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Product Review: Potassium Iodide (KI) and Potassium Iodate (KIO3): Radioprotective Agents |
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Initial Posting: 6/12/07 Updated 8/17/2007
What It Is:
Potassium iodide (KI) and potassium iodate (KIO3) are compounds that can deliver usable, stable iodine to the body. Both forms can be equally effective but vary somewhat in taste and dosage (See ConsumerTips™: What to Consider when Buying for more information about the forms and brands).
What It Does:
As demonstrated following the Chernobyl nuclear reactor accident in 1986, iodine supplements can protect the thyroid gland from the effects of radioactive iodine released by such accidents, as well as from other nuclear events. It is an effective means by which to protect against the effects of radioactive iodine when evacuation, sheltering, or avoidance of contaminated food and milk cannot prevent exposure. KI and KIO3 cannot, however, protect against absorption of materials besides radioactive iodine.
Thyroid cancer rates have been reported to increase by as much as 100 fold in exposed populations, with malignancies beginning approximately four years after exposure. Children are particularly sensitive to radioactive iodine because their thyroid glands are very active. In fact, prophylaxis with stable iodine is recommended for children when even low doses of radiation are present, while adult prophylaxis is only recommended at higher levels of exposure. (See ConsumerTips™: What to Consider When Using for more information.)
Radioactive iodine released during a nuclear accident or explosion moves in the environment through the air and can be inhaled, making it most dangerous to individuals downwind of the accident or explosion. As it moves, it can also affect drinking water and exposed crops. Milk from animals grazing on exposed grasses is also affected and, in the Chernobyl incident, milk exposed many people to radioactive iodine who were not otherwise directly exposed. Iodine is needed by the thyroid gland to produce hormones. The iodine pills essentially saturate the thyroid gland with non-radioactive iodine and block the uptake of radioactive iodine. Stable iodine is most effective if taken a few hours prior to exposure but can be beneficial even if taken within three hours after exposure.
Risks of Exposure and Availability of Iodine Pills in the U.S.:
There are more than 100 nuclear reactors operating in the United States. As shown in the diagram below, states with the highest number of reactors are Illinois (11), Pennsylvania (9), New York (6), South Carolina (7), Alabama (5), Florida (5), North Carolina (5), California (4), Georgia (4), Michigan (4), New Jersey (4) and Texas (4), and Virginia (4).
Currently, the Nuclear Regulatory Commission (NRC) offers KI tablets at no cost to States that request it for people within 10 miles of a nuclear power plant. However, to date, only 15 of the 35 eligible States have accepted the NRC's offer or had a pre-existing public KI stockpile, and some States, such as Illinois and Georgia, are on record as staunchly in opposition to this simple, effective drug out of concern that people will feel protected from all nuclear consequences and not evacuate. States that have accepted the tablets have largely left the distribution up to those municipalities having residents within 10-mile radius zone of nuclear power plants.
The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 recently passed by Congress includes a provision (introduced by Congressman Edward J. Markey of Massachusetts) that expands the radius of KI distribution to twenty miles. However, currently outside the ten-mile radius of the nuclear facility, the Federal Emergency Management Agency (FEMA) is responsible for regulating the distribution of KI. The Department of Health and Human Services controls the national pharmaceutical stockpiles that are to be sent rapidly into emergencies. And other government agencies control evacuation of radiological emergency zones. To make matters even more confusing, if you happen to live within a ten-mile radius of a nuclear weapons facility, the Department of Energy controls the distribution of the KI. Because of the potential for bureaucratic delays due to overlapping responsibilities, President Bush, in his recent proposal to create a cabinet-level Department of Homeland Security, highlighted KI as an illustrative example of the need for better coordination among the various federal agencies and State and local authorities charged with protecting public health in the event of a radiological emergency. The proposal characterizes KI as a "crucial drug" and calls for a single agency to be responsible for its distribution.
Meanwhile, the American Thyroid Association recommends for distribution of pills to individuals living within 50 miles of a nuclear facility, extra stockpiles at emergency centers within that radius, and additional stockpiles at public facilities from 50 to 200-miles out.
Quality Concerns and What CL Tested For:
Some KI products are sold as over-the-counter medications and others, including KIO3 products, are sold as dietary supplements. While OTC products are required to be manufactured under more strict guidelines and in FDA approved facilities than dietary supplements, neither type of product is routinely tested for quality prior to sale by any government agency. Consequently, ConsumerLab.com as part of its mission to independently evaluate products that affect health, wellness, and nutrition, purchased and tested KI and KIO3 products for the following: (See How Products Were Evaluated for more information):
- Labeled Amount — Does the product really contain the labeled amount of stable iodine? Too little iodine in a supplement is a problem if relying on it to block radioactive iodine. Excessive consumption, particularly among infants, can affect thyroid functioning and metabolism.
- Availability for absorption — Once in your body, will the pill break down properly so that it can be absorbed?
In addition, because timely administration of stable iodine is crucial during an emergency but government distribution systems are largely untested at this time, ConsumerLab.com sought to determine how effectively the products could be obtained through local pharmacies — although not a requirement for a product to pass testing.
What CL Found:
Getting it:
Checking with various pharmacies across the country near nuclear reactors, CL found that it was virtually impossible in April and May 2002 to obtain these KI or KIO3 locally. Many pharmacies did not have any available and could not order it. Others did not have any on hand, but said that they could order with a prescription — even though the KI and KIO3 are not prescription drugs but supplements or over-the-counter medicines. CL was, however, able to find several brands of KI or KIO3 sold on the Internet, with shipments taking approximately 4 to 12 days.
After purchasing the products, it came to ConsumerLab.com's attention that some local pharmacies supposedly do sell KI or KIO3 products and municipalities near nuclear reactors have begun to list such pharmacies on their Web sites. Interestingly, an instance of potential price gauging was recently reported in Westchester Country, New York, where a local pharmacy was charging $75 for 14 pills — which is eight to fourteen times the normal price.
CL purchased six products through the Internet: Three KI tablet products, one KI powder product, and two KIO3 tablet products. Two of the KI tablet products are approved by the FDA as over-the-counter (OTC) medications, indicating that they produced under more rigid quality controls than products sold as supplements.
Of the six products, all were found to contain the labeled amount of KI or KIO3. In addition, all tablet forms were found to disintegrate properly in solution, indicating that they would be available for absorption. These results compare very favorably to other tests conducted by ConsumerLab.com on other mineral, vitamin, and herbal supplements.
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