Radiation Safety in a Bottle

The Nuclear Regulatory Commission (NRC) stated July 1, 1998:

"Potassium iodide, 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."

Label dosing recommendations mirrors new WHO guidelines below. (Especially important for dosing children.)

For all its serious potential for widespread damage to populations (and especially among our youngest), far downwind from the site of a nuclear event, radioiodine health concerns can be largely neutralized by inexpensive thyroid blocking via prompt prophylactic use of potassium iodide (KI). This, in addition to successful evacuation, when indicated, and vigilance that food and milk are not also radioiodine contaminated, has proven itself the best combination strategy.

Each bottle contains 200 tablets, sufficient for 100 adult daily doses, or 200 child (age 3+) doses, etc. Easily dose a child age 3+ with a single coated tablet! Small coated tablets overcome typical KI bitterness when dosing children 3+ years old with single whole tablet.

Bottles have NDC#, are double safety sealed, with childproof cap and contain desiccant for extended storage life. Manufactured March/02 with expiration date of April/05. A Product Information Guide is included with each bottle.

*Adolescents approaching adult size (> 154 pounds or 70 kg) should receive the full adult dose (130 mg).

The World Health Organization recent recommendations has a step increase in doses by age (chart below) and also states the potential benefit diminishes with older adults. In fact, if only a limited number of Potassium Iodide (KI) or KIO3 tablets are available, these should always be given to infants, children and young adults first as they are the most vulnerable and also the risk of thyroid cancer fully developing begins to drop off with adults much over 40 years of age.

Why the Difference in Dosage Recommendations?

To help make sense of any possible dosing confusion and radiation level thresholds, it should be remembered first that you should not commence dosing until so directed by a doctor or public health officials. Also, the biggest difference in dosage and ages, between the two recommendations, is that WHO suggests an adult dose (130mg KI) for everyone over 12 where the FDA suggests an adult dose for everyone over 18, unless the adolescent weighs 70kg (154 lbs) or more. The primary reason for this divergence from the WHO recommendations is that, according to the FDA: For the sake of logistical simplicity in the dispensing and administration of KI to children, FDA recommends a 65-mg dose as standard for all school-age children while allowing for the adult dose (130 mg, 2 X 65 mg tablets) in adolescents approaching adult size.

At the WHO dosages recommended above, an adverse reaction rate of less than 1 in 10 million children and less than 1 in 1 million adults is expected. However, Potassium Iodide should not be used by people allergic to iodine. According to the WHO, contraindications for use of potassium iodide are: (1) past or present thyroid disease (e.g., active hyperthyroidism), (2) known iodine hypersensitivity, (3) dermatitis herpetiformis, and (4) hypocomplementaemic vasculitis.

You should also check with your doctor before taking this medication if you have myotonia or hyperkalemia congenita or tuberculosis or kidney disease. See http://www.mayoclinic.com/ for more information.

Pregnant women should consult a physician prior to continuing dosages for more than two days. According to the WHO, "No negative consequences are to be expected after one or two doses of stable iodine. However, especially in areas with dietary iodine deficiency, prolonged dosage could lead to maternal and/ or fetal thyroid blockage, with possible consequences for fetal development. ... Pregnant women with active hyperthyroidism must not take stable iodine because of the risk of fetal thyroid blockage."

For pregnant or nursing women, and for cautions to the proper dosing of neonates, also read the appropriate sections here in the newly released (November, 2001) FDA document entitled Potassium Iodide as a Thyroid Blocking Agent in Radiation Emergencies.

The WHO also states, and the FDA concurs, "Side effects in other parts of the body, such as gastrointestinal effects or hypersensitivity reactions, may occur but are generally mild and can be considered of minor importance."

Certain forms of iodine help your thyroid gland work right. Most people get the iodine they need from foods like iodized salt or fish. The thyroid can "store" or hold only a certain amount of iodine.

In a radiation emergency, radioactive iodine may be released in the air. This material may be breathed or swallowed. It may enter the thyroid gland and damage it. The damage would probably not show itself for years. Children are most likely to have thyroid damage.

If you take potassium iodide, it will fill up your thyroid gland. This reduces the chance that harmful radioactive iodine will enter the thyroid gland.

Usually, side effects of potassium iodide happen when people take higher doses for a long time. You should be careful not to take more than the recommended dose or take it for longer than you are told. Side effects are unlikely because of the low dose and the short time you will be taking the drug.

Possible side effects include skin rashes, swelling of the salivary glands, and "iodism" (metallic taste, burning mouth and throat, sore teeth and gums, symptoms of a head cold, and sometimes stomach upset and diarrhea).

A few people have an allergic reaction with more serious symptoms. These could be fever and joint pains, or swelling of parts of the face and body and at times severe shortness of breath requiring immediate medical attention.

Taking iodide may rarely cause overactivity of the thyroid gland, underactivity of the thyroid gland, or enlargement of the thyroid gland (goiter).

Threshold Thyroid Radioactive Exposures and Recommended Doses of KI for Different Risk Groups
	Predicted Thyroid exposure (cGy)	KI dose (mg)	# of 130 mg tablets	# of 65 mg tablets
Adults over 40 yrs	>500	130	1	2
Adults over 18 through 40 yrs	>10
Pregnant or lactating women	> 5
Teens over 12 through 18 yrs*		65	1/2	1
Children over 3 through 12 yrs		65	1/2	1
Over 1 month through 3 years		32	1/4	1/2
Birth through 1 month		16	1/8	1/4

Age Group	Mass of iodine mg	Mass of KI mg	Mass of KIO3 mg	Fraction of 100 mg tablet
Adults and adolescents (over 12 years)	100	130	170	1
Children (3-12 years)	50	65	85	1/2
Infants (1 month to 3 years)	25	32	42	1/4
Neonates (birth to 1 month)	12.5	16	21	1/8