MR Imaging: Risks and Benefits

In this article-blog, i will first review the newly discovered dangers that come from MRI’s contrast agents. (Section A) In a second section, I will suggest a few holistic techniques to mitigate and remove these MRI toxins (Section B). Lastly, i will give an update on the legal front. (Section C)

Section A

MRI Gadolinium-based contrasts have toxic side effects, especially for weak kidneys: the evidence

MRI has been widely touted by conventional medicine’s experts and the government authorities as the safest advanced imaging available, if only because it uses magnetic fields and radio waves with no ionizing radiation. Even many integrative health practitioners recommend getting them for the positive effect their strong magnets have on painful joints and to avoid the ionizing radiation of CT scans.

However, this popular screening tool has a dark side. The evidence undeniably shows that gadolinium-based contrast used to enhance the images is toxic when it accumulates in the organs and can lead to serous complications.

First off, contrarily to what the Government and Industry have claimed, studies have consistently shown that the gadolinium is not be immediately eliminated and instead persists in different tissues of the  body. (1)

“Gadolinium chelates are widely used as contrast media for magnetic resonance imaging. The approved gadolinium-based contrast agents (GBCAs) have historically been considered safe and well tolerated when used at recommended dosing levels. However, for nearly a decade, an association between GBCA administration and the development of nephrogenic systemic fibrosis (NSF) has been recognized in patients with severe renal impairment”. (Source)

In this perspective, one study compared brain images of patients who had undergone six or more contrast-enhanced MRI brain scans with those of patients who had received six or fewer unenhanced scans. The results of this study showed areas of high intensity, or hyperintensity, in two brain regions fo those who took the MRI contrast agents, in particular in the dentate nucleus (DN and globus pallidus (GP) part of the brain, which correlated with the number of gadolinium-based enhanced MRIs. (1) (Source)

Furthermore, among patients with severe kidney disease, the use of gadolinium-based contrast agents is linked to the development of Nephrogenic Systemic Fibrosis, or NSF. Nephrogenic systemic fibrosis causes skin thickening that can prevent bending and extending  joints and other tissues like the diaphragm, thigh muscles, lung vessels, and lower abdomen. Along with causing decreased mobility of joints, NSF can be fatal. (2) (Source)

The acute nephrotoxic effect of GBCA administration to humans has also been demonstrated in a case report by Akgun et al. A 56-year-old woman with normal baseline renal function had 2 consecutive vascular imaging procedures employing GBCA administration. A few days later, the patient developed acute renal failure. A renal biopsy revealed acute tubular necrosis (Akgun et al. 2006).

The effects of GBCA administration are not limited to nephrotoxic effects. Histopathological and molecular changes (apoptosis) in the liver, lungs, and kidney tissues have been observed in GBCA-treated mice (Chen et al. 2015).

Section B

Precautions and Holistic Remedial Measures

The first line of protection against gadolinium toxicity is to avoid having an MRI with contrast agents whenever other, less toxic options are available, in particular Elastography,  ultrasound and other types of detection and monitoring tests. (See the Institute’s link on these including one of our Video interviews). The contrast material the iodine-based materials used for x-rays and CT scanning can also be problematic (see Discussion below).

If the patient can’t avoid these imaging techniques, then the best would be to negotiate with the prescribing health-care provider the use of MRI without contrast agents.  In effect, if a doctor recommends this test, often they can use an MRI without contrast.  The patient can discuss different options with his or her doctor, including using saline (salt water) and air  as contrast materials in imaging exams. Microbubbles and microspheres have been administered for ultrasound imaging exams, (3)

However, because in life there are lots of howevers, if the patient is too weak to follow the Happiness-holistic approach and-or too imbued with family and society pressures to follow the conventional standard of care, then it’s best to try to mitigate the toxic onslaught by loading up on antioxidants like N-Acetyl Cysteine (NAC),  alpha lipoic acid, vitamin C and more (See Institute’s Coaching session for an individual determination). These and other molecules help human livers to make additional glutathoine, which is key for intra-cellular broom-cleaning. Getting IV of glutathione or even the Meyes coctail can also be envisaged, although one should get all of the benefits and risks analyses of  this approach in other to make an informed decision.

Supplement with the natural chelators cilantro and chlorella can help to remove some of the gadolinium out of the body.  I would start these supplements the week before testing and continue for one or two weeks.  Right after the test is done, start taking a binder like activated charcoal or bentonite clay and make sure to drink plenty of clean water. It’s important to drink as much water as possible during that first 24 hours, maybe even 48 hours, to eliminate the contrast dye from the kidneys quickly. Some naturopaths prescribed me EDTA, which is an oral chelating agent. The Institute has its preferences, all based on science. (See our workshops and coaching sessions for the details).

If the patient already has symptoms from gadolinium toxicity, a more comprehensive plan may be needed which would including adrenal and nutritional protocols mixed in with chelators and binders.  Spending time in the sauna to stimulate detox through the skin.

