WHO Iodine thyroid blocking: Guidelines for use in planning and responding to radiological and nuclear emergencies 2017, UW I-131 meta-iodobenzylguanidine (Iobenguane Sulfate) (MIBG) 2017, Look Out for Lugols: Error-Prevention Strategies for This Strong Iodine Solution 2015, ACRSPR PRACTICE PARAMETER FOR THE PERFORMANCE OF TUMOR SCINTIGRAPHY (WITH GAMMA CAMERAS) 2015, EANM 131I/123I-Metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging 2010, Society of Nuclear Medicine and Molecular Imaging, The American Society of Nuclear Cardiology, International Commission On Radiological Protection. and transmitted securely. Screening for hypothyroidism in elderly inpatients. Pregnant and breastfeeding women should take a maximum of two doses. It is suggested that for the performance of the 125I-fibrinogen test potassium iodide need not be given to the elderly and should be given in a dose of 30 mg daily for two weeks to younger patients. Iodine Thyroid Blocking (ITB) should only be taken if public health or emergency response professionals, or a healthcare provider, instructs to. The treatment of Graves' hyperthyroidism (GD) complicated with malignancy is challenging, as anti-thyroid thionamide drugs (ATDs) and anti-cancer chemotherapy are both associated with a risk of neutropenia. - When inflammation occurs in the thyroid gland, medically known as thyroiditis, the reserved thyroid hormone leaks out from it, resulting in too much production of thyroid hormone. Potassium Iodide may be used as an adjunct to other antithyroid agents in the treatment of hyperthyroidism and thyrotoxicosis and preoperatively to induce thyroid involution. After surgery, levothyroxine replacement should be started and TSH . . It may be used before and after administration of medicine containing radioactive iodine or after accidental exposure to radioactive iodine (for example, from nuclear power plant accidents that involved release of radioactivity to the . A single administration of stable iodine is usually sufficient. We use cookies to improve user experience. Pulmonary oedema can also occur. The actual doses of potassium iodide for hyperthyroidism will be different for different individuals depending on the strength of the product you take and the specific health condition you have. Instructions Patients should start 24 hours before mIBG injection then continue for 1-2 days for I-123 mIBG or 2-3 days for I131 mIBG. }; Icons designed by Infants and children between 1 month and 3 years of age should take 32 mg ( of a 65 mg tablet OR mL of solution). Bethesda, MD 20894, Web Policies Oedema of the glottis resulting in asphyxia or aspiration pneumonia can occur. Prolonged exposure may require repeat dosing, however repeat dosing in the neonate, and in pregnant and lactating women should be avoided (see section 4.2). An overactive thyroid gland, thyroiditis, and an enlarged thyroid gland with or without development or myxoedema have also been reported. Gastric lavage should not be considered due to the possibility of corrosive injury. The tablet can be divided into equal quarters. The human body contains 20 to 50 mg of iodine. - This is an autoimmune condition and the most prevalent cause of hyperthyroidism in which the immune system mistakenly attacks the thyroid gland and forces it to release too much thyroid hormone. KI also can be used as a treatment for hyperthyroidism as well as iodine deficiency. The actual doses of potassium iodide for hyperthyroidism will be different for different individuals depending on the strength of the product you take and the specific health condition you have. Under certain circumstances potassium perchlorate may be a preferable drug for preventing the accumulation of radioactive iodine by the thyroid. In this article, well discuss the benefits and uses of. In areas of iodine deficiency prolonged dosage could lead to maternal or foetal thyroid blockage with possible consequences for foetal development. Would you like email updates of new search results? Owing to the sensitivity of the neonate and foetus thyroid to large doses of iodine, repeated administration of stable iodine should be avoided for neonates and pregnant and lactating women. KI (potassium iodide) is a salt of stable (non-radioactive) iodine that can help limit radioactive iodine absorption by the thyroid gland, sparing it from radiation damage. The human body is able to metabolise doses even manyfold higher than the daily recommended dose, mainly