REACTOR FIRE IN UKRAINE: IODINE PROPHYLAXIS?

A Russian attack on a nuclear power plant in Ukraine has resulted in a fire at the site. The reactor itself was not hit and there was no release of radioactivity. Since then, I have been asked almost daily whether it makes sense to take iodine tablets prophylactically.

The background to this is the reactor accident in Chernobyl, which resulted in the release of radioactive iodine and, as a consequence,in particular children and young people developed thyroid cancer. By taking high doses of iodine tablets, the iodine transporter of the thyroid gland can be blocked. Compared to iodine therapy of thyroid disease with iodide or thyroid hormone plus iodide tablets, the necessary iodine dose is 500-1000 times higher - instead of micrograms, milligrams are needed.

The Federal Office for Radiation Protection recommends such iodine blockade only for children, adolescents, pregnant women and adults up to the age of 45. Preventive intake is not advisable. Only in the case of a confirmed release of radioactivity should the thyroid gland be blocked by taking high doses of iodide. More details on individual thyroid diseases will be given in the next article. 

HIGH DOSIS IODINE IN HASHIMOTO-THYREOIDITIS, GRAVES' DISEASE OR NODULAR GOITER AFTER REACTOR ACIDENT

In HASHIMOTO-THYREOIDITIS excessive iodine intake can cause activation of the disease and further destruction of the thyroid gland .
In the case of GRAVES`DISEASE, there may be a considerable worsening of the clinical picture with severe hyperthyroidism, which can hardly be stopped with medication. In extreme cases, a life-threatening hyperfunction, a thyrotoxic crisis, can develop, with severe cardiac arrhythmias, high temperature, dehydration, loss of consciousness and even coma. Only emergency surgery can then be save.
Many patients ask for Lugol's solution, a high-dose iodine solution that is occasionally administered immediately before Graves' surgery to block the thyroid. However, it is not suitable as an iodine blocker after reactor accident in Graves' disease.
High doses of iodine can also cause severe hyperthyroidism in patients with thyroid nodules, especially autonomous nodular goiter. This can lead to life-threatening cardiac arrhythmias, especially in older people. In summary, we can only warn against the independent use of high-dose iodine preparations in thyroid diseases.