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This confuses me also. I am paraphrasing from a nursing journal, Nursing 2009
Iodine is not an allergan. Iodine is found throughout the body in thyroid hormones, amino acids, etc. If a patient says they are allergic to iodine it is something else in the solution not iodine. If a patient says they are allergic to shellfish again it is not iodine, it is primarily the muscle protein tropomyosin. Any time a patient states an allergy they need to be further questioned as to the type and severity of reaction.
The iodine/shellfish allergy is a myth that just won't go a way: an allergy to shellfish does not equal an allergy to iodine. Long ago, it was assumed that those with shellfish allergies were reacting to the Iodine since it was assumed that all meat was the same. We have known for some time that this is not the case and that different proteins present specific allergens.
This is on top of the fact that it is not possible to have a true allergy to iodine. Allergic reactions are caused by an over-sensitive immune response to an allergen-antibody reaction. Iodine is an elemental molecule and does not contain the complex allergen markers that are required to initiate an allergic reaction. Also, Iodine cannot be avoided, it is present an any diet and is required for the normal functioning of the body.
Reactions to iodine contrast is real, but it is considered to be due to the osmolarity of the solution and not to the iodine itself.
Anaphylaxis: eMedicine Emergency Medicine
Shellfish Allergy and Iodine -- IV Dye and Shellfish Allergies
I think it's just easier for people to understand "I'm allergic to Betadine" than to have the whole it's-not-the-iodine-it's-something-else-you-wouldn't-understand conversation. I have been sensitive to Betadine ever since I first started nursing--about 35 years. Now, I dont' know what it is about Betadine that makes me break out, swell up and itch, but I'd just as soon avoid it altogether. I had thumb reconstruction surgery a couple years ago. I told everyone I met in the OR that I was "allergic to Betadine"--intake nurse, anesthesiologist, surgeon, circulator. Yeah yeah yeah...The day after surgery, when I finally got my eyes open what do I spy peeking out from under my bandage? Gold Or, I should say Greenish-gold. What I learned later is that "someone" scrubbed my arm with Betadine. "Someone else" stopped her and reminded her that I was "allergic." Rather than scrub the Betadine OFF, she then poured Hibiclens over it "to neutralize it."
Of course, I didn't discover all this until I went to have the bandage removed and sheets of skin peeled off. The skin on that part of my hand looks like I've suffered burns and it will never look normal again.
So, as far as I'm concerned, i will be "allergic to Betadine". And in the future I will write that directly on the body part which is about to undergo surgery...
carebearsRN
140 Posts
Why is betadine rubbed onto the skin for those with shellfish/iodine allergies before surgery/procedure?