Introduction
The human thyroid gland uses iodine as part of its natural function. When radioactive iodine is present in an environment (due to a nuclear incident), if inhaled or ingested it will be absorbed by the thyroid which can cause thyroid cancer to develop. Non-radioactive iodine can be used to saturate the thyroid, blocking it from taking up radioactive iodine and thus reducing the risk of developing thyroid cancer. Taking iodine does not protect the whole body from radiation (taking refuge in a well-shielded shelter is the best way to do that, see below).
Recommendation 1: KI Tablets
The first recommendation is to have at least one pack (14 tablets) of potassium iodide (KI) pills for each individual on hand. The recommended source is nukepills.com because these have been FDA approved for this purpose (thyroid blocking in radiation emergencies) since 1982. This recommendation applies particularly to people under age 40, who are at highest risk of developing thyroid cancer from radiation. It also applies to people over age 40 who are subjected to significant doses of radiation, for example because they are part of an emergency response team working outdoors (unshielded) in an affected area. Much more information, including dosing for children etc. is available in the package insert:
Recommendation 2: Dosimeters
This author also recommends dosimeters to help assess radiation exposure, particularly for people who will be working outside of shelters (with more potential for exposure to radiation). Stock at least one for
each individual in your household, especially those who will be spending time in different environments (e.g. inside your house / shelter vs. outside).
Recommendation 3: Geiger counter
“Survey meters” or “Geiger counters” are used to measure the exposure rate of radiation in an environment, for example in units of R/hour or mSv/minute. This author suggests having one unit per household. These devices are available from firms such as KI4U, Inc. which sells refurbished and calibrated Cold War era “Civil Defense” units http://www.ki4u.com/products1.php and GQ Electronics, LLC which offers units of modern design here (many of the CCG Electronicss products are available on Amazon.com for example as well). A modern Geiger counter can be set to sound an alarm when local radiation levels exceed a set threshold, allowing you to become aware of any risk independent of notifications from “the authorities.” It can be used to assess the health risks from radiation in your local environment and to check the effectiveness of your shelter’s shielding. It is useful for checking food (including animal feed) that might have fallout in / on it and for checking clothing of people who are coming into a shelter (essentially, it helps you ensure you are not ingesting, or bringing into your shelter, items which are emitting radiation and thus would be increasing your exposure over time). Thus it is particularly useful in a “shelter management” role (i.e. have at least one per shelter) but not necessarily an item each individual needs to have. This author chose the GMC-500+ which has the highest detection range in the GQ Electronics lineup (up to 20 mSv/hr), but even that rate may be exceeded in areas with heavy fallout.
Recommendation 4: Shelter Plan
Create a plan for sheltering in place. This includes planning for shielding from radiation, and supplies and procedures to sustain the occupants of your shelter. Shielding is the best and most preferred solution to a radiation emergency because it protects the whole body. It is essential for the most vulnerable groups including babies, pregnant mothers, nursing mothers, etc. Proper shielding can only be done by placing many feet of dense material (dirt, concrete, stacks of books, etc) in between the patient and the radiation source, in all directions (since radiated particles can “bounce”). Excellent guides (consider printing one or more in advance) are available online, including:
Recommendation 5: Treatment Plan
Plan to treat symptoms of radiation exposure, starting with the video and reference document available here:
Ingestion of pectin preparations can be used to reduce radiation damage, and has been used in Eastern Europe particularly for children in areas impacted by the Chernobyl disaster. A brief overview can be found here but this author has not found specific step-by-step preparation and dosing guidance. (One preparation involves drying and then milling the leftovers from pressing apples, for example.)
FAQ
Isn’t iodine a magic pill that will protect my whole body? No. Do not fixate on iodine supplementation as some sort of “magical radiation protection potion” for the whole body, for everyone. This is simply not correct. Saturating the thyroid with iodine in a radiation emergency is specifically to reduce the risk of developing thyroid cancer in people under 40, or people over 40 who are exposed to significant doses of radiation.
“The risk of radioinduced thyroid cancer for adults aged over 40 years is quite low, so adults over 40-45 should take potassium iodide only in case of a predicted high internal dose of thyroid radiation (>5 Gy).”
I’m over 40. How do I know if I should take KI?
The conversion from units of mSv on your RadTriage dosimeter to Gy (in this context, a measure of the internal exposure of a specific organ, in this case the thyroid) is not a direct one, but per page 11 of Handbook for Survival – Saving Lives During Radiation Releases and Other Disasters you can use the approximation 1 Gy = 1 Sv = 1000mSv: “…except in the rare cases when persons are caught in the
radioactive (or “mushroom”) cloud, internal doses are not likely to be as serious as external doses, and would likely be negligible for those indoors during times of maximum fallout and external radiation. Therefore, for the general citizen’s purposes in providing immediate protection, any measurements from radiation instruments should assume that… 1 Gy = 1 Sv … and you will be on the safe side.”
Your RadTriage dosimeter maxes out at 4000mSv (approx 4Gy). Thus in the opinion of this author (who is not an expert and not giving medical advice), if you are over age 40 you should only think about taking potassium iodide prophylactically for thyroid protection if your personal dosimeter is on track to max out. If that is the case, you quite likely have many other things to worry about (in terms of radiation exposure symptoms at that dose, which from 4Gy up is considered “severe” also per the above link).
