We are all saddened as we watch the unfolding events in Japan. There is a growing sense of fear, as well.
The nuclear catastrophe raging through Japan's nuclear power complex is generating an intense fear of radioactive fallout potentially reaching North America. My patients and friends have been asking about how best to protect themselves and their families, as there is considerable confusion in the media about the issue.
Even as government officials and health experts downplay the health risk to U.S. citizens, pharmacies up and down the West Coast of the United States have been stripped bare of their stock of potassium iodide tablets -- a frontline treatment for radiation exposure. Anxious buyers turning to the internet are faced with a similar lack of available supplies. So, what do we do? It's a growing, ever-changing scenario, and here are my current thoughts, certainly open to modification.
Are we really at risk of exposure from radioactive fallout generated by a nuclear meltdown in Japan? I believe this is a question best left to qualified nuclear scientists and meteorologists. But after serving as a consultant to the Independent Safety Committee for the Diablo Canyon Nuclear Power Plant from 1990 to 2002, I know firsthand how important it is to be prepared for all possibilities when dealing with nuclear radiation.
One of the greatest dangers following a nuclear accident comes from exposure to gases containing radioactive isotopes of iodine. These highly carcinogenic isotopes are readily taken up by the thyroid gland, resulting in the development of thyroid cancer. Exposure to radioactive iodine calls for immediate treatment with another form of iodine, potassium iodide, to saturate the thyroid and block the absorption of radioactive iodine. This is especially critical for children, pregnant women, and nursing mothers, who are most at risk following a nuclear disaster. A lack of adequate supplies of potassium iodide tablets after the Chernobyl nuclear disaster in 1986 resulted in thyroid cancer for thousands of untreated children.
Potassium Iodide (KI)
Potassium iodide tablets are commonly stockpiled near nuclear power plants to allow for rapid distribution in case of a radioactive accident. In the absence of tablets, potassium iodide may also be administered as a "saturated solution of potassium iodide" (SSKI) which in the U.S.P. generic formulation contains 1000 mg of KI per ml of solution. Two drops of U.S.P. SSKI solution is equivalent to one 130 mg KI tablet (100 mg iodide).
According to the World Health Organization (WHO), the following doses of potassium iodide should be taken as a single dose within three hours of exposure, or up to 10 hours after exposure, although this is less effective.
• Adults : 130 mg (see below as well for CDC addendum)
• Adolescents: 12-18: WHO -- adult dose; CDC -- children's dose; if adult size (150 pounds or over) they should take the full adult dose, regardless of their age.
• Children age 3-12 years: 65 mg
• Infants : 1 mo. to 3 years, 32. 25 mg (ie half tablet)
• Newborns to 1 mo., 1/4 capsule.
Note: Dosages may be crushed and taken mixed with milk or water. For kids, chocolate milk or raspberry syrup disguise the unpleasant taste.
While potassium iodide can be taken by a majority of people without any problems, it should only be used in case of a nuclear emergency. Doses in excess of the single (one time only) daily dose listed above should be taken only upon recommendation by a physician or public health authority. Patients should ask their doctor if taking quinidine, captopril, or enalopril, amiodarone, or if they are sensitive to iodine, or suffer from dermatitis herpetiformis, thyrotoxicosis or kidney problems before taking potassium iodate (or any thyroid blocker).
It is best to take iodide prophylactically, prior to exposure. Every family should have a good supply in their homes. At this time we may recommend taking 10-40mg per day. A dose of 30-50mg is the range of dietary intake in Japan and relatively safe to take long term but under practitioner monitoring. Build up gradually: 10mg-20mg-30mg-40mg.
Then, in case there is an official announcement of significantly increased radiation, adults should go to the dose mentioned above: 130mg/day and children to lower doses per body weight, generally 65 mg, age 3-12 years. You can use a loading dose of two drops daily of Lugol's Iodine, a commonly available pharmaceutical form of potassium iodide, or SSKI, and increase to 130 mg if needed. See the U.S. Centers for Disease Control recommendations. Adults over 40 should not take KI unless public health officials say that contamination with a very large dose of radioactive iodine is expected, since have the lowest risk of developing thyroid cancer or thyroid injury after such contamination. They also have a greater chance of having allergic reactions to KI. Everyone should check with their doctor, in any case.
Other supplements that may be protective are: vitamin D and vitamin K as they support appropriate apoptosis, which is programmed death of cells that accumulate various DNA errors (due to radiation and other causes), and vitamin D also supports DNA repair.
Avoid exposure to rain that may be laden with radiation if we are exposed. You'll be informed by authorities if that is the case.
Other Radiation Dangers
Besides I-131, there are other toxic radio-isotopes, including cerium 137 and plutonium. Dr. Gabriel Cousens has provided some excellent advice in his book "Conscious Eating." To protect yourself from cesium poisoning, consume plenty of high potassium foods, as potassium competitively inhibits cesium uptake. Foods high in potassium include avocados, sea vegetables, and leafy green vegetables, and are more effective than taking a potassium supplement.
To protect yourself from plutonium poisoning, eat lots of dulse and consume iron from plant sources, namely sea algaes such as spirulina and chlorella, which provide more iron than red meat. Miso soup has also been shown to have a protective effect. See also Michio Kushi's well-referenced book, "The Cancer Prevention Diet." The mineral, zeolite, is being investigated for taking most radioactive materials out of the body.
Additionally, foods and supplements high in antioxidants, will also help the body cope with these higher toxic levels as radioactive materials cause antioxidant depletion and ill health.
The Nuclear Regulatory Commission has admitted it is 'quite possible' that fallout from the Japanese reactors could reach America, though levels expected to be so low as to be almost undetectable. Given the unprecedented circumstances of the current crisis, though, it would be prudent to keep some potassium iodide on hand as a precautionary measure.
Stay tuned to news sources for ongoing information, as this story is clearly developing by the minute.
For both those directly affected and those of us who feel the stress of this tragedy, check out some simple trauma-releasing methods, such as EMDR, EFT: or download free EFT audio "Tapping for Japan."
If I am able to find sources of tablets, I'll put a note here in comments, and list them on my website, as well. Otherwise, I'd recommend using SSKI which I'll likely be getting for my patients in the absence of tablets or capsules.
Our prayers are with the people of Japan, those who have lost their lives and those who have survived, and are dealing with trauma, grief and unspeakable loss.
Follow Hyla Cass, M.D. on Twitter: www.twitter.com/hylacassmd