Publisher Summary This chapter discusses the adverse effects associated with the use of thyroid and antithyroid drugs. These include use of thyroid hormone, antithyroid drugs, and iodine preparations. Hyperthyroidism developing during therapy with normal amounts of thyroid hormones and persisting after stopping levothyroxine therapy can occasionally be observed. This is because of the activation of a previously silent autoimmune disorder (Graves' disease or TSI hyperthyroidism). The optimal intake of iodine remains a controversial topic. A nutritional intake below 50 μg/day is associated with an increased incidence of goiter and hypothyroidism. The Food and Nutritional Board of the National Academy of Sciences, USA, therefore, proposed 100 μg/day as the desirable lower limit of intake. The upper tolerance limit is defined as 1000 μg/day with 300 μg as the upper desirable limit. A high-normal intake (>300 μg/day) may be associated with an increased incidence of goiter and Hashimoto thyroiditis and a decreased remission rate after medical treatment for Graves' disease. The problem of iodine-induced or iodine related hyperthyroidism is very frequent.

Iodine/iodide toxic reaction: case report with emphasis on the nature of the metabolic acidosis

Thyroid and antithyroid drugs

This article summarizes case reports, population studies, and experimental studies from the literature concerning adverse effects of exposure to iodine from the mid-1880s to 1988. Exposure to excessive iodine through foods, dietary supplements, topical medications, and/or iodinated contrast media has resulted in thyroiditis, goiter, hypothyroidism, hyperthyroidism, sensitivity reactions, or acute responses for some individuals. Reports of maternal iodine exposure during pregnancy or lactation affecting newborn or nursing infants are cited. Susceptibility to excess iodine is discussed as well as the relationship between dose and response. It is concluded that some individuals can tolerate very high levels of iodine with no apparent side effects and that iodine intakes less than or equal to 1.000 mg/day are probably safe for the majority of the population, but may cause adverse effects in some individuals. Determination of maximum tolerable levels of iodine intake will require human experimental studies at levels between 0.150 and 1.000 mg/day for normal subjects, subjects with autonomous thyroid tissue, and iodine-sensitive subjects.

A review of iodine toxicity reports.

Potassium iodide (KI) is a useful drug in the dermatologic armamentarium. It is successfully used for inflammatory dermatoses, most notably erythema nodosum, subacute nodular migratory panniculitis, nodular vasculitis, erythema multiforme, and Sweet's syndrome. KI is also successfully used for cutaneous and lymphocutaneous sporotrichosis. The precise mechanism by which KI acts is unknown. Although many minor side effects are common with this drug, major side effects can occur in pregnant patients and those with a history of kidney or thyroid disease. This article reviews the pharmacology, mechanism of action, indications, contraindications, and adverse effects of KI as a therapeutic agent. (J Am Acad Dermatol 2000;43:691-7.)

Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications.

DISCLAIMER The use of company or product name(s) is for identification only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry. A Toxicological Profile for Iodine, Draft for Public Comment was released in September 2001. This edition supersedes any previously released draft or final profile. Toxicological profiles are revised and republished as necessary. For information regarding the update status of previously released profiles, contact ATSDR at: vi Background Information The toxicological profiles are developed by ATSDR pursuant to Section 104(i) (3) and (5) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA or Superfund) for hazardous substances found at Department of Energy (DOE) waste sites. CERCLA directs ATSDR to prepare toxicological profiles for hazardous substances most commonly found at facilities on the CERCLA National Priorities List (NPL) and that pose the most significant potential threat to human health, as determined by ATSDR and the EPA. ATSDR and DOE entered into a Memorandum of Understanding on November 4, 1992 which provided that ATSDR would prepare toxicological profiles for hazardous substances based upon ATSDR=s or DOE=s identification of need. The current ATSDR priority list of hazardous substances at DOE NPL sites was announced in the Toxicological Profiles are a unique compilation of toxicological information on a given hazardous substance. Each profile reflects a comprehensive and extensive evaluation, summary, and interpretation of available toxicologic and epidemiologic information on a substance. Health care providers treating patients potentially exposed to hazardous substances will find the following information helpful for fast answers to often-asked questions. Chapter 1: Public Health Statement: The Public Health Statement can be a useful tool for educating patients about possible exposure to a hazardous substance. It explains a substance's relevant toxicologic properties in a nontechnical, question-and-answer format, and it includes a review of the general health effects observed following exposure. Chapter 3: Health Effects: Specific health effects of a given hazardous compound are reported by type of health effect (death, systemic, immunologic, reproductive), by route of exposure, and by length of exposure (acute, intermediate, and chronic). In addition, both human and animal studies are reported in this section. NOTE: Not all health effects reported in this section are necessarily observed in the clinical setting. Please refer to the Public Health Statement to identify general health effects observed following exposure. The following additional material can be ordered through the ATSDR Information Center: IODINE viii Case …

Iodine/iodide toxic reaction: case report with emphasis on the nature of the metabolic acidosis

Citations

Thyroid and antithyroid drugs

A review of iodine toxicity reports.

Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications.

Toxicological profile for iodine

Iodine and inorganic iodides : human health aspects

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