Side effects of contrast dye may include mild symptoms like nausea and dizziness or more severe conditions such as nephrogenic systemic fibrosis.

What is Contrast Dye?

Gadolinium contrast agents are injectable solutions used during magnetic resonance imaging (MRI) test.

Gadolinium, a heavy metal, helps provide additional contrast to the magnetic scan. This allows radiologists to better visualize blood vessels, tissues, and inflammation.

According to Inside Radiology, gadolinium based contrast agents are used in around one out of every three MRI scans performed. Doctors may suggest an MRI with contrast when looking to diagnose inflammatory conditions, internal injuries, cancers, and other problems.

What Are the Side Effects of Contrast Dye?

Most patients do not experience any side effects of contrast dye. When the contrast agent is first injected into an IV, some patients report a cold sensation that passes. Occasionally, patients will develop mild nausea or a headache. Even more rare is actual vomiting.

Drug manufacturers say that in patients with normal kidney function, there should be no long term side effects. 90 percent of the injected gadolinium reportedly leaves the body through urine within 24 hours of injection.

Gadolinium contrast agents are not recommended for use in patients with kidney problems. According to the National Kidney Foundation, these patients are at an increased risk of developing kidney complications.

One possible complication is contrast induced nephropathy (CIN). This rare disorder reportedly involves a sharp decrease in kidney function over a 48 to 72 hour period. Symptoms may include fatigue, loss of appetite, swelling, puffiness, and dry, itchy skin.

Some cases of CIN are reversible and leave no lasting side effects. Other, more severe cases can lead to further kidney problems as well as heart and blood vessel complications.

Another possible complication, according to the National Kidney Foundation, is nephrogenic systemic fibrosis (NSF). NSF is a rare, potentially life-threatening skin condition that can cause organ damage.

When a patient has NSF, their skin burns, itches, and develops red or dark patches. Patients may also develop stiff joints and weak muscles. Symptoms can develop in as little as 24 hours or as long as three months.

In patients with decreased kidney function, the kidneys are unable to sufficiently process out gadolinium after a contrast agent is used during an MRI. This reportedly results in retention of gadolinium which leads to an increased risk of CIN and NSF.

Contrast agent manufacturers insist that these complications are rare and only occur in patients with damaged or diseased kidneys. However, some consumers claim to have experienced gadolinium retention after undergoing an MRI with gadolinium contrast agents, even if they have perfectly healthy kidneys.

In December 2017, after more consumers came forward with reports of gadolinium retention, the U.S. Food and Drug Administration (FDA) released a safety announcement stating that gadolinium retention is possible with contrast agents.

Due to the recognized risk, the FDA required new labeling and medication guides for gadolinium based contrast agents which warn about gadolinium retention.

Why Might Contrast Dye Pose A Health Risk?

Imaging Technology News provides more context for how gadolinium may stay in the body than it should. The news source explains that in gadolinium contrast agents, the gadolinium molecules are coupled with what experts refer to a as a “chaperone molecule” — a molecule that allows the gadolinium to pass through the body without being retained.

However, if the gadolinium molecules can become detached from their “chaperones,” then they may stay in the body, and cause harm, reports Imagine Technology News.

Various gadolinium contrast agents may approach this attachment of a chaperone molecule to a gadolinium molecule differently, which some experts speculate is why some gadolinium contrast agents may pose more of a risk to patients of the gadolinium staying in their body. 

Experts are now examining how this gadolinium retention might affect different parts of the body. One expert, Emanuel Kanal MD, director of MRI services and professor of radiology and neuroradiology at the University of Pittsburgh Medical Center explains that this retention may lead to nephrogenic systemic fibrosis, but experts are still examining how it may affect other body systems.

Reportedly, there is particular concern about how it could affect a patient’s brain. He notes that whether or not the presence of gadolinium in the brain is actually harmful is still under investigation. 

Though there are many unknowns about potential side effects of contrast dye made with gadolinium, Science Daily reports that a recent study examined the potential for another metal — manganese — to be used in contrast agents that may pose less risk to human health than gadolinium might.