Lugol's Solution

Lugol's iodine, also known as aqueous iodine and strong iodine solution, is a solution of potassium iodide with iodine in water. It is a medication and disinfectant used for a number of purposes. Taken by mouth it is used to treat thyrotoxicosis until surgery can be carried out, protect the thyroid gland from radioactive iodine, and to treat iodine deficiency. When applied to the cervix it is used to help in screening for cervical cancer. As a disinfectant it may be applied to small wounds such as a needle stick injury. A small amount may also be used for emergency disinfection of drinking water. Lugol's iodine, also known as aqueous iodine and strong iodine solution, is a solution of potassium iodide with iodine in water. It is a medication and disinfectant used for a number of purposes. Taken by mouth it is used to treat thyrotoxicosis until surgery can be carried out, protect the thyroid gland from radioactive iodine, and to treat iodine deficiency. When applied to the cervix it is used to help in screening for cervical cancer. As a disinfectant it may be applied to small wounds such as a needle stick injury. A small amount may also be used for emergency disinfection of drinking water. Side effects may include allergic reactions, headache, vomiting, and inflammation of the whites of the eyes. Long term use may result in trouble sleeping and depression. It should not typically be used during pregnancy or breastfeeding. Lugol's iodine is a liquid made up of two parts potassium iodide for every one part elemental iodine in water. Lugol's iodine was first made in 1829 by the French physician Jean Lugol. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Lugol's iodine is available as a generic medication and over the counter. In the United Kingdom the NHS pays £9.57 for 500ml of solution. Lugol's solution is available in different strengths of iodine. Large volumes of concentrations more than 2.2% may be subject to regulation. Preoperative administration of Lugol's solution decreases intraoperative blood loss during thyroidectomy in patients with Graves' disease. However, it appears ineffective in patients who are already euthyroid on anti-thyroid drugs and levothyroxine. Because it contains free iodine, Lugol's solution at 2% or 5% concentration without dilution is irritating and destructive to mucosa, such as the lining of the esophagus and stomach. Doses of 10 mL of undiluted 5% solution have been reported to cause gastric lesions when used in endoscopy. The LD50 for 5% Iodine is 14,000 mg/kg (14 g/kg) and 22,000 mg/kg (22 g/kg) . The World Health Organization classifies substances taken orally with an LD50 of 5–50 mg/kg as the second highest toxicity class, Class Ib (Highly Hazardous). The Global Harmonized System of Classification and Labeling of Chemicals categorizes this as Category 2 with a hazard statement “Fatal if swallowed”. Potassium Iodide is not considered hazardous. These uses are possible since the solution is a source of effectively free elemental iodine, which is readily generated from the equilibrium between elemental iodine molecules and polyiodide ions in the solution. It was historically used as a first line treatment for hyperthyroidism, as the administration of pharmacologic amounts of iodine leads to temporary inhibition of iodine organification in the thyroid gland, a phenomenon called the Wolff-Chaikoff effect. However it is not used to treat certain autoimmune causes of thyroid disease as iodine-induced blockade of iodine organification may result in hypothyroidism. They are not considered as a first line therapy because of possible induction of resistant hyperthyroidism but may be considered as an adjuvant therapy when used together with other hyperthyroidism medications. Lugol's iodine has been used traditionally to replenish iodine deficiency. Because of its wide availability as a drinking-water decontaminant, and high content of potassium iodide, emergency use of it was at first recommended to the Polish government in 1986, after the Chernobyl disaster to replace and block any intake of radioactive 131I, even though it was known to be a non-optimal agent, due to its somewhat toxic free-iodine content. Other sources state that pure potassium iodide solution in water (SSKI) was eventually used for most of the thyroid protection after this accident. There is 'strong scientific evidence' for potassium iodide thyroid protection to help prevent thyroid cancer. Potassium iodide does not provide immediate protection but can be a component of a general strategy in a radiation emergency.