via urine, enterohepatic circulation and salivary glands (after the administration of one single dose of 3 g potassium iodide the dose is completely eliminated after 75 hours, 89% via urine). The thyroid of the foetus, neonate and young infant has a higher yearly thyroid cancer risk per unit dose of radioactive iodine than the thyroid of an adult. Use: As a thyroid blocking agent during a nuclear radiation emergency. The hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks after iodide withdrawal, but transient T4 replacement therapy may be required in some patients. Pretreatment with inorganic iodide, such as potassium iodide (50 mg iodide, three times daily, for 7-10 days before surgery) can also be considered in patients with Graves' disease. U.S. Food and Drug Administration -approved dosing of potassium iodide for this purpose with iobenguane, is as follows (per 24 hours): infants less than 1 month old, 16 mg; children 1 month to 3 years, 32 mg; children 3 years to 18 years, 65 mg; adults 130 mg. [15] However, some sources recommend alternative dosing regimens. - Iodine is widely used in cough syrups, medicines, and various dietary supplements. . 125I-fibrinogen: thyroid blocking with 2.5 mg potassium iodide twice daily in patients after hip surgery. Iodine prophylaxis should be performed in case of a nuclear accident, when radioactive iodine is released, in all people involved including children and pregnant and breastfeeding women located in the endangered area. 'event_types' : '', Iodine thyroid blocking (ITB) can be hazardous to ones health and may induce allergic responses. Br Med J. In I (-) Groups, the levels of FT3 and FT4 were very low. Br Med J. Taking too much iodine - Iodine is widely used in cough syrups, medicines, and various dietary supplements. 'location' : '', Epub 2013 Mar 9. Activated charcoal may be considered in iodide poisoning if the patient presents within 1 hour of ingestion. Usual Pediatric Dose for Radiation Emergency Birth to 1 month: 16.25 mg orally once Over 1 month to 3 years: 32.5 mg orally once Over 3 months to 12 years: 65 mg orally once Over 12 years; weight less than 150 pounds (68.18 kg): 65 mg orally once In overdose, symptoms of iodism such as headache, pain and swelling of the salivary glands, fever or laryngitis, swelling or inflammation of the throat, gastrointestinal upset and diarrhoea can occur. An underactive thyroid (hypothyroidism) occurs when your body doesn't make enough thyroid hormones for your body's needs. Enlarged thyroid or goiter that may sometimes cause difficulty swallowing or breathing and may the neck look swelled. But well start with the basics of hyperthyroidism first. An official website of the United States government. They returned to favor in the 1920s as preoperative treatment for hyperthyroidism and were used in the 1930s as the sole therapy for mild hyperthyroidism prior to the introduction of the thionamides. Therefore, it is very important that public notice of possible nuclear accident is given as soon as possible. Escape from the KI effect was suggested when the serum fT 4 and/or free T 3 (fT 3) level again became elevated while taking KI. In another study in rats, the administration of high daily iodine doses led to incomplete parturition, failure of lactation and reduced mothering activities. Although iodine is typically well-tolerated, reports exist of local esophageal or duodenal mucosal injury and hemorrhage, particularly in the treatment of thyroid storm. Acute ingestion of iodine can result in corrosive injury of the gastrointestinal tract and renal damage. 2001 Apr;11(4):353-60. doi: 10.1089/10507250152039082. Any unused medicinal product or waste material should be disposed of in accordance with local requirements. Flat Icons Freepik Pixel Perfect Smashicons FShbib vectorjuice macrovector rawpixel-com DinosoftLabs. Neonates will not require further doses. According to the FDA, the following doses are appropriate to take after internal contamination with (or likely internal contamination with) radioactive iodine: Newborns from birth to 1 month of age should be given 16 mg ( of a 65 mg tablet or mL of solution). Severe illness or death in people who take more ITB than recommended (lethal adult dose of free iodine is 2 to 4 g). A single daily dose should be administered. Lactating women should avoid repeat doses (see section 4.2). Acute ingestion of iodine can result in corrosive injury of the gastrointestinal tract and renal