Pharmacological properties of the drug Iodomarin
iodine is a trace element that takes part in the synthesis of thyroid hormones - thyroxine and triiodothyronine. The daily requirement for iodine to prevent the development of endemic goiter is 100–150 mcg. The WHO recommended daily amount of iodine is 150–300 mcg. Iodine usually enters the body through the digestive tract, but can also be absorbed through the skin or from body cavities. Inorganic iodine is absorbed in the small intestine, and through the skin - insignificantly and uncontrollably. The content of inorganic iodine in blood plasma is usually 0.1–0.5 μg/dl. In the body, iodine accumulates in the thyroid gland and other tissues, for example, in the tissue of the salivary glands, mammary glands, and the wall of the stomach. In saliva, gastric juice and breast milk, the concentration of iodine is 30 times higher than in blood plasma.
Instructions for use IODOMARIN 200
The effect that the administration of exogenous iodine has on the human body depends on the daily amount of iodine, the type of iodine preparation and the condition of the thyroid gland (healthy organ, latent or severe form of the disease).
Iodine is an important component of food, which is an element for the synthesis of thyroid hormones - thyroxine and triiodothyronine. Daily requirement for iodine, i.e. the amount of iodine that must be ingested daily in order to prevent the development of endemic goiter is about 100-150 mcg per day. The daily dose recommended by WHO is 150 to 300 mcg.
After the absorption of iodine by electrochemical means (iodization), the oxidation of iodine by hydrogen peroxide (H2O2), which is a cosubstrate, occurs in the epithelial cells of the thyroid follicles, catalyzed by the enzyme iodide peroxidase, resulting in the release of elemental iodine. In this case, part of the tyrosine residues of the glucoprotein (thyroglobulin) is iodinated in positions 3 and, partially, 5 of the aromatic ring (iodization).
As a result of oxidative condensation, the iodinated groups of tyrosine are combined to form the thyronine framework. The main products are thyroxine (T4) and triiodothyronine (T3). The “thyronine-thyroglobulin” complex formed in this way is released, representing the depot form of the thyroid hormone, into the colloid of its follicle. Physiological amounts of iodine (up to approximately 300 mcg) have a replacement effect for iodine deficiency, which occurs in the Federal Republic of Germany, i.e., they prevent the formation of goiter due to iodine deficiency, contribute to the normalization of the size of the thyroid gland in newborns, children and adolescents, and also affect a number of disturbed biochemical parameters (T3/T4 ratio, TSH level).
Pharmacologically active doses of iodine (more than 1 mg/day) can cause the following effects:
- Wolf-Chaikoff effect:
- Reduction of intrathyroidal iodine metabolism and colloid proteolysis and the resulting decrease in hormone release. This effect is especially pronounced in hyperthyroidism and is accompanied - especially in immune thyropathies - by a decrease in blood supply, a decrease in the size of the organ, and also its compaction.
- acute toxicity;
- chronic toxicity;
- mutagenic and oncogenic potential;
- toxicity to reproductive organs;
excess iodine leads to inhibition of its intrathyroidal organification. If this excess is maintained, inhibition is replaced by a decrease in iodine absorption. If the Wolf-Chaikoff effect persists under pathological conditions, it leads to hypothyroidism and goiter formation.
Preclinical safety data
There is no information about studies to detect mutagenic and carcinogenic potential. There are no indications that iodine and iodide have similar properties.
During experimental studies in animals, no indication of the presence of teratogenic effects was obtained. Iodine crosses the placenta and can cause hypothyroidism and goiter in the fetus. Iodine is concentrated in mother's milk and excreted with it. When taking iodine in pharmacologically active doses, there is a risk of developing hypothyroidism in infants.
Use of the drug Iodomarin
The drug is taken after meals with a sufficient amount of liquid. For infants, the drug is mixed with food. Prophylactic use of the drug must be carried out for several years, and often throughout life. Treatment of goiter in newborns usually requires 2–4 weeks, and in children, adolescents and adults it usually takes ≥6–12 months. The issue of dosage and duration of use of the drug Iodomarin 100 is decided on an individual basis. Prevention of iodine deficiency and endemic goiter (in cases where the intake of iodine into the body is less than 150–200 mcg per day): infants and older: 1/2–1 tablet of Iodomarin 100 (50–100 mcg of iodine per day); adolescents and adults: 1–2 tablets of Iodomarin 100 (100–200 mcg of iodine per day); period of pregnancy and breastfeeding: 2 tablets of Iodomarin 100 (200 mcg of iodine per day). Prevention of relapses after surgery for euthyroid goiter or its drug treatment Children and adults: 1-2 tablets of Iodomarin 100 (100-200 mcg of iodine per day). These recommendations are of a general nature and in each case it is necessary to take into account the daily amount of iodine entering the body with food. Recommendations regarding dosage are also valid for further treatment after the end of therapy for euthyroid goiter with levothyroxine. Treatment of euthyroid goiter: infants - adolescents: 1-2 tablets of Iodomarin 100 (100-200 mcg of iodine per day); adults: 3–5 tablets of Iodomarin 100 (300–500 mcg of iodine per day).
