Gadolinium is a highly toxic metal that is currently a popular choice in healthcare for increasing the quality of images taken by MRI machines.
Gadolinium-based contrast agents as they are known are often used for taking a better look at blood vessels and the brain.
Several reports of patients who had undergone an imaging procedure that involved using a gadolinium containing contrast agent have claimed that it negatively affected their health, and potentially did more harm than good.
The first lawsuit was filed in 2016 against a gadolinium-based contrast agent (GBCA) manufacturer.
Since then, several other law suits have been filed against medical practices and various contrast agent manufacturers, thus raising questions about the true side effects of gadolinium as a contrast agent.
so how safe is it?
Before we get into the side effects of gadolinium based contrast agents, lets get the sciency bits over with.
When patients have MRIs, their cells are blasted with electromagnetic waves that cause protons found in body fluids (AKA water molecules) to have an aligned spin.
This is what we call polarization in the direction of the magnetic field.
Spin is simply terminology used to describe a particles natural rotation. When a magnetic field is switched off, the protons release energy that can be measured by a receiver to generate an image.
An entire picture can be generated because the receiver is getting information from a range of different protons which are releasing different amounts of energy depending on their tissue of origin and how quickly they return to their natural spin states.
Gadolinium is used as a contrast agent meaning it is injected intravenously (into the veins), (or given orally) to increase MRI resolution.
On its own, it’s a very toxic heavy metal but when used as a contrast agent, gadolinium ions are bound to a chelating agent which prevents the direct toxicity associated with a free gadolinium (3+) ion from damaging tissue.
The toxic effects associated with gadolinium ions are linked to its ability to bind enzymes and disrupt the state of voltage-gated calcium channels, thus they can have adversely negative effects in the body.
Calcium channels are tightly regulated gates that control the flow of calcium into and out of cells. They are crucial in processes such as the synchronized beating of heart cells, and the movement of muscles.
The use of GBCA’s has been linked to the development of nephrogenic systemic fibrosis (NSF). NSF is a rare disease that occurs in individuals with kidney problems.
NSF is characterized by swelling and tightening of the skin. Skin on the arms and legs often become hardened which inhibits movement and ultimately results in reduced joint flexibility.
In patients without any renal problems, and a perfectly intact blood-brain barrier, intended to control movement of particles from blood into brain, there is still a reported risk of gadolinium being deposited in the brain.
Gadolinium deposition has also been reported in bone and skin tissue of individuals with normal kidney function. This is contrary to the long-held belief that GBCAs are quickly and entirely excreted from the human body.
The biggest argument in favor of the use of gadolinium is that the benefits outweigh the negatives.
When surveying the number of people who have benefited from treatments versus the number of people who have died as a result of gadolinium poisoning from a contrast agent, the scales are highly in the favor of the continued use of gadolinium as a component in contrast agents.
More information to come…