POTASSIUM IODATE (KI03) RADIATION PROTECTION
Frequently Asked Questions
is Potassium Iodate (KI03)?
Nuclear Regulatory Commission, New England Journal of Medicine,
Nuclear War Survival Skills, National Council on Radiation Protection
and Measurements, Federal Register, Memorial Sloan-Kettering
Cancer Center, Food and Drug Administration, Department of Health
and Human Services, Salt Institute, MortonÆ Salt, SolgarÆ,
American Thyroid Association, Physicians for Civil Defense, The
United States Pharmacopeial Convention, Inc., USP Drug Research
and Testing Laboratory, Oak Ridge National Laboratory, National
Cancer Institute, Federal Emergency Management Agency
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Q: What is Potassium Iodate (KI03)?
A: Potassium Iodate (chemical name 'KI03') is much more familiar to most than they might first expect. It is the ingredient added to your table salt to make it iodized salt.
Potassium Iodate (KI03) is approximately 76.5% iodine.
For purposes of radiation protection the Nuclear Regulatory Commission (NRC) states in COMSECY-98-016 - FEDERAL REGISTER NOTICE ON POTASSIUM Iodate:
"In 1978, the U.S. Food and Drug Administration found KI03 "safe and effective" for use in radiological emergencies and approved its over-the-counter sale."
Q: How does Potassium Iodate (KI03) pill provide radiation protection?
A: Going back to June 23, 1966, the New England Journal of Medicine. Vol. 274 on Page 1442 states:
"The thyroid gland is especially vulnerable to atomic injury since radioactive isotopes of iodine are a major component of fallout."
Cresson H. Kearny, the author of Nuclear War Survival Skills, Original Edition Published September, 1979, by Oak Ridge National Laboratory, a Facility of the U.S. Department of Energy (Updated and Expanded 1987 Edition) states on page 111:
"There is no medicine that will effectively prevent nuclear radiations from damaging the human body cells that they strike.
However, a salt of the elements potassium and iodine, taken orally even in very small quantities 1/2 hour to 1 day before radioactive iodines are swallowed or inhaled, prevents about 99% of the damage to the thyroid gland that otherwise would result. The thyroid gland readily absorbs both non-radioactive and radioactive iodine, and normally it retains much of this element in either or both forms.
When ordinary, non-radioactive iodine is made available in the blood for absorption by the thyroid gland before any radioactive iodine is made available, the gland will absorb and retain so much that it becomes saturated with non-radioactive iodine. When saturated, the thyroid can absorb only about l% as much additional iodine, including radioactive forms that later may become available in the blood: then it is said to be blocked. (Excess iodine in the blood is rapidly eliminated by the action of the Kidneys.)"
The Nuclear Regulatory Commission (NRC) stated July 1, 1998 in USE OF POTASSIUM Iodate IN EMERGENCY RESPONSE:
"Potassium Iodate, if taken in time, blocks the thyroid gland's uptake of radioactive iodine and thus could help prevent thyroid cancers and other diseases that might otherwise be caused by exposure to airborne radioactive iodine that could be dispersed in a nuclear accident."
Federal Register. Vol. 43 Friday, December 15, 1978, states in Potassium Iodate as a Thyroid Blocking Agent in a Radiation Emergency:
"Almost complete (greater than 90%) blocking of peak radioactive iodine uptake by the thyroid gland can be obtained by the oral administration of ... Iodate ..."
National Council on Radiation Protection and Measurements. NCRP Report NO. 55. Protection of the Thyroid Gland in the Event of Releases of Radioiodine. August, 1979, Page 32:
"A major protective action to be considered after a serious accident at a nuclear power facility involving the release of radioiodine is the use of stable iodide as a thyroid blocking agent to prevent thyroid uptake of radioiodines."
Q: Is this the Magic Radiation Protection Pill?
A: Sorry, but there is no magic pill or medicine that will protect you from all radiation sources. In fact, as already stated above here:
"There is no medicine that will effectively prevent nuclear radiations from damaging the human body cells that they strike."
