In pharmacology, the International Unit is a unit of measurement for the amount of a substance, based on biological activity or effect. It is abbreviated as IU, as UI (Spanish unidad internacional or French unité internationale or Italian unità internazionale), or IE (German Internationale Einheit, Dutch Internationale Eenheid, Danish International Enhed, Swedish Internationell Enhet), or as NE (Hungarian Nemzetközi Egység). It is used to quantify vitamins, hormones, some medications, vaccines, blood products, and similar biologically active substances.
Many biological agents exist in different forms or preparations (e.g. vitamin A in the form of retinol or beta-carotene). The goal of the IU is to be able to compare these, so that different forms or preparations with the same biological effect will contain the same number of IUs. To do so, the WHO Expert Committee on Biological Standardization provides a reference preparation of the agent, arbitrarily sets the number of IUs contained in that preparation, and specifies a biological procedure to compare other preparations of the same agent to the reference preparation. Since the number of IUs contained in a new substance is arbitrarily set, there is no equivalence between IU measurements of different biological agents. For instance, one IU of vitamin E cannot be equated with one IU of vitamin A in any way, including mass or efficacy.
Despite its name, IU is not part of the International System of Units used in physics and chemistry. The IU should not be confused with the enzyme unit, also known as the International unit of enzyme activity and abbreviated as U.
In order to remove the possibility of having the letter "I" confused with the digit "1", some hospitals have it as a stated policy to omit the "I", that is, to only use U or E when talking and writing about dosages, while other hospitals require the word "Units" to be written out entirely.
Equality and equivalency of IU for different substances
To define the IU for a substance, an international collaborative study is organized by the WHO Expert Committee on Biological Standardization using various assay systems in several laboratories. The main goal of the study is to reach a consensus regarding methods of analysis and the approach to standardization so that results can be compared.
The study is performed using highly purified preparations of the substance, typically in lyophilized form, called "international reference preparations" or IRPs. Each preparation is divided into precisely weighed samples, with each sample stored in its own ampoule labeled with a code corresponding to the source IRP. Assays are performed using these samples and are calibrated against the previously available IU standard. These results can be quite variable; the final IU value for samples of a given IRP are determined by consensus. The IRP that provides the best results and shows the best long term stability is selected to define the next IU. This IRP is then referred to as the "international standard."
Mass equivalents of 1 IU
For some substances, the precise mass equivalent of one IU is later established. If that happens, the former IU mass for that substance is officially abandoned in favor of a newly established mass. The unit count often will still remain in use.
- Vitamin A: 1 IU is the biological equivalent of 0.3 μg retinol, or of 0.6 μg beta-carotene
- Vitamin C: 1 IU is 50 μg L-ascorbic acid
- Vitamin D: 1 IU is the biological equivalent of 0.025 μg cholecalciferol/ergocalciferol
- Vitamin E: 1 IU is the biological equivalent of about 0.667 mg d-alpha-tocopherol (2/3 mg exactly), or of 0.45 mg of dl-alpha-tocopherol acetate.
- Insulin: 1 IU is equivalent to 0.0347 mg of human insulin (28.8 IU/mg).
- "Facts about the Official “Do Not Use” List" (PDF). The Joint Commission. Retrieved 30 May 2013.
- Canadian Society of Clinical Chemists (Dec 1992). "Canadian Society of Clinical Chemists position paper: standardization of selected polypeptide hormone measurements.". Clin Biochem. 25 (6): 415–24. doi:10.1016/0009-9120(92)90030-V. PMID 1477965.
- Jeffcoate SL (1988). "What are we measuring in gonadotropin assays?". Acta Endocrinol Suppl (Copenh). 288: 28–30. PMID 3048031.
- Wicher JT (1991). "Calibration is the key to immunoassay but the ideal calibrator is unattainable.". Scand J Clin Lab Invest Suppl. 205: 21–32. PMID 1947745.
- Ekins R (1991). "Immunoassay standardization". Scand J Clin Lab Invest Suppl. 205: 33–46. PMID 1947747.
- Dietary Supplements Ingredient Database
- Dietary Reference Intakes Tables: Unit Conversion Factors
- "Dietary Supplement Fact Sheet: Vitamin E". Retrieved 6 October 2012.
- "Dietary Reference Intakes Tables". Retrieved 6 October 2012.