Treatment of Iodine Toxicity

Immediate Management

Identify and immediately discontinue all sources of excess iodine, including iodinated contrast agents, topical povidone-iodine disinfectants, amiodarone, Lugol's solution, iodine-containing supplements, and iodized salt, to prevent further toxicity in patients with iodine overdose 1, 3
In acute iodine poisoning, provide support of vital functions and aggressive electrolyte management to stabilize the patient 2
Monitor for clinical signs including abdominal pain, loss of appetite, metallic taste, coughing, fever, delirium, diarrhea, gum and tooth soreness, and vomiting in patients exposed to excess iodine 1, 4

Measure 24-hour urinary iodine excretion combined with assessment of thyroid function (TSH, free T4, T3) and thyroid size to evaluate the extent of iodine toxicity and its effects on thyroid function 1, 4
Patients with reduced kidney function and unexplained acidosis require heightened suspicion, as excess iodine may alter renal function 1, 5

Excess iodine intake is most commonly associated with elevated TSH, lower thyroid hormone levels, increased thyroid autoimmunity, leading to hypothyroidism and goiter in patients with iodine-induced thyroid dysfunction 1, 4
Patients with nodular thyroid disease can develop hyperthyroidism when exposed to excess iodine, particularly those with autonomous thyroid nodules 5, 6

Do not administer additional iodine-containing medications or supplements during the recovery period to prevent further iodine toxicity 1, 7
Do not overlook topical iodine sources (povidone-iodine disinfectants, surgical preparations) in patients with major burns, fasciotomies, or mediastinitis treatment, as these can cause significant systemic absorption 1, 3, 5
Be aware that there is no specific antidote for iodine toxicity—treatment is entirely supportive and focused on source removal 2