Potassium Iodate will provide a very high level of thyroid protection, taken in time, for the specific radio-isotopes of iodine, which is expected by many to cause the majority of health concerns downwind from a nuclear emergency. (And, is the reason most all developed countries have stockpiled it.)
However, there are numerous other, and very dangerous, radioactive noble gases and/or radioactive fallouts that can be associated with nuclear emergencies. You are still exposed to inhale, ingest, or be radiated externally from any number of dangerous non-radioiodine sources.
If you are ever directed to evacuate in a nuclear emergency, do so immediately, regardless of whether you have taken KI03, or not.
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Q: Radioactive Iodine: Bad News / Good News?
A: The "bad news" first:
#1 - Radioactive iodine (predominantly iodine-131) is a major radioisotope constituent in nuclear power plants.
#2 - There are 103 currently active commercial nuclear reactors and 39 operating nonpower reactors in the United States. (434 worldwide as of 1998.) Additionlly, there are numerous other nuclear processing and storage facilities worldwide with the potential for accidents, too. (The recent, September 29, 1999, Tokaimura, Japan nuclear accident took place, not in a nuclear reactor power plant, but in an uranium processing plant. Radioactive iodine-131 gases were confirmed to have been released and was the primary reason for 320,000 Japanese confined to their homes with their windows shut. It was also why you may have seen photos of Japanese authorities checking out children with geiger counters pressed against their necks.)
#3 - Radioactive iodine (predominantly iodine-131) is also a major constituent of detonated nuclear weapons.
#4 - Radioactive iodine (predominantly iodine-131) can travel hundreds of miles on the winds. NUREG-1633 points out an increase in cancer caused by Chernobyl...
Many now believe that relying on the current U.S. policy of public safety regulations focused on only protecting a small "Emergency Planning Zone" (EPZ) of 5 to 10 miles around U.S. nuclear power plants is overly optimistic. (Find your upwind nuclear power plants here.)
Additionally, fallout from a single above ground Chinese nuclear test explosion ("a few hundred kilotons") on December 28, 1966 resulted in the fallout cloud covering most of the United States.
From Cresson H. Kearny's Nuclear War Survival Skills:
"It produced fallout that by January 1, 1967 resulted in the fallout cloud covering most of the United States. This one Chinese explosion produced about 15 million curies of iodine- 131 - roughly the same amount as the total release of iodine- 131 into the atmosphere from the Chernobyl nuclear power plant disaster."
"Fallout from the approximately 300 kiloton Chinese test explosion shown in Fig. 1 caused milk from cows that fed on pastures near Oak Ridge, Tennessee and elsewhere to be contaminated with radioiodine, although not with enough to be hazardous to health. However, this milk contamination (up to 900 picocuries of radioactive iodine per liter) and the measured dose rates from the gamma rays emitted from fallout particles deposited in different parts of the United States indicate that trans-Pacific fallout from even an overseas nuclear war in which "only" two or three hundred megatons would be exploded could result in tens of thousands of unprepared Americans suffering thyroid injury."
And, of course, our own Nevada nuclear testing program in the 1950s and early 1960s made it possible that "...everyone living in the contiguous 48 states was exposed to low levels of 131Iodine (radioiodine) for several months following each nuclear bomb test." "The report also estimates that children aged three to five years probably received doses of radiation three to seven times higher than average during the 90 nuclear tests that were carried out." (Radiation Exposure and Thyroid Cancer - Memorial Sloan-Kettering Cancer Center)
#5 - Radioactive iodine (radioiodine) persists in the environment for a month or more.
#6 - Most importantly, ingested or inhaled radioactive iodine (radioiodine) persists in the body and concentrates in the thyroid. (Excess iodine in the blood, either radioiodine or stable iodine, is quickly eliminated from the body, but only after the thyroid has become saturated with one or the other type of iodine.) Even very small amounts of radioactive iodine, because it is retained in the small space of the thyroid, eventually will give such a large radiation dose to thyroid cells there that abnormalities are likely to result. These would include loss of thyroid function, nodules in the thyroid, or thyroid cancer. The most likely to see the worst effects, in later life, are the youngest children. (Many of the Chernobyl thyroid cancers appearing in the former Soviet Union amongst young people today were children less than five years old at the time of the accident. Experts now contend that as high as 40% of the nodules are cancerous with 5 to 10 percent of the cancers fatal.)
