Dear Patients,

I am sorry that this email has to be so long. My sadness that it is necessary is, of course, far greater. Also, please do review this material carefully, as I am unable to respond to the very large volume of emails and phone calls that we have been receiving. Reviewing my previous email/blog posting might also be helpful. If you have further questions regarding your own health, please call the office and schedule an appointment.

I understand the instinctive fear so many of you are experiencing. The trauma suffered by the Japanese is nearly unimaginable. If you have the means, I hope you have made some donation to the American Red Cross or some other humanitarian organization on behalf of the Japanese.

Despite this nightmare, at our distance the radiation released is very unlikely to pose any significant health risks. The Chernobyl disaster (25 years ago next month) is the standard against which all are compared. For perspective, Chernobyl effects extended about 1,000 miles, and the great majority of ill effects were limited to a few hundred miles. Santa Rosa is approximately 4,600 miles from these plants. As the winds are driving the air across northeast towards Alaska and then down into Canada first, we are effectively even further away. Chernobyl was the worst nuclear reactor disaster of all time because of the combination of a large explosion (much larger than anything in Japan so far), as well as the volume and nature of radioactive material released.

I gained much of my earliest experience as a physician explaining health issues to other doctors, the media and the public thirty years ago, when I started speaking on “The Medical Consequences of Nuclear Waste Storage”. The point of my effort was to act on my concerns about the long term safety and security threats created by nuclear power. The range of responses taught me a lot about how people respond to controversial information that they did not want to hear. One caller on a radio show was upset because I was “scaring old people”. Another suggested that I crawl back into my “cave on Fantasy Island”. The Chief of Staff at a hospital where I lectured proposed launching nuclear waste on rockets to the sun, somehow ignoring the fact that rocket failures happen regularly and scattering plutonium over thousands of miles was a really, really bad idea. The funniest might have been the front page newspaper story which began quoting “Dr. Michael Carlston, age 26”, immediately proving my naivete and inevitable ignorance.

The work I did speaking on this topic was on behalf of Physicians for Social Responsibility. I founded a chapter in Minneapolis-St Paul and was the first local chair. This organization has advocated in opposition to nuclear power and weapons since 1961. Today some PSR experts held a very useful press conference, with information beyond what I have found elsewhere. You can access it at:

Sadly, the impacts of the tragic situation in Japan are widening. In addition to the severe challenges they face with rescues, medical care and basic survival needs for at least one half million displaced people, the collapse of infrastructure has made it impossible for authorities to gain control over all of their damaged reactors. After expanding the quarantine area and warning of radiation releases endangering the local population, the company withdrew operators from the reactors for their safety, unfortunately ending the vital efforts to prevent worse damage than has already occurred. In addition, after encountering clouds of radiation, US ships and airplanes moved further off the Japanese coast, with some relocating to the other side of the island, away from the prevailing winds. This is all extremely bad for the Japanese people, and possibly the Chinese, if the winds shift. As there is plutonium on the site and the half life of plutonium is ridiculously long (24,000 years) the present crisis is not only a short-term issue. Some of you might recall the line in the old song that went “plutonium is forever”.

One type of radiation being released into the environment at the Japanese site at a rate equivalent to 400 chest Xrays/hour. That kind of radiation is deadly to people on and near the site, but can have absolutely no effect on us. Particulate forms of radiation (including radioactive iodine, strontium and cesium) are the forms that are carried on the wind. A tiny particle of radioactive material, inhaled, swallowed or entering your body through broken skin, would hardly budge a geiger counter, but would increase your risk of cancer markedly, especially if it were an element that remained radioactive for a long time.

Radiation impacts are always the most severe on young children, infants and babies developing in their mother’s womb. In contrast, the consensus is that the proven thyroid-protective effects of potassium iodide are outweighed by its adverse effects on adults over age 40, except when exposed to doses those nearby the reactors might experience. Age, type of radiation, amount of radiation and your health conditions are all factors to consider.

My recommendations:

There is nothing specific you can do to prevent all possible adverse effects of radiation, except to avoid exposure. General measures may seem wimpy but they are actually the most important, as they are the best overall protective measures you can take. If you are deficient in iodine, you are prone to absorbing any iodine including the radioactive version

Eat well (especially leafy greens, sea vegetables and fish)
Avoid the things that make you sick
One special point here is that radioactive iodine loses its radioactivity over weeks. Consequently, plants and animals in areas inundated by fallout will incorporate radioactive iodine and then expose people eating them (including milk products). BTW, radioactive iodine levels are 10 times higher in goat and sheep milk products than in cows milk.

