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welcome to another medcram lecture today

we're going to talk about iodine and why

countries are stockpiling it that has to

do with the fact that we may be having

some nuclear fallout either from a

reactor or a nuclear weapon that gets

deployed and the problem is is that

there's going to be radiation associated

with that and we're going to talk about

why iodine may be beneficial in just one

area of radiation toxicity

so we're going to go back to our

Blackboard I'm going to talk about the

thyroid gland now the thyroid gland has

really just one purpose and it's to make

a substance called T4 which is later

converted into T3 just know that T3 is

kind of like the oil that greases all of

the processes of your body so it's a

really important organ if you had no

thyroid gland you would die eventually

some people who don't have good thyroid

glands actually take supplementation and

need to make sure that they're checking

on that but your thyroid gland needs

iodine to make T4 and then T3 iodine is

extremely important basically iodine

gets incorporated into T4 into T3 where

do you get iodine from iodine can get

into your body several different ways

obviously food but even air

and the iodine that we find in the

regular environment is an isotope called

iodine 127. now there are other types

but this is the major one and this

number up here is telling you how many

particles basically of neutrons and

protons are in the nucleus of the atom

of iodine the atomic number of Iodine

which is the number of protons is 53 and

so you can have different numbers of

neutrons in the nucleus of the iodine

atom and in this case if you have 74

then you can see that it adds up to 127.

this is basically what's going on every

day in our lives we take in iodine 127

into our thyroid gland the thyroid gland

then as a factory produces T4 and T3

which the body needs if you have some

sort of a nuclear event and there's been

a couple of these unfortunately that

have happened Japanese atomic bomb

survivors we also have the Marshall

Islands where the United States was

testing nuclear ordinances and the

people there were actually getting

radiated probably the best well-known

where we were able to do medical science

on what happened after that is Chernobyl

that's a disaster that occurred in

Ukraine in 1986.

