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Emergency Iodine Supplementation In Radiation Dispersal Emergencies: A Brief Guide

Dr. Keith Brown, FAAFP (US), FRSTMH (UK)
NOTE: If you will gift me $5 (or whatever) via PayPal (MKBROWN13@YAHOO.COM) I will send the total onto Japan for use by RELIABLE relief teams (rather than media jerks *coughGuptaetalcough*).

DISCLAIMER: This is for information only! Iodine is a dangerous material and should not be handled or experimented with. By reading this document in part or in whole you and every person you have ever had contact with or your heirs have ever had contact with or your estate has ever had contact with explicitly absolve the author, poster, website, and every human being alive on the planet now or in the future of any responsibility for the use, misuse, or abuse of this information!

DO NOT SUPPLEMENT POTASSIUM IODIDE OR FREE IODINE UNLESS DIRECTED TO DO SO BY EMERGENCY AUTHORITIES OR MEDICAL PERSONNEL. USE YOUR BEST JUDGMENT IF YOU ARE IN A RADIATION DISPERSAL AREA AND HAVE NO CONTACT WITH THE ABOVE. YOU ASSUME ALL RESPONSIBILITY FOR YOUR DECISIONS TO USE OR NOT USE IODINE SUPPLEMENTATION PRODUCTS IN A RADIATION EMERGENCY!

Iodine is a chemical element that is essential to your health and welfare. It is needed for your thyroid gland to make required hormones, plays a role in fertility, resistance to several types of cancer as well as diabetes heart disease and stroke.

Your body is unable to make iodine and MUST recover it from your diet. Iodine deficiency is a serious problem in much of the world and if a pregnant woman is iodine deficient her children may be born with a form of mental retardation call cretinism, which is where the insult ‘you cretin!’ comes from.

Fortunately, most commercially processed salt is now ‘iodized’ and supplies all you need if you have normal thyroid gland function AND are not currently being exposed to significant radiation. Iodized table salt does NOT have enough Iodine to protect you from radioactive Iodine.

Iodized salt is not a .gov conspiracy to control your mind through contaminated food and if you think it is please don’t contaminate the world with your idiocy.

Potassium, being a free element, normally is found combined with something, most commonly Iodine, to produce Potassium Iodide or similar stable compounds, often abbreviated ‘KI.’ The standard dose of ‘emergency’ Potassium Iodide for an adult is 130 mg of Potassium Iodide, about 100 mg of free Iodine. Dosing discussed in detail below. The Iodine is the thing, the Potassium is irrelevant, you won’t take in enough to produce ‘hyperkalemia.’ An older form is/was Potassium Iodate (KIO3) and was a lot harder on the stomach. I doubt you will ever see any unless it is in an old stash. Dose just like KI.

The problem with radiation is your thyroid gland is a bit of a hog, and will take a load of iodine the easiest and fastest way possible. In a radiation emergency you may be both inhaling and eating radioactive Iodine… and when your thyroid absorbs the radioactive Iodine the radioactivity goes with it, increasing the risk for damage to the thyroid gland (possibly leading to either too little or too much thyroid hormone production) as well as thyroid cancer. By giving you extra Iodine, we fill up your thyroid gland so it doesn’t take up the radioactive Iodine. It’s not 100% protection, but will help a great deal.

The younger you are the higher the risk, the unborn, infants and small children being the biggest losers. The closer to the ground you are, the higher the risk, as radioactive particles settle to the ground. The more you breathe, eat, and drink in contaminated areas the greater the risk. If you have pre-existing thyroid disease, the higher the risk.
Potassium Iodide or Iodine will NOT protect you from other effects of the radiation on your body. It only protects your thyroid gland.

Thus, .gov has stockpiled iodine, in the form of Potassium Iodide, to hand out if we have a major radiation dispersal event. And you can buy expensive over the counter pills, IoSat the same as .gov has stored, over the counter. But you don’t need to buy that.

Knowledge here:

1. The current Chernobyl-sized event (and possible first ever China-syndrome event if the floor of the containment vessel breaches) in Japan is not putting enough radioactive material into the atmosphere to worry about in North America. You get far more radiation exposure daily if you live downwind from a coal fired power plant.

