Additional details about forms of Iodine and Iodide: Potassium Iodide (KI/SSKI) is used Nutritionally/Internally whereas Povidone-Iodine is for External Use
Here is some additional detail for our recent causal weekend discussion on July 10, 2021
Iodine is a chemical element, represented by the atomic number 53 in the periodic table of the elements corresponding with the 53 protons in its nucleus. Iodine is one of seven diatomic elements, characterized by their ability to bind together in groups of two; iodine can also bind to other atoms as a negatively charged ion named iodide. In the human body, iodine is an essential nutrient for the formation of thyroid hormones and likely also for modulating/reducing the effects of excess/unopposed estrogen; higher concentrations of iodine and iodide can kill microbes of all types (viruses, bacteria, fungi) without any risk of “antibiotic resistance” seen with other antimicrobial/antibiotic drugs.
As I mentioned in the recent causal weekend video discussion (July 10, 2021), I remember this by using the N in iodine to represent the Natural diatomic form, whereas the D in iodiDe is the ionic, independent Divided form.
Both iodine and iodide are used medicinally and nutritionally.
Both iodine and iodide are used as antimicrobial/antiseptic agents because both forms kill a wide range of viruses, bacteria, and fungi.
However, we have to be aware of other chemicals/substances that are added to the formula that might not be appropriate for internal/nutritional use; I think povidone iodine should generally not be used internally/nutritionally.
POTASSIUM IODIDE
Iodide combined with potassium is termed potassium iodide and is commonly used for both 1) nutritional/medicinal/internal ingestion, ie, it is taken internally by mouth and swallowed, and 2) antiseptic/antimicrobial use for example on the skin to kill microbes. To increase the density and reduce the volume of the formulation, potassium iodide can be concentrated into a form called super-saturated potassium iodide, or SSKI. Again, both KI and SSKI can be used internally for nutritional/medical purposes, and both KI and SSKI can be used externally for antiseptic/antimicrobial purposes to clean wounds and to disinfect the skin prior to surgery. KI and SSKI are both commonly carried/delivered in a base of water or alcohol/ethanol. Different strengths of concentration are available.
LUGOL’S SOLUTION = combination of iodine and iodide
Lugol’s solution provides a combination of iodine and potassium iodide; again as with pure KI and SSKI, Lugol’s solution is used for 1) nutritional/medicinal/internal purposes, and 2) external antiseptic/antimicrobial cleansing. Different strengths of concentration are available.
POVIDONE IODINE
When used to disinfect external surfaces, iodine is commonly used in combination with povidone/polyvinylpyrrolidone to yield povidone iodine. The povidone acts as a carrier and stabilizer for the iodine and helps keep the iodine on the surface of the skin where it can kill microbes, rather than allowing the free iodine to be absorbed more rapidly into the skin as it would if it were free and unbound. Povidone iodine is the single most commonly used antiseptic employed for cleaning surgical sites, cleaning wounds, cleaning surgeon’s hands (presurgical “scrub”) and medical equipment. Allergic-type reactions to povidone can occur but are rare. Povidone has been used medically for internal use in the form of a tableting base for drugs in pill form and (until the 1950s, now mostly obsolete) intravenously as a plasma volume expander (The use of polyvinylpyrrolidone as a plasma volume expander in preventing or combating shock. Tex Rep Biol Med 1953;11(1):138-43); despite these established “internal” uses, I advise against the use of povidone iodine for oral consumption/swallowing because we have more evidence, experience, and confidence with KI/SSKI and Lugol’s solution for nutritional/medicinal/internal use.
HOW I USE THESE FOR DIFFERENT PURPOSES
FORMS: Here is how I use these different forms of iodine:
KI/SSKI = topical antimicrobial + internal ingestion
Lugol’s solution = topical antimicrobial + internal ingestion
Povidone iodine = topical antimicrobial only, including my use of it in very diluted form as part of nasal rinse/lavage because of its ability to 1) kill nearly all microbes, and 2) thin mucus, thus making it theoretically ideal for sinusitis characterized by microbial/polymicrobial infection and thick mucus that is contributing to the retention and feeding (via its content of protein and sugars) of microbes. For the pre-surgical decontamination of the nares (nasal vestibule, first entry of the nose), concentrations of povidone iodine for intranasal use range from 5% to 10%, with the 5% proprietary formulation (3M™ SoluPrep™ Nasal Antiseptic (Povidone-Iodine Solution 5% w/w [0.5% available iodine] USP; instructional video youtube.com/watch?v=DQ6B24KK078) showing greater antimicrobial effectiveness (J Arthroplasty 2017 Sep;10.1016/j.arth.2017.04.039). Readers should note that use of 5-10% povidone iodine in the nares (relatively durable stratified squamous epithelium) does not justify using this same concentration within the sinuses (relatively fragile mucosal epithelium), as doing so would be likely to cause irritation within the sinus/respiratory tract; see my discussion and personal routine in the video discussion (July 10, 2021).
