Iodine is an essential component of thyroid hormones. No iodine means no these hormones. And the absence or sharp decrease in the level of thyroid hormones can lead to catastrophic consequences, because these substances take part in almost all vital processes in the body:
- ensure normal energy metabolism
- stimulate protein synthesis, take part in fat metabolism
- help develop the immune system
- determine the quality of reproductive health
The importance of thyroid hormones and, accordingly, iodine necessary for their synthesis cannot be overestimated. And this is especially true for residents of Russia, where almost the entire population suffers from iodine deficiency in the diet.
Folic acid
The normal course of growth and division of body cells is impossible without folic acid (folates). For the proper development of fetal organs and tissues, including the brain and spinal cord, it is recommended to start taking additional folic acid at the stage of pregnancy planning. If a woman does not receive a sufficient amount of folate from food before pregnancy and at the very beginning, there is a risk of developing severe defects of the brain and spinal cord of the fetus (neural tube malformations), since the formation of these organs occurs in the very first weeks of pregnancy. Taking more than normal amounts of dietary folate throughout pregnancy also promotes normal growth and renewal of maternal tissue. Folate deficiency is one of the most common causes of megaloblastic anemia in pregnant women.
It is also advisable to continue taking folates during breastfeeding in order to compensate for the loss of folates in the mother through breast milk to meet the needs of the child.
Overdose
Symptoms:
staining of the mucous membranes brown, reflex vomiting (if there are starch-containing components in the food, the vomit becomes blue), abdominal pain and diarrhea (blood may be present in the stool). In severe cases, dehydration and shock may develop. In rare cases, esophageal stenosis has occurred. Cases of death were observed only after taking large amounts of iodine (30 - 250 ml of iodine tincture).
In rare cases, long-term overdose of potassium iodide can lead to the development of so-called “iodism”, i.e. iodine intoxication: metallic taste in the mouth, swelling and irritation of the mucous membranes (runny nose, conjunctivitis, gastroenteritis, bronchitis). Potassium iodide can activate latent inflammatory processes such as tuberculosis. Possible development of edema, erythema, acne-like and bullous rash, hemorrhage, fever and irritability.
Treatment for acute intoxication:
gastric lavage with a solution of starch, protein or 5% sodium thiosulfate solution until all traces of iodine are removed.
Symptomatic treatment of water balance disorders, electrolyte balance, anti-shock therapy. Treatment for chronic intoxication:
drug withdrawal.
Treatment of iodine-induced hypothyroidism:
discontinuation of the drug, normalization of metabolism with the help of thyroid hormones.
Treatment of iodine-induced thyrotoxicosis:
for mild forms, treatment is not required; in severe forms, thyreostatic therapy is required (the effect of which is always delayed). In severe cases (thyrotoxic crisis), intensive therapy, plasmapheresis or thyroidectomy are necessary.
In the case of hyperthyroidism, we cannot talk about an overdose as such, since hyperthyroidism can be caused by an amount of iodine that is normal in other countries.
Iodine
Iodine is a vital trace element that is necessary for the normal functioning of the thyroid gland, the hormones of which provide many functions in the human body. That is why, already at the stage of pregnancy planning, women living in regions of iodine deficiency, where there is a lack of iodine in the environment, and, as a consequence, a lack of iodine in the diet, need additional iodine intake. During pregnancy, the need for iodine increases, since the mother's thyroid gland during this period synthesizes additional amounts of thyroid hormones, which enter the fetus's body. The fetal thyroid gland begins to produce its own thyroid hormones only at the end of the first trimester of pregnancy. Until this time, the fetus is completely dependent on thyroid hormones received from the mother. During the second and third trimesters, additional iodine intake is necessary for sufficient synthesis of thyroid hormones not only in the mother’s body, but also in the fetus.
Thyroid hormones are necessary for normal growth, proper brain development and physical development of the fetus.
Additional iodine intake during breastfeeding is necessary to meet the baby's needs. Insufficient intake of iodine into a woman’s body during pregnancy and breastfeeding can cause diseases in the fetus and newborn, such as goiter (enlarged thyroid gland) and hypothyroidism (insufficient thyroid function).
