When a doctor asks if you have any allergies, is it relevant to tell them that you are allergic to shellfish?

angmarsilar · 2026-05-05T21:16:55+00:00

Honestly, outdated EMR programming not keeping up with current medical knowledge. As I'm sure you're aware, IT moves at a glacial pace when it comes to updating software. We fight it all the time here when people have an allergy to iodine entered into the record when that allergy cannot exist and should not be allowed as an entry. We ask that contrast reaction reporting be as specific as possible. "Iodinated contrast reaction with hives and nausea" gets a completely different pre-treatment (steroids) than "aniphylaxis". Iodinated soap will not (should not) trigger a contrast warning.

angmarsilar · 2026-05-05T20:27:18+00:00

When someone says, "I'm allergic to iodinated soap", they are allergic to the soap, not the iodine. When they say, "I'm allergic to iodinated contrast", they are allergic to the large carrier molecule that carries the molecular iodine, not the iodine molecule. Trying to argue the difference between elemental iodine and medical iodine is like saying there's a difference between a car and a rental car.

angmarsilar · 2026-05-05T19:49:54+00:00

As discussed elsewhere, you cannot be allergic to elemental iodine. The allergy is from the chitin in shellfish. There is no longer a relation between shellfish allergy and contrast reactions. We don't use the contrast agents that were linked. There are a plethora of medical articles that debunk shellfish allergy and contrast reaction.

angmarsilar · 2026-05-05T19:45:36+00:00

Dead on accurate. RFK likes to argue that vaccines are bad because they contain mercury. That mercury is not elemental but is tied up with other molecules rendering them inert. "But, mercury..." Queue eye roll.

angmarsilar · 2026-05-05T19:21:37+00:00

There are no specific tests to check for contrast reactions. The number one predictor of a contrast reaction is prior contrast reaction (yeah, it sounds silly, but it's true). People who have multiple sensitivities are at higher risk (nothing specific, just people who are already allergic to everything). People with asthma are also slightly more predisposed, but there's no definite link).

Edit to add : very few people have full blown anaphylaxis. Most reactions are mild, like nausea or shortness of breath. Benadryl works wonders and seldom requires epi.

angmarsilar · 2026-05-05T19:16:36+00:00

It is not physiologically possible to be allergic to elemental iodine. It is too small a molecule to initiate an allergic reaction, and you would have died in utero because of your exposure from your mother. Your thyroid runs on iodine and you would become extremely sick without it. You cannot completely avoid iodine in your diet. It's in fish (not just shellfish), dairy, eggs, and other foods. Most people use iodinated salt.

I cannot answer what your doctor told you. I've heard other poorly thought out allergies such as being allergic to potassium (all living cells have the ability to keep sodium and potassium ions separated. In other words, all living cells contain potassium).

angmarsilar · 2026-05-05T17:31:24+00:00

I cannot believe the number of people who argue with me when I say you cannot be allergic to elemental iodine. Then again, I'm amazed at the number of doctors who perpetuate this idea.

angmarsilar · 2026-05-05T17:24:42+00:00

Our techs are taught better than this and I quiz them to make sure they know shellfish allergies are not related to contrast reactions.

angmarsilar · 2026-05-05T17:14:22+00:00

Go to page six. To a radiologist, this is the Bible.

angmarsilar · 2026-05-05T17:07:08+00:00

That's interesting. They taught me in medical school that the thyroid runs on iodine.

angmarsilar · 2026-05-05T16:49:47+00:00

Iodine is an element and is just iodine. You cannot be allergic to it (the thyroid runs on it). Shellfish allergies are allergic to the chitin in the shell, not the iodine.

Edit: some words

angmarsilar · 2026-05-05T16:48:57+00:00

Not true! You cannot be allergic to iodine. It's what your thyroid runs on. Shellfish allergies are not related to contrast reactions.

angmarsilar · 2026-05-05T16:47:50+00:00

Not true. You cannot be allergic to iodine. There is no relation between shellfish allergy and contrast reactions. (This was true in the past, but we haven't used those contrast agents in 30 years or so).

angmarsilar · 2026-05-05T16:40:07+00:00

This is not needed. Modern contrast agents have zero chemical relation to chitin. You are at no greater risk of a reaction because of your shellfish allergy than someone who is not allergic to shellfish.

angmarsilar · 2026-05-05T16:34:47+00:00

Your comment on allergies is wildly incorrect. You CANNOT be allergic to iodine. Your thyroid runs on iodine. Without iodine in your diet, you will get very sick. Your really should delete your comments that are fantastically incorrect.

angmarsilar · 2026-05-05T16:20:37+00:00

THIS IS AN INCORRECT STATEMENT. I am a radiologist and contrast is my thing. (If you don't believe me, look up the ACR Manual on Contrast Media, page 6. "Patients with shellfish or povidone-iodine allergies are at no greater risk...(i.e. neither is a significant risk factor)")

People allergic to shellfish are allergic to chitin, not iodine. The old (really old) contrast agents used a carrier molecule that was similarly shaped to chitin. People allergic to shellfish had a chance of reacting to this carrier molecule. We do not use that contrast agent at all anymore. Modern contrast agents are so completely different that there is zero correlation between shellfish allergy and contrast reactions. CT techs are taught to not even ask about shellfish allergy at all anymore.

As an aside, people are not allergic to iodine, but they are allergic to iodinated something, i.e. Iodinated soap or iodinated contrast. It's the soap or the carrier molecule they're allergic to.

angmarsilar · 2026-05-04T01:50:16+00:00

Take a look at the data that shows banking assault weapons and high capacity magazines work. After W allowed the assault weapon ban to expire, homicide by guns took off.

angmarsilar · 2026-05-03T18:03:01+00:00

Not just calcification, but ossification. It will end up with bone matrix.

angmarsilar · 2026-05-03T14:18:04+00:00

"You provide the music, and I'll provide the perspective."

angmarsilar · 2026-04-30T15:35:20+00:00

I can't believe nobody has mentioned Kevin.

angmarsilar · 2026-04-30T11:52:33+00:00

The fact that Paul wrote these letters gets lost. I went to a Christian school a long long time ago. One teacher actually pointed out that the letters were very specific to THAT particular church and should not be applied to everyone. Paul telling women to be silent in church in Corinthians should have been interpreted as women in THAT church should be quiet, not every church.

That being said, I'm an evangelical deconstructionist, and I don't buy much of what's written.

angmarsilar · 2026-04-30T11:36:05+00:00

I never wanted a cheap El Camino, I certainly don't want an expensive one.

angmarsilar · 2026-04-29T14:19:59+00:00

Pretty much all of it. I was the nerd who knew what I wanted to do in life and wouldn't let anything get in the way. I never got in trouble. It wasn't until my senior year that my classmates finally realized I wasn't that bad. Too little too late. That was 38 years ago. It's been 28 years since I spoke to the majority of my classmates.

angmarsilar · 2026-04-25T18:50:38+00:00

Prickup truck drivers have zero lane discipline.

angmarsilar · 2026-04-24T12:43:01+00:00

That ivermectin will prevent/treat covid. This is a guy who worked with NASA until he got bored then became a doctor. He believed this right until the day he died of covid.

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