Doctors Warn Against Using Betadine Povidone Iodine Nasal Spray or Mouthwash to Prevent COVID-19—Here's Why

From hydroxychloroquine and veterinarian doses of the antiparasitic drug ivermectin, questionable—and potentially harmful—treatments for COVID-19 have circulated the internet since the pandemic first hit. The latest misinformed trend, gargling Betadine to prevent COVID-19 infection, allegedly started on Twitter.

While advice about gargling Betadine or adding it to nasal spray has been gaining traction in anti-vax circles, infectious disease experts say iodine isn't a safe or reliable way to prevent getting sick with COVID-19. "There's no evidence that povidone iodine [Betadine] has any impact on COVID-19," Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, tells Health.

Here's what you need to know about Betadine—and why doctors really, really don't want you (or anyone) to start gargling or using it in a nasal spray in hopes of preventing COVID-19.

What exactly is Betadine?

So, Betadine is the brand name for a chemical compound called povidone iodine or iodopovidone. It's a brownish liquid solution that's often used as a topical antiseptic—it can sterilize routine cuts and scrapes, or clean skin before stitches or surgical procedures, says Dr. Adalja.

Betadine also has an antiseptic throat gargle made with 0.5% povidone iodine, but it's only meant to treat and relieve symptoms of a sore throat. There are also medicated douches—made with 0.3% povidone iodne—to help relieve minor vaginal irritation and itching.

Can Betadine help prevent COVID-19 at all?

The short answer: No. Doctors don't recommend even trying to use Betadine to prevent or treat COVID-19 because there's no real evidence that supports those claims. It's not clear where the idea that Betadine could potentially prevent COVID-19 came from, but some studies—though inconclusive—have looked into a connection.

One study, published as a research letter in the journal JAMA Otolaryngology–Head & Neck Surgery, sought to find if nasopharyngeal application of povidone iodine could reduce the viral load of patients with "nonsevere" COVID-19. Researchers chose 12 participants as a control group (meaning no intervention was taken) and 12 patients to rinse their mouths with a solution containing 1% povidone iodine solution four times, spray their nostrils with the same solution, and apply an ointment with 10% povidone iodine to their nostrils. They were instructed to do this four times a day for five days.

The study found that povidone iodine "may reduce the carriage of infectious SARS-CoV-2 in adults with mild to moderate COVID-19"—but that means it was found to only reduce the amount of virus in a person's nose when they're already infected with COVID-19. The povidone iodine solution also had some gnarly side effects: 42% of patients exposed to it experienced "thyroid dysfunction" as well as "unpleasant nasal tingling."

Overall, study authors concluded that more research needed to be done regarding povidone iodine's effect on excretion and transmission of the SARS-CoV-2 virus. And the JAMA study wasn't the only one to look at povidone iodine (though it was the only one to look at its effect in actual humans). A Letter to the Editor published in the Journal of Otolaryngology–Head & Neck Surgery merely suggested the use of "topical povidone iodine to the upper aerodigestive tract." Another earlier JAMA study also found povidone iodine to be effective against the SARS-CoV-2 virus—but only in a lab setting.

None of these studies specifically suggest that Betadine or povidone iodine can help prevent COVID-19, Cassandra M. Pierre, MD, MPH, an infectious disease physician and the medical director of public health programs at Boston Medical Center, tells Health. (Dr. Pierre wasn't affiliated with any of the studies). She says as of right now, "there's no reliable data" to suggest that povidone iodine can help prevent COVID-19 or its spread.

Recently, Betadine's manufacturer, Avrio Health, also published a statement on its website warning customers against using Betadine to prevent COVID-19: "Betadine Antiseptic Sore Throat Gargle is only for the temporary relief of occasional sore throat," the statement reads. "Betadine Antiseptic products have not been demonstrated to be effective for the treatment or prevention of COVID-19 or any other viruses."

Are there any dangers of using Betadine as a gargle or nasal spray?

Yep. Aside from being unhelpful, ingesting povidone iodine can also pose health risks. According to Dr. Adalja, povidone iodine is commonly used for a gargle for sore throats, but accidentally ingesting it—whether you swallow it by mouth or put it up your nose and it drips down your throat—could cause gastrointestinal upset.

High doses of povidone iodine could also cause kidney problems, adds Dr. Adalja, along with potentially interfering with thyroid function (which is what happened in the JAMA study, too). Plus, according to Dr. Pierre, it may tarnish the color of a person's mucus membranes and skin, and even cause pulmonary irritation and shortness of breath,

There is, of course, another danger too: It's that people are using remedies like povidone iodine instead of the vaccine—which is proven to work. "It's odd because there's so much evidence for the vaccine, but people are turning to povidone iodine, which has no evidence," says Dr. Adalja.

Read More: https://www.health.com/condition/infectious-diseases/coronavirus/betadine-nasal-spray-mouthwash-covid

Do we have any scientific evidence that povidone iodine is effective against COVID-19 for early treatment and prevention?

There are more than 20 published studies on povidone-iodine for COVID-19. You can check out the list and details on c19pvpi.com. Most of the studies are for early and late treatments. 

There was one RCT (randomised controlled trial) for prevention: Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: An open-label randomized trial (International Journal of Infectious Diseases 2021).

Do Not Use Iodine-Based Skin Disinfectant for Gargling

Importantly, Neal Naito (M.D., M.P.H., a former director of public health for the U.S. Navy) stresses that povidone-iodine solutions sold as skin disinfectants are NOT suitable for gargling as they contain potentially harmful ingredients that should not be ingested.

“It’s critical that people not gargle with skin disinfectant solutions, including those that contain povidone-iodine,” he says. So, when using povidone-iodine for gargling, be sure to look for solutions such as Betadine formulated specifically as a sore throat gargle, not products intended for cuts and wound care. (source)

Online Shopping Guide:

• 0.6% Povidone Iodine Nasal Spray (0.6%) - 30ml - ePothex (Amazon)

• 1% Povidone Iodine: Betadine Gargle and Mouthwash (Amazon) 

• 0.45% Povidone Iodine | Betadine Sore Throat Spray (Amazon)

• Saline Nasal Spray: Amazon Basic Care Premium Saline Nasal Moisturizing Spray

• Amber Glass 1 oz Nasal Sprayer. EMPTY, Refillable, Travel Sized, Quality Glass for Saline Applications.