People who claim to be allergic to iodine may actually be allergic to shellfish, which is often used interchangeably with iodine allergy. It is important for patients to inform their healthcare provider of any allergies or previous reactions to contrast media, as well as to understand that there is no test to determine an iodine allergy. Other contrast agents or increased vigilance may be used to avoid potential reactions.
When people say they are allergic to iodine, they could be saying it for a variety of reasons. One of the most common of these is that people are allergic to shellfish, which, in the past, has been used synonymously to describe iodine allergy. There is a possibility that a shellfish and iodine allergy could occur in the same person, but the two are typically not related, as shellfish allergy is a response to fish proteins. What that tends to mean is that unless they’ve experienced a specific reaction to iodine, most people can’t tell they’re allergic by inferring a connection between iodine and shellfish.
The issue of iodine allergy is quite confusing and, at times, deeply medically important. Iodine is used on the skin during many first aid procedures and before many surgeries, and a sudden skin reaction could be very serious. Iodinated contrast media can also be injected into the body during different types of scans which could include contrast echocardiograms or contrast computed tomography (CT) scans, and such injections could result in a systemic reaction which could include anaphylactic shock. However, not all people who react to injections also react to external contact with iodine from topical drugs.
It would be very helpful if people who were about to undergo radio contrast media tests could simply have a test run or skin scratch test to determine if they are allergic to iodine. These tests don’t exist, however, making it difficult to determine in advance who might have a reaction. Typically, if people have had a reaction in the past, other contrast agents might be used, and if a person mentions shellfish allergy, that might be cause for caution. Alternatively, if patients become ill from eating foods that contain iodine, such as iodized salt, increased vigilance is required during contrast testing, and additional medications are sometimes used to avoid a potential reaction.
To this end, some responsibility rests on the patient. Other allergies, shellfish allergies, or previous reactions to contrast media should be brought to the attention of a physician. Mentioning that a person is allergic to iodine is not enough, as this does not give healthcare professionals the information they need. Also, stating an allergy to iodine is a bit inaccurate because people don’t have a histamine reaction to iodine. On the other hand, there is a release of histamines due to the elements in contrasting colour; It’s a subtle but important distinction.
A preponderance of evidence that a person may be “allergic to iodine” can be managed in a number of ways. There are other types of contrast agents such as non-ionic forms which could be used instead, reducing the incidence of reactions in sensitive people. Another way to deal with this situation is to simply be vigilant when dosing and be prepared to counter a serious reaction if it occurs. Again, patients must also participate, mentioning and explaining any allergies and letting some doctors know if a particularly serious contrast reaction has occurred previously.
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