damage. Children between 3 and 18 years of age should take 65 mg (one 65 mg tablet OR 1 mL of solution). The benefits of. Consuming too much iodine may also cause your thyroid to be overactive and make excess hormones. Studies suggest that potassium iodide therapy may be an alternative strategy for people with hyperthyroidism, especially those who want to avoid various side effects of antithyroid drugs. This website is not intended to provide diagnosis, treatment or medical advice. Keep the blister in the outer carton in order to protect from light and moisture. Note: Lugol's 5% solution (potassium iodide 10% and iodine 5%) contains ~6.25 mg iodine/iodide per drop (ACR-SPR 2015). Risks in mass distribution of potassium iodide. If you are instructed to take KI, only use KI products that are approved by the U.S. FDA. Potassium iodide (KI) has a long history of medicinal use and perhaps it had been working as the most substantial therapeutic agent for protecting the thyroid gland throughout history. The site is secure. It would still be reasonable to administer (ITB) up to eight hours after the estimated onset of exposure. Cardiopulmonary collapse due to circulatory failure should be treated by maintenance of airway and stabilisation of the circulation. Senior Nuclear Medicine Specialist at Hafar Al-Batin Central Hospital, Founder of NuclearMed Website. These acuteside effects often go away during treatment as your body adjusts to the medicine or can be lessened by avoiding rapid dosage increases. But well start with the basics of hyperthyroidism first. In children of 3 to 12 years 50% of the adult dose should be given and in children of 1 month to 3 years the dose should be 25% of the adult dose. 111 Inorganic iodide reduces thyroid hormone release and thyroid vascularity, 112 which in turn decreases intraoperative blood loss. Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution). (hyperthyroidism): Adults and teenagers250 milligrams (mg) (0.25 milliliters [mL]) three times a day. Consuming too much iodine may also cause your thyroid to be overactive and make excess hormones. For children the medicine may be crushed and mixed with milk, water or juice before administration. 1983 Dec;59(10):1020-7. Qualitative and quantitative composition, 4.2 Posology and method of administration, 4.4 Special warnings and precautions for use, 4.5 Interaction with other medicinal products and other forms of interaction, 4.7 Effects on ability to drive and use machines, 6.6 Special precautions for disposal and other handling, 9. are well known and most of its uses have been substantiated by modern scientific research over recent years. Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution). High quantities of radioactive iodine absorbed by the thyroid can raise the risk of thyroid cancer in newborns, children, and youths for many years following exposure. . Potassium iodide has been found to be effective in treating overactive thyroid or hyperthyroidism. If not treated, hypothyroidism can cause brain damage. Iodine uptake by the thyroid gland is 80-fold higher compared with other organs. So, lets get started. This will protect against exposure lasting up to 24 hours (see section 4.4). It is used in the treatment of iodine deficiency as well as hyperthyroidism. Federal government websites often end in .gov or .mil. Thyroiditis - When inflammation occurs in the thyroid gland, medically known as thyroiditis, the reserved thyroid hormone leaks out from it, resulting in too much production of thyroid hormone. MeSH Hyperthyroidism, iodine induced autoimmunity (Grave's and Hashimoto type), toxic nodular goitre and iodine-induced hypothyroidism have been reported as side effects of iodine therapy. 'script_url' : 'https://nuclearmed.org/?embed=wp_event_manager_widget', How potassium iodide can help with hyperthyroidism, How to use potassium iodide for hyperthyroidism. In all the cases blood was obtained before and 3 and 7 days after treatment and then every week, for 5 weeks. 