Contraindications
- hypersensitivity to the active substance or auxiliary components of the drug;
- manifest hyperthyroidism;
- subclinical hyperthyroidism - in doses exceeding 150 mcg of iodine per day;
- solitary toxic adenomas of the thyroid gland and functional autonomy of the thyroid gland (focal and diffuse), nodular toxic goiter (with the exception of preoperative therapy for the purpose of blocking the thyroid gland);
- Dühring's herpetiform (senile) dermatitis;
- lactose intolerance, lactase deficiency or glucose-galactose malabsorption.
The drug should not be used for hypothyroidism, except in cases where the development of the latter is caused by severe iodine deficiency.
The use of the drug should be avoided during therapy with radioactive iodine, the presence or suspicion of thyroid cancer.
Recommendations for use
Adult women take 1 tablet orally 1 time per day with meals; The tablet should be swallowed whole with water.
Do not exceed the recommended daily dose. If you accidentally exceed the recommended daily dose, consult your doctor if necessary. Dietary supplements are intended to complement the diet and should not be considered a substitute for dietary diversity and a healthy lifestyle. Before starting to take any dietary supplements, it is recommended to consult a doctor.
Interaction with other drugs
Iodine deficiency increases, and iodine excess decreases, the effectiveness of hyperthyroidism treatment with antithyroid drugs. Therefore, before or during treatment for hyperthyroidism, it is recommended to avoid any iodine intake if possible. On the other hand, antithyroid drugs inhibit the conversion of iodine into an organic compound in the thyroid gland and, thus, can cause the formation of goiter.
Substances that enter the thyroid gland through the same mechanism as iodides can compete with iodine and inhibit its uptake by the thyroid gland (for example, perchlorate, which also inhibits the recycling of iodides within the thyroid gland). Iodine absorption may also be reduced when using drugs that do not themselves enter the thyroid gland, for example, thiocyanate in concentrations exceeding 5 mg/dl.
Iodine uptake by the thyroid gland and its metabolism are stimulated by endogenous and exogenously administered thyroid-stimulating hormone (TSH).
Simultaneous treatment with high doses of iodine and lithium salts can contribute to the occurrence of goiter and hypothyroidism. High doses of potassium iodide in combination with potassium-sparing diuretics can lead to hyperkalemia.
Compound
One tablet contains:
calcium hydrogen phosphate dihydrate (antioxidant, E341), hydroxypropyl distarch phosphate (stabilizer, E1442), hydroxypropylcellulose (stabilizer, E463), microcrystalline cellulose (anti-caking agent, E460), magnesium stearate (emulsifier, E470b), silicon dioxide (anti-caking agent, E551), croscarmellose sodium (stabilizer, E468), vitamin B 12 0.1% (cyanocobalamin, corresponds to 2 mcg of vitamin B 12), folic acid (400 mcg), potassium iodide (corresponds to 225 mcg of iodine).
special instructions
It should be taken into account that during drug therapy in patients with renal failure, hyperkalemia may develop.
Before starting therapy, it is necessary to exclude the presence of hyperthyroidism or nodular toxic goiter in the patient, as well as a history of these diseases.
If there is a predisposition to autoimmune thyroid diseases, the formation of antibodies to thyroid peroxidase is possible. Saturation of the thyroid gland with iodine can prevent the accumulation of radioactive iodine used for therapeutic or diagnostic purposes. In this regard, it is not recommended to take the drug before carrying out activities using radioactive iodine.
Side effects
With the prophylactic use of iodide in patients of any age, as well as with therapeutic use in newborns, infants and children, no side effects are usually observed. however, in the presence of large autonomous foci of the thyroid gland and when iodine is prescribed in daily doses exceeding 150 mcg, it is impossible to completely exclude the occurrence of severe hyperthyroidism.
The following adverse reactions occurred with the following frequency: very often (≥1/10); often (from ≥1/100 to 1/10); uncommon (≥1/1000 to 1/100); rare (≥1/10,000 to 1/1000); very rare (1/10,000); unknown (cannot be estimated from available data).
