The potassium ion is primarily responsible for the observed effects in this example; the saltiness of sodium bromide remains constant regardless of concentration. The average concentration of bromide in human blood in Queensland, Australia, is 5.3±1.4 mg/L and varies with age and gender. The human body has natural detoxification capabilities, but heavy exposure to environmental toxins like bromide can overwhelm these systems. The primary anthropogenic sources of bromide in food include the use of bromide-containing fumigants in agriculture and the treatment of food stocks, which can lead to significant contamination levels. Agricultural practices, food contamination, and environmental pollutants can expose individuals to elevated bromide levels, which have been linked to adverse health effects. Treatment for bromism typically involves discontinuing bromide exposure and administering sodium chloride (saline loading) to help the body excrete the excess bromide.

3. Gastrointestinal signs

Similarly, the currently accepted therapeutic ranges as an “add-on” treatment or in monotherapy are only based on a few studies where these serum concentrations appeared to be effective (16, 23, 26, 27). Despite the lack of statistically significant results, this study identified a trend where dogs living by the sea appeared to require higher doses of potassium bromide, suggesting that the impact of chloride in dogs treated with bromide might go beyond nutrition (90). Rossmeisl et al. (77) concluded that in dogs this relationship was unsatisfactory for routine use in practice and bromide dose adjustments should be based on the direct assessment of bromide detox bromide serum concentration.

• Sodium bromide (NaBr) constitutes an alternative, less common formulation that can also be used in veterinary patients.
• It helps the body reduce oxidative stress and inflammation by neutralizing reactive oxygen species (ROS) and protecting cells from damage.
• Bromide remains a cornerstone in the treatment of canine epilepsy since its introduction in the 1990s.
• The currently known challenges in measuring and monitoring bromide serum concentrations, make it difficult to tailor dosages to the individual patient and represent one of the downsides (or bad aspects) of its use.
• Despite this, since chloride can easily be measured in-house in most practices, the variation and degree of hyperchloremia can still be used as a general guide to adjust bromide dosage in emergency situations (77).

Bromide serum concentration monitoring is indicated in patients receiving treatment with this medication. Respiratory adverse effects were rarely reported in clinical studies in canine patients (51, 63). For this reason, clinical signs should always be used in association with serum bromide concentrations to appropriately judge the tolerability of bromide treatment in a specific patient (63).

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Bromide chemicals, particularly potassium bromide, were frequently used as hypnotics in the late nineteenth and early twentieth centuries. The principal use of organobromine compounds is as fire retardants, however even this application is debatable. Bromide’s major economic value, both in terms of value and quantity, is found in the production of organobromine chemicals, which is rather specialized. Scientists usually abbreviate it as “EtBr” (which is also used as an abbreviation for ethidium bromide). Evidence suggests that methyl bromide also contributes to ozone depletion.

Final Thoughts on Bromide Detoxification

Despite this, it is important to note that evidence to support the use of bromide in monotherapy is limited to one single study by Boothe et al. (76). Furosemide was also formerly used to promote bromide diuresis in cases of bromism and bromoderma (49, 50). In simple terms, mass spectrometers measure the mass of molecules that were previously converted into ions, allowing their precise quantification (84). These results concerningly show that bromide measurements can differ very significantly between different laboratories, even when the same laboratory method is used, providing further evidence on the difficulty in obtaining reliable bromide measurement results. Due to the impact of hemolysis in spectrophotometrical techniques (82), care to avoid erythrocyte damage should be taken when collecting blood samples for bromide measurement.

Nonetheless, we can identify some potential good, bad and ugly aspects of the use of this medication. Owners and clinicians alike should be aware of the impact abrupt changes in chloride intake can have in seizure control. It’s no surprise that the field of epilepsy continues to receive extensive research efforts in order to find additional therapeutic options that can potentially enhance the management of this condition.

• A dosage of 30 mg/kg/day was suggested for use in cats (41), but currently there is a weak level of evidence regarding the efficacy and safety of this medication in feline patients (53).
• The bromide ion is antiepileptic and as bromide salt, is used in veterinary medicine in the US.
• Bromide toxicity is an emerging concern that demands attention, especially as individuals are increasingly exposed to this harmful compound through various environmental and dietary sources.

The end result of a loading dose can be assessed 1 week after the administration of a loading dose protocol. Resolution of cough occurs only after discontinuation of treatment, supporting a relationship with bromide treatment (41, 62). Onset of cough was reported between 2 weeks to 23 months after starting treatment (41), but was seen to developed as late as 8 years after initiation of treatment (62). Experimental studies in rats revealed that bromide can disturb the thyroid, testes and adrenal’s function (70, 71). Breakthrough seizures might occur during the treatment of bromism, which might increase the patient’s hospitalization time.

Dissociation of bromide salts

Since its discovery in 1827, scientists have been keen to find out fresh uses for bromine. Bromide was the sole viable anticonvulsant on the market until the discovery of phenobarbital in 1912. Sir Charles Locock was the first to use it as an anticonvulsant on humans in 1857.