2. You have plenty of iodine on board for daily use if you use iodized salt and have a normal thyroid gland.

3. If you want to have a supply of iodine available in case of a radiation dispersal event in your area, or if you do not store iodized salt in your food storage program (why wouldn’t you?), you can buy the expensive tablets or use one of several perfectly fine alternatives:

a. Pure iodine crystals in bulk (a few ounces of dry crystals per bottle): you can’t buy this any more in any significant quantity due to its ability to make dangerous things, at least not without a license. This is what I store due to its multitude of uses, but c’set la vie for most of you.

b. Polar Pure Iodine Crystals for water disinfection: a very small bottle of dry crystals that makes a super saturated elemental Iodide solution (SSI). Temperature affects the saturation – the warmer the more Iodine in SSI – so we will say that at 70F there is ‘about’ 25 mg of Iodine in 1 drop (defined as 1/3 ml) of SSI. Dosing discussed below. One bottle of Polar Pure will make about 3 ounces or 90 ml of SSI, so you will get about 70 standard adult dose days. Ideal for storage if kept from heat and light, and cheap - $15 for a 3 ounce bottle that provides 70 doses or the ability to treat 500 gallons of water! My choice for prepping. Pack away and forget till needed, will not deteriorate in your (or anyone else’s) lifetime if stored properly. Buy a quality dropper that delivers 1/3 ml per drop don’t guess.

c. Lugol’s Solution: over the counter, get the 5% not the 2 %. This is 85% water, 10% Potassium Iodide, 5 % iodine that when mixed actually ends up as 15% Potassium Tri-iodide Solution, just fine for thyroid blocking. There is ‘about’ 6.3 mg of Iodine in 1 drop of Lugol’s Solution. Dosing given below. Comes with a dropper usually. Good for storage if kept from heat and light. Should not deteriorate to any significant extent.

d. IoSat tablets: the standard Potassium Iodide KI 130 mg tablet for treatment. Handy. Expensive. Good for travel kits – a patient’s hubby was on the ground at Tokyo Narita airport when the earthquake hit and is stuck there now, good thing my exec. travel kit for him had these, huh? Individually sealed tabs, these are what you want for an Uh-Oh supply in the travel kit. Dosing below.

e. Povidone/Iodine (PI) 10% Solution: Available in pads, sticks, and bottles. Don’t use the ‘scrub’ unless you like diarrhea, it has a soap product in it. Ignore the povidone it’s a surfactant that isn’t digested. PI solution contains ‘about’ a 10% Iodine solution, in other words it’s about 1/3 weaker than Lugols’s Solution. There is ‘about’ 4.2 mg of Iodine in 1 drop of Povidone/Iodine 10% solution. Dosing below.

f. Standard water purification tablets: The old military style has ‘about’ 8 mg of Potassium Iodide KI per tablet… swallowing 12.5 tablets daily is not recommended, you will get some awesome nausea. Better to crush the tabs in the bottle to make an SSKI as above. NOTE: many surplus bottles have air leaked or been heat damaged. If they are already crumbling or stuck together or have been open > 3 months they are shot. NOTE: many current water purification tabs are NOT iodine based but chlorine or silver based – won’t help you! Dosing below.

g. Tincture of Iodine 2% - 7%, depending on what you can find. Tinctures (2%) have ‘about’ 4.5 mg iodine per 100 ml – too dilute to be of much use. 2% Free Iodine Solution has 1 mg per drop… still looking at 130 drops for an adult dose. Not very convenient.

h. Various Iodine supplements: They come in a LOT of different strengths. Iodorol is Lugols mix in a tablet, 12.5 mg/tab and 50 mg/tab & SLIGHTLY cheaper than IoSat. Iogen is ridiculously overpriced and too dilute for radiation protection. Ditto Iosol. There are no doubt many others. Remember, many ‘natural’ products have crappy quality control and are very variable on actual quantity of active ingredient. Iodorol is the way to go if you want bulk tablets.

i. Kelp: salt water grown kelp has a strong iodine content. It can be boiled to produce an indeterminate concentration solution. You can soak a piece of paper in the boiled solution, dry, and then expose to sunlight. The faster it turns brown, the stronger the solution. If the solution tastes like metallic crap, you are on the right track. Kelp tablets are available, read the label, typical iodine content is 100-150 MICRO grams per tab so you will be eating a lot of them, not a realistic choice unless you have no other option.

j. ‘Detoxified’/Nacent/Magnanacent/’Cayce’ Iodine: Absolute junk. Ignore.

4. United States FDA/CDC Recommendations for Specific Groups:

a. Iodine in Pregnancy: Because all forms of iodine cross the placenta, pregnant women should take KI to protect the growing fetus. However, pregnant women should take only one dose total of KI following internal contamination with (or likely internal contamination with) radioactive iodine.

b. Women who are breastfeeding: should take only one dose total of KI if they have been internally contaminated with (or are likely to be internally contaminated with) radioactive iodine. Because radioactive iodine quickly gets into breast milk, CDC recommends that women internally contaminated with (or are likely to be internally contaminated with) radioactive iodine stop breastfeeding and feed their child baby formula or other food if it is available. If breast milk is the only food available for an infant, nursing should continue.

