Iodine

Trace Element·Vitamins & Minerals

Thyrotoxic crisis, preparation for thyroid surgery, nuclear radiation emergencies

MINERALLugol's Solution (Aqueous iodine)Liquid dropsUNSCHEDULEDTGA

Max Dose

Varies

Thyroid Storm

RESCUE DRUG

Wolff-Chaikoff

BLOCKS THYROID

Timing

AFTER PTU

Rapid Summary

Overview

Essential trace element for making thyroid hormone. However, given in MASSIVE pharmacological doses, it paradoxically shuts the thyroid gland down completely (Wolff-Chaikoff effect).

Maximum Dose

Varies by indication (Drops of Lugol's solution).

Clinical Focus

Nutritional iodine is required in pregnancy, but pharmacological iodine for thyroid storm or radiation exposure is a separate high-dose treatment requiring specialist timing and fetal thyroid-risk review.

Bottom Line

Iodine is essential for thyroid hormone synthesis and used in thyroid storm preparation, but excess can paradoxically cause both hypo- and hyperthyroidism (Wolff-Chaikoff/Jod-Basedow effects).

Formulation & Access

Brand Names

Lugol's Solution (Aqueous iodine)

Oral Routes

Liquid drops. MUST be diluted in water or juice (highly caustic to the throat).

Prescribing & PBS

Hospital/Pharmacy supply.

Indications & Use

Primary

TGA

Thyrotoxic crisis, preparation for thyroid surgery, nuclear radiation emergencies.

Clinical Place

Emergency endocrine rescue drug.

Quick reference

Class & Role

Trace Element — Essential trace element for making thyroid hormone.

Route / Formulation

Liquid drops. MUST be diluted in water or juice (highly caustic to the throat). (Lugol's Solution (Aqueous iodine))

Usual Dose & Max

PO Lugol's Iodine: 3-5 drops TDS (Administer exactly 1 hour AFTER giving antithyroid drugs). Varies by indication (Drops of Lugol's solution).

Key Indication Doses

Thyrotoxic Crisis (Thyroid Storm): PO Lugol's Iodine: 3-5 drops TDS (Administer exactly 1 hour AFTER giving antithyroid drugs). Pre-operative Thyroidectomy: PO Lugol's Iodine: 3-5 drops TDS for 10 days before surgery (Shrinks the gland and reduces blood flow, stopping the surgeon from causing massive bleeding). Radiation Emergency: PO Potassium Iodide (KI) 130 mg STAT (Floods the thyroid with safe iodine, preventing it from absorbing radioactive iodine fallout).

Best Uses

Iodine is essential for thyroid hormone synthesis and used in thyroid storm preparation, but excess can paradoxically cause both hypo- and hyperthyroidism (Wolff-Chaikoff/Jod-Basedow effects).

Avoid / Cautions

Pre-existing iodine allergy, dermatitis herpetiformis. Pregnancy Category D (High doses cause massive fetal goitre, asphyxiating the baby).

Key Risks

Endocrine: Jod-Basedow phenomenon (Paradoxical induction of severe hyperthyroidism if given to a deficient patient). Gastrointestinal: Severe metallic taste, burning mouth/throat, GI bleeding (if undiluted). Immunological: Iodism (chronic toxicity: brassy taste, severe acne-like rash, swollen salivary glands).

Key Interactions

Lithium (Additive hypothyroid effect).

Monitoring

Ensure the timing protocol (PTU first, Iodine second) is strictly adhered to in ICU.

Clinical Pearl

Surgeons love Lugol's Iodine. A hyperactive thyroid gland is engorged with blood vessels and bleeds catastrophically when cut. 10 days of Lugol's drastically shrinks the vessels, turning it into a firm, safe gland to operate on.

Access

Lugol's Solution (Aqueous iodine)Liquid drops

Brand: Lugol's Solution (Aqueous iodine)
Formulation: Liquid drops

Iodine

Trace Element·Vitamins & Minerals

Thyrotoxic crisis, preparation for thyroid surgery, nuclear radiation emergencies

MINERALLugol's Solution (Aqueous iodine)Liquid dropsUNSCHEDULEDTGA

Max Dose

Varies

Thyroid Storm

RESCUE DRUG

Wolff-Chaikoff

BLOCKS THYROID

Timing

AFTER PTU

Rapid Summary

Overview

Essential trace element for making thyroid hormone. However, given in MASSIVE pharmacological doses, it paradoxically shuts the thyroid gland down completely (Wolff-Chaikoff effect).

Maximum Dose

Varies by indication (Drops of Lugol's solution).

Clinical Focus

Bottom Line

Iodine is essential for thyroid hormone synthesis and used in thyroid storm preparation, but excess can paradoxically cause both hypo- and hyperthyroidism (Wolff-Chaikoff/Jod-Basedow effects).

Formulation & Access

Brand Names

Lugol's Solution (Aqueous iodine)

Oral Routes

Liquid drops. MUST be diluted in water or juice (highly caustic to the throat).

Prescribing & PBS

Hospital/Pharmacy supply.

Indications & Use

Primary

TGA

Thyrotoxic crisis, preparation for thyroid surgery, nuclear radiation emergencies.

Clinical Place

Emergency endocrine rescue drug.

Quick reference

Class & Role

Trace Element — Essential trace element for making thyroid hormone.

Route / Formulation

Liquid drops. MUST be diluted in water or juice (highly caustic to the throat). (Lugol's Solution (Aqueous iodine))

Usual Dose & Max

PO Lugol's Iodine: 3-5 drops TDS (Administer exactly 1 hour AFTER giving antithyroid drugs). Varies by indication (Drops of Lugol's solution).

Key Indication Doses

Best Uses

Iodine is essential for thyroid hormone synthesis and used in thyroid storm preparation, but excess can paradoxically cause both hypo- and hyperthyroidism (Wolff-Chaikoff/Jod-Basedow effects).

Avoid / Cautions

Pre-existing iodine allergy, dermatitis herpetiformis. Pregnancy Category D (High doses cause massive fetal goitre, asphyxiating the baby).

Key Risks

Key Interactions

Lithium (Additive hypothyroid effect).

Monitoring

Ensure the timing protocol (PTU first, Iodine second) is strictly adhered to in ICU.

Clinical Pearl

Access

Lugol's Solution (Aqueous iodine)Liquid drops

Brand: Lugol's Solution (Aqueous iodine)
Formulation: Liquid drops