Iodine pills: is it right to stockpile in case of nuclear radiation?
The debate over the preventive intake of iodine to protect the thyroid against possible nuclear accidents is back in the news these days
To properly frame the issue, it is good to understand the role and function of iodine.
What is iodine and what is it used for?
Iodine is an indispensable element for the proper functioning of the thyroid gland, one of the endocrine glands (i.e., which releases hormones into the bloodstream) of our body.
The thyroid gland produces two hormones, tri-iodothyronine (T3) and tetra-iodothyronine (T4), containing three and four iodine atoms respectively, which perform essential functions for the body: without these hormones, hypothyroidism, which is responsible for serious consequences for many organs and apparatuses, sets in; without iodine, the gland cannot synthesise these two hormones.
What is the iodine requirement?
The daily requirement of iodine is 150 micrograms and, in pregnant and breastfeeding women, 250-300 mcg.
Iodine is present in some foods such as fish and crustaceans, seaweed, milk and eggs, garlic, beans, beets, courgettes and cheese, but with the common daily diet the intake amount does not reach 150 mcg/day.
This is a problem, albeit with regional differences, all over the world because for hydrogeological reasons, the Earth has become progressively depleted of iodine over the course of its evolution.
Iodine and thyroid: what is the link?
This iodine deficiency is the main reason why, some 400 million years ago, Earth beings began to develop a specific organ (the thyroid) in order to concentrate iodine, which was and remains a powerful antioxidant.
Thyroid cells then developed receptors called NIS, from the English acronym Na (sodium) Iodide Symporter, to capture iodine.
Fish do not have thyroid glands because the sea is rich in iodine, while hybrid (saltwater and freshwater) fish such as salmon have a thyroid gland.
Iodine in nature is so important that if there is a lack of iodine in a pond, the tadpole cannot turn into a frog.
Iodised salt intake
Because of this chronic iodine deficiency, prophylactic policies have been implemented in all countries.
By law no. 55 of 21 March 2005, Italy too introduced iodine prophylaxis, which is implemented by taking iodised salt.
Salt must be used in moderation and the maximum daily amount must not exceed 4-5 g, which includes both discretionary salt (which we add to food) and non-discretionary salt (found in pre-packaged foods).
Therefore, for the purpose of iodine prophylaxis, it is essential to use iodized salt, available in all food distribution, in a total daily quantity (discretionary and non-discretionary) corresponding to the “shaved” bottom of a teaspoon (not the whole teaspoon!) according to the formula: little salt, but iodized.
In pregnant women, excessive salt intake being contraindicated, appropriate calibrated supplements are used instead.
It is necessary here to dispel a myth.
Proximity to the sea is not a privileged condition for iodine intake: iodine is volatile and what evaporates into the air from the sea is breathed in and not ingested, so it is useless for hormone synthesis.
What happens when a nuclear device goes off?
In addition to the explosive effect, radiation is released into the environment, resulting in acute and chronic lethal effects.
During this process, certain radioisotopes are generated, chemical elements that differ from the original element in the number of neutrons.
They are marked by a number in the top left-hand corner representing the sum of neutrons and protons (called the mass number).
These radioisotopes are unstable
They return to stability by emitting radiation for periods ranging, depending on the radioisotope, from days to thousands of years.
The most frequently released radioactive isotopes during nuclear accidents are Iodine (131I), Cesium (137Cs), Strontium (90Sr), Polonium (210Po) and Plutonium (239Pu), which can irradiate our bodies and produce illnesses and reactions of various kinds.
As far as iodine is concerned, the thyroid gland does not distinguish between dietary iodine and radioisotope 131I so, in the event of a nuclear accident, the latter can also concentrate in the thyroid gland via the NIS receptors and here, through radiation, it can modify DNA and induce thyroid cancer.
Although one should not play down, it should be emphasised, however, that fortunately thyroid tumours have a high cure rate of up to 95%.
Is preventive iodine intake useful?
The most frequently asked question is whether, in anticipation of explosions or nuclear conflicts, it is useful to start taking iodine pills preventively. First of all, let’s see what the rationale is.
How do we prevent iodine 131I from entering the thyroid gland?
Because of what we said above, we will have to occupy all the NIS receptors in the gland and, to do this, we will have to give enough elemental iodine to saturate all the NIS receptors.
In this way the 131I, finding all sites occupied, will not enter the thyroid gland.
Is it possible to prevent nuclear contamination with self-medication?
The answer is: absolutely not, because it is not a matter of taking supplements, but real potassium iodide or sodium iodide drugs that provide 700 to 1000 times more iodine than supplements, an excess of iodine with potential health side effects.
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Iodine and radiation risk: public prophylaxis
In the event of a nuclear accident, it will therefore be necessary to await the instructions of the health authorities.
In fact, prophylaxis with appropriate drugs will be implemented within a reasonable period of time, starting with the under-18s and pregnant and breastfeeding women who are, for age reasons, the most exposed to the risk.
We must therefore absolutely not self-medicate.
Precisely in order to avoid this, the scientific societies in the sector and the Italian Institute of Health issued a recommendation last year that reads as follows:
‘Following the conflict in Ukraine, news reports have reported an increased demand for ‘iodine pills’ in some European countries to counteract the negative health effects of radiation exposure.
In this connection, it should be pointed out that currently in Italy only the use of iodized salt is recommended for the preparation and preservation of foodstuffs, while DIY recourse to preparations containing high quantities of iodine is discouraged, as these could have negative consequences for the body, including functional blockage of the thyroid gland.
Only in the event of a real nuclear emergency, which does not currently exist in our country, will the Civil Defence give precise indications on how and when to implement a possible pharmacological-based iodine prophylaxis intervention for the entire population’.
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