What is potassium iodide? The drug is in demand as Russia’s invasion stokes radiation fears

Potassium iodide has become a hot commodity as the war in Ukraine raises fears of global nuclear conflict

As news of nuclear contamination in Fukushima made its way to the United States, pharmaceutical companies such as Anbex were flooded with orders (Copyright 2022 The Associated Press. All rights reserved)

As Russia’s invasion of Ukraine nears its three-week mark, repercussions are being felt around the world as the prices of oil and grain climb. But a less common consumer product has also become a hot commodity as the war raises fears of global nuclear conflict: potassium iodide.

Twenty tablets of ThyroSafe, whose active ingredient is potassium iodide, can fetch as much as $175 (£134) on eBay. ThyroSafe’s official distributor has stopped taking new orders from its website, and existing ones will see a delay in shipping, according to a statement last week. Of the four companies approved by the US Food and Drug Administration (FDA) to sell the compound, also known as KI, at least one other has sold out.

Demand has grown in Europe, too, prompting Belgium’s federal nuclear control agency to assure the public on 1 March that the situation in Ukraine does not pose any danger to its residents and that there is no reason to buy or hoard supplies. Local media outlets have reported spikes in demand in Romania, Croatia, Poland and other countries.

Here’s what you need to know about potassium iodide.

--What is potassium iodide?

It is a stable chemical relative of the element iodine. It is approved by the FDA for use after one’s exposure to radioactive iodine, a harmful substance usually released into the atmosphere after a nuclear disaster.

The substance, which does not require a prescription, can come in tablet or liquid form.

Research has established a link between radioactive iodine exposure and thyroid cancer. The 1986 Chernobyl nuclear power plant meltdown, which resulted in a massive release of radioactive iodine, led to a large number of thyroid cancer cases in the region.

The US Centers for Disease Control and Prevention (CDC) says people should take potassium iodide only on the advice of public health or emergency management officials because there are health risks associated with the substance. The CDC also warned that taking more than the recommended dosage does not offer more protection and may cause illness or even death.

--How does potassium iodide protect against radioactive iodine?

Iodine, a key element needed for the production of thyroid hormones, is usually absorbed by the body through the consumption of foods such as iodized table salt or health supplements. Potassium iodide helps counteract the effects of radioactive exposure by blocking the body’s absorption of the radioactive form of iodine, according to the CDC.

After taking one of the FDA-approved medications, one’s thyroid gland - a butterfly-shaped organ that is the most sensitive part of the body to radioactive iodine - would become too “full” to absorb more iodine, radioactive or not, for the next 24 hours, the CDC explained.

Food and supplements that contain iodine (as opposed to potassium iodide) do not contain enough iodine to protect one from radioactive exposure, the CDC cautioned.

Furthermore, potassium iodide should not be considered a panacea to all radioactive exposures. The compound does nothing to guard against other common radioactive fallout such as cesium isotopes, and the longer one waits to take it after being exposed to radioactive iodine, the less effective the medication becomes.

--Why are potassium iodide products out of stock during Russia’s war in Ukraine?

Since Russia launched its invasion on 24 February, Moscow’s forces have captured and taken control of two nuclear facilities - the inactive site at Chernobyl and the Zaporizhzhia nuclear power plant in southern Ukraine.

Clashes between Russian and Ukrainian forces near these sites have cast a pall over Europe and beyond as people fear a leak of radioactive materials. So far, Ukrainian officials and the International Atomic Energy Agency (IAEA), a UN monitor, said there has been no observable uptick in radiation levels. But the IAEA warned last week that it has lost data transmission from the sites that normally allow outside monitoring of nuclear safety.

Beyond fears of unintentional leaks, Russian President Vladimir Putin’s announcement that he had put his nuclear forces on alert - in response to what he called the West’s “aggressive statements” and escalating economic sanctions - has alarmed U.S. officials and other world leaders.

The Kremlin has the world’s largest nuclear stockpile.

UN Secretary-General António Guterres said Monday that the prospect of nuclear conflict is “now back within the realm of possibility.”

--What is the situation in Ukraine’s nuclear power plants?

At Chernobyl, more than 20,000 spent fuel rods are housed and require consistent power to be kept cool. This month, the Kremlin’s troops disconnected Chernobyl from the national electricity grid, causing concern among experts that the spent fuel rods may be left overheated and vulnerable to leaks. Troops also damaged a high-power voltage line Monday after Ukraine had reconnected the facility to the grid over the weekend. The Zaporizhzhia plant, the largest of its kind in Europe, partly caught on fire after Russian shelling on 4 March. But no “essential” equipment was affected, the IAEA said.

Both facilities are staffed with Ukrainian nuclear technicians. But the working conditions inside are challenging, as workers remain confined there by Russian troops.

--How have people reacted to nuclear radiation scares in the past?

Over the years, spikes in potassium iodide sales have corresponded with increased public anxiety over radioactive leaks. In 2011, people stocked up on potassium iodide medication after a record-breaking earthquake in Japan resulted in a nuclear reactor meltdown and explosion at the Fukushima Daiichi power plant, the worst nuclear crisis since Chernobyl.

As news of nuclear contamination in Fukushima made its way to the United States, pharmaceutical companies such as Anbex were flooded with orders, and frantic customers begged for more supplies, even though public health officials said it was highly unlikely that significant amounts of dangerous material would travel across the Pacific Ocean. Chinese residents even emptied out shelves of iodized salt in the supermarket, prompting state media outlets to debunk the myth that the condiment could lessen radiation poisoning.

The German city of Aachen distributed iodide tablets free in 2017 as residents feared that an ageing Belgian nuclear power plant about 40 miles away might release radioactive material, the BBC reported.

The early 2000s also saw a surge in demand for potassium iodide, making it a staple in many household medicine cabinets, often stored next to supplies of Cipro to protect against anthrax. In the aftermath of 9/11, senior Bush administration officials accused Iraqi dictator Saddam Hussein of pursuing nuclear capabilities. And India and Pakistan, both armed with nuclear weapons, were near the brink of war over territorial disputes in Kashmir.

“Every time [Defense Secretary Donald] Rumsfeld or [Homeland Security Director Tom] Ridge gets on TV, there’s a sales spike,” an Anbex distributor told The Washington Post in 2002. “Ridge just says the word ‘nuclear,’ and our phones start to ring.”

The Washington Post