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Bromide Toxicity- Causes, Symptoms, and Treatment

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While bromide is an essential mineral for human health and is commonly found in trace amounts in some foods, it can be toxic at higher doses. Read to know more.

Written by

Dr. Vandana Rai

Medically reviewed by

Dr. Sugandh Garg

Published At May 16, 2023
Reviewed AtMay 2, 2024

Introduction

Bromide toxicity has been linked to various physical and mental health problems in humans, including thyroid disorders and brain fog. While bromide is an essential trace mineral for human health and is commonly found in some foods, it can become toxic at higher doses. In humans, bromide toxicity can lead to a range of symptoms, including headaches, fatigue, anxiety, depression, irritability, and memory problems. In severe cases, bromide toxicity can cause seizures and coma. Bromide toxicity is most commonly seen in people who work in industries where they are exposed to brominated chemicals (such as flame retardants) or who live near sources of environmental contamination (such as coal-fired power plants).

Where Is Bromide Found?

Bromide is a naturally occurring element that is found in trace amounts in the environment. It can be found in some minerals, such as bromine-rich brines and bromide-containing rocks. It is also present in some medications, such as sedatives and anticonvulsants (antiepileptic drugs).

Bromide can also be found in certain foods, such as seafood, grains, and nuts, as well as in some water sources. The levels of bromide in these sources are generally low and not harmful to human health. However, long-term exposure to high bromide levels from any source can lead to bromide toxicity and negative health effects.

What Are the Sources of Bromine?

There are several ways that humans can be exposed to bromine. One common way is through the ingestion of food that contains bromine residues, such as fruits and vegetables that have not been washed thoroughly or have not had their skin removed. Bromine can also be found in flour and other grains contaminated with bromine-containing pesticides. Bromine is also used as an additive in some foods, such as potassium bromate in bread dough, and can be found in certain personal care products like mouthwash, toothpaste, and hair dyes. In addition, bromine can be present in drinking water and in the air inside motor vehicles.

How Does Bromide Cause Toxicity?

Bromine is a naturally occurring element that can cause toxicity when an individual is exposed to high levels of it over a long period of time. When it enters the body, bromine can replace iodine, which can lead to an underactive thyroid gland. Bromine also has its own toxic effects on tissues, and there is some evidence that it may have cancer-inducing properties. It can affect the modulation of neurotransmitters in the brain, potentially causing emotional problems such as depression, psychosis, anxiety, and mood instability. Some cases of schizophrenia are also related to bromine toxicity.

What Are the Symptoms Of Bromide Toxicity?

The symptoms of bromide toxicity can vary depending on the level of exposure and the length of time that an individual has been exposed to high levels of bromide. Some common symptoms of bromide toxicity include:

  • Nausea and vomiting.

  • Diarrhea.

  • Tremors.

  • Confusion.

  • Memory loss.

  • Difficulty in concentrating.

  • Drowsiness.

  • Headache.

  • Weakness.

  • Weight loss.

In severe cases, bromide toxicity can also cause serious symptoms, such as:

  • Seizures.

  • Coma.

  • Kidney damage.

  • Respiratory failure.

Other symptoms of bromine toxicity can include:

  • Severe skin problems.

  • Anorexia.

  • Vague abdominal cramps.

  • Bloating.

  • Excessive fatigue.

  • An abnormal or metallic taste.

  • Unstable cardiac rhythms.

How To Diagnose Bromide Toxicity?

Bromide toxicity can be difficult to diagnose because the symptoms can be similar to those of other conditions. To diagnose bromide toxicity, the healthcare provider will inquire about medical history, including any medications that the patient is taking or has taken in the past and any potential exposures to bromide. They will also perform a physical examination and may order several tests to help diagnose bromide toxicity. These tests may include the following:

  • Blood Tests: Blood tests can measure the bromide levels in the body and help the healthcare provider to determine if the patient has been exposed to high bromide levels.

  • Urine Tests: Urine tests can also measure the bromide levels in the body and help the healthcare provider to determine if the patient has been exposed to high bromide levels.

  • Imaging Tests: Imaging tests, such as CT scans or MRIs, can help the healthcare provider to see if bromide has caused any damage to the patient’s organs.

  • Thyroid Function Tests: Bromide toxicity can affect the thyroid gland, so the healthcare provider may order thyroid function tests to check for any changes in thyroid hormones.

What is The Treatment For Bromide Toxicity?

Treating bromide toxicity typically involves supportive care to address symptoms and remove excess bromide from the body. This may include medications to control seizures, fluids to prevent dehydration, and medications to improve breathing. In severe cases, dialysis may be necessary to remove excess bromide from the blood. It is important to report to the healthcare provider as soon as possible if a person suspects they may have been exposed to high levels of bromide. The specific treatment will depend on the amount and duration of exposure, as well as the individual's symptoms and overall health.

How Can One Prevent the Toxicity Of Bromide?

By taking the precautions listed below, an individual can help reduce their risk of bromide toxicity and protect their health. Listed below are some methods of prevention:

  • Avoid Medications That Contain Bromide- If a person is taking a medication that contains bromide, they should talk to the healthcare provider about alternative options.