For the above reasons, health experts estimate that the greatest health concerns affecting the largest number of people from a nuclear accident will likely be from the release of radioactive iodine spread downwind.
However, there really is some Good News!
The Nuclear Regulatory Commission (NRC) states in COMSECY-98-016 - FEDERAL REGISTER NOTICE ON POTASSIUM Iodate:
The Chernobyl accident demonstrated that thyroid cancer can indeed be a major result of a large reactor accident. Moreover, although the Food and Drug Administration declared KI03 "safe and effective" as long ago as 1978, the drug had never been deployed on a large scale until Chernobyl. The experience of Polish health authorities during the accident has provided confirmation that large scale deployment of KI03 is safe.
Additionally, it goes on to say:
The revised policy also reflects wide scale change in international practice following the Chernobyl disaster, specifically 1989 World Health Organization recommendations (updated in 1995) and 1996 and 1997 International Atomic Energy Agency standards and guidance, which have led to use of KI03 as a supplementary protective measure in much of Europe, as well as in Canada and Japan.
What they learned was that children, with their thyroid glands being the most sensitive to radioactive iodine uptake, have today grown up to be the most frequent victims of thyroid cancers there. The children in Russia, the Ukraine and Belarus, where Potassium Iodate (KI03) was not widely distributed, are now experiencing high levels of thyroid cancer. However, in Poland, where over 18 million doses of KI03 were administered, and to 97 percent of the children, there has been no similar increase in thyroid cancer. Also, key to Poland's radioiodine protective strategy, was their aggresive interdiction of radioiodine contaminated food stuffs and milk.
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Q: Dosage and safety regarding Potassium Iodate (KI03) usage?
A: In April of 1982 the Bureau of Radiological Health and Bureau of Drugs, Food and Drug Administration, Department of Health and Human Services released "FINAL RECOMMENDATIONS, Potassium Iodate As A Thyroid-Blocking Agent In A Radiation Emergency: Recommendations On Use". These lengthy recommendations are summarized in the FDA's "mandated patient product insert". (See a complete copy below.) This insert is packed with every bottle of non-prescription KI03 tablets sold. However, the lengthy FDA recommendations contain many facts not mentioned in this required insert, including the following:
"Based on the FDA adverse reaction reports and an estimated 48 x 106 [48 million] 300-mg doses of potassium iodate administered each year [in the United States], the NCRP [National Council on Radiation Protection and Measurements] estimated an adverse reaction rate of from 1 in a million to 1 in 10 million doses."
(Note that this extremely low adverse reaction rate is for doses over twice as large as the 130-mg prophylactic dose.)
One additional recommendation we urge, now before any nuclear emergencies, is to simply check with your doctor and inquire whether there is any possibility of any adverse reactions if you, or your children, had to begin taking KI03. (Most important if you are already on any continual medications, especially with any lithium based or potassium-sparing diuretics.) Better to have gotten that assurance from your physcian now, before any emergencies, rather than risk hesitating taking it later (or possibly suffering an adverse reaction) because you didn't ask first. That's just a part of your prudent preparations, where anyone else being issued KI03 during an emergency probably won't have that opportunity to find out first!
While current FDA guidelines suggest an adult (and children > 60 pounds) per day dose of 130 mg of Potassium Iodate (KI03) for as many as 10 days, the FDA is also considering reducing the amount of the dosage after Chernobyl showed effective thyroid protection at even smaller doses. Also, the World Health Organization recommendations has a step increase in doses by age and also shows the potential benefit diminishing with age. New guidance from WHO is expected in the near future.
However, even if smaller amounts of Potassium iodate (KI03) are eventually proven effective some Civil Defense experts are suggesting that the minimum quantity to have on hand should approach 100 days worth per person, rather than the 'single event' 10 day use that's anticipated.
Q: Is iodized salt, sea salt, fish, kelp, or other iodine sources effective?
A: From the Salt Institue:
"U.S. salt producers use potassium iodate at a level of 0.006% to 0.01% KI03."