Strontium accumulates in the same manner and is radioactive for decades not weeks.
Supplements – calcium blocks many radioactive minerals including the radioactive form of strontium with its half life of 29 yrs.

Specific supplementation
At this time, I am not personally taking or planning to take potassium iodide. I may take some ginseng and certainly will, as always, take calcium, my MVM and do my best to follow excellent health habits.

Herbs – Siberian ginseng has been shown to reduce damage caused by radiation.

VITANOX Is a combination of green tea, turmeric, rosemary leaf and grape seed I use for various conditions including radiation exposures. As a compromise, you can also (and with greater enjoyment) consume somewhat more nominal doses of some of these in your diet

Potassium iodide
To remind you of what I have written previously-
Potassium iodide is only useful for protecting the thyroid gland. It also disturbs the thyroid, and so should not be used carelessly. The last time I saw a patient whose thyroid function was impaired, seemingly by taking a slightly increased amount of iodine (600 mcg vs the 100,000 mcg in most anti-radiation pills), was yesterday. Adverse effects from high doses of iodine DO occur. The high dose, protective approach is effective when started at the beginning of exposure. There has not been any radiation spread to the US, and it is likely that there will not be at a level likely to cause any health effects.

The young are the most vulnerable, with the developing fetus and newborns the most extremely vulnerable, AND most vulnerable to ill effects of potassium iodide.

If you are over 40, and living in N California, I do not recommend taking it at this time based upon my understanding of the worst possible outcomes arising from the Japanese nuclear crisis. Although I have had potassium iodide on hand at my home for many years, I do not anticipate taking any of it with this incident. The exposure simply does not warrant doing so. I may take Siberian Ginseng and VITANOX as well as my usual calcium.

Again, I feel most strongly that the right approach as far as iodine is to take the RDA of iodine (100-150 mcg for people of all ages). There is evidence that the thyroid damage (including cancer) caused by Chernobyl, was compounded by chronic iodine deficiency. If you have not been taking a supplement with such a level of iodine, avoiding iodized salt, not consuming sea food, and have no thyroid disease, taking a bit more for a couple of weeks would be wise and not harmful. How much is that? For adults a maximum of 1-2,000 mcg (ie 1-2 mg), scaled down for children by age (200 mcg in the youngest). You really should start taking a MVM with an appropriate level of iodine for many long-term health reasons.

Decisions about whom to dose and when are related to level of radiation exposure. When there is a major exposure as the Japanese face, the decision is very clear. Unfortunately, radiation dosage units are very confusing because they mean different things. One measurement you have probably never heard of (Gray units) are the best guideline for thyroid protection, as it indicates how much radiation the thyroid has absorbed. An expert was quoted on the LA Times online site today stating that iodide is recommended at a 50 rad exposure. We do not use rads any more but actually the equivalence should be 5 rads for children or 500 rads for adults. Quite confusing. To simply things

Detectable radioactive iodine (5 cGy) – treat children only
Up to 1 month of age: 16 mg
1 month to 3 yrs of age: 32 mg
3 – 18 yrs: 65 mg (if 150 lbs+ take full adult dose 130 mg)

Higher levels (10 cGy)
Adults to age 40: 130 mg

Levels 100 times higher (500 cGy)
Adults over age 40: 130 mg


I would extremely cautious about continuing these doses more than a week.

At higher exposure levels the preventive iodine dose for children does not increase.

PREGNANT women and newborn babies are very vulnerable to radioactive iodine AND high doses of preventive iodine. These individuals should take one dose with the guidance of a physician (never more than two), and shelter away from exposures (ie, stay indoors). The reason for this is the high risk of killing off the newborns thyroid with high doses of iodine, leading to congenital hypothyroidism (also known as cretinism).

Remember that people who have thyroid disease or an allergy to iodine should not take high doses of iodine.

Instructions on how to make iodide palatable to children

General INFO on potassium iodide

Michael Carlston, M.D.



Written by 

Michael Carlston, MD is an internationally recognized authority in the integration of conventional and complementary medicine in clinical practice, as well as medical education, research and organizational consulting. Practicing in Santa Rosa, California, Dr. Carlston was voted “Best General Physician In Sonoma County, California” by readers of the Sonoma County Independent newspaper and also named one of the outstanding physicians in the Bay Area by San Francisco Focus Magazine. With 30+ years in private practice, his expertise is in nutrition, homeopathy and sports medicine.

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