Iodine poisoning is reported in several countries and the number of cases is constantly increasing [1] [2]. Complications associated with this type of poisoning are linked to the thyroid gland, such as hypothyroidism, malignancy, hyperthyroidism, and autoimmune thyroid disease [3]. Research suggests these disorders are related to reactive oxygen species (ROS) causing oxidative stress, as well as consequent recruitment of immune cells and release of cytokines [4].

Patients might get an excess of this mineral by including iodinated salt in their diet or by taking dietary supplements containing iodine. Also, contrast agents used e.g. in coronary angiography or other radiologic procedures contain iodine that elevates its amount in the tissues, particularly in the thyroid gland. Some cases describe patient death caused by cardiac arrest after investigations with contrast agents. Additionally, treatment of Graves disease includes administration of iodine-containing agents that lower production of the thyroid hormones but increase iodine concentration, leading to possible toxicity [5].

The medical staff is at risk of iodine excess from the use of antiseptics that include iodine e.g. povidone-iodine, as it is absorbed through the skin [5].

Radioactive iodine (131I) produced by the fission of uranium is also the cause of major complications. A study suggested that children located in a 300-mile radius from Chernobyl nuclear accident were affected and developed malignant tumors of the thyroid gland [6].

Furthermore, medications such as amiodarone (used to treat ventricular and supraventricular arrhythmias) have iodine incorporated within their active substance, and contain up to about 37% of the iodine in a dose. Amiodarone induces hypothyroidism or, more frequently, thyrotoxicosis called amiodarone-induced thyrotoxicosis (AIT). AIT is further classified into two types:

1. type AIT is characterized by increased production of thyroid hormones;
2. type AIT is linked with destructive thyroiditis [7].

• Fever

  Fever is also common with Iodine Overdose, which becomes very frequent with headache and body ache as well. It may look like a viral fever but the severity of fever increases with the amount of Iodine Overdose. [overdoseinfo.com]

  Abdominal pain Coma Delirium Fever Lack of urine output Seizure Shock Shortness of breath Stupor Swelling of face and body Weak pulse Side Effects of Iodine Poisoning A patient with an overdose of iodine shows symptoms that are similar to iodine deficiency [tandurust.com]

  Furthermore, there may be fever while some develop delirium. It is frequent for a casualty to report pain in the throat and mouth and metallic taste in the mouth. [ic.steadyhealth.com]

  Poisoning may also cause coughing, fever, thirst, and stomach pain. Although these symptoms are generally considered common, they may still be dangerous if they occur with other, more potentially fatal conditions. [wisegeek.com]

  Symptoms Abdominal pain Coughing Delirium Diarrhea Fever Metallic taste in mouth Mouth and throat pain No urine output Seizures Shock Shortness of breath Stupor Thirst Vomiting Home Treatment Seek immediate medical help. [indiatoday.intoday.in]

• Unconsciousness

  Buchman took her to the hospital unconscious. Neighbors said that the girl lived with her father and a sister but both father and sister were away last night. [iodinehistory.blogspot.com]

  Symptoms are dyspnea, cyanosis, fall of blood pressure, unconsciousness and convulsions, (Dreisbach & Robertson, 1987). 9.1.6 Other No data available. 9.2 Chronic poisoning 9.2.1 Ingestion Repeated administration of small amounts of iodine may result [inchem.org]

• Burning Pain

  Symptoms include burning pain in the mouth and esophagus, abdominal pain, vomiting, diarrhea, delirium, shock, nephritis, laryngeal edema, and circulatory collapse. [medical-dictionary.thefreedictionary.com]

• Anorexia

  It causes lacrimation, anorexia, coughing due to bronchopneumonia, and a heavy dandruff. Paradoxically, iodine excess may result in thyroid hyperplasia and goiter, especially in the young. protein-bound iodine a test of thyroid function. [medical-dictionary.thefreedictionary.com]

• Epilepsy

  tricyclic antidepressants, calcium channel blocking drugs, β-blockers and chloral hydrate) 4) Toxicity with agents that lower the seizure threshold (cocaine, amphetamines, tricyclic antidepressants, phenothiazines, theophylline) 5) Past history of epilepsy [emed.ie]

• Respiratory Distress

  Iodides cross the placenta, and neonatal hypothyroidism and death from respiratory distress secondary to goiter have been reported. Chronic iodine ... [mhmedical.com]