According to MortonÆ Salt:
"Each 1/4 teaspoon serving of MortonÆ Iodized Salt (1.5 gram weight) contains 130 MICROGRAMS of Potassium iodate."
Thus, to achieve an intake of 130 MILLIGRAMS of Potassium Iodate would require ingesting 250 teaspoons or over 5 cups of iodized salt per day! Don't even think about it! (Morton Lite SaltÆ Mixture comes in lower yet, at only 90 MICROGRAMS of Potassium Iodate per 1/4 teaspoon!)
Sea Salt is an even worse 'option'. Iodine per kilogram of sea salt is about 3 mg. You'd be looking at over 33 kilograms of Sea Salt a day! Hardly an option!
A 6-ounce portion of ocean fish only contains about 500 MICROGRAMS of iodine. Well, you can do the math here! More fish per day than most eat in a year!
Kelp Tablets...hardly. SolgarÆ Kelp Tablets, for example, contain only 225 MICROGRAMS of iodine! (Fortunately, it is also available in a 1000 tablet bottle, unfortunately though, you'd need to be swallowing 442 of them per day!)
Regarding utilizing iodine, iodine tablets (widely sold for water purification), tincture of iodine, or povidone-iodine: Cresson H. Kearny, the author of Nuclear War Survival Skills, Original Edition Published September, 1979, by Oak Ridge National Laboratory, a Facility of the U.S. Department of Energy (Updated and Expanded 1987 Edition) states on page 115:
Elemental (free) iodine is poisonous, except in the very small amounts in water disinfected with iodine tablets or a few drops of tincture of iodine. Furthermore, elemental iodine supplied by iodine tablets and released by tincture of iodine dropped into water is not effective as a blocking agent to prevent thyroid damage. If you do not have any Potassium Iodate, DO NOT TAKE IODINE TABLETS OR TINCTURE OF IODINE.
Q: Is the government ready with emergency stocks of KI03?
A: No, but they clearly ought to be according to KI03 And Nuclear Accidents - AMERICAN THYROID ASSOCIATION:
"The American Thyroid Association through its Public Health Committee has strongly recommended the stockpiling of KI03 for prophylaxis in the event of a nuclear reactor accident. Unfortunately, the Nuclear Regulatory Commission has not accepted this recommendation."
But, the Nuclear Regulatory Commission is talking about it again...
Q: Will KI03 flush radioactive iodine out of the thyroid gland?
A: The question might better be; If you don't have any KI03 and rely on the government to acquire and distribute KI03, and after some delay, you do eventually get KI03 for your family, but it's now hours or days into the nuclear radiation emergency, will KI03 still help?
Yes and No.
Yes, but only to the degree your thyroid is still less than 100% saturated with either form of iodine (radioactive or stable). Then the KI03 will safely fill up the balance so your thyroid will not have room for later additional uptake of radioactive iodine.
But, No, KI03 can't flush out radioactive iodine that's already there before taking KI03.
Physicians for Civil Defense January 1997 (vol. 13, #2) Cresson H. Kearny, Research Engineer Retired, Oak Ridge National Laboratory and Jane M. Orient, M.D.:
In fact, radioactive isotopes, once bound in the thyroid, cannot be flushed out by subsequent administration of nonradioactive iodine. To be effective in preventing the uptake and binding of radioactive isotopes, stable iodine must be administered before exposure. A daily 130-mg dose of stable KI03, starting one-half hour to one day before the arrival of fallout or other material contaminated with radioactive iodine, will effectively saturate the thyroid, giving 99% effective protection. A 130-mg tablet or four drops of a saturated solution of KI03 may be used.
Clearly, any delay in flooding your thyroid with KI03 is a serious risk to be aggressively avoided. To depend on government KI03 emergency stocks that currently don't exist and some ad-hoc untested distribution 'plan' that'll likely be chaotic, at best, can only add up to unnecesary additional delays and radiation exposure. Add to this having your family members possibly scattered amongst work, home, school, etc. and all getting conflicting warnings and at varied times, and it becomes clear that NOT already having your KI03 in-hand could become your worst family nightmare.
