This article discusses the treatment options for radiation sickness, including medication and decontamination.
Symptoms and Diagnosis
Radiation sickness primarily affects the skin, the stomach and intestines, and the bone marrow. Bone marrow is the spongy inner part of the bone responsible for producing red blood cells, infection-fighting white blood cells, and platelets that help a person clot.
If the heart and brain are affected, then radiation sickness will be fatal.
For those who survive the first few hours, the skin can look like a bad sunburn and blister.
People can also experience:
Nausea, vomiting, and diarrhea from damage to the stomach and intestinesDecreased appetiteFeverLack of energy
Eventually, the bone marrow shows damage, and people suffer a drop in white blood cell counts leading to infection and platelets, putting them at risk for bleeding.
Diagnosing radiation sickness can be challenging depending on the time between the event and the time a person seeks treatment.
Diagnosis is based on:
A history of a significant exposure eventComplete blood count (CBC) tests that help determine the effects on the bodyGeiger counter testing that monitors the amount of radiation in the area
Decontaminating Your Environment
The most important immediate action to take after a radiation event is to leave the environment to reduce further exposure. Decontamination requires removing any contaminants from your body and environment.
This includes taking the following actions:
Remove yourself from the contaminated environment because radioactive material can also be inhaled. Remove and discard your clothing. Wash your body with soap in a warm shower. Wash your hair with lots of water and regular soap. Avoid using conditioner because it allows the radioactive material to stick to your hair. Seek shelter if you reside within a fallout area (the area where radioactive particles are floating in the wind and air) to limit further radioactive exposure.
Hospital Treatment
After a significant radiation event, a person will require further evaluation at a hospital or with a healthcare provider to determine the extent of their injuries.
Certain medications are given as countermeasures to:
Block the effects of the radioactive material on particular organ systemsSpeed up the removal of the radioactive materialHelp the body recover from the radiation impact, particularly the effects on the bone marrow
Diethylenetriamine Pentaacetic Acid (DTPA)
One treatment option is diethylenetriamine pentaacetic acid (DPTA). DPTA is given into the veins to bind radioactive plutonium, americium, and curium. It does not prevent the radioactive substances from entering the body, but it does help eliminate them.
There are two forms of DTPA: calcium-DTPA and zinc-DTPA. Both work in the same way and are best used shortly after radiation exposure.
Calcium-DTPA is more effective in the first 24 hours after exposure. Still, both the calcium and zinc formulations are equally effective after that. These medicines bind the radioactive material and eliminate it from the body in the urine.
Children and adults are treated in the same way with this medicine. However, pregnant people should use the zinc formulation unless the person has very high levels of internal radioactive contamination.
People treated with this medicine can have various side effects, including:
NauseaVomitingMuscle crampsMetallic taste in the mouth
It’s important to remember that these medicines also bind to essential minerals that the body needs, including zinc, magnesium, and manganese. If you are receiving long-term treatment with DTPA, you also need to take vitamin and mineral supplements.
Neupogen (Filgrastim)
Radiation sickness leads to a problem in the bone marrow in which people cannot make new infection-fighting white blood cells. Neupogen is a drug that stimulates the growth of white blood cells to help people fight infection.
This injection medicine is often administered for two weeks after radiation exposure. After the treatment period, a healthcare provider should reassess a person’s need for continued treatment.
Neupogen is safe for all adults unless they have a hypersensitivity to proteins derived from Escherichia coli, or E. coli. Children and pregnant people should use it with caution. The most common side effect is bone pain.
Nplate (Romiplostim)
Radiation sickness leads to a problem in the bone marrow in which people cannot make new platelets (the cell fragments that help a person clot). The Food and Drug Administration (FDA) approved Nplate in January 2021 as an agent that increases platelet counts, helping to reduce radiation-induced bleeding.
The injection medicine is used in children and adults, and it should be given as soon as possible after exposure to high levels of radiation.