  (the Occupational Safety and Health Administration), due to it causing respiratory distress and eye irritation. For the same reason, fire-fighters wear self-contained breathing apparatuses before they enter into buildings containing this substance. [healthwyze.org]

  Infant and neonatal death from respiratory distress secondary to goitre has been reported in mothers taking iodides(Parmalee et al., 1940; Galima et al., 1962). [inchem.org]

• Painful Cough

  Symptoms Abdominal pain Coughing Delirium Diarrhea Fever Metallic taste in mouth Mouth and throat pain No urine output Seizures Shock Shortness of breath Stupor Thirst Vomiting Home Treatment Seek immediate medical help. [indiatoday.intoday.in]

  Symptoms of Iodine Toxicity and Overdose Abdominal pain Coughing Delirium Diarrhea Fever Metallic taste in mouth Mouth and throat pain Inability to urinate Seizures Shock Shortness of breath Stupor Excessive thirst Profuse vomiting Death Other misguided [healthwyze.org]

• Dyspnea

  Symptoms are dyspnea, cyanosis, fall of blood pressure, unconsciousness and convulsions, (Dreisbach & Robertson, 1987). 9.1.6 Other No data available. 9.2 Chronic poisoning 9.2.1 Ingestion Repeated administration of small amounts of iodine may result [inchem.org]

• Diarrhea

  Symptoms include burning pain in the mouth and esophagus, abdominal pain, vomiting, diarrhea, delirium, shock, nephritis, laryngeal edema, and circulatory collapse. [medical-dictionary.thefreedictionary.com]

  Six hours later she became acutely ill with vomiting, diarrhea, faintness, pain in the hands, fingers, wrists, and face, followed almost immediately by urticarial wheals over the knuckles, wrists, forearms, forehead, nose, lips, chin, cheeks, ears, and [annals.org]

  Initially, these people may feel a burning sensation in their mouth and throat, vomiting, diarrhea, stomach upset and development of skin rash. [medicalfoxx.com]

  Signs of Iodine Toxicity Harmless amount of iodine contained in medicine results in these initial symptoms: Burning mouth and throat Head cold symptoms Skin rash Sore throat and gums Stomach upset Diarrhea Vomiting Toxicity from iodine is a risk as it [tandurust.com]

  Iodine Poisoning Symptoms and Signs In majority of iodine poisoning cases people start to cough and experience abdominal pain and diarrhea. Furthermore, there may be fever while some develop delirium. [ic.steadyhealth.com]

• Vomiting

  This condition is marked by brown stains on the lips and mouth; burning pain in the mouth, throat, and stomach; vomiting (blue vomit if the stomach contained starches, otherwise yellow vomit); bloody diarrhea. [medical-dictionary.thefreedictionary.com]

  Vomiting occurs, food masses are colored dark yellow or blue (if there is starchy food in the stomach) color. Possible blood impurities. Diarrhea, sometimes with blood. [en.intoxication-stop.com]

  Apply this treatment only when the victim is alert but discontinue treatment when victim is vomiting or having convulsions. Activated charcoal is effective in decontaminating the stomach. [tandurust.com]

  In more severe instances of poisoning, uncontrollable vomiting and diarrhea may occur. Poisoning may also cause coughing, fever, thirst, and stomach pain. [wisegeek.com]

  DO NOT give these items if the patient is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow. [indiatoday.intoday.in]

• Abdominal Pain

  Abdominal pain Coma Delirium Fever Lack of urine output Seizure Shock Shortness of breath Stupor Swelling of face and body Weak pulse Side Effects of Iodine Poisoning A patient with an overdose of iodine shows symptoms that are similar to iodine deficiency [tandurust.com]

  Iodine Poisoning Symptoms and Signs In majority of iodine poisoning cases people start to cough and experience abdominal pain and diarrhea. Furthermore, there may be fever while some develop delirium. [ic.steadyhealth.com]

  Vomiting, abdominal pain and diarrhea may follow ingestion along with severe gastroenteritis. A metallic taste may result in the mouth. [globalhealingcenter.com]

  Symptoms include burning pain in the mouth and esophagus, abdominal pain, vomiting, diarrhea, delirium, shock, nephritis, laryngeal edema, and circulatory collapse. [medical-dictionary.thefreedictionary.com]

  Symptoms Abdominal pain Coughing Delirium Diarrhea Fever Metallic taste in mouth Mouth and throat pain No urine output Seizures Shock Shortness of breath Stupor Thirst Vomiting Home Treatment Seek immediate medical help. [indiatoday.intoday.in]