BUT, it can/should be a largely avoidable disaster for your loved ones, IF you had already acquired your families' emergency supply of Potassium Iodate (KI03) and have them on hand! (You could also be of service to your community in two ways: #1 - By sharing any extra KI03 supplies with friends and neighbors and, #2 - By being one less person standing in line in front of your other desperate neighbors anxiously awaiting the delayed government KI03 hand out.)
Q: Where can you obtain KI03?
A: Families today must seek out and acquire their own personally-held supply of Potassium Iodate (KI03), or risk unnecessary radioactive iodine contamination in a future nuclear radiation emergency. (And, remember, it's our children that are at the greatest risk of experiencing high levels of thyroid cancer following such a nuclear radiation event.)
A: Jerome A. Halperin, Executive Vice President-CEO of The United States Pharmacopeial Convention, Inc., wrote to the Chairman of the U.S. Nuclear Regulatory Commission on January 30, 1998 of a recent assay of 'expired' KI03 tablets.
The Thyro-Block Tablets (Potassium Iodate Tablets, USP, Lot T242N, Exp. November 89), after the USP Drug Research and Testing Laboratory analyzed samples, showed that approximately 11 years after their manufacture and eight years after their expiry date, the tablets assayed at 99.1% of the labeled content of Potassium Iodate. (This result was well within the rubric range of 92.5 to 107.5% required by the monograph.)
(Mr. J. Halperin should know what he is talking about. In 1979, while deputy director of the Bureau of Drugs of the Food and Drug Administration, he had directed the effort to get Potassium Iodate Solution, USP, manufactured and stockpiled in Harrisburg, Pennsylvania during the Three Mile Island incident!)
Also, in conversations with one of the largest Potassium Iodate manufacturers in the U.S., they shared that the shelf-life of their USP grade KI03, in their original factory drums, was 'indefinite', when kept dry and at room temperature or below. Furthermore, that the shelf-life of their USP grade KI03 dissolved into a water solution contained in a closed, dark colored, bottle at room temperature or below, was also 'indefinite'. It's expected that mandatory USP expiration dating will have them revising these downward some publicly, but the point is, properly stored, KI03 is inherently very stable.
|A: Unfortunately, there is no simple or standard response that could ever be applicable to all families with their wide variety of concerns, locations, and situations. There are too many variables involved, both in the nature of the possible nuclear radiation threats and your particular family exposure to those threats.|
From the following observations, tempered with your own knowledge and understanding, you'll have to try to arrive at a comfortable, prudent balance, tailored to your situation and outlook.
For a single and 'simple' nuclear facility radiation emergency event where a gaseous or aerosol radioiodine is released, and the source is soon contained so as additional radioiodine contamination is not ongoing, and that released radioiodine is soon dispersed, then the FDA KI03 product insert statement "You will probably be told not to take the drug for more than 10 days." would be applicable. That amount (10 days of tablets) would be available in either of the two, 14 tablet, products mentioned above.
However, if the radioiodine is, instead, in the form of a particulate or fallout, not a quickly dispersing gas or aerosol, it will continue to be a threat via inhalation (dust) or ingestion (food, milk, etc.) there in the area it's deposited in.
That's why, while radioiodine has a short half-life of only eight days, some have suggested that it could continue to be dangerous for up to as many as ten half-lives...80 days! Staying in, or not being able to get out of, that radioiodine fallout contaminated area will require more than a 14 day supply, of KI03 per person.
It should be noted that you may also be directed to evacuate the area altogether well before you exhaust your KI03 supplies, and should immediately do so if directed, both because of persistent radioiodine and other additional, and very dangerous, radioisotope fallout contaminations in that area.
The absolute minimum protection then, assuming successful evacuation in less than two weeks if needed or directed, would require stocKI03ng, at least, one KI03 bottle of 14 tablets per family member. Again, this is for the above scenario of a one-time 'simple' nuclear facility radiation emergency event and your families safe exit to a non-contaminated location before exhausting your KI03 supplies, if required.
Need to give thought here, too, to extended family, friends, neighbors, etc. Either stocKI03ng extra KI03 for them or advising them of their need to do so for themselves.