Dosage and administration routes

The good is that bromide has proved efficacy as an add-on treatment in cases of canine refractory idiopathic epilepsy and might also serve as an alternative first-line ASM in selected cases. Bromide remains a cornerstone in the treatment of canine epilepsy since its introduction in the 1990s. To the authors knowledge, studies assessing bromide use and efficacy in horses are not available and the possible role of bromide as a treatment of epileptic seizures in this species is still unknown. Studies assessing the risk of pancreatitis in bromide treated dogs are limited (65–67) and although this still appears to be a possible complication of the use of this medication, evidence for a causal effect has not yet been obtained.

Natural Presence and Common Uses

Bromide’s potential for neurodevelopmental toxicity is particularly concerning, especially for vulnerable populations like children. Bromide is a negatively charged ion that can be found naturally in the environment, though it often becomes problematic when present in excessive amounts. Bromide toxicity is an emerging concern that demands attention, especially as individuals are increasingly exposed to this harmful compound through various environmental and dietary sources. Excessive intake of bromide can lead to bromism, which is chronic bromide toxicity. Bromide has a long half-life in the human body, typically 9 to 12 days, meaning it can accumulate with continuous exposure. This ion is involved in biological processes, such as its use by eosinophils in fighting multicellular parasites.

By incorporating these strategies into your wellness routine, you can better safeguard your health and reduce the burden that environmental toxins like bromide can impose. Supporting your detoxification pathways is an ongoing process that requires a combination of proper nutrition, safe supplementation, and regular consultation with healthcare professionals. Given the growing exposure to toxins like bromide through our food and environment, taking proactive steps to protect your body is essential.

Bromide concentration should be closely monitored, and dose adjustment might be required during these periods. This is important to remember when these patients receive treatment for other conditions, particularly when intravenous fluid therapy is used. In cases of bromide toxicity, this known interaction can be used to increase the excretion of bromide by the administration of high amounts of sodium or ammonium chloride (43), as previously described. A study by Mandigers (83) assessed 51 dogs receiving bromide treatment in two different laboratories and revealed a difference between −1111 mg/L to 3,910 mg/L, with a mean difference of −128 ± 728 mg/L between the two laboratories. Despite this, since chloride can easily be measured in-house in most practices, the variation and degree of hyperchloremia can still be used as a general guide to adjust bromide dosage in emergency situations (77).

Potassium Bromide

In addition to silver, bromine is also in minerals combined with mercury and copper. Bromide is present in typical seawater (35 PSU) with a concentration of around 65 mg/L, which is about 0.2% of all dissolved salts. For thousands of years, medicinal mushrooms have held an esteemed place in traditional Asian medicine. Dr. Hulda Clark, a naturopath whose work has gained attention in alternative health circles, has developed a distinctive theory about cancer causation that differs markedly from conventional medical understanding. For more science-backed tips and solutions on detoxification support, explore our library of expert resources.

Potassium bromide, for example, was quickly adopted as a sedative for conditions ranging from epilepsy to restlessness. Before the sigh-inducing type, though, bromides were most familiar in compounds like potassium bromide, used in the late 19th century as a sedative to treat everything from epilepsy to sleeplessness. This post-translational modification occurs in all animals and bromine is an essential trace element for humans.

Primary Sources of Bromide Exposure

This leads to spurious hyperchloremia (or pseudohyperchloremia) to be frequently recorded when assessing the serum, whole blood or plasma of patients receiving bromide treatment (77, 78). To date, determining an accurate serum bromide concentration remains challenging, typically requiring samples to be sent to an external laboratory, which can potentially delay therapeutic decisions (77). Serum level monitoring also allows the clinician to determine if medication failure is related to metabolic tolerance (in patients requiring dose adjustment) or functional tolerance (in patients requiring a change of medications). Dermatitis (bromoderma; idiosyncratic or dose-independent) and vomiting, weight gain and polydipsia (dose-dependent) were the most uncommon adverse effects reported in cats (53).

Bromide concentration in standard seawater (35 PSU) is about 65 mg/L, or around 0.2% of total dissolved salts. In contrast to the United States, where bromide has yet to be approved for use, it has been approved for distribution in other countries such as the United Kingdom and Australia. Bromide was originally used to treat refractory epileptics in combination with phenobarbital. Bromine is located in the periodic table’s halogens group, and its negatively charged form (Br) is an ion known as a bromide ion. Hypobromite is produced via eosinophil peroxidase, an enzyme that can use chloride but preferentially uses bromide.

Bromide’s mechanism of action seems related to its preferential movement across neuronal chloride channels. The present research gaps and potential future developments in the use of this medication are also reviewed and discussed. This syndrome is caused by long-term therapeutic usage of ammonium, sodium, or potassium bromides as sedatives.

Managing epilepsy effectively in veterinary patients remains a challenging aspect of veterinary neurology since poorly controlled seizures can severely impact both the patient’s and the owner’s quality of life. Regular monitoring of the kidney function is therefore recommended in patients receiving bromide treatment (50). Since bromide is eliminated by the kidneys, renal disease can lead to an inappropriate rise in bromide serum concentration and consequent bromide toxicity (50). It is thought that dogs living close to the sea can be exposed to air with higher concentrations of salt in the form of aerosols (91, 92). The absence of known interactions between bromide and other antiseizure medications may be attributed to its lack of metabolism within the patient’s body (81). After precipitation of the proteins in the sample, tri-gold chloride is added to the serum leading to a color change that is related to the level of bromide present in the blood.