'keywords' : '', For a full list of excipients, see section 6.1. Radioactive iodine may be discharged into the environment in some radiation events, such as nuclear power plant accidents, and enter the body by inhalation or ingestion. Several drugs, such as captopril and enalapril can cause hyperkalaemia and this effect may be enhanced if potassium iodide is also administered. Therefore, its chemical formula is KI. The potential benefit of iodine prophylaxis is greatest in the young. Thyroidectomy preparation in patients with Graves disease: Lugol's 5% solution: Oral: 5 to 7 drops (0.25 to 0.35 mL) 3 times daily; administer for 10 days . Potassium Iodide is an oral antithyroid agent used for the prevention of radioactive iodine uptake into the thyroid gland . Main Outcome Measures: The primary endpoint was the initial response to KI, and the secondary endpoint was the long-term prognosis. Potassium iodide has the ability to block the uptake of iodine into the thyroid, making it one of the most effective therapeutic agents to counteract the overactivity of the thyroid gland and to check excess secretion of thyroid hormone. They might become overactive and produce too much thyroid hormone. Kasai K, Suzuki H, Kikuchi T, Ieiri T, Takemura Y. Verger P, Aurengo A, Geoffroy B, Le Guen B. Thyroid. Another term that people use oftentimes for this issue is thyrotoxicosis, which refers to the elevated levels of thyroid hormone in the blood, regardless of their causes. The optimal period of administration of stable iodine is less than 24 hours prior to, and up to two hours after, the expected onset of exposure. Potassium iodide is a salt made up of the minerals potassium (K) and iodine (I). When exposed to radioactive iodine, potassium iodide prevents damage by radioactive iodine to the thyroid gland due to saturation by non-radioactive iodine of thyroid gland preventing the uptake of radioactive iodine from contaminated air, water, milk and other foods. The hypothyroid and goitrogenic effects of lithium carbonate and iodides can be additive if they are given concurrently. The most common side effects are abdominal pain, diarrhoea, nausea or vomiting. The effectiveness of KI as a specific blocker of thyroid radioiodine uptake is well established. dosage, form, labeller, route of . In a long term study where rats received potassium iodide in the drinking water for two years the development of squamous cell carcinomas in the salivary glands were observed. In other words, the thyroid gland is overworking than needed or it became overactive. Studies suggest that potassium iodide therapy may be an alternative strategy for people with hyperthyroidism, especially those who want to avoid various side effects of antithyroid drugs. It can help calm down the thyroid gland and to keep the secretion of thyroid hormone at a healthy level. The tablets are white to yellowish slightly marbled round tablets, with a smooth surface without any defects, cross-scored for ease of breaking. Iodine is actively transported into breast milk, however those breast feeding should continue to do so (see section 5.2). In cases of exposure to radioiodine from nuclear accidents, dosing of potassium iodide should be based on emergency plans and predetermined operational intervention levels. Iodine induced hyperthyroidism may be precipitated in patients with asymptomatic nodular goitre or latent Graves` disease, who are not under medical care. Potassium iodide (KI) is a type of iodine that is not radioactive and can be used to help block one type of radioactive material, radioactive iodine (I-131), from being absorbed by the thyroid. Besides, potassium iodide may interact with certain prescription drugs such as warfarin, acenocoumarol, and phenindione. Its chemical formula is "KI." Potassium iodide is a medication and, when used properly, it can help. It is suggested that for the performance of the 125I-fibrinogen test potassium iodide need not be given to the elderly and should be given in a dose of 30 mg daily for two weeks to younger patients. Potassium salts should be given cautiously to patients with renal or adrenal insufficiency, acute dehydration or heat cramp. Radiat Environ Biophys. ITB is only useful for certain groups of people in specific circumstances. In overdose, symptoms of iodism such as headache, pain and swelling of the salivary glands, fever or laryngitis, swelling or inflammation of the throat, gastrointestinal upset and diarrhoea can occur. Women who are breastfeeding should take the adult dose of 130 mg. Side effects of KI (potassium iodide) may include stomach or gastro-intestinal upset, allergic reactions, rashes, and inflammation of the salivary glands. Iodine kinetics and effectiveness of stable iodine prophylaxis after intake of radioactive iodine: a review. The differences of FT3 were not statistically significant. Potassium perchlorate can be prescribed along with thionamide since the first