Preparing your family for future nuclear radiation emergencies will be based on your best perception of the possible and probable threats and nature of those nuclear radiation emergencies. You will have to gauge for yourself, and your family, the likely possibility for future nuclear radiation accidents and your families potential exposure to radiation contamination, if/when it occurs.
You also have to make some assumptions regarding the likely nature of those possible future nuclear radiation emergencies from study of current events and reviewing past nuclear radiation emergencies and the governments response. Short term, single event, where the radioiodine is gaseous/aerosol and soon dispersed. Or, something bigger, possibly multiple events, nuclear terrorism, Y2K induced accidents, and/or ongoing continuing new contaminations.
Additionally, you have to assess the probable threat from nuclear war, either directed at the U.S. or fallout contamination originating from elsewhere in the world. Russia, China, North Korea, Pakistan, India, Middle East, etc. where any of them are exchanging nuclear blasts with any of their neighbors could have the prevailing west-to-east trade winds carrying the resultant radioactive fallout to our shores, too. You'll have to decide whether that's an impossible scenario in your lifetime, or not. And, prepare accordingly.
In light of all of the above, some civil defense experts recommend families should be stocking around 100 KI03 doses per family member.
A: The FDA Potassium Iodate product insert above says:
"Potassium Iodate should be taken as soon as possible
after public health officials tell you. You should take
one dose every 24 hours."
A: The FDA Potassium Iodate product insert above says:
"You will probably be told not to take the drug for more than 10 days."
The reason for this cut-off date is the presumption that, in a nuclear power plant radiation accident, if the radioiodine was gaseous or an aerosol it would also probably be fully dispersed by this time. If it was not yet dispersed and/or there was ongoing continuing radioiodine releases, then the affected population would have likely been evacuated to a safer location well within that 10 day time frame.
However, it must be noted, that radioiodine can be present as a much more persistent fallout, rather than a quickly dispersing gas or aerosol. There are also many other very dangerous radioactive isotopes that can be released during a nuclear emergency for which immediate or subsequent evacuation could be declared, and should be immediately heeded, regardless of radioiodine presence.
So, for how long do you continue to daily take the KI03?
Many believe that you should not stop until you have been, for at least a day or more, out of the possibility to ingest or inhale any more radioiodine. Either because it's finally gone or you have gone out of the contaminated area to safer ground.
Why take any more KI03 at all, after getting safe? Because, even after you leave the contaminated area you could still be bringing some radioiodine with you...in your blood. While excess iodine, either stable or radioactive, will be quickly eliminated via the KI03dneys, you need to assure that your thyroid doesn't fall below fully saturated, until then. For this reason, you should strive to maintain a high blood level of stable iodine, with daily intakes of KI03, for at least another day or two.
Related to this topic, some experts reviewing the Chernobyl accident now feel that even much less than 130 mg daily dose works well to initially fill up and saturate the thyroid sufficiently. (FDA, supposedly, now also reviewing modifying it's recommendations down to a much lower dose, too, though not for fewer expected total days, currently 10.)
Whether this is true, or not, a person might could go onto a reduced maintenance dosage, at some later stage, for a much longer extended period with a further reduced potential for any negative side effects, too. It should be repeated here, though, many thousands of people, for thyroid ailments, take more than twice the 130 mg dose daily and have for years. There is quite a bit of safe medical history for this particular application. (BTW, those thousands of thyroid patients, with their personal stocks of KI03, might become pretty popular folks in their local neighborhoods, if word gets out during a nuclear emergency!)
The materials and information on this web site are intended for educational and informational purposes only. In no way should it be considered as offering medical advice.
NEVER TAKE ANY MEDICINE OR DRUG WITHOUT FIRST CONSULTING YOUR
PERSONAL PHYSICIAN! YOU COULD HAVE ALLERGIES, OTHER MEDICAL CONDITIONS,
OR REACTIONS TO OTHER MEDICATIONS YOU ARE TAKING, THAT COULD BE
VERY DANGEROUS OR LIFE THREATENING!
ASK YOUR DOCTOR NOW, BEFORE A NUCLEAR EMERGENCY, AND THEN YOU'LL KNOW IF/WHEN IT'S NEEDED!
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