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| Potassium Iodide |
Thyroid protection during medical treatment
Thyroid iodine uptake blockade with potassium iodide is used in nuclear medicine scintigraphy and therapy with some radioiodinated compounds that are not targeted to the thyroid, such as iobenguane (MIBG), which is used to image or treat neural tissue tumors, or iodinated fibrinogen, which is used in fibrinogen scans to investigate clotting. These compounds contain iodine, but not in the iodide form. However, since they may be ultimately metabolized or break down to radioactive iodide, it is common to administer non-radioactive potassium iodide to ensure that iodide from these radiopharmaceuticals is not sequestered by the normal affinity of the thryoid for iodide.(Buy Potassium Iodide here
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)FDA-approved dosing of potassium iodide for this purpose with iobenguane, is as follows (per 24 hours): infants less than 1 month old, 16 mg; children 1 month to 3 years, 32 mg; children 3 years to 18 years, 65 mg; adults 130 mg.[20] However, some sources recommend alternative dosing regimens.
Not all sources are in agreement on the necessary duration of thyroid blockade, although agreement appears to have been reached about the necessity of blockade for both scintigraphic and therapeutic applications of iobenguane. Commercially available iobenguane is labeled with iodine-123, and product labeling recommends administration of potassium iodide 1 hour prior to administration of the radiopharmaceutical for all age groups, while the European Associated of Nuclear Medicine recommends (for iobenguane labeled with either isotope,) that potassium iodide administration begin one day prior to radiopharmaceutical administration, and continue until the day following the injection, with the exception of new-borns, who do not require potassium iodide doses following radiopharmaceutical injection.
Thyroid protection due to nuclear accidents and emergencies
Product labeling for diagnostic iodine-131 iobenguane recommends potassium iodide administration one day before injection and continuing 5 to 7 days following administration, in keeping with the much longer half-life of this isotope and its greater danger to the thyroid. Iodine-131 iobenguane used for therapeutic purposes requires a different pre-medication duration, beginning 24–48 hours prior to iobenguane injection and continuing 10–15 days following injection.
In 1982, the US FDA approved potassium iodide to protect thyroid glands from radioactive iodine involving accidents or fission emergencies. In an accidental event or attack on a nuclear power plant, or in nuclear bomb fallout, volatile fission product radionuclides may be released. Of these products, 131I is one of the most common and is particularly dangerous to the thyroid gland because it may lead to thyroid cancer. By saturating the body with a source of stable iodide prior to exposure, inhaled or ingested 131I tends to be excreted, which prevents radioiodine uptake by the thyroid. The protective effect of KI lasts approximately 24 hours. For optimal prophylaxis, KI must be dosed daily until a risk of significant exposure to radioiodine by either inhalation or ingestion no longer exists.
Emergency 130 milligrams potassium iodide doses provide 100 mg iodide (the other 30 mg is the potassium in the compound), which is roughly 700 times larger than the normal nutritional need (see recommended dietary allowance) for iodine, which is 150 micrograms (0.15 mg) of iodine (as iodide) per day for an adult.
Potassium iodide cannot protect against any other causes of radiation poisoning, nor can it provide any degree of protection against dirty bombs that produce radionuclides other than radioisotopes of iodine. See fission products and the external links for more details concerning radionuclides.
Historical use and analysis
Following the Chernobyl nuclear reactor disaster in April, 1986, a saturated solution of potassium iodide (SSKI) was administered to 10.5 million children and 7 million adults in Poland as a prophylactic measure against accumulation of radioactive iodine-131 in the thyroid gland. People in the areas immediately surrounding Chernobyl itself, however, were not given the supplement.
Potassium iodide’s (KI) value as a radiation protective (thyroid blocking) agent was demonstrated at the time of the Chernobyl nuclear accident when Soviet authorities distributed it in a 30 km zone around the plant. The purpose was to protect residents from radioactive iodine, a highly carcinogenic material found in nuclear reactors which had been released by the damaged reactor. Only a limited amount of KI was available, but those who received it were protected. Later, the US Nuclear Regulatory Commission (NRC) reported, “thousands of measurements of I-131 (radioactive iodine) activity...suggest that the observed levels were lower than would have been expected had this prophylactic measure not been taken. The use of KI...was credited with permissible iodine content in 97% of the evacuees tested.”
Poland, 300 miles from Chernobyl, also distributed KI to protect its population. Approximately 18 million doses were distributed, with follow-up studies showing no known thyroid cancer among KI recipients.With the passage of time, people living in irradiated areas where KI was not available have developed thyroid cancer at epidemic levels, which is why the US Food and Drug Administration (FDA) reported “The data clearly demonstrate the risks of thyroid radiation...KI can be used [to] provide safe and effective protection against thyroid cancer caused by irradiation.
Chernobyl also demonstrated that the need to protect the thyroid from radiation was greater than expected. Within ten years of the accident, it became clear that thyroid damage caused by released radioactive iodine was virtually the only adverse health effect that could be measured. As reported by the NRC, studies after the accident showed that “As of 1996, except for thyroid cancer, there has been no confirmed increase in the rates of other cancers, including leukemia, among the...public, that have been attributed to releases from the accident.”
But equally important to the question of KI is the fact that radiation releases are not “local” events. Researchers at the World Health Organization accurately located and counted the cancer victims from Chernobyl and were startled to find that “the increase in incidence [of thyroid cancer] has been documented up to 500 km from the accident site...significant doses from radioactive iodine can occur hundreds of kilometers from the site, beyond emergency planning zones." Consequently, far more people than anticipated were affected by the radiation, which caused the United Nations to report in 2002 that “The number of people with thyroid cancer...has exceeded expectations. Over 11,000 cases have already been reported.”
These findings were consistent with studies of the effects of previous radiation releases. In 1945, millions of Japanese were exposed to radiation from nuclear weapons, and the effects can still be measured. Today, nearly half (44.8%) the survivors of Nagasaki studied have identifiable thyroid disease, with the American Medical Association reporting “it is remarkable that a biological effect from a single brief environmental exposure nearly 60 years in the past is still present and can be detected.” This, as well as the development of thyroid cancer among residents in the North Pacific from radioactive fallout following the United States' nuclear weapons testing in the 1950s (on islands nearly 200 miles downwind of the tests) were instrumental in the decision by the FDA in 1978 to issue a request for the availability of KI for thyroid protection in the event of a release from a commercial nuclear power plant or weapons-related nuclear incident. Noting that KI’s effectiveness was “virtually complete” and finding that iodine in the form of potassium iodide (KI) was substantially superior to other forms including iodate (KIO3) in terms of safety, effectiveness, lack of side effects, and speed of onset, the FDA invited manufacturers to submit applications to produce and market KI.
Today, three companies (Anbex, Inc., Fleming Co, and Recip of Sweden) have met the strict FDA requirements for manufacturing and testing of KI, and they offer products (IOSAT, ThyroShield, and Thyro-Safe, respectively) which are available for purchase. The Swedish manufacturing facility for Thyrosafe, a potassium iodide tablet for thyroid protection from radiation manufactured by Recipharm AB, was mentioned on the secret US 2008 Critical Foreign Dependencies Initiative leaked by Wikileaks in 2010.
It was reported on March 16, 2011, that potassium iodide tablets were given prophylactically to U.S. Naval air crew members flying within 70 nautical miles of the Fukushima Daiichi Nuclear plant damaged in the massive Japanese earthquake (8.9/9.0 magnitude) and ensuing tsunami on March 11, 2011. The measures were seen as precautions, and the Pentagon said no U.S. forces have shown signs of radiation poisoning.
souurce: wikipedia.org