"Hidden iodine hunger"
A combination of a number of unfavorable factors:
- Low iodine content in the soil.
- Heat treatment of products.
- Excessive technological processing of products.
- Low consumption of fish and other seafood, especially seaweed (seaweed).
Leads to what is called “iodine deficiency conditions.”
If there is insufficient intake of iodine in the body through food, the synthesis of thyroid hormones is disrupted. This most acutely affects children, adolescents, pregnant and lactating women. If a pregnant woman does not have enough iodine, her child may develop mental retardation (even cretinism), hearing and speech may be affected. Children suffering from iodine deficiency develop poorly intellectually and often exhibit behavioral disorders. A lack of iodine and, accordingly, thyroid hormones leads to short stature, decreased immunity, and improper development of the reproductive system in children.
Outside of risk groups (children, adolescents, pregnant and lactating women), iodine deficiency first of all, even before the appearance of any external signs, negatively affects a person’s intellectual abilities. We do not notice a slight decrease in memory, a decrease in the speed of thinking, or rapid fatigue, but, meanwhile, even a slight lack of iodine reduces the IQ level by 10-15%.
Another sign of iodine deficiency is an enlarged thyroid gland - diffuse euthyroid goiter. The gland tries to compensate for the hormone deficiency by increasing the mass of synthesizing tissue. An isolated enlargement of the thyroid gland, without changes in hormone levels, and an imperceptible drop in intellectual abilities for a person may be the only manifestations of iodine deficiency for a very long time. Therefore, the second name for iodine deficiency is “hidden hunger.”
Side effects of the drug Iodomarin
To assess the frequency of adverse effects, the following parameters were used: very often: ≥1/10; often: ≥1/100 and ≤1/10; ≥ sometimes: 1/1000 and ≤1/100; rare: ≥1/10,000 and ≤1/1000; very rare: ≤1/10,000, unknown (estimate not possible due to lack of data). From the endocrine system: very rarely - if there are significant autonomous areas in the thyroid gland, when using the drug in a daily dose of 150 mcg of iodine, hyperthyroidism can become manifest. When using the drug in adults at a dose of 300 mcg to a maximum of 1000 mcg of iodine per day, iodine-induced hyperthyroidism may develop in some cases. The prerequisite for this in most cases is the presence of diffuse or limited foci of autonomy in the thyroid gland. First of all, this applies to elderly patients with a long course of the disease. From the immune system: very rarely - hypersensitivity reactions (angioedema).
Special instructions for the use of the drug Iodomarin
The drug contains lactose, so it should not be used in cases of congenital galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome. Use during pregnancy and lactation. During pregnancy and lactation, the need for iodine is increased, so a sufficient intake of iodine in the body (200 mcg/day) is especially important. Due to the penetration of iodine through the placental barrier and the sensitivity of the fetus to it, the recommended doses should not be exceeded. This requirement also applies to the period of breastfeeding, since the concentration of iodine in milk is 30 times higher than that in blood plasma. An exception is high-dose iodine prophylaxis, which is carried out in case of man-made radioactive contamination. Use in children. The drug can be used in children at any age if indicated. The ability to influence reaction speed when driving vehicles or operating machinery. There is no data on negative effects.
Interactions of the drug Iodomarin
Iodine deficiency increases, and its excess reduces, the effectiveness of hyperthyroidism therapy with thyreostatic drugs; therefore, before or during the treatment of hyperthyroidism, it is recommended to avoid, if possible, any use of iodine. Thyrostatic agents inhibit the transition of iodine into organic compounds in the thyroid gland and thus can cause the formation of goiter. The absorption of iodine by the thyroid gland is competitively inhibited by substances whose penetration into the thyroid gland occurs by the same mechanism as the penetration of iodine, for example, perchlorate, as well as substances that are not transported by themselves, for example, thiocyanate at a concentration of 5 mg/dl. The absorption of iodine by the thyroid gland and its metabolism in it are stimulated by endogenous and exogenous TSH. The simultaneous use of iodine in high doses, which inhibit the secretion of thyroid hormones, and lithium salts can cause goiter and hypothyroidism. Potassium iodide in high doses and in combination with potassium-sparing diuretics can lead to hyperkalemia.
Iodomarin®
As already mentioned, in Russia the situation with iodine deficiency conditions is simply terrifying. The prevalence of goiter among residents of the central regions of Russia (Tambov, Voronezh, etc.) reaches 40%, in the south of the Arkhangelsk region (i.e. far from the White Sea) - up to 80%, in Siberia - up to 40-70%!