• Nausea

  At the beginning stages, a person may experience nausea. In more severe instances of poisoning, uncontrollable vomiting and diarrhea may occur. Poisoning may also cause coughing, fever, thirst, and stomach pain. [wisegeek.com]

  Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Less common Diarrhea nausea or vomiting stomach pain Other side effects not listed may also occur in some [mayoclinic.org]

  Acute iodine toxicity may cause symptoms such as diarrhea, nausea and vomiting, as well as a burning sensation in the stomach, throat and mouth. Weak pulse and coma are also potential complications of acute toxicity. [livestrong.com]

  It is when a person has taken too much iodine that his body begins to show symptoms of discomfort such as vomiting, nausea, diarrhea, burning sensations around the upper gastrointestinal tract, weak pulse, and – god forbid – coma. [cheers4health.com]

  More mild symptoms of iodine poisoning include: diarrhea burning sensation in your mouth nausea vomiting Severe symptoms of iodine poisoning include: swelling of your airways turning blue (cyanosis) weak pulse coma Consuming too much iodine can also lead [healthline.com]

• Abdominal Cramps

  Vomiting Nausea Diarrhea Burning sensations, occurring on the tongue, in the throat, or in the stomach Abdominal cramps Weak pulse Fainting Coma Elevated iodine consumption over time can sometimes affect the thyroid, causing either hypothyroidism or hyperthyroidism [vitamins.lovetoknow.com]

• Hypersalivation

  Manifestations of acute poisoning include abdominal pain, nausea, vomiting, hypersalivation, conjunctivitis, and collapse. [forum.marksdailyapple.com]

• Fear

  fear of radiation reaching the U.S causing potential radiation sickness. [businessinsider.com]

  Iodine poisoning is one of the greatest fears of those who consider taking iodine supplements. [cheers4health.com]

  This fear is not supported by any medical science but is a perpetuation of the iodophobia (fear of iodine) in the medical community. If you are afraid to start iodine at 25 mgs or more per day then it is OK to try 6.26 mgs and work up. [iodine.kr]

• Anuria

  Kidney effect Anuria may occur 1 to 3 days after exposure, (Reynolds, 1989). 8. [inchem.org]

• Convulsions

  Apply this treatment only when the victim is alert but discontinue treatment when victim is vomiting or having convulsions. Activated charcoal is effective in decontaminating the stomach. [tandurust.com]

  If the casualty is not vomiting or there are no signs of convulsions and decreased level of alertness, he/she may be given milk, cornstarch or flour milk mixed with water. [ic.steadyhealth.com]

  If a person begins convulsing and loses consciousness, vomiting can become extremely dangerous because it could pose a choking hazard, especially if the person is alone when it occurs. [wisegeek.com]

  DO NOT give these items if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow. [medlineplus.gov]

  DO NOT give these items if the patient is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow. [indiatoday.intoday.in]

• Seizure

  Abdominal pain Coma Delirium Fever Lack of urine output Seizure Shock Shortness of breath Stupor Swelling of face and body Weak pulse Side Effects of Iodine Poisoning A patient with an overdose of iodine shows symptoms that are similar to iodine deficiency [tandurust.com]

  More severe neurological symptoms and signs such as seizures and stupor are also possible. Respiratory issues develop in a form of shortness of breath. [ic.steadyhealth.com]

  One of the most serious symptoms is seizures. If a person begins convulsing and loses consciousness, vomiting can become extremely dangerous because it could pose a choking hazard, especially if the person is alone when it occurs. [wisegeek.com]

  ] 2) Toxicity with unknown agents 3) Toxicity with cardiotoxic agents [arrhythmias] (Cocaine, amphetamines, tricyclic antidepressants, calcium channel blocking drugs, β-blockers and chloral hydrate) 4) Toxicity with agents that lower the seizure threshold [emed.ie]

• Confusion

  Check with your doctor as soon as possible if any of the following side effects occur: Less common Hives joint pain swelling of the arms, face, legs, lips, tongue, and/or throat swelling of the lymph glands With long-term use Burning of mouth or throat confusion [mayoclinic.org]

  Initial Symptoms Initial symptoms of iodine toxicity may be: Skin rash Burning mouth and throat Sore teeth and gums Head cold symptoms Vomiting Stomach upset and diarrhea These symptoms may be confused with an iodine allergy or iodine allergy symptoms [iodine-resource.com]