Blood and Platelet Transfusions
An injection medicine to stimulate platelet production is new on the market, and some people do develop anemia that might require treatment after radiation sickness. Therefore, the management of a patient with radiation sickness sometimes includes blood and platelet transfusions. Based on laboratory tests, a healthcare provider will determine the need for a transfusion.
Blood and platelet transfusions can be given to children and adults, including pregnant patients.
Bone Marrow Transplantation
A bone marrow transplant replaces all of the cells in the bone marrow: white blood cells, red blood cells, and platelets.
Scientists have been studying the utility of bone marrow transplants in people with significant radiation exposure. Thus far, the transplants seem to help for a short time but do not change overall survival rates. There is ongoing research into this type of experimental treatment.
Prescriptions
There is one prescription medicine used to treat radiation sickness called Prussian blue. Otherwise, all other prescribed medications are used to treat just the symptoms associated with radiation sickness, such as bone pain and vomiting.
Prussian Blue
Prussian blue is a pill that helps trap the chemical elements cesium and thallium after radiation exposure. It then holds them in the intestines to avoid absorption into the body. The radioactive materials are excreted in a bowel movement.
The biological half-life is the amount of time it takes for radioactive material to leave the body. Prussian blue reduces the half-life of cesium from 110 to 30 days and thallium from eight to three days.
Prussian blue is safe for adults, including pregnant people and children more than 2 years old. Experts have not determined whether it is safe in infants.
The most common side effects are upset stomach and constipation. Additionally, a person’s mouth, teeth, and feces (stool) might turn blue.
Antiemetics
Reglan (metoclopramide), Zofran (ondansetron), and Compazine (prochlorperazine) are antiemetics often used to treat nausea and vomiting associated with radiation therapy used in cancer treatment. These medications are also used in many other chronic health conditions that are associated with nausea and vomiting.
Antiemetics include:
Compazine (procloperazine): This medication is in a class of medicines called antipsychotics. It has many different side effects and is not used as an antiemetic unless other medicines have failed. It can be used to control severe nausea and vomiting, but clinicians can also use it to treat anxiety and disturbed thinking associated with schizophrenia. It comes as an oral tablet or rectal suppository. It is often given three or four times a day. Reglan (metoclopramide): Reglan treats heartburn in people with gastroesophageal reflux disease (GERD) and relieves the symptoms associated with slowed gastric emptying, including nausea and vomiting. It comes as a tablet, disintegrating tablet, or oral solution. Usually, it is given four times a day. The most debilitating side effect of Reglan is an uncontrollable muscle movement problem called tardive dyskinesia. Zofran (ondansetron): Zofran is used to prevent nausea and vomiting associated with different therapies, particularly cancer therapy. It comes as a tablet, disintegrating tablet, or oral solution. The dose depends on the severity of the symptoms, but this medicine is often given three times a day.
Over-the-Counter (OTC) Therapies
Potassium iodide is the most commonly used medication that counteracts some effects of significant radiation exposure. All other recommended OTC treatments control the symptoms associated with radiation exposure, such as burn and bone pain.
Potassium Iodide
The thyroid gland is most susceptible to injury after radiation exposure. Potassium iodide is a salt tablet that helps block radioactive iodine from being absorbed by the thyroid gland.
The thyroid gland needs iodine to produce hormones that regulate the body’s metabolism. Iodine exists in your diet, and the thyroid absorbs the iodine from the bloodstream (think iodized salt).
Most nuclear accidents release radioactive iodine, which is absorbed into the body. Since the thyroid regularly uses iodine to balance the body’s metabolism, the thyroid is very susceptible to radioactive material.
Potassium iodide does not prevent radioactive iodine from entering the body. It only blocks the thyroid from using radioactive iodine.
Potassium iodide protects the thyroid but no other parts of the body. Additionally, potassium iodide does not protect you from other radioactive elements.
