Re: A possible alternative to potassium iodide

[mozley@darius.pet.upenn.edu (P. David Mozley, M.D.)]

Although relatively rare, there are definitely allergic reactions to
topical iodide.

A better alternative may be perchlorate.  Topicals would not be palitable
to the general public for several reasons.  Their absorption may be too
slow--turnover is a critical logistical issue. The discoloration of the
skin and clothing could make a practice that depends on them less
competitive.

Many wonderful things that enrich our lives are potentially toxic to a few
individuals.  Ordinary examples may include milk, wheat, chocolate,
aspirin, and SSKI.  I prescribe SSKI to my patients regularly, but with
caution. The issue in this thread is simply unsupervised distribution to
large segments of the population for the purpose of prophylaxis against an
undocumented risk.  The warrent is that caution should be considered before
the government actively promotes a policy that could endanger some of its
citizens.

mozley@darius.pet.upenn.edu

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>This is just a question on topical applications of iodine.  If there is no
>problem with topical applications, and I personally can not see a problem, why
>does the Red Cross always ask if the blood donor has an iodine allergy before
>cleaning the donor site with betadine (an iodine based antiseptic)?
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>Again, this is a question for my own edification.
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>Regards,
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>R.R.Goodwin
>Ronald_Goodwin@health.ohio.gov
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>______________________________ Reply Separator
>_________________________________
>Subject: A possible alternative to potassium iodide
>Author:  radsafe@romulus.ehs.uiuc.edu at Internet
>Date:    2/21/96 6:38 PM
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>
>The recent discussion of the safety (or not) of potassium iodide has been
>interesting, but none of the correspondents have mentioned a possible
>alternative.  Several years ago there was a brief report in _Science News_
>(Volume 128, p. 360) about research by a group, led by Prof. Kenneth Miller,
>at Penn State's Hershey Medical Center into the possibility of loading the
>thyroid with stable iodine using topical application of iodine-based
>antiseptics, specifically tincture of iodine and povidone iodine.  Briefly,
>topical application of the antiseptics blocked thyroid uptake of injected
>radioiodine I-131 as well as ingestion of potassium iodide did (the
>experimental animals were rats).  The article ended with a note that Miller's
>team was planning human tests of the idea.
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>The particular charm of this idea is that it seems to avoid many of the
>problems or potential problems associated with prophylatic administration of
>potassium iodide.  The iodine-based antiseptics are non-prescription drugs.  I
>assume they are "Generally Recognized as Safe" (in the formal regulatory sense
>of that phrase).  I am not aware of any problems with allergic reaction to
>topical application of these products.  Finally, they are probably already
>found in many homes and could be easily and inexpensively stocked in the rest.
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>I was curious what subsequent research had shown, so I chased down Professor
>Miller's email address and asked him about the rest of the story.  He replied:
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><< Begin Miller reply >>
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>Our research on effectiveness of topically applied iodine culminated in
>studies in humans and was published in HEALTH PHYSICS as per the following:
>
>Miller, K.L.; Coen, P.E.;  White, W.J.;  Hurst, W.J.;  Achey, B.E.;  Lang,
>C.M.:  "Effectiveness of Skin Absorption of Tincture of I in Blocking
>Radioiodine from the Human Thyroid Gland",   Health Physics, Vol. 56, No. 6.
>Pages 911-914, 1989.
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>Unfortunately, although we needed to do additional studies in order to come up
>with specific recommendations on optimum dose of tincture of iodine, ideal
>body location for application, advanages/disadvantages of occlusive dressing,
>etc. there were no TMI or Chernobyl accidents going on at the time and we
>could not obtain the funding necessary to do further studies. In all, we
>published the results of 3 studies, first in rats, secondly in dogs and
>finally, in humans. All showed promise of an alternative for those times when
>KI would not be sufficiently available.
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>I hope this helps. Incidentally, my phone number is (office) 717-531-8027,
>   ... . My e-mail address is kmiller@xray.hmc.psu.edu
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>If you need further information, please let me know.
>Regards,
>Ken
>
><< End Miller reply >>
>
>Best regards.
>
>Jim Dukelow
>Pacific Northwest National Laboratory
>Richland, WA
>
>js_dukelow@pnl.gov
>
>The message has not been reviewed and/or approved by either my management or
>by the U.S. Department of Energy.
>