c. Infants: Infants need to be given only one dose total the recommended dosage of KI, see dosing below. The amount of KI that gets into breast milk is not enough to protect breastfed infants from exposure to radioactive iodine. The proper dose of KI given to a nursing infant will help protect it from radioactive iodine that it breathes in or drinks in breast milk.

d. Children: Children internally contaminated with (or likely to be internally contaminated with) radioactive iodine should take KI, unless they have known allergies to iodine. Children from newborn to 18 years of age are the most sensitive to the potentially harmful effects of radioactive iodine.

e. Teens & Adults To Age 40: Young adults (between the ages of 18 and 40 years) internally contaminated with (or likely to be internally contaminated with) radioactive iodine take the recommended dose of KI. Young adults are less sensitive to the effects of radioactive iodine than are children.

f. Adults older than 40 years: should not take KI unless public health or emergency management officials say that contamination with a very large dose of radioactive iodine is expected. Adults older than 40 years have the lowest chance of developing thyroid cancer or thyroid injury after contamination with radioactive iodine. They also have a greater chance of having allergic reactions to KI.

5. Iodine Supplementation Side Effects, Complications, Emergencies:

a. Normal side effects include;
i. Nausea, vomiting, stomach ache, diarrhea, metallic taste in the mouth, fever, headache, runny nose, sneezing, or acne may occur

b. Complications include:
i. Burning mouth/throat, sore teeth/gums, swelling inside the mouth, increased saliva, eye irritation/swollen eyelids, severe headache, swelling of the front of the neck/throat (goiter), signs of decreased thyroid gland function (e.g., weight gain, cold intolerance, slow/irregular heartbeat, constipation, unusual tiredness), confusion, tingling in hands/feet.

c. Emergencies include:
i. Chest pain, black stools, vomit that looks like coffee grounds, bloody diarrhea, swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, fever with joint pain, unconsciousness, death.

6. Standard Dosing Guidelines:
a. NOTE: These were recently reduced; make sure you are not using the old ones! These daily doses represent what is currently believed to be the minimum effective doses for Potassium Iodide for thyroid blocking in a radiation dispersal event.

b. Duration? Till .gov says you can stop, or you exit the contamination zone AND are decontaminated, or you experience serious side effects, or you run out.

c. REMEMBER: You MUST know if you are using Potassium Iodide (KI, SSKI, IoSat = 130 mg Potassium Iodide adult daily dose); or Free Iodine (I, SSI, Polar Pure, Povidone/Iodine, Iodine water tabs, Kelp, supplements = 100 mg Iodine adult daily dose) as these each have DIFFERENT mounts of Iodine in them!

d. Dose Potassium Iodide (KI)/Free Iodine (I):
i. Pregnant: 130 mg KI/100 mg I; One Dose Only unless directed otherwise
ii. Breastfeeding: 130 mg KI/100 mg I; One Dose Only unless directed otherwise
iii. Infants birth – 1 month: 16 mg KI/12 mg I; One Dose Only unless directed otherwise
iv. Children 1 month – 3 years: 32 mg KI/25 mg I daily
v. Kids 3 years – 18 years: 65 mg KI/50 mg I daily
vi. Adults/anyone above 150 lbs: 130 mg KI/100 mg daily

Do No Harm. Do Know Harm.

Thanks folks - some excellent info there. I will take time to read it. Like I said earlier, I am not worried about Japan. However, we have 2 reactors in CA and they are both designed to withstand earthquakes up to the 7-7.5 scale (but no more). Not totally reassuring. I am hoping that this Japanese crisis might prompt a review of the emergency shutdown procedures for all reactors in the USA. That is something that we should be able to improve.

One other thing about radioactive iodine ... seems like if you had contamination sources in your environment (or food) that were radioactive, you should be able to detect this with some sort of radiation meter. Assuming that you had a personal meter available (with enough sensitivity), maybe you could just do spot checks on your food and drinking water before consuming it? I don't know if this is really practical, but it might be one approach.

Someone asked (on another thread at the site) how exactly does the radiation in Japan break down? How much is due to alpha, beta, and gamma radiation? Good question. I have never seen that data disseminated, but I bet they've got it. We could ask the same thing about future radiation contamination in the USA. Suppose that we had a real problem with a radioactive plume in the atmosphere. We've got scientsts who should be able to tell us exactly which isotopes are causing the problem - again, this stuff is not rocket science. We've got good people who should be able to give answers.

other Pete

Thanks, a lot of info there.
We have a partially used bottle of "Iosol Iodine". The label on the bottle reads: Below that it indicates that the amount per serving as specified above is 153 mg of iodine which would seem to be a 153% of a standard dose of KI. . .

. . . I think I'm getting enough -- probably more than enough. Time to throttle back . . .

I saw this story about Chinese buying up table salt for treatment of radioactive iodine-131 from Japan (possibly).