Can’t I use cheaper iodine products?
This author specifically recommends that people DO NOT plan to use Lugol’s solution and other commonly available potassium iodate or potassium iodide pill products (often cheaper and available in bottles / bulk) for this purpose (thyroid blocking in radiation emergencies) for a variety of reasons.
Why not use / recommend Lugol’s?
Lugol’s is typically used orally in context of daily / multiple times per week nutritional supplementation of iodine for general health. In the doses we’re talking about here – high enough to saturate the thyroid to prevent uptake of environmental iodine – Lugol’s ingested orally can be harmful. It can be used via skin absorption, however. (“Iodine prophylaxis” in the reference below refers to what we’re talking about here, thyroid saturation in a radiation emergency.)
“As iodine prophylaxis, alcohol tincture of iodine and Lugol’s solution are prescribed ONLY for SKIN use. Ingestion of tincture of iodine, Betadine, or Lugol’s solution can cause severe mucosal burns and poisoning. Numerous studies have confirmed the effectiveness of the cutaneous application of iodine alcohol tincture and Lugol’s solution in the recommended dosage at the level of a single dose of potassium iodide orally (see the dosage table). Alcoholic iodine solution, as well as Lugol’s glycerol solution, contains molecular iodine in addition to potassium iodide, which does not enter the bloodstream immediately and when ingested can cause damage and burns to gastrointestinal tissues, poisoning due to the iodine toxicity as halogen. These drugs should be applied to the skin only. To be applied to the skin of the forearm or leg (to be repeated in two days if a risk of radioactive iodine intake remains). Attention: allergy is possible when applied to the skin, be sure to check the reaction before applying a
drop of the drug on the inside of the wrist.”
The link above gives specific recommendations for dosing Lugol’s for skin absorption in this context (for example, for adults up to 40 years old “40-44 drops of 5% iodine solution or 20 drops of Lugol’s solution to be applied on the forearm or shin skin once per day”). For this basic guide, this author recommends the FDA-approved KI tablets instead because in a radiation emergency do you really want to be running around trying to manage a shelter / care for loved ones while also taking the time to effectively absorb that much iodine through your skin (keeping the area clean, not having the iodine get brushed off by clothing / activity, etc.)? It’s much easier to just pop 1 KI pill a day so you can focus on critical tasks.
What about potassium iodate?
It is important to distinguish between iodate and iodide. Potassium iodate is a stronger intestinal irritant, is less effective for thyroid blocking, and has a higher risk of side effects than potassium iodide. Thus iodate is not FDA approved for this purpose and manufacturer claims of FDA approval for potassium iodate products are false. See:
What about bottles of pills?
Again, such products are not FDA approved. Potassium iodide and iodate products are sensitive to moisture in the air and will start to degrade / become unstable if exposed to humidity. See:
What if someone is allergic to iodine?
The Iosat package insert says “People who are allergic to iodine, have dermatitis herpetiformis or hypocomplementemic vasculitis, or have nodular thyroid disease with heart disease should not take KI.” If someone is in that situation, the best recommendation is for them to take shelter in a well-shielded area which is a more complete and the best form of protection for anyone.
Nukepills.com sounds like a meme site. Are they legit?
Yes. See:
What’s the difference between a dosimeter and a Geiger counter?
The RADTriage is a dosimeter and is meant to document the total radiation exposure you as a person have accumulated over time, in units of milliSieverts (abbreviated mSv); older US Civil Defense dosimeters use roentgens (abbreviated as R). For general purposes of immediate protection in a radiation emergency, the approximation 1 R ≈ 10 mSv can be used per Handbook for Survival (discussed above). On the other hand, “survey meters” or “Geiger counters” are used to measure the exposure rate of radiation in an environment, for example in units of R/hour or mSv/minute.
How do I use a Geiger counter to determine the risk in my environment?
For those who plan to use a Geiger counter to measure the current health risks from radiation in their local environment, this simple chart is a helpful guide to interpreting the risk from the numbers you’re measuring. Remember, the radioactivity of fallout decays over time, so at the moment “fresh” fallout is deposited on your location, the radiation levels are most dangerous right then but will continue to decrease from there:
This OSHA guidance can also give you a feel for the risk level you may be dealing with:
Note, as discussed above, the difference in units – e.g. mSv/hr measures the rate of exposure (as you’d see on a Geiger counter), vs. mSv or Sv measures the total accumulated dose as you’d see on a dosimeter. 1 Sv = 1,000 mSv = 1,000,000 uSv.
How do I use a Geiger counter to assess whether food or animal feed is safe to consume?
This is a complex topic, but more information is available at
-
- KI4U >
- Really Simple Guide to Radiation Levels in μSv/h and mSv/h (in particular, see page 27).
I don’t have a Geiger counter. How do I know if my area is at risk?
If a radiation event occurs and you don’t have a way to measure local radiation, you may be able to use these maps to see radiation trends across an area.
Note: displayed units are NOT in uSv/hr, you need to click on a station to see that value) or:
Disclaimer
The author is not a medical practitioner or domain expert in any of the fields discussed here. These notes are not medical advice. Please seek your own training, do your own research, and have your own conversations with qualified medical practitioners.
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