diagnosis of type 1 AIT or as an adjuvant drug after failure to control hyperthyroidism by thionamide drug [32, 47, 48]. This is generally met by routine screening in the neonatal period. Solution (SSKI) 65mg/mL. hameln pharma ltd, Nexus, Gloucester Business Park, Gloucester, GL3 4AG, UK, Nexus, Gloucester Business Park, Gloucester, GL3 4AG, UK. These rare adverse effects are more likely if a person: Takes a higher than recommended dose of KI. To view the changes to a medicine you must sign up and log in. Accessibility Before Today, iodine continues to have a minor role in the treatment of hyperthyroidism. Always check with your doctor to determine what dose of potassium iodide would be the best for your specific condition and never change your dose unless or until your doctor tells you to do so. So, lets get started. Increase as tolerated to 40 to 50 drops PO 3 times daily for 2 to 4 weeks after all lesions have resolved, usually for a total of 3 to 6 months in patients who do not respond to itraconazole. Here you can check out Vorsts Potassium Iodide Supplement. For privacy reasons Twitter needs your permission to be loaded. Hyperthyroidism: 24 to 48 hours (Nayak 2006); Peak effect: ~2 weeks after continuous therapy (Nayak 2006) Duration of Action Radioactive iodine exposure: Each dose has a duration of ~24 hours Use: Labeled Indications Antidote: Block thyroidal uptake of radioactive isotopes of iodine in a nuclear radiation emergency. This reduces the risk of developing thyroid cancer. Another alternative is to give the newborn 16 mg of the liquid form of KI (saturated solution of potassium iodide [SSKI]), which requires a doctor's prescription. They might become overactive and produce too much thyroid hormone. Women who are breastfeeding should take the adult dose of 130 mg. Side effects of KI (potassium iodide) may include stomach or gastro-intestinal upset, allergic reactions, rashes, and inflammation of the salivary glands. Oral dosage (saturated oral solution of potassium iodide, 1 g/mL, e.g., SSKI) Adults 5 drops PO 3 times daily, initially. Using excess thyroid medicine - Taking too much thyroid hormone medicine particularly to fight hypothyroidism or underactive thyroid may cause excessive levels of thyroid hormone. - Taking too much thyroid hormone medicine particularly to fight hypothyroidism or underactive thyroid may cause excessive levels of thyroid hormone. Potassium Iodide Dosage. Potassium iodide is indicated as a thyroid-blocking agent to prevent the uptake of radioactive iodine, for example after a nuclear accident or during a nuclear medicine investigation before administering a radioiodinated compound, which is metabolised to iodide or which contains radioiodine impurities. Typical dosing for potassium iodide (SSKI) The dose of potassium iodide (SSKI) depends on age and recommendations by public health officials or your healthcare provider. The performance and the interpretation of the 125I-fibrinogen test are unaffected if iodide is not administered to the patient. The risk of thyroid cancer is extremely low in this group whereas the incidence of thyroid disease is higher in this group therefore the risk of iodine induced thyroid complications are higher. What is the mechanism of action of KI (potassium iodide)? In this article, well discuss the benefits and uses of potassium iodide for hyperthyroidism along with essential precautions and possible side effects. When taken as recommended, KI (potassium iodide) can cause rare adverse health effects related to the thyroid gland. The development of hypothyroidism in infants less than one month old who receive more than one dose of ITB. The effects of iodine and iodides on the thyroid may be altered by other compounds which may also have an effect on the thyroid, including amiodarone and lithium. It is also used to protect the thyroid gland from absorbing radioactive iodine after a nuclear accident. The term hyperthyroidism is used to refer to any condition in which there is an excess level of thyroid hormone released in the body. (10 drops of Lugol's solution).Currently, the daily dose of potassium iodide used in the United States for an average person is 150 mcg (0.15 mg), for pregnant women it is . Potassium iodide prophylaxis is not usually indicated in adults over 40 unless doses to the thyroid from inhalation rise to levels threatening thyroid function, that is of the order of about 5 Gy. Throughout pregnancy the number of doses of potassium