Ask the Pharmacist: Gadolinium MRI contrast dye accumulates in brain
Gadolinium is a silvery-white heavy metal that is injected into the body through a vein and it is a contrast dye. Sometimes it is referred to as contrast media. They help the radiologist see inside you. Gadolinium is like a flashlight in your body.
MRIs that require gadolinium can be ordered for many reasons including migraines, coronary artery disease, stroke evaluation, brain tumors, infections and cysts/tumors. Thousands of shots of gadolinium dye are administered to people each day.
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Side effects may or may not occur. If they do, they are generally very mild like a headache, dizziness, pain at the injection site, prickling or burning sensation on the skin and sometimes nausea. These issues settle down within 24 hours as your body eliminates the drug from your kidneys. It helps if you take an analgesic and some detoxification supplements like glutathione, catalase and R-lipoic acid.
Gadolinium is in the news because the popular dye appears to be retained in the brain, raising safety concerns, especially for people who have multiple MRIs per year. More specifically, there has been a study regarding patients who have MS (multiple sclerosis) and these patients were tracked for five years starting from their diagnosis. Over the five years, the researchers found that a by-product of gadolinium called “gadodiamide” does in fact accumulate in the brain.
About nine percent of MS patients who received five doses or less did have accumulation in their dentate nucleus, which is involved in voluntary motor function and cognition. What is the clinical impact of this? No one is certain yet. The findings were published in a medical journal called Neurology, July 2019.
The study is causing controversy MS community for good reason. The MRIs are needed and useful, but the contrast dye might be harmful if used over and over. Should they get MRIs and if so, is there another contrast dye to use? Is the dye necessary at all? Are all the MRIs necessary? Is the disease progression causing the brain to hold more, or is it ‘sticking’ to everyone’s brain that gets injected with it? No one knows these answers. There are more questions than answers as of this writing. The study did not find any clear correlation between deposition of the dye in the brain and disability.
Radiologists nationwide must be beside themselves because again, the dye allows them to provide more accurate results for you. If, for example, the doctor needs to locate an aneurysm, do you really reject to the contrast dye?
Since the relationship of gadolinium with disease severity remains unclear, talk to your doctor about whether or not the radiologist needs the contrast dye. Sometimes they can see certain areas without it. If you have a history of kidney compromise, let them know at the imaging center. Every now and then, there’s an extremely dangerous kidney complication, or life-threatening allergic reaction but predicting who has a high risk for these problems is almost impossible.
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Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit SuzyCohen.com.