  […] noticed in both adults and children include: Abdominal pain which can vary from mild to moderate Metallic taste can be felt in the mouth, quite frequently Pain in throat and mouth Low or no urine output Shortness of breath Shock and seizures Mental confusion [buzzle.com]

  The extra iodine confuses your thyroid, causing it to produce extra thyroid hormone. This leads to a phenomenon called the Wolff-Chaikoff effect, which is a decrease in thyroid hormone production that usually lasts for about a week. [healthline.com]

  People often get confused with the Iodine Deficiency and Overdose. Both has a drastic effect on the body but the course of action for both the problems are entirely different. So, it is important to understand the symptoms of the iodine overdose. [overdoseinfo.com]

• Stupor

  Abdominal pain Coma Delirium Fever Lack of urine output Seizure Shock Shortness of breath Stupor Swelling of face and body Weak pulse Side Effects of Iodine Poisoning A patient with an overdose of iodine shows symptoms that are similar to iodine deficiency [tandurust.com]

  More severe neurological symptoms and signs such as seizures and stupor are also possible. Respiratory issues develop in a form of shortness of breath. [ic.steadyhealth.com]

  Symptoms Abdominal pain Coughing Delirium Diarrhea Fever Metallic taste in mouth Mouth and throat pain No urine output Seizures Shock Shortness of breath Stupor Thirst Vomiting Home Treatment Seek immediate medical help. [indiatoday.intoday.in]

  Severe Symptoms of Iodine Overdose If the overdose continues it can lead to: Abdominal pain Delirium Fever Lack of urine output Seizures Shock Swelling of face and body Shortness of breath Stupor Weak pulse Coma Japanese Kelp Consumption A type of acne [iodine-resource.com]

  […] severe headache · fever · no urine output (kidney failure) · corrosive effects on the gastrointestinal tract · esophageal stricture, asphyxiation (swelling of the throat, esophagus) · vomiting · diarrhea · abdominal pain with internal damage · delirium · stupor [health.phys.iit.edu]

• Lethargy

  If there is vomiting, convulsions, or lethargy making it hard for the individual to swallow, stop the treatment. Chocolate Will Not Solve the Overdose Contrary to popular belief, the consumption of chocolate to absorb excess iodine does not work. [iodine-resource.com]

  Diets deficient in iodine increase the risk of retarded brain development in children (cretinism), mental slowness, high cholesterol, lethargy, fatigue, depression, weight gain, and goiter: a swelling of the thyroid gland in the neck. [healthaliciousness.com]

  Symptoms of Bromide Detox Psychiatric Dermatologic / Physical Neurological Fatigue Cherry Angiomas Headache Sluggishness / Lethargy Rash Tremor Impaired Memory/Concentration Bromoderma (acne) on face and hands Eyelid twitching Irritability Abnormal pigmentation [iodine.kr]

  Symptoms of Amiodarone Induced Hypothyroidism are similar to hypothyroidism symptoms in general: fatigue, lethargy, cold intolerance, mental sluggishness, weakness, constipation, heavy or abnormal periods for women, dry skin, eyes and hair, goiter, and [fluoroquinolonethyroid.com]

Iodine poisoning or iodine excess is diagnosed by evaluating patient's history. Consumption of iodine supplementation or excessive intake of iodine-rich food, previous radiologic diagnostic procedures or possible exposure to radioactive iodine, use of antiseptics containing povidone-iodine, and a history of arrhythmias should be taken into account when interviewing the patient. Specific biomarkers that lead to suspicion of thyroid disorders are available. These include:

• Iodine concentration in the urine;
• Thyroid stimulating hormone (TSH) levels regulating the production and secretion of thyroid hormones by the pituitary gland. Levels are heightened in case of hypothyroidism and decreased in cases of hyperthyroidism or thyrotoxicosis;
• Thyroglobulin which is secreted into blood in small concentrations and
• Thyroid hormone thyroxine (T4) and triiodothyronine (T3) concentrations in free form that correlate to the state of hypothyroidism or hypothyroidism;
• A presence of goiter revealed by palpation. The thyroid gland is considered enlarged if a lobe of is bigger than a distal phalanx of a patient's thumb. Ultrasonography is recommended over palpation as it is a more accurate technique, although requires specific experience and skill [8].