Japan radiation fears spark panic salt-buying in China
http://www.latimes.com/news/la-fg-china-iodine-salt-20110318,0,4281601.story?track=rss

I knew it that wouldn't work, but I did some checking.

Prophylactic KI contains 130milligrams of KI for an adult dose of one tablet per day for up to 10 days, depending on the expected length of exposure. (http://ki4u.com/#5)

Iodized salt contains 67 micrograms of iodine per 1/4 tsp. It would take 1940 quarter teaspoon doses of iodized salt to equal one 130mg tablet dose. That's about 10CUPS/6.4lbs of salt!!! (almost 4 - 26oz. cartons)

A little checking (http://members.tripod.com/~Prof_Anil_Aggrawal/POISO014.HTML) and I found that 40tsp/13Tbsp/8.4oz/>3/4C of salt is considered a fatal dose for a 154lb human.

So, in order to get the prophylactic dose of KI from iodized table salt, you'd need to take 13.3 times the fatal dosage of salt EACH day!



Here's some information on the topical application of Iodine.

If Potassium Iodide tablets and access to health care is not available, Iodine tincture should NOT be ingested. Some research has been done showing that applying tincture of Iodine to the skin will allow absorption and protection.

A 1989 study headed by Health Physicist Ken Miller of the Hershey Medical Center conducted on 24 healthy adult male subjects tested the effectiveness of topically applied tincture of Iodine. The subjects were administered a blocking dose of stable iodine by painting 8 ml of a 2 percent tincture of Iodine on a 200 x 100mm area of the abdomen for one group and a 4ml dose administered to a 200mm x 50mm area of the forearm for another group approximately 2 hours prior to I-131 contamination. The synopsis of the study found that "Although there were large variations within each subject group in regard to serum-I (Iodine) levels and thyroid uptakes, the increase in serum-I concentration after topical-I application was effective in reducing the thyroid uptake of I-131. The authors conclude that IN THE ABSENSE OF KI, most humans would benefit from topical application of tincture of-I, and that in some the effectiveness would equal that of oral KI."
(The abstract of his study entitled "Effectiveness of Skin Absorption of Tincture of I in Blocking Radioiodine from the Human Thyroid Gland" published in Health Physics, June 1989, Vol. 56, No. 6, pages 911-914, http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~vL9NcN:1 )

Here is an interesting response from a reader in the UK who was sending a personal comment to the BBC about one of their stories ...

--------------------------------
"It is not 'radiation' that is the concern in a nuclear accident. It is the release of radioactive particles that can then be ingested either directly or months later in food. If that happens, the radioactivity will be permanently lodged in your body to become part of your bones, teeth and organs. Then you will be continuously exposed to radiation for the rest of your life - nothing like [i.e. no comparison to] a quick visit to the X-Ray department for a broken bone."

from Tony Duffin, Didcot, UK
---------------------------------

Pete #2

I'd be more worried about mutagenic properties of many radioactive isotopes. I don't really fancy turning into Hulk, and I suspect any useful super power would be too rare to take the risk.

And from the mutagenic characteristics, it follows that a weak dose can be more dangerous than a more severe one. The latter will kill the cells, while the former would/could mutate them while allowing them to duplicate.

-jh

Interesting, I just read that the French are clearing the store shelves of salt, too.

it would be nice if the producers of iodine containing compounds would provide the molar concentrations of their solutions rather than the percentages

...remember your high school chemistry that a mole of substance is the molecular mass in grams of that substance, and that a molar (M) solution is that amount dissolved in a liter of water, or that a molal (m) solution is dissolved in a 1000g of solvent (typically other than water)

for potassium iodide (KI).... K, mass of 39, I, mass of 127 so a mole (mol) of KI is 166g per mol... dissolved in a liter of water would be a 1M solution of KI

millimole...so if there are 166g KI per liter.... there are 166mg KI per milliliter (ml)

calibration or standardization of the eyedropper/ml calculations....there are a variety of "standards" when doing calculations...there are typically 20 drops of water per mililiter in normal chem calculations, but approx 15 drops for a solution of KI

to titrate for the recommended adult dosage of KI for thyroid blocking of 130mg per day you need 130/166 of 1 ml or around 12drops on the 15d/ml or about 16 drops if the 20 drops /ml value is used

This article pretty much repeats the information already presented. I add it because it is short, written by someone who knows what he is talking about, and it is easy to read and understand while not obscuring the important points:

http://scientopia.org/blogs/whitecoatunderground/2011/03/12/saturday-evening-rant-iodine-edition/

From Nuclear War Survival Skills (available free here )

Trans-Pacific fallout: http://www.oism.org/nwss/s73p929.htm

PREVENTION OF THYROID DAMAGE FROM RADIOACTIVE IODINES http://www.oism.org/nwss/s73p924.htm#Message2476