Japanese atomic bomb released amazing

amount of radiation very quickly and

then dissipated same with the Marshall

Island the thing that was different

about Chernobyl is that it was a slow

amount over a long period of time which

actually could be worse in terms of what

we're about to talk about these types of

events make not iodine 127 but iodine

131 which is radioactive

it's still 53 protons but instead of 74

neutrons there are 78. unfortunately

what happens with iodine 131 is that it

gives off different types of radiation

one of them is gamma radiation which is

extremely high powerful electromagnetic

radiation and the other one is beta

particle which is basically a negatively

charged electron but the problem is is

that when this gets incorporated into

your thyroid gland it destroys the

tissue in the thyroid gland and it

Alters the DNA and it causes cancer

specifically causes papillary thyroid

cancer otherwise known as p t c

we can measure this radiation and it's

measured in a unit called a gray which

is abbreviated as g y so how much

radiation potentially to get thyroid

cancer and they found that anywhere

between 50 and 100 milligres that's also

0.050 grays

the problem here is that it can take

anywhere from five to ten years after

the exposure to actually develop thyroid

cancer and it's particularly higher risk

in people who are less than 20 years of

age this is not going to affect people

who are older than 20 years as much as

it is those that are less than 20. so

we're looking at children who are

exposed to high amounts of radiation

anything more than 50 to 100 milligres

of radiation so they've done some

research and we'll put the link to the

reference in the description below and

they looked at survivors of Hiroshima

and Nagasaki they recorded out of 105

000 people who were exposed

371 thyroid cancers between 1958 and

2005. generally speaking the average

person in the study was about 10 years

of age when they were exposed and they

were able to look at them when they were

about 50 years of age and they found

that the exposure increased the risk of

thyroid cancer by 28 percent

they also found in the study that 36

percent of all the thyroid cancer was

attributable to exposure before the age

of 20 to radiation

there is an increase it's not a massive

increase But realize that it's an

increase that can be prevented this 131

iodine goes everywhere it goes into the

air the trees the cows their milk

becomes radioactive and so breathing in

air eating food products all of these

things are ways that iodine gets into

your diet the problem is it's the iodine

131 that's coming in well The receptors

for iodine 131 are identical to The

receptors for iodine 127 which is the

normal iodine and so what we do here is

basically a competition to exclude

iodine 131 from coming into the thyroid

gland so if you take high doses of

iodine 127 you can effectively block out

and prevent iodine 131 from going into

the thyroid gland if you take potassium

iodide it's not going to prevent you

from other types of radiation exposure

that will only prevent the issues with

radiation exposure to the thyroid gland

you can't go out and get the iodine

tablets after the radiation exposure

because you have to do it at the same

time or even before so that the iodine

131 doesn't come in and get taken up by

the thyroid gland

now let's go over some practical

information for how you can acquire and

know how to dose and what to do with

iodine tablets

first question is going to be how do I

get them

so the good news is you don't need a

prescription to purchase potassium

iodide tablets it's not a controlled

substance you can actually buy it as a

nutritional supplement but what I would

recommend is digging a little bit deeper

and I don't endorse any of these

particular Brands but let's see we can

click on one here and we'll see here's a

three pack they come in different

milligram dosages like this one's 130

milligrams there's also a 65 milligram

version that you can buy and we'll talk

about the dosing in a little bit you can

ask questions and see whether or not the

company and the factory that it's made

at is FDA approved and whether or not

it's been verified by a third party

how much do I take

so this is a great website put out by

New York State potassium iodide and

radiation emergencies they have nuclear

power plants in New York state and so

they actually have a rule that anybody

that's within five or ten miles of a

nuclear power plant should have

potassium iodide tablets on hand perhaps

some of you listening can tell us a

little bit more about what they've told

you here's a great FAQ and here's the

table you should look at and it's how

much potassium iodide do I take and so

for birth to one month of age they have

the potassium iodide dosing the number

of milliliters of liquid the number of

65 milligram tablets if you have them

and the number of 130 milligram tablets

if you have those and they have it here

for each one of the ages now we said

that over the age of 20 the chances of

getting thyroid cancer from radiation

exposure is pretty low it's pretty

minimal but if you want to protect

yourself that is an option that you can

do

when should I start taking it what's

going to happen is there's going to be

an announcement from the public health

department or some local Authority

that's going to say you need to start

taking your potassium iodide and if you

don't have it in your home then

obviously you're going to have to go out

and get it and there's going to be a big

surge to get that at that time so it's

good to make sure that you have it on

hand to begin with but the short answer

to this is that they will tell you when

to start taking it because the

authorities actually have ways of

measuring continuously the amount of

radiation in the air there's no harm in

taking it beforehand other than the

risks of taking the medication which

we'll talk about but there is a risk if

you take it too late because if you

start to absorb too much i-131 before

you can block it with the oral tablets

then obviously i-131 is going to go into

your system

for example you can see what the wind

did to the radiation from Chernobyl back

in 1986 and how it spread across Europe

this happened within hours to days to

weeks by the way the radiation here was

in the level of thousands of milligrays

so well above the 50 milligrams that

would increase the risk

how long should I take it for well again

the officials monitoring the radiation

the air will let you know when those

have gone down to safe levels and you

don't have to take potassium iodide

tablets this could last for weeks maybe

even a month or so and this is the

reason countries are stockpiling

potassium iodide it's very cheap to make

very easy but if there's a big demand

for it it might be difficult to get next

question is are there risks of taking

potassium iodide

well if there were big risks they

probably wouldn't make it available over

the counter but are there risks of

taking potassium iodide

back to this New York State Health

Department website on the topic and they

say here that in general most people who

have taken potassium iodide have not had

any reactions or side effects if people

did have a reaction it did not last very

long in a few cases babies had a

reaction in their thyroids adults who

had reactions and stomach problems or

rash the federal government thinks the

benefits of taking potassium iodide are

much greater than the risks that would

of course be during a nuclear incident

but corollary is question number nine

are there some people who should not

take potassium iodide they say most

people can take it but you should talk

to your doctor before taking it let me

just tell you as a physician if you have

a thyroid condition you may want to talk

to your doctor about this especially if

you're under the age of 20 because

you're at most risk for getting thyroid

cancer from radiation exposure but there

are hyperthyroid conditions that if you

were to give high doses of potassium

iodide could actually flare up the

hyperthyroid State an example of that

would be a Graves disease it's possible

that if you took a lot of potassium

iodide that could flare up your your

hyperthyroidism so it's important to

talk to your doctor about whether or not

iodine is the right thing to do there

are some people that are allergic to

seafood and there is a correlation and a

connection between Seafood allergies and

iodine allergies as well at least in the

realm of getting eye donated contrast in

the hospital

can Ki be purchased at local pharmacies

and they say here yes though it may not

widely be available in drug stores near

you since it is not a prescription drug

you can buy it over the internet as with

other drugs make sure that the potassium

iodide you buy has been approved by the

FDA a supply of potassium iodide has

been made available to people who live

within 10 miles of a nuclear power plant

in the New York state area if you live

within 10 miles of a nuclear power plant

and did not receive potassium iodide

contact your local office of Emergency

Management

I'll put a couple links to some great

review articles like this one called

radiation exposure and thyroid cancer a

review

and also this article titled radiation

exposure to the thyroid after the

Chernobyl accident

well I hope this has been helpful to you

and highlighted some things that you may

not have known thanks for joining us

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