Expert: Ronald Levy, M.D. - 7/29/2010

Question
Hi Dr.Levy
You have mentioned before that an iodine/shellfish reaction can also be triggered by some general anesthetics.
My partner has this severe reaction to shellfish. She had a D&C about 6 months ago, under a general anesthetic (via injection). For a couple of months menstration was perfect, but then stopped. Since then she has had constant diarrhea, and 'low level' symptoms of hyperthyroid, though we didn't realize it at the time. She has just been biochemically confirmed hyperthyroid and a nuclear scan on thyroid (after an injection) barely showed the thyroid viable, and was told it was because she has to much iodine in her thyroid, as if she had been injected with a contrast. Endocrinologist gave her beta-blockers to slow down the symptoms and thinks it should run itself out in the next month or so.
Could the general anesthetic have initially caused an iodine related reaction and affected her thyroid in this manner?

Answer
What I said is that people who are allergic to shellfish can have an allergic reaction to some anesthetics. The symptoms you are describing are completely unrelated to that. It sounds like she had hyperthyroid exacerbation (or perhaps something like Hashimoto's) which caused hyperthyroidism. This is completely unrelated to the anesthesia. The thyroid normally processes iodine so the fact that there is too much iodine agrees with my comments above.


Ronald Levy, MD
Professor of Anesthesiology
UTM-Galveston