iodide should be kept to a minimum and repeat doses should be avoided (see section 4.2). Another compound that national health authorities may decide to use is potassium iodate (KIO3) and in that case the appropriate dosage will be indicated. To bookmark a medicine you must sign up and log in. Reporting suspected adverse reactions after authorisation of the medicinal product is important. Potassium iodide (KI): a stable form of iodine that blocks uptake of iodine into the thyroid. However, starting with ITB later than 24 hours following exposure may yield more harm than benefit since it would prolong the biological half-life of radioactive iodine that has accumulated in the thyroid. Iodine Thyroid Blocking (ITB) should not be considered a stand-alone protective action. The easiest way to prepare a 16-mg dose is to dissolve a 130-mg pill in 8 oz of a clear liquid and feed the newborn 1 oz of the liquid. If stable iodine is given to neonates close follow up of thyroid function is essential. Patients with thyrotoxicosis treated medically, or patients with a past history of thyrotoxicosis treated medically who are now off treatment and apparently in remission, may be at risk. 1. A single dose of potassium iodate gives adequate protection for one day. BACKGROUND The most common cause of hyperthyroidism is Graves' disease. Graves ophthalmopathy or thyroid eye disease (TED), Graves dermopathy or skin issues caused by Graves disease, Various cardiovascular diseases such as heart attack, stroke, and peripheral vascular disease, Thyrotoxic crisis which is an emergency medical condition that needs immediate medical assistance, Hyperkalemia or elevated levels of potassium in the blood, Potassium iodide has historically been used for the protection of the thyroid gland. The onset of action: Hyperthyroidism: 24 to 48 hours Peak effect: 10 to 15 days after continuous therapy International Brands of Potassium iodide and iodine: Gemstain Transient hypothyroidism during this early period of brain development can result in loss of intellectual capacity. Potassium iodide dosing information Usual Adult Dose for Cough: 300 to 600 mg diluted in a glass of water, fruit juice or milk orally 3 to 4 times a day Comments: -This drug should be used no longer than necessary to produce desired effect. Care should be exercised if potassium salts are given concomitantly with potassium-sparing diuretics, as hyperkalaemia may result (see section 4.5). They returned to favor in the 1920s as preoperative treatment for hyperthyroidism and were used in the 1930s as the sole therapy for mild hyperthyroidism prior to the introduction of the thionamides. For every hours' delay the percentage of saturation decreases: after three hours the saturation with non-radioactive iodine is 50%. The same criteria should apply when selecting a dose of potassium iodide to protect a lactating mother as that used for other young adults under 40 years of age. For neonates who have been administered potassium iodide in the first few weeks of life TSH levels and, if necessary, T4 levels should be monitored and appropriate replacement therapy given. The use of. A single dose of potassium iodide gives adequate protection for one day. Although iodine is typically well-tolerated, reports exist of local esophageal or duodenal mucosal injury and hemorrhage, particularly in the treatment of thyroid storm. To find similar products you must sign up and log in. 2013 May;52(2):189-93. doi: 10.1007/s00411-013-0462-0. When provided at the authorized dose, KI is helpful in lowering the risk of thyroid cancer in people or communities who are at risk of radioiodine inhalation or ingestion. In general, for adults, the dosages of potassium iodide for hyperthyroidism range from 250 mg to 750 mg per day. This dose can be taken in two to three divided doses throughout the day. Unable to load your collection due to an error, Unable to load your delegates due to an error. When the nuclear accident is announced the required doses of potassium iodide are as follows: 16 mg potassium iodide equivalent to 12.5 mg iodine, 32 mg potassium iodide equivalent to 25 mg iodine, 65 mg potassium iodide equivalent to 50 mg iodine, Children from 12 years of age, adults and elderly, 130 mg potassium iodide equivalent to 100 mg iodine. . This dose is for both nursing and non-nursing newborn infants. Please enable it to take advantage of the complete set of features! 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