Apply this treatment only when the victim is alert but discontinue treatment when victim is vomiting or having convulsions. Activated charcoal is effective in decontaminating the stomach. [tandurust.com]

Treatment includes activated charcoal, breathing support (if necessary), fluids and milk and medications which deal with accompanying symptoms. [ic.steadyhealth.com]

Symptoms Abdominal pain Coughing Delirium Diarrhea Fever Metallic taste in mouth Mouth and throat pain No urine output Seizures Shock Shortness of breath Stupor Thirst Vomiting Home Treatment Seek immediate medical help. [indiatoday.intoday.in]

Iodinated glycerol is used as a mucolytic agent in the treatment of chronic obstructive pulmonary disease. Its efficacy is controversial, and reports of its toxicity are substantial. [ncbi.nlm.nih.gov]

Those undergoing radioactive iodine therapy for treatment of thyroid disease can also get an overdose. Symptoms Identification of symptoms is very important, as it will ensure proper treatment at the right time. [buzzle.com]

The prognosis of Iodine Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient. [dovemed.com]

Prognosis The prognosis for mineral toxicity due to sodium, potassium, calcium, and phosphate is usually excellent. Toxicity due to the deposit of calcium phosphate crystals is not usually reversible. [healthofchildren.com]

The patient may receive: Activated charcoal Breathing support Fluids and milk Medicines to treat symptoms Tube through the mouth or nose into the stomach to wash out the stomach ( gastric lavage ) Expectations (prognosis) How well a patient does depends [indiatoday.intoday.in]

9.1.1 Ingestion 9.1.2 Inhalation 9.1.3 Skin exposure 9.1.4 Eye contact 9.1.5 Parenteral exposure 9.1.6 Other 9.2 Chronic poisoning 9.2.1 Ingestion 9.2.2 Inhalation 9.2.3 Skin exposure 9.2.4 Eye contact 9.2.5 Parenteral exposure 9.2.6 Other 9.3 Course, prognosis [inchem.org]

Infection Control & Hospital Epidemiology, 10 (10): 447-450. Gommolin IH (1987) Iodated glycerol-induced hypothyroidism. Drug Intell Clin Pharm, 21 : 726-727. [inchem.org]

To help prevent this kind of toxicity, the Institute of Medicine provided the guideline known as Tolerable Upper Intake Levels (TUL). [tandurust.com]

Iodine is used to prevent iodine deficiency and its consequences, including goiter. [webmd.com]

Care" from Medicine for Mountaineering * The best-selling backcountry medical guide of its kind * This edition includes new chapters on avalanche injuries, drowning, eye disorders, medical evacuations, and lightning * Provides expert information on prevention [books.google.com]

How to prevent Iodine Overdose? In order to prevent an overdose in iodine, these medications should be taken according to the prescription of the physician. No medications should be taken without the knowledge of the physician. [medicalfoxx.com]

In addition, some evidence suggests iodine has an important part to play in preventing certain types of cancers, namely breast and stomach cancer. [vitamins.lovetoknow.com]

1. Pearce EN, Andersson M, Zimmermann MB. Global iodine nutrition: Where do we stand in 2013? Thyroid. 2013;23:523–528.
2. Kassim IAR, Moloney G, Busili A, et al. Iodine Intake in Somalia Is Excessive and Associated with the Source of Household Drinking Water. J Nutr. 2014;144(3):375-381.
3. Luo Y, Kawashima A, Ishido Y, et al. Iodine Excess as an Environmental Risk Factor for Autoimmune Thyroid Disease. Int J Mol Sci. 2014;15(7):12895-12912.
4. Kawashima A, Yamazaki K, Hara T, Akama T, Yoshihara A, Sue M, et al. Demonstration of innate immune responses in the thyroid gland: Potential to sense danger and a possible trigger for autoimmune reactions. Thyroid. 2013;23:477–487.
5. Nobukuni K, Kawahara S. Thyroid function in nurses: The influence of povidone-iodine hand washing and gargling. Dermatology. 2002;204(1):99–102.
6. Braverman ER, Blum K, Loeffke B, et al. Managing Terrorism or Accidental Nuclear Errors, Preparing for Iodine-131 Emergencies: A Comprehensive Review. Int J Environ Res Public Health. 2014;11(4):4158-4200.
7. Leung AM, Braverman LE. Consequences of excess iodine. Nat Rev Endocrinol. 2014;10(3):136-142.
8. Rohner F, Zimmermann M, Jooste P, et al. Biomarkers of Nutrition for Development—Iodine Review. J Nutr. 2014;144(8):1322S-1342S.