CONCENTRATION/STRENGTH: Obviously more risk with more concentration and higher doses:
External use for killing microbes: More concentration/strength kills microbes but is also more likely to damage surfaces, rust metals, and irritate skin. The other factor for the antimicrobial effect is time, including repeated applications; such that if a weaker concentration is used, then it might be applied more than once or allowed to remain in contact for a longer time in order to kill more microbes.
Internal use for killing microbes, hormonal effects, nutritional/nutrigenomic and metabolic effects: 3-6 mg has been employed for hormonal especially “anti-estrogen” benefits. For clinically fragile situations especially of deep/recurrent/recalcitrant bacterial and fungal infections of the skin, doses are initiated as tolerated (eg, 1 gram) and increased as tolerated until a target dose of a few grams up to several (eg, 4-11) grams is attained for a limited time; these dosages have to be customized to the disease and the patient and should therefore be used/prescribed only with professional healthcare/medical supervision.
RISKS WITH IODINE/IODIDE
Allergy-type reactions and so-called “iodine allergy” appear to be due to other chemicals in the formulation and not due to the iodine/iodide itself. Per Am J Health Syst Pharm 2021 Apr (10.1093/ajhp/zxab033), "Patients who report having adverse reactions to iodine-containing substances are often labelled as having an "iodine allergy," which can result in delays in care or patients being denied essential iodinated contrast media (ICM) or other iodine-containing drugs. A literature review was conducted to evaluate the evidence regarding iodine allergy and iodine-containing drugs. ... The results of the literature review indicated that iodine has not been shown to be the allergen responsible for allergic reactions to iodinated contrast media, amiodarone, povidone-iodine, and other iodine-containing compounds."
Local irritation of tissues, including killing or “chemical burning’ of skin if the concentration/duration are excessive
Thyroid hormone/gland problems, including problematic changes in hormone levels and potential worsening of autoimmune problems
Inhalation of iodine vapors can cause severe irritation of the respiratory tract. According to the US FDA (document dated 2002 Aug), "Iodine vapor is intensely irritating to mucous membranes and adversely affects the upper and lower respiratory system. Inhalation of iodine vapor leads to excessive flow of tears, tightness in the chest, sore throat and headache. ... Therefore, opening a container could easily expose personnel to very high levels of iodine for a brief period of time. Given these conditions, a container should be opened in a well-ventilated area while wearing appropriate respiratory protection."
Again as I mentioned in the causal weekend video discussion (July 10, 2021), see my previous information on iodine-iodide/Lugol from the diet protocol (PDF, excerpt from Chapter 4 of Inflammation Mastery, 4th Edition).
Dr Alex Kennerly Vasquez (introduction; brief Bio-CV) writes and teaches for an international audience on various topics ranging from leadership to nutrition to functional inflammology. Major books include Inflammation Mastery, 4th Edition (full-color printing, 1182 pages, equivalent to 25 typical books [averaging 60,000 words each]), which was also published in two separate volumes as Textbook of Clinical Nutrition and Functional Medicine (Volume 1: Chapters 1-4; Volume 2: Chapter 5—Clinical Protocols for Diabetes, Hypertension, Migraine, Fibromyalgia, Rheumatoid Arthritis, Psoriasis, Vasculitis, Dermatomyositis and most other major inflammatory/autoimmune disorders); several sections have been excerpted including Antiviral Strategies and Immune Nutrition (ISBN 1502894890) (aka, Antiviral Nutrition [available as PDF download] and Brain Inflammation in Chronic Pain, Migraine, and Fibromyalgia. Dr Vasquez’s books are available internationally via bookstores such as BookDepository, Amazon.com, Barnes and Noble, ThriftBooks, AbeBooks, BetterWorldBooks, WaterStonesBooks and his new Telegram channel is https://t.me/DrAlexVasquez.
Notes:
This wonderful and insightful information is not personalized medical advice :-)
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