Section C

On the Legal and Political Front

Notwithstanding the above mentioned deleterious effects of contrast agents, the conventional medical system feels that there are more benefits than risks, thus, these products are still legal. But it should be up to the patient to decide. However, the prescribing doctor, let alone the MRI technician don’t even warn and inform the patient of possible serious adverse effects. This is a clear violation of the “informed consent” rules and damaged victims have therefore ipso facto a strong cause of action to vindicate his or her right in a court of law including via a class action suit.

At most, the US Food and Drug Administration (FDA) conceded to request that the manufacturers of all five gadolinium-based contrast agents (Magnevist, MultiHance, Omniscan, OptiMARK, and ProHance) add a boxed warning and a new Warnings section to their labels to describe the risk of developing NSF. (4) (Source)

Despite the FDA black box label in 2007 and  this NSF warning in 2015, practitioners continue to order these scans routinely without informing patients of the risks. The black box warning is for nephrogenic systemic fibrosis (NSF), a serious and sometimes fatal kidney condition, and anyone with kidney impairment is at risk. Gadolinium is normally excreted by the body through the kidneys, but kidneys functioning less than optimally have trouble getting rid of all of the gadolinium, so toxic levels build up in the body’s tissues and organs, including the brain. Worse, recent studies have shown that toxic build up exists even without weak kidneys. (See supra).

Meanwhile, GE and Bayer have confidentially settled hundreds of lawsuits (many involving deaths)  while denying liability for their contrast agents, just like Tobacco companies. In this perspective,  one case went to trial in Cleveland and resulted in a $5 million verdict against GE. A federal appeals court upheld the verdict last year. By then the plaintiff, who had NSF, had died. (5) (Source).

Gadolinium is a heavy metal that gets retained in two key brain areas. It has been previously shown that heavy metal toxicity in the brain is often associated with neurological diseases like Alzheimer’s, multiple sclerosis, and Parkinson’s as well as a whole array of different symptoms from retina, pineal gland, and much more (6). Time-varying magnetic fields may also interfere with nerve cell function and muscle fibers, while MRIs also produce acoustic noise that has been known to cause temporary and even, to a lesser degree, permanent hearing loss.  Furthermore, due to the strong magnetic field produced, an MRI can become deadly if metal objects in the room. Medical devices such as a pacemaker in your body can go haywire with a MRI blast. Yet, the vast majority of MDs still do not even informed the patient of these risks. (7)

Discussion

The debate between conventional and holistic medicine proponents is centered on the benefits-risks ratio analysis. Rogosnitzky, who heads the Center for Drug Repurposing at Ariel University, called upon the scientific community to quickly develop treatments for gadolinium overload. “Our literature review did not reveal a single suitable drug to swiftly remove gadolinium from the body,” he said. “In one study, the authors estimated it might take up to 156 years to remove a patient’s stored gadolinium using a particular drug.” Rogosnitzky believes that a good first step is to study existing chelator drugs used for other metal toxicities in order to assess their possible utility in gadolinium accumulation. (8) (Source)

With the ominous discovery that gadolinium is retained in healthy patients, there is a critical shortage of scientific information regarding how to assess gadolinium toxicity, and perhaps most importantly, how to treat it.

So What Imaging technique to use ? If any.

Although everyone is different, so toxic chemical reactions can vary individually, the Science confirms that comparatively,  MRI contrast agents are  worse than CTs contrast agents. In effect, results from an in vivo study in pigs demonstrated the material existence of higher toxicity of GBCAs (the MRI contrast agents) when compared to iodine contrast agents in CT scans (Elmstahl et al. 2006). Pigs are one of our closest mammalian cousins, more than rats and cows. Human clinical trials comparig these two  types of contest agents appear to have been done, most likely because of the financial disincentive, medical imaging is a multi-billion industry. But just about all in vitro and animal studies substantiate the above-mentioned assertion.

But this assessment does not mean that Ct scans are without significant adverse effects. In addition to their ionizing cancer-causing radiation, they also have issues with kidney failure.

“…life-threatening contrast-induced nephropathy (CIN) is associated with CT and nephrogenic systemic fibrosis (NSF) with MRI contrast agents”.  (Source) (See Exhibit A below)

Personally, I would choose neither. The first precautionary measure is avoidance until proven safe. This is called the precautionary principle, which is obligatory in Europe, but not in the US.  Many times, physicians will order these tests just to avoid possible liability.

Many times, patients and their MDs are too focused on the testing, many of which are false positives and produce nefarious effects. Hence, the Happiness-Holistic Medicine approach is to  forego test at first, except for the preliminary clinical appraisal via a good relaxed discussion with the patient. After this the patient-health professional relationship has coalesced with this preliminary meeting, the Happiness-Holistic Medicine approach is to get immediately engaged with the major holistic pathways that will unregulated Life, including via the removal of toxins and burdensome elements thare are usually part of the problem. So why just add to more anxiety and toxins via these exams ? My preference is just to assume one has a big challenge and that it’s time to immediately engate in a rejuvenation fitness program.

