Panic is the last thing we should feel in any situation. It never helps. If that’s what’s happening in Nevada County right now, it won’t help either.

Let’s hope that the reported rush on pharmacies in the county for supplies of potassium iodide is not a panic, but merely a sensible effort to prepare for its possible future use if the situation at Fukushima and elsewhere in Japan turns into a large-scale meltdown worse than Chernobyl, one of the more alarming possibilities hinted at by some commentators.

Both Raley’s and Rite-Aid in Grass Valley have told me that — while they don’t keep the typical over-the-counter preparation of potassium iodide in stock — they are getting a remarkable number of inquiries about it, more than 40 today at each pharmacy.

Potassium Iodide (molecular symbol KI) is sometimes useful for treatment in cases of exposure to the nuclear fission byproduct, radioactive iodine, which is preferentially taken up by the thyroid. Much of the alarmist chatter in the United States has mentioned the danger of Cesium-137, which can apparently challenge most tissues in the body, not just the thyroid. Since potassium iodide may be helpful in preventing radioactive exposure to the thyroid, it’s usefulness against exposure to Cesium-137 is obviously limited.

Rachel Maddow today interviewed a nuclear specialist with the Colombia University Medical Center. He said that people living near the Japanese reactors are probably being exposed to a “whole panoply” of radioactive fission byproducts, including iodine and Cesium-137, but he suggested that taking potassium iodide was of doubtful benefit even to them, since they could avoid most iodine exposure by “not drinking milk.”

A lot of information is being promoted by people on Facebook, as you would expect. One Facebook commenter reported being treated very rudely by an angry Grass Valley pharmacist (at yet a third pharmacy which I’m choosing not to identify):

‘I had my young children with me and just nicely asked the pharmacist if they carried it. He (an older gentleman) went into a rage about how many people were asking for it, and how it is all BS and that he wouldn’t give it to me even if he had it. He was abusive and rude, and yelled at the clerk, telling her “the next time someone asks tell them to get a life and stop bothering us.” ‘

It’s ironic that in one of the least vaccinated counties in the state, there’s such a rush to acquire a product with a much more nuanced and complicated set of recommendations for its use than there is for most vaccines.

So, what are the facts, and what are the recommendations? Here’s the FDA recommendation on potassium iodide from their “Bio-terrorism and Drug Preparedness Information Page:”

Who really needs to take potassium iodide (KI) after a nuclear radiation release?
The FDA guidance prioritizes groups based on age, which primarily determines risk for radioiodine-induced thyroid cancer. Those at highest risk are infants and children, as well as pregnant and nursing females, and the recommendation is to treat them at the lowest threshold (with respect to predicted radioactive dose to the thyroid). Anyone over age 18 and up to age 40 should be treated at a slightly higher threshold. Finally, anyone over 40 should be treated with KI only if the predicted exposure is high enough to destroy the thyroid and induce lifelong hypothyroidism (thyroid deficiency).

What potassium iodide (KI) products are currently available?
As of January 2005, Iosat, ThyroSafe, and ThyroShield are FDA approved KI products. You can find out more about these products at Drugs@FDA. Please be aware that only the KI products approved by FDA may be legally marketed in the United States.
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How are these products available?
In addition to distributing to state, local and federal agencies, Anbex, Inc., has made Iosat Tablets (130 mg) available to the general public via the Internet. For further information on KI products, you can contact these companies as noted below:
Anbex, Inc. for Iosat Tablets (130 mg) at 212-580-2810 (M-F 9am-5pm), at 1-866-463-6754 (other times), or http://www.anbex.com
Recipe for ThyroSafe Tablets (65 mg) at 1-866-849-7672 or http://www.thyrosafe.com/recip.html
Fleming & Company, Pharmaceuticals for ThyroShield Solution at 636-343-8200 or http://www.flemingcompany.com or http://www.thyroshield.com

As of an hour or so ago, every one of these websites carry messages that they are currently sold out.

Some promise new supplies within weeks.

I sent an email over the weekend to Sherry Dunn, the Immunization Coordinator for Nevada County, and asked her what — if any — advice the county might have on this subject. Although I’ve not heard from her yet, Tom Grundy sent us this email this afternoon:

“Sometime between this morning and now, they posted some early info – even if it’s not locally specific. Very refreshing to see it’s at least on their radar. I bet our calls to them helped out.

http://mynevadacounty.com/whatsnews/index.cfm?ccs=1354&cs=4550 “

It would seem that information on this subject is moving fast.

I’ll continue to report on this subject as it continues to unfold, as I expect other local bloggers will do also.

See earlier report I published today on cautions about the use of potassium iodide.