The regions that suffered as a result of the accident at the Chernobyl nuclear power plant (Bryansk, Tambov, Tula, etc.) still stand on their own. There, under conditions of iodine deficiency, radioactive iodine intensively accumulates in the thyroid gland. This leads to an increase in cancer, especially in children.
Therefore, individual iodine prophylaxis takes on such importance: taking additional amounts of iodine in the form of medications. Back in 1915, the outstanding American researcher D. Marin wrote: “It is easier to prevent endemic goiter than any other disease.”
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- Iodomarin® is a medicinal product. This means that the drug itself and its production were thoroughly tested before the drug was “released” to the market.
- Iodomarin® is available in two dosage forms: tablets containing 100 and 200 mcg of iodine. This makes it easy to select the required individual dosage for everyone who requires iodine prophylaxis: children, adolescents, adults, pregnant and lactating women.
- Iodomarin® can be used not only for the prevention of thyroid diseases, but also for the treatment of endemic goiter.
- Iodomarin® is well tolerated. This is important because For prevention, this drug must be taken for a long time.
- Iodomarin® is produced in Germany, which indicates its high quality.
- The use of the drug Iodomarin® is available to a wide range of people in our country, because The cost of daily admission is 2-3 rubles per day.
Taking just one tablet in the morning can help restore full functioning of the thyroid gland, get rid of the feeling of constant fatigue, activate mental processes and avoid the development of a host of complications associated with iodine deficiency.
Do you know that…
“In most regions of the Russian Federation, there is a deficiency of iodine in soils, water and food.
This leads to widespread endemic goiter among the population, causing retarded mental and physical development of children, deaf-muteness, neurological cretinism, and visual impairment. The situation has worsened as a result of negative trends in the nutritional structure of the population, especially socially vulnerable groups, characterized by a sharp decrease in the consumption of iodine-rich fish and seafood, meat and dairy products...” (Chief Sanitary Doctor of the Russian Federation G. Onishchenko)
One of the obvious symptoms of iodine deficiency in the body is an enlarged thyroid gland (goiter). The mechanism of this increase is quite complex. Iodine deficiency leads to insufficient synthesis of thyroid hormones. Because of this, thyroid-stimulating hormone (TSH) begins to be over-synthesized in the hypothalamus, which “forces” the thyroid gland to grow and produce a sufficient amount of hormones. At the same time, iodine deficiency itself causes thyroid cells to grow rapidly, because iodine “restrains” cell growth factors. With a lack of iodine, growth factors are activated and cause the gland to grow vigorously. However, iodine deficiency diseases can manifest themselves not only by the presence of goiter.
Iodine deficiency also leads to decreased intelligence, impaired bone composition (osteoporosis), which is accompanied by increased bone fragility, a noticeable decrease in immunity and frequent colds. Iodine deficiency also affects reproductive function. In women, dysfunction of the thyroid gland can lead to infertility, in men - to erectile dysfunction. In general, a person who does not receive enough iodine may suffer from deterioration of memory and attention, and a decrease in mental abilities. Iodine deficiency during pregnancy leads to numerous disorders in the unborn child: from a slight decrease in intellectual abilities to cretinism (dementia combined with deafness, visual impairment and short stature (dwarfism)).
Overdose of the drug Iodomarin, symptoms and treatment
Symptoms of acute poisoning: brown staining of the mucous membranes, vomiting (if starch-containing components are present in food, the vomit turns blue), abdominal pain and diarrhea (even bloody diarrhea is possible). Dehydration and shock may occur. In rare cases, the development of esophageal stenosis has been noted. Deaths were recorded only after the use of iodine in high doses - from 30 to 250 ml of iodine tincture. There is a report of the development of acute nephritis after simultaneous administration of potassium iodide solution and mefenamic acid tablets. Long-term use can cause the development of the phenomenon of iodism: a metallic taste in the mouth, swelling and inflammation of the mucous membranes (rhinitis, conjunctivitis, gastroenteritis, bronchitis). Latent processes, such as tuberculosis, can be activated under the influence of iodine. The development of peripheral edema, erythema, acne-like and bullous rash, hemorrhage, fever and nervous agitation is possible. Treatment of acute intoxication: gastric lavage with starch, protein or 5% sodium thiosulfate solution until traces of iodine disappear. Carrying out symptomatic therapy to eliminate disturbances in water and electrolyte balance, and, if necessary, anti-shock therapy. Treatment for chronic intoxication: discontinuation of iodine-containing drugs. Iodine-induced hyperthyroidism: This is not an overdose in the literal sense, since hyperthyroidism can also arise from an amount of iodine that is considered physiological in other countries. Mild forms do not require therapy, while severe forms require thyreostatic treatment, the effectiveness of which is delayed over time. In severe cases (thyrotoxic crisis), intensive therapy, plasmapheresis or thyroidectomy are necessary.
