Gadolinium contrast agents are heavy metals used in intravenous contrast fluids for magnetic resonance imaging, or MRI.

They are meant to help improve images or organs, blood vessels, and tissue. This is because gadolinium contrast agents are highly reactive to the magnetism of the MRI machines.

Gadolinium is a heavy metal that does not naturally occur in the human body. It’s used in contrast agents that are held together by chemical bonds. According to Inside Radiology, the chemical bonds consist of gadolinium ions and carrier molecules called chelating agents, which prevent the metal’s toxic properties from affecting patients. Depending on the brand of gadolinium contrast medium, different chelating molecules are used to mediate the metal’s toxic effects.

Due to the effectiveness of gadolinium, it is used in as many as one in three MRI scans to improve the quality of the diagnostic images. Improved images give doctors and other medical professionals a clear view of the patient’s organs, tissues, blood vessels, and bones allowing for a more accurate diagnosis. Gadolinium is typically administered based on the notes from the patient’s referring doctor, which helps determine if the contrast agent may be necessary or not.

Before it is implemented, patients may be asked several questions about their medical histories including if they have any metal implants. Metal implants may interfere with the magnetic fields of the scanner, with the final decision sometimes being made by a radiologist.

After the MRI is completed, the gadolinium is supposed to be expelled through the kidneys. Patients with normal kidney function should expel the gadolinium contrast through urination within 24 hours of implementation.

However, there are a number of serious complications patients should be wary of, including gadolinium deposition disease and nephrogenic systemic fibrosis (NSF). The FDA recently warned against complications like these in 2017, stating that a growing number of patients have reportedly retained dangerous amounts of gadolinium.

Overview of Gadolinium Toxicity Side Effects

The most common reactions patients report with gadolinium contrast are minor headaches or nausea for a brief period after the infection, with some feeling coldness at the injection site. But there are some who are concerned that the substance may be retained in the bodies of patients.

Recent data prompted the FDA to issue a warning in December 2017, stating that gadolinium retention could leave heavy metal in the body much longer than previously thought. Some patients who received gadolinium contrast agents during an MRI could retain the metal in their bodies for months or even years after implementation. More specifically, it was found that about one percent of the injected gadolinium may be retained in the body, with most of it in the bones and a small amount in the brain.

The FDA stated gadolinium may trigger a rare condition called nephrogenic systemic fibrosis (NSF) in patients with preexisting kidney problems. The FDA has also received injury reports of multiorgan system failure in patients with healthy kidney function.

According to a gadolinium toxicity advocacy group, patients with normal kidney function and recently got a gadolinium contrast for their MRI should be wary for the signs of gadolinium deposition disease including:

• Intense burning of the skin and below the skin
• Intense pain in bones or joints
• Brain fog
• Muscle vibrations and skin tingling
• Head pain
• Distal arm and leg skin thickening or becoming discolored

Patients who develop gadolinium deposition disease can suffer severe toxicity effects in the bones and brain. Patients should report these symptoms to their doctor as soon as possible.