  • Limit Exposure To Bromide-Containing Products - Avoid using products that contain bromides, such as some flame retardants, pesticides, and cleaning products.

  • Choose Low-bromide Foods- Some foods, such as seafood, grains, and nuts, contain small amounts of bromide. To reduce the risk of bromide toxicity, choose low-bromide options when possible.

  • Drink Clean Water- Bromide can be found in some water sources. To reduce the risk of exposure to bromide, make sure to drink clean, filtered water.

  • Avoid Inhaling Bromine- Containing Fumes and Dust - If someone works in an industry that uses bromide-containing chemicals, follow proper safety protocols to protect them from inhaling fumes or dust.

Conclusion

Bromide toxicity is a condition that occurs when a person is exposed to high levels of bromide, either through ingestion, inhalation, or skin contact. Bromide is a chemical that is used in a variety of industrial and commercial products, including flame retardants, insecticides, and disinfectants. In large amounts, bromide can be toxic to humans and can cause a range of symptoms, including nausea, vomiting, diarrhea, seizures, and coma. In severe cases, bromide toxicity can be life-threatening. To prevent bromide toxicity, it is important to follow safety protocols when working with bromide-containing chemicals and to avoid ingesting or inhaling large amounts of bromide.

Frequently Asked Questions

1.

Is Bromine Toxic to Touch?

Skin exposure to bromine may occur due to contact with gaseous or liquid bromine. Skin exposure results in skin irritation and skin burns. When skin is exposed to liquid bromine, it initially produces a cooling sensation followed by a burning feeling.

2.

What Are the Uses of Bromine?

Bromine is naturally present in the earth’s crust and seawater. Bromine-containing products are used in sanitation, agriculture, and as fire retardants (to prevent substances from catching fire). Some products that contained bromine were earlier used as sedatives.

3.

Is Bromine More or Less Toxic Than Chlorine?

Estimates suggest that bromine is 1.5 times less toxic than chlorine. Chlorine may be harsh for those with breathing issues like asthma or those with sensitive eyes or skin. Bromine is a good alternative as it is less chemical-smelling and less abrasive.

4.

Is Bromine in Drinking Water Safe?

The degree of toxicity of bromide ions is low. Bromine is an alternative disinfectant in spas, swimming pools, and cooling tower water. However, it is not used in municipal drinking water due to its cost and concerns regarding the formation of DBP (disinfection byproducts).

5.

What Are the Toxic Effects of Bromide?

Inhaling bromine gas can result in:


- Breathing difficulty.


- Headache.


- Watery eyes.


- Dizziness.


Skin exposure to bromine gas or liquid result in:


- Skin irritation and skin burns.


- Skin exposure first results in a cooling sensation followed by a burning sensation.


Ingestion of bromine-containing compounds results in gastrointestinal symptoms like:


- Nausea.


- Vomiting.

6.

Is Bromide Toxic?

Bromide is used in various commercial and industrial products like insecticides, flame retardants, and disinfectants. However, high-level exposure can result in a wide range of symptoms like vomiting, nausea, diarrhea, seizures, and coma. When the blood concentration of bromide exceeds 1000 milligrams per 100 milliliters, it results in severe toxicity.

7.

Which Food Contains Bromide?

BFR (brominated flame retardants) are manufactured products and are not naturally occurring. As BFRs are lipophilic, these bioaccumulate in food chains. Therefore, poultry, fish, eggs, dairy products, etc., contain increased BFR concentration.

8.

What Happens if Bromine Is Consumed?

Ingestion of bromine-containing compounds results in different effects. Ingestion of a large amount of bromine for a short period results in gastrointestinal symptoms like vomiting and nausea. Ingestion of food contaminated with bromine can result in exposure.

9.

How Long Does Bromide Stay in the System?

The elimination half-life of bromide is nine to twelve days, so that it can cause excessive accumulation. A daily dose of 0.5 to 1 gram can lead to bromism. In earlier times, the therapeutic dose of bromide was three to five grams therefore, chronic toxicity was common in earlier times.

10.

What Is the Mechanism of Action of Toxicity of Bromine?

Bromine, a strong oxidizing agent, acts as a respiratory irritant and results in pulmonary edema. Bromine reacts with water and forms hypobromous acid that further decomposes to hydrobromic acid and oxygen. Bromine works by releasing oxygen-free radicals or nascent oxygen from oxygen in the mucous membrane. This oxygen-free radical results in tissue damage.

11.

How Much Bromine Is Toxic?

The revised IDHL (immediately dangerous to life or health consideration) is 3 ppm based on acute inhalation toxicity data in humans. The REL (recommended airborne exposure limit) of bromine is 0.1 ppm, averaged over a ten-hour work shift.

12.

What Does Bromine Taste Like?

Within normal levels, bromate or bromide in drinking water does not give color, taste, or any other aesthetically detectable changes in the water quality. However, the presence of bromine may give a medicine-like taste. Halogens like bromine and chlorine are used for disinfecting water.

13.

What Are Some Natural Sources of Bromide?

Bromine is present in seawater at a concentration of 65 milligrams per liter. It exists in a liquid state at room temperature. In low levels, it is also present in the earth’s crust.

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Dr. Sugandh Garg
Dr. Sugandh Garg

Internal Medicine

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