For people living with the effects of Chernobyl, a drug shortage threatens

By Talya Meyers

In the days following the Russian invasion of Ukraine, a local non-profit started receiving an unusual request.

Many people called the NGO, Charity Fund Modern Village and Town, in search of insulin and other typical medicines – increasingly difficult to find as the war caused logistical problems throughout Ukraine, and even basic medicines were scarce in the attacked areas.

In addition to supplying hospitals and other health facilities with medical aid, the organization responds by tracking down requested medicines and telling patients where they can access them. In some cases, they will even acquire a drug for a specific patient.

But some people were looking for something more unusual: levothyroxine – a replacement hormone used by people whose thyroid gland has been removed or whose thyroid function is impaired. Before the war in Ukraine, it was inexpensive and widely available, said Dr. Robert McConnell, a physician at Columbia University’s Irving Medical Center and an expert in radiation-induced thyroid disease, which he has studied in Ukraine since. the aftermath of Chernobyl in 1986. nuclear power plant disaster.

It was also widely needed. Over the past 25 years, in collaboration with the National Cancer Institute and in partnership with the Ukrainian government, McConnell and his colleagues have studied a cohort of 12,000 people under the age of 18 when exposed to the effects fallout from Chernobyl.

Even among their cohort, about 300 people underwent thyroidectomy, about half of them because of cancer. Even decades later, “we’re finding an excessive number of cancers, beyond what you’d expect from screening. And the cancers have a unique genetic signature…they’re radiation-induced,” McConnell said.

Many people affected by thyroid disease depend on the drug levothyroxine.

According to McConnell, a pharmaceutical manufacturer of the drug was destroyed by artillery fire. Ukrainians “have not had locally available levothyroxine since the second week of the war”, he said. “Now we have these young adults who were exposed to Chernobyl, and they’re thyroid hormone-free.”

Additionally, there have been reports of people wanting levothyroxine to protect against the effects of radiation from a nuclear attack.

However, it works differently than something preventative like potassium iodide, said Alycia Clark, director of pharmacy and clinical affairs for Direct Relief. “As a hormone replacement, it’s really for people who have already had impaired thyroid function,” she said.

Doing without medication is dangerous. McConnell explained that withdrawal symptoms — including low blood pressure, extreme fatigue, muscle cramps, depression and sensitivity to cold (“and it’s winter,” he pointed out) — start after about two weeks without treatment. After three months without it, people’s conditions can become life-threatening.

To complicate matters, the subjects McConnell and his colleagues follow have become dispersed because of the war. “It’s just a big, big question mark. We don’t know how many came out,” he said. “It’s heartbreaking and sickening.”

Even before the war started, Direct Relief had a shipment containing levothyroxine packaged and ready to be shipped to Ukraine. “We almost always have levothyroxine in our inventory,” Clark said.

In the days immediately following the invasion, “the first demands were [for] all wound care and trauma,” she said. But as the war drags on, the drugs needed for routine care – including levothyroxine – are in increasing demand.

Direct Relief has shipped over 14 million defined daily doses – totaling over 30,000 pounds – of levothyroxine to the Ukrainian Ministry of Health at their request, and to the Charity Fund Modern Village and Town, for distribution to health facilities serving people affected by the conflict.

Comments are closed.