Foods and table salt rich in iodine do not contain enough potassium iodide to block radioactive iodine from entering the thyroid. Do not use table salt as a substitute for potassium iodide.
Potassium iodide is found over the counter but should only be used under the advice of a clinician or public health official.
All people, including adults, children, and infants, can take potassium iodide. It is especially recommended for infants and children since they are at higher risk for future thyroid cancer after a significant radiation event. It is also safe for pregnant people.
Infants and pregnant people should only take one dose of potassium iodide, because a one-time dose at the recommended level is usually all that is needed to protect the thyroid. More medication offers no more protection, and too much potassium iodide can lead to problems with normal development.
Pain Relievers
Pain relievers help treat headaches, sore muscles, arthritis, or other aches and pains. There are several different OTC medicines, and each one has certain advantages and disadvantages. Each person may have slightly different responses to the various treatments.
The two main categories of pain relievers are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).
Acetaminophen
Acetaminophen (Tylenol) is a mild-to-moderate pain reliever for headaches, muscle aches, back pain, and other general medical illnesses. It comes in many different formulations, and you can use it in combination with additional pain relievers like NSAIDs.
People can develop allergic reactions to acetaminophen, but, generally, this is a well-tolerated medicine. Taking too much Tylenol can cause liver damage.
Ibuprofen
Ibuprofen (Advil or Motrin) is an example of an NSAID used as a pain reliever for muscle aches. It also works as an anti-inflammatory medicine to treat swelling and stiffness, often associated with osteoarthritis.
It comes in several different formulations over the counter. Generally, children younger than four years old should not take NSAIDs.
People who take NSAIDs, such as Advil or Motrin, may be at higher risk of heart attack or stroke. These medications can also lead to ulcers and bleeding in the stomach.
Talk to your healthcare provider or pharmacist if you have questions about the medicine.
Aspirin
Aspirin can sometimes be used as pain medicine, but it should be reserved for people with rheumatoid arthritis or other rheumatological conditions when used to treat pain.
Aspirin also functions as an antiplatelet agent and helps prevent heart attack and stroke in people at risk.
The antiplatelet effect of aspirin means that people can be at risk for bleeding. People with radiation sickness can have bone marrow problems in which they do not produce enough platelets. Therefore, aspirin would not be a recommended pain reliever.
Complementary and Alternative Medicine (CAM)
There is a range of complementary and alternative medicine treatments that can possibly help treat radiation sickness, but they have not been tested in clinical trials or proven to be effective. These treatments should not replace standard recommendations and should only be pursued under guidance from your healthcare provider.
The complementary strategies used to manage radiation therapy to treat cancer include getting regular exercise, ensuring proper supplementation with vitamins and minerals through a healthy diet, and getting plenty of sleep.
There is no evidence to support the use of cesium chloride as a treatment for radiation sickness.
Zeolites are crystalline rocks or clay that can absorb radioactive strontium and cesium. While there is some discussion that taking zeolite clay works as a detoxifying agent after radiation exposure, clinical studies have not been done to support its use in humans for radiation sickness.
There is also discussion that some oils such as sesame oil, extra-virgin olive oil, and coconut oil can help treat some types of radiation sickness. However, clinical studies have not been performed to determine whether this truly works. There is minimal risk to using these oils to maintain a healthy diet, though.
Summary
Radiation sickness is a serious illness that occurs after high-dose exposure to penetrating radioactive materials. Since these events are rare, there are only a few treatments that are proven effective. Decontamination is the most critical step to take after exposure. Most other treatments are available in a hospital. In all situations of radiation contamination, all treatment decisions should be made in consultation with a public health official or healthcare provider.
A Word From Verywell
It can be traumatic to experience a significant radiation event, and you may be concerned about the effects radiation exposure can have on your health. There are effective treatment methods available, and recommendations for how to decontaminate your environment to keep yourself and others safe.
Reach out to your healthcare provider with any questions concerning your exposure and how you can treat radiation sickness.
