What You Need to Know About Gadolinium
Gadolinium was created for use in Magnetic Resonance Imaging (MRI) in 1988. Soon after it became the preferred contrast agents in MRI’s administered to patients with kidney problems. This was because the agents in Gadolinium were thought to be safer than other iodine-based contrast agents.What is Gadolinium Specifically Used For?
Gadolinium injections are used as an MRI contrast agent because its magnetic properties allow healthcare professionals to better observe lesions with abnormal vascularity in the brain, spine, and associated tissues. When the doctor calls for a Gadolinium injection, an MRI is first taken without any injection followed by an MRI after the Gadolinium has been injected into the patient.What Are the Possible Side Effects of Gadolinium?
Gadolinium has several possible side effects, some less severe than others. The most concerning side effect of Gadolinium is Nephrogenic Systemic Fibrosis (NSF). NSF is a progressive disorder that is associated with the development of excessive scar tissue as well as thick, hardened, and tight areas of skin which often cover the joints, resulting in severe limitations on movement. There is no cure or effective treatment for NSF, and it has lead to death in some cases. The victim may become unable to walk or fully move the joints of their arms, hands, legs and/or feet. Victims will become dependent on wheelchairs within weeks.What Are Some Less Severe Possible Side Effects?
Less severe possible side effects of Gadolinium are also possible. In some cases, you may only experience an allergic reaction to the injection. Symptoms would include:
- Swelling of the face
Other possible side effects of Gadolinium that are more severe than an allergic reaction, however not as dangerous as NSF include:
- Skin problems at the point of injection
- Irritation to the veins
- Blood clots
- Red or dark patches on the skin
- Stiff joints with trouble straightening or moving limbs
- Pain in the hip or ribs
- Yellow spots on the whites of the eyes
Gadolinium-based agents that are approved by the FDA (Food and Drug Administration) but have come under heavy scrutiny:
- Magnevist (gadopentetate dimeglumine)
- Omniscan (gadodiamide)
- OptiMARK (gadoversetamide)
- MultiHance (gadobenate dimeglumine)
- ProHance (gadoteridol)
In 2008, as a response to the alarming and concerning news of Gadolinium and its link to possible side effects including NSF, the Food and Drug Administration (FDA) granted a Fast Track Designation to a new type of MRI contrast agent called Ferumoxytol. Ferumoxytol could be a safer alternative to Gadolinium and Gadolinium-based contrast agents for people with chronic kidney problems.
The Fast Track Designation is issued by the FDA for products that are intended for the treatment of serious conditions or have the potential for use in unfulfilled medical needs. This designation allows the FDA to accelerate the process of development and review of these products by allowing more frequent interactions. The FDA’s sudden decision to allow a quicker approval process for Ferumoxytol was due to the potential for a newer and safer diagnostic agent that could serve as an alternative for individuals with chronic kidney disease. These individuals can not take Gadolinium due to possible side effects but must have a Vascular Enhanced MRI for assessment of peripheral arterial disease. Gadolinium can and still may be safe for most users, it is, however, more dangerous to people who suffer from chronic kidney disease.Gadolinium, MRI, and Pregnancy
Magnetic resonance imaging or MRI is considered safe during pregnancy. Magnetic energy has been shown not to be harmful to a developing fetus. However, the FDA strongly warns against any use of Gadolinium contrast dyes during pregnancy because they cross the placenta and their long-term effects are unknown. If you are pregnant, consult with your doctor before having an MRI. It is also not known at this time if Ferumoxytol is safe to be used for an MRI during pregnancy. The FDA stresses caution for all forms of MRI contrast dyes used while a patient is pregnant or breastfeeding.What Pre-existing Conditions Put You at Risk When Using Gadolinium?
The most likely pre-existing conditions to allow for possible side effects when injected with the contrast dye Gadolinium is kidney problems. This is because Gadolinium is flushed out of your system by your kidneys soon after it’s injected. When Gadolinium remains in your system for too long, it can cause injuries that can be severe.Can I Just Have an MRI Without Gadolinium or Any Other Contrast Dye?
If your doctor has ordered an MRI along with an injection of Gadolinium, chances are you will first have an MRI without Gadolinium. The reason the doctor orders an injection of a contrast dye is to get a more detailed picture of the patient's internal organs, tissues, bones, and vessels.
The video below provides information regarding the use of Gadolinium-based contrast.How Likely Am I to Get NSF If I Am Injected with Gadolinium?
NSF is a rare disease. The chances of someone with regularly functioning kidneys to get NSF from a Gadolinium are extremely rare. Gadolinium is relatively safe because the dye is passed through the kidneys quickly. The main concern is for patients who do not have regularly functioning kidneys. When Gadolinium isn’t flushed out of the kidneys in a certain amount of time, the risk of all possible side effects drastically increases. Please consult your doctor for more information.Gadolinium Legal Info
There have been legal proceedings and letters warning about the possible side effects of Gadolinium. If you have experienced any of these symptoms after taking Gadolinium consult with your doctor to determine if this was a direct result of the injection.
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Editor’s Note: This page has been updated for accuracy and relevancy [cha 5.11.20]