If you’ve ever had an MRI you might be familiar with the name Gadolinium. It’s the technical name for contrast. Contrast is used to get sharper MRI images. In the case of Multiple Sclerosis, it’s how active lesions can be seen. Until recently, contrast was thought to be safe. But latest research is showing a different picture.
History of the MRI and Gadolinium
The MRI is a medical imaging technique that uses strong magnetic fields, gradients and radio waves to create images of internal organs of the body. It was invented in the early 1970’s by Paul Lauterbur who would later win a Nobel Prize for his work on the MRI. It is used in diagnosis, staging of cancer/disease and follow up.
The first MRI used with an individual with MS came in 1981, 4 years after the first medical MRI scan. 7 years later, the first gadolinium based contrast dye was used for the first time to enhance the MRI scan for a clearer picture and improved interpretation.
Gadolinium is a rare earth metal that was discovered in 1880. When used in MRI contrast, it is chelated, or bonded then created into the dye medium. Without the chelation process, gadolinium would be toxic to our bodies.
Use in MRI and Safety
The most commonly used contrast agents in MRIs are gadolinium-based. The contrast causes molecules in your body to react differently to the MRI, therefore showing up differently on the scan.
In previous research, it was only thought that individuals with severe kidney illness or renal failure would be impacted by any long-term side effects. However, recent research has shown that gadolinium may be retained in tissue, primarily the brain, of all people.
At the beginning of the year, the FDA put out a new warning for gadolinium-based contrast agents, as well as new safety measures and a new medical guide for patients. This is prompting further research and study to be done on the safety of the contrast. The FDA is also urging doctors to consider risks for patients when choosing the need for contrast. Research is showing that small amounts of gadolinium may be left in the brain when people have had multiple doses of gadolinium. It was once believed that the gadolinium would totally clear from your body, but this new research is showing that it might not be fully eliminated.
The FDA states that side effects of the leftover gadolinium have not shown to be harmful, however anecdotal evidence points to other conclusions. Side effects common linked to gadolinium use are dizziness, nausea, headache and itchiness at the injection site. The most severe reaction is anaphylaxis, which is rare. In several articles I found symptoms of greater gadolinium toxicity, which unfortunately look very similar to MS symptoms. Those side effects include pain, bone pain, skin changes, muscle issues, I issues and cognitive difficulties among others.
When going for an MRI, and given gadolinium, the instructions afterwards are to drink a lot of water. This will hopefully help to detox and flush it from your system, but clearly this might not be enough. If actual toxicity is present, there are treatment options available. These include chelation therapy, which is the standard for all heavy-metal toxicities. Sauna, epsom salt bath, specific diet/foods to aid in detox and supplements.
Going forward, gadolinium might not be needed at all. New advancements in MRI technology have proven to be just as effective as comparing non-contrast and contrast MRI’s to check for disease progression. In one large study, where 3T images were tested, only 4 out of 1992 lesions were missed. These scans are currently available and in use. While gadolinium might still be needed at times like at initial diagnosis, using follow-up scans may be phased out in the near future.