From the immune system: very rarely - hypersensitivity reactions (for example, rhinitis caused by iodine, bullous or tuberous iododerma, exfoliative dermatitis, angioedema, fever, acne and swelling of the salivary glands).
From the endocrine system: very rarely - during the treatment of diffuse euthyroid iodine deficiency goiter in adults, in some cases the development of hyperthyroidism caused by iodine is possible. In the vast majority of cases, the prerequisite for this is the presence of diffuse or limited autonomous foci of the thyroid gland. First of all, this applies to elderly patients with long-term goiter.
Also possible: manifestations of iodism (including symptoms such as swelling of the nasal mucosa, urticaria, Quincke's edema, skin rash, itching, in isolated cases - anaphylactic shock), eosinophilia, tachycardia, tremor, irritability, sleep disturbance, increased sweating, discomfort in the epigastric region, diarrhea. When using the drug in high doses, in some cases the development of goiter and hypothyroidism is possible.
Reports of suspected adverse reactions. Reporting of suspected adverse reactions after drug registration plays an important role. This allows continued monitoring of the benefit-risk ratio of the drug. Health care workers should report any suspected adverse reactions through the national reporting system.
Instructions for Iodomarin (Method and dosage)
Instructions for use Iodomarin 100
To prevent goiter , Iodomarin for children under 12 years of age (including newborns) should be taken 1/2-1 tablet/day, the daily dose for patients over 12 years of age is 1-2 tablets/day.
During pregnancy and lactating women, it is recommended to take 2 tablets per day. Iodomarin 100 (200 mcg/day).
To prevent goiter recurrence, you should take 1-2 tablets per day.
Dosage regimen for euthyroid goiter :
- patients under 18 years of age (including newborn babies) - 1-2 tablets/day;
- adults under 40 years old - 3-5 tablets/day.
The tablets should be taken orally after meals with sufficient liquid. For children, the drug is pre-dissolved in milk or fruit juice.
For preventive purposes, it is recommended to drink Iodomarin for several years. If there are indications, the drug can be prescribed for life.
Treatment of goiter in newborn infants involves taking pills for 14-30 days; all other patients (children, adolescents and adults), as a rule, need to take the drug for six months to a year. In some cases, longer treatment may be required.
Instructions for use Yodomarin 200
To prevent iodine deficiency conditions and endemic goiter iodine entering the body of an adult does not exceed 150-200 mcg/day), you should take:
- ¼-½ tablet/day. (50-100 mcg/day) - children under 12 years of age (including newborn infants);
- ½-1 tablet/day. (100-200 mcg/day) - patients over 12 years of age;
- 1 tablet/day (200 mcg/day) - for pregnant women and during breastfeeding.
To prevent recurrence of iodine-deficient goiter after thyroidectomy , as well as after completing a course of therapy with thyroid hormones , both children and adults are prescribed to take 1-2 tablets daily.
Treatment of euthyroid goiter involves taking:
- from 100 to 200 mcg of iodine per day (½-1 tablet of Iodomarin 200) - for children;
- from 300 to 500 mcg of iodine per day (from 1 ½ to 2 ½ tablets) - for adults.
How to take Iodomarin 200?
It is recommended to take the tablets after meals. Take them with a sufficient amount of liquid, for example, a glass of water. Children under three years of age (including newborns) should first crush the tablets into powder before taking them.
Taking the drug for preventive purposes is usually recommended from several months to several years, often throughout life. Treatment of goiter in newborns usually takes from 2 to 4 weeks, in older children and adults - six months to a year or more.
In general, issues of dosing and duration of use of the drug for the prevention or treatment of thyroid diseases are decided individually by the attending physician.
Indications for use
Indications for use of the drug:
- prevention of endemic goiter (associated with insufficient iodine content in the environment);
- prevention of goiter recurrence after completion of a course of conservative treatment with thyroid hormones or surgical removal;
- treatment of euthyroid (non-toxic diffuse) goiter by iodine deficiency in children, adolescents and adults under 40 years of age.