Conclusion

Everyone should use caution with gadolinium-based contrast agents and only use them when absolutely essential. Even if the patient is healthy, these contrast agents may cause side effects like life-threatening allergic reaction, blood clots, blood vessel irritation and skin reactions, including hives, itching, and facial swelling. If the patient has a kidney issue,  caution is particularly important. Often the use of contrast agents is optional and an acceptable MRI can be conducted without the use of a contrast. Furthermore, for these expensive MRIs to be cost friendly, it is best to avoid hospitals and choose more community-based imaging companies. (9)

Pr. Joubert (ACR Institute’s director)

For more information and support, visit gadoliniumtoxicity.com.

Reference and Precision Notes

(1)  pubs.rsna.org/doi/abs/10.1148/radiol.13131669

(2).   www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/ucm142889.htm

(3) Microbubble contrast materials are tiny bubbles of an injectable gas held in a supporting shell. They are extremely small —smaller than a red blood cell— and have a high degree of “echogenicity”, or ability to reflect ultrasound waves. Structures with higher echogenicity will appear brighter on ultrasound. Once the microbubbles are in the bloodstream, ultrasound technology is able capture differences in echogenicity between the gas in the microbubbles and the surrounding tissues of the body, producing a sonogram with increased contrast. The microbubbles dissolve, usually within 10 to 15 minutes, and the gas within them is removed from the body through exhalation. Contrast-enhanced ultrasound with microbubbles is a convenient, relatively inexpensive way to improve visualization of blood flow that does not use radiation. It is a useful option for patients with kidney failure or allergies to MRI and/or computed tomography (CT) (Source)

(4). www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/ucm142889.htm

(5)  www.propublica.org/article/ge-failed-to-adequately-warn-about-dangers-of-its-mri-dye-jury-findsdfd

 (6). Symptoms.  Many symptoms of gadolinium toxicity mimic the chronic conditions many people get imaging for, but there’s one that sets it apart. People describe it as a feeling of being electrified just underneath the skin, and some people experience it as feeling like their skin is crawling. Other symptoms include joint pains, muscle twitches, and cognitive changes which usually start within the first month after the exposure. Also common are itchy skin, deep bone pain close to the site of the MRI, numbness or tingling, dry eyes, tinnitus (ringing in the ears), hair loss, balance problems and swelling in feet and hands.

(7). Most MDs have sadly become cunning Masters of Deception in this and other fields. Maybe  mainstream dictionaries like the one the US Supreme Court uses (Webster dictionary),  should give a second meaning to MD, masters of deception. The weight of the evidence that is called the “preponderance of the evidence” certainly substantiates this ACR Institute piece of recommendation (See link on the limiation of Conventional medicine).

(8).  Moshe Rogosnitzky, Stacy Branch. Gadolinium-based contrast agent toxicity: a review of known and proposed mechanisms. BioMetals, 2016. (Source)

 (9). Hospitals tend to be the most expensive option for diagnostics and outpatient procedures—sometimes by an enormous margin. Freestanding diagnostic centers are alternative places to obtain services, such as lab studies, X-rays, and MRIs, often at a fraction of the cost charged by hospitals. Hospitals often charge higher fees for their services to offset the costs of their 24/7 operations. Hospitals also may charge exorbitant fees for high-tech diagnostics, like MRIs, to subsidize other poorly reimbursed services. And, hospitals are allowed to charge Medicare and other third-party insurers a “facility fee,” leading to even more price inflation. So, if you do find that you need an MRI, don’t be afraid to shop around. With a few phone calls to diagnostic centers in your area, you could save up to 90 percent over what a hospital would charge for the same service.

Exhibit A

Toxicity of MRI and CT contrast agents.

Hasebroock KM1, Serkova NJ.

Abstract

Anatomical and physiological imaging using CT and MRI are playing a critical role in patients’ diagnosis, disease characterization and treatment planning. CT- and MRI-based protocols increasingly require an injection of iodinated CT and gadolinium (Gd)-based MRI contrast media. Although routinely used in clinical practice, iodinated and to a less extent Gd-based contrast media possess side effects: life-threatening contrast-induced nephropathy (CIN) is associated with CT and nephrogenic systemic fibrosis (NSF) with MRI contrast agents. CIN is defined as an acute decline in renal functions (serum creatinine increase > 0.5 mg/dl) after administration of iodinated contrast media. Patients with moderate-to-severe chronic kidney disease are considered the highest risk group for development of CIN. CIN is more common with ionic high-osmolar contrast CT media. NSF is a rare condition characterized by the formation of connective tissue in the skin and systemically in the lung, liver, heart and kidney. Patients with end stage kidney disease, acute kidney injury and stage 4-5 chronic kidney disease are at a high risk for NSF. The nonionic linear Gd-chelates are associated with the highest risk of NSF. This review summarizes the incidence, symptoms, safety profile of various CT and MRI contrast agents based on their physiochemical properties. (Source)

DISCLAIMER Nothing in this educational blog should be construed as medical advise.

2016 Copyright: ACRI (Advanced Cancer Research Institute) and agents. All rights reserved.