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Potassion Iodine solution 30ml 65%
Potassion Iodine solution 30ml 65%
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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.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.
WHO Recommended Dosage for Radiological Emergencies involving radioactive iodine[25] Age KI in mg per day
Over 12 years old 130
3 – 12 years old 65*
1 – 36 months old 32
< 1 month old 16
(*...contained in one scored tablet specific for this use. The potassium iodide in iodized salt is insufficient for this use as 80 tablespoons would be needed to equal one tablet.)
The World Health Organization does not recommend KI prophylaxis for adults over 40 years, unless inhaled radiation dose levels are expected to threaten thyroid function; because, the KI side effects increases with age and may exceed the KI protective effects "...unless doses to the thyroid from inhalation rise to levels threatening thyroid function, that is of the order of about 5 Gy. Such radiation doses will not occur far away from an accident site."[25]
The U.S. Department of Health and Human Services restated these two years later as "The downward KI (potassium iodide) dose adjustment by age group, based on body size considerations, adheres to the principle of minimum effective dose. The recommended standard (daily) dose of KI for all school-age children is the same (65 mg). However, adolescents approaching adult size (i.e., >70 kg [154 lbs]) should receive the full adult dose (130 mg) for maximal block of thyroid radioiodine uptake. Neonates ideally should receive the lowest dose (16 mg) of KI."[26]
SSKI (i.e., the solution of KI rather than tablets) may be used in radioiodine-contamination emergencies (i.e., nuclear accidents) to "block" the thyroid's uptake of radioiodine. This is not the same as blocking the thyroid's release of thyroid hormone, for which the dose is different, and for which high-dose KI pills (not a common medical treatment form of KI) are not usually available, or normally used.
[edit] 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[26] 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.[27]
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.”[28]
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.[29] 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.[30]
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.”[31]
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."[25] 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.”[32]
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.”[33] 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.[34]
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.[35]
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.
[edit] Adverse reactions
There have been some reports of potassium iodide treatment causing swelling of the parotid gland (one of the three glands which secrete saliva), due to its stimulatory effects on saliva production.[36]
A saturated solution of KI (SSKI) is typically given orally in adult doses of about 250 mg iodide several times a day (5 drops of SSKI assumed to be ⅓ mL) for thyroid blockage and occasionally as an expectorant. At these doses, and sometimes at much lower doses, side effects may include: acne, loss of appetite, or upset stomach (especially during the first several days, as the body adjusts to the medication). More severe side effects which require notification of a physician are: fever, weakness, unusual tiredness, swelling in the neck or throat, mouth sores, skin rash, nausea, vomiting, stomach pains, irregular heartbeat, numbness or tingling of the hands or feet, or a metallic taste in the mouth.[37]
[edit] Precautions
Mild irritant, wear gloves. Chronic overexposure can have adverse effects on the thyroid. Potassium iodide is a possible teratogen.