoimmune thyroid diseases that can be triggered by exposure to iodine.1,33
KI is also contraindicated in patients with any type of allergy to iodine.4,28,29,30 Its use should be avoided in patients with chronic renal failure because of the presence of potassium in its formulation and is proscribed in those whose renal function is greatly impaired. Similarly, those using potassium-sparing diuretics or angiotensin-converting-enzyme inhibitors should be closely monitored.1,4,28
It is prudent to avoid the concomitant use of other medications such as lithium, because of its drug interaction, and of medications containing iodine in its formulation such as amiodarone.4,28
Transplant patients and patients with cancer, a history of alcoholic disease, poorly controlled diabetes mellitus and insulin-dependency, autoimmune diseases and immunosuppressive characteristics such as AIDS, and patients who use corticosteroids and immunosuppressive medications should not use this medicine, for its mechanism of action affects the immune system. Active tuberculosis is also included in this group.30
It should not be used by pregnant and lactating women, for it causes neonatal hypothyroidism, thyromegaly, fetal airway obstruction and prolonged labor, being among the category D drugs.1,4,28,30
It should also not be administered to patients with Addison's disease, since they do not only present an autoimmune condition but also changes similar to those that occur with the use of angiotensin-converting-enzyme inhibitors.28
Regarding infectious diseases, KI is not recommended in cases of extensive disease or in cases of involvement of internal organs such as systemic or disseminated cutaneous forms of sporotrichosis, because it is believed that these patients' immune system is impaired.18
Adverse effects, usually mild to moderate, may occur due to the high doses administered, especially for the treatment of infectious skin disorders. They are often related to the digestive system, with a predominance of gastrointestinal intolerance and a metallic or bitter taste in the mouth.1,30
To relieve these symptoms, it is recommended to start the treatment with low doses of the drug, usually five drops of 1.42 mg/mL (0.35 g) three times a day, with daily increases of a drop every time the medicine is taken until the target dosage is reached, for both adults and children.1,4,17,18,29,30 Another recommendation is to take the medicine after meals, with the intake of juice or milk soon afterwards.29 Some pharmacological references recommend mixing the medicine with these drinks.1,17,30 Reducing the dose every time the medicine is taken often eliminates the gastrointestinal complaint without reducing its efficacy.
Due to the presence of large amounts of iodine in the drug, it is possible that it has some effects on the metabolism of the thyroid. There is a physiological mechanism of autoregulation in the human body that aims to keep the pool of stored iodine balanced. Thus, an excess of iodine causes an acute inhibitory effect with a temporary increase in TSH called adaptive block. However, there are escape mechanisms that help maintain the normal function of the gland.1,10
The Wolff-Chaikoff phenomenon is described as an interruption in the thyroid hormone synthesis due to the inability of the thyroid to overcome the acute inhibitory effect resulting from inefficient escape mechanisms in individuals with underlying thyroid disorders, especially Hashimoto's thyroiditis. In these cases, there is axis suppression and increased TSH levels, with consequent hypothyroidism (decreased free T4).1,33
On the other hand, if the patient presents autonomous hormone production in toxic multinodular goiter or in Graves' disease, there may be hyperthyroidism or thyrotoxicosis, which is called Jod-Basedow.1,33
Other adverse effects are occasionally found in the scientific literature, such as acneiform eruption, dermatitis herpetiformis, pustular psoriasis, bullous pemphigoid and iododerma, possibly related to the action on the chemotaxis of polymorphonuclear cells, with iododerma being the most frequent condition in patients with underlying systemic diseases. The syndrome caused by iodine poisoning is called iodism. It is characterized by conjunctival hyperemia, lacrimation, blurred vision, rhinorrhea and sialorrhea.1,28,30
As with any drug, allergic reactions such as urticaria and angioedema should be considered.1,29 Cases of congestive heart failure with pulmonary edema and cases of toxicity related to potassium iodine, such as renal dysfunction, cardiac arrhythmia and metabolic acidosis, have been described.30,34,35 Headaches, arthralgia and prolonged fever have also been reported.1,30
CONCLUSION
Despite being used in Medicine for over a century, potassium iodine remains a good therapeutic option for the treatment of several dermatoses as a drug of first or second choice and may be part of the dermatologist's therapeutic arsenal. When treatment with potassium iodide is considered, it is important to know the exact dose being administered, since the toxicity is directly related to dosage and not to the drug. This involves knowing the formulation being used and the effective dose per drop (in grams) for each individual and therapeutic indication. The toxicity of a drug alone does not constitute a reason to abandon its use, since deeper knowledge of the drug may generate benefits to the patient who does not have access or cannot use other medications due to high cost, adverse effects, drug interactions or even therapeutic failure, in case adverse effects can be controlled, of course. Simply recommending the number of drops may lead to misuse and undue dose administration with risks for the patient.
* Work conducted at the Mycology Laboratory of the Dermatology Service, Hospital Universitário Pedro Ernesto (Pedro Hernesto University Hospital), Universidade do Estado do Rio de Janeiro (Rio de Janeiro State University) - HUPE-UERJ - Rio de Janeiro (RJ), Brazil.
Conflict of interest: None
Financial Support: None
