Sharon Williams They can be very intense soon after the MRI. The development of symptoms such as headaches, bone/joint pain and skin changes appear to occur earlier, with typical onset times reported between hours and days post-contrast-enhanced MRI [ 24, 25 ]. Marckmann and Skov noted that the “clinical picture of NSF is diversified” and “it varies from one patient to another and it varies over time“. I believe the problem is Gadolinium Toxicity, and not NSF, or anything else. Intense burning of the skin and skin substrate. I/we knew they were wrong about that, but because of what had been said repeatedly in the published literature, patients with normal kidney function could not convince doctors that their symptoms were connected to the MRI with contrast that they had. The word “nephrogenic” in the name caused doctors and researchers to focus on people with severe renal disease. Retrieved from http://ard.bmj.com/content/69/11/1895.full.pdf, Marckmann, P., & Skov, L. (2009). They don’t connect the … Small fiber neuropathy (SFN) is a disorder of thinly myelinated Aδ-fibers and unmyelinated C-fibers, and it is typically associated with burning pain in the lower arms and legs. Some people also experience tingling and shaking. On August 25, 2020, I wrote an open letter to the FDA, Radiologists and Researchers about the symptoms of gadolinium toxicity that have not, as yet, been recognized by the FDA or medical community as being caused by retained gadolinium (Gd). This symptom complex should be expected. Journal of Magnetic Resonance Imaging : JMRI, 30(6), 1240–8. Four weeks after injection, the mice were euthanized, and footpads were assessed using immunofluorescence staining. einzuordnen. The median lethal dose (LD50) of Gadolinium is roughly 100-200 mg/kg of body weight, but the dosage used for each MRI scan with contrast falls under this threshold.According to earlier studies, GBCA toxicity depends not on the presence of gadolinium, but on the strength of the chelating agent. Signs and symptoms of gadolinium toxicity or Gadolinium Deposition Disease include: Intense burning of the skin and skin substrate: This may be localized in the torso or extremities (arms or legs) or it may affect the entire body. Their self-reported symptoms have recently been published. Patients with normal kidney function were being overlooked; however, they were not unaffected by retained gadolinium from GBCAs. Change ), You are commenting using your Facebook account. Skin that may feel \"woody\" and develop an orange-peel appearance and darkening (excess pigmentation) 4. As an affected patient with normal kidney function, I respectfully disagree. Why should patients with normal kidney function be expected to be any different when they retain gadolinium? Allgemein / Gadolinium. As more research was performed and more patient data was gathered, the evidence and understanding of what retained gadolinium can do to the human body has increased significantly. Purpose: This study aims to describe the self-reporting symptoms experienced by individuals with self-reported normal renal function after gadolinium based contrast agent (GBCA) administration. Interestingly, as you will see in my letter, many symptoms of SFN are the same as the clinical symptoms associated with nephrogenic systemic fibrosis (NSF), which makes sense to me since the cause is the same. The long-term and cumulative effects of retained gadolinium in the brain and elsewhere are not as yet understood. One only needs to read the NSF autopsy-based review articles to know that gadolinium can affect every organ in the body and cause extensive fibrosis and calcification of tissues. those patients with only one or two chronic symptoms of gadolinium toxicity, or another disease such as MS, won’t meet the diagnostic criteria for GDD. Gadolinium Toxicity Symptoms. With all of that published evidence of gadolinium’s toxic effects, I don’t believe it should come as a surprise to anyone that patients are reporting a wide range of symptoms after their MRIs with a gadolinium-based contrast agent – if anything, it seems it should be expected. shedding light on the effects of retained gadolinium from Contrast MRI, September 22, 2020 12:19 pm / Leave a comment. When researchers later learned that the problem went well beyond the patients’ skin and caused a systemic disease process, the name was changed to Nephrogenic Systemic Fibrosis (NSF). They found a significant reduction of IEFND in the footpad of mice for all GBCAs tested compared with the control group. Change ), You are commenting using your Twitter account. The authors made an important point that I believe should apply to all patients who have had MRIs with a GBCA. Arising in the subacute stage (2 weeks +): This is very much like the principal features of NSF, but generally less severe. I understand the logic behind that, but don’t we already have scientific evidence? First, symptoms of GDD must start within minutes to one month after administration of a gadolinium-based contrast agent (GBCA). Change ), You are commenting using your Google account. The long-term and cumulative effects of retained gadolinium in the brain and elsewhere are not as yet understood. The literature also indicates that gadolinium is neurotoxic, nephrotoxic, and cytotoxic, it inhibits mitochondrial function, induces oxidative stress, triggers endoplasmic reticulum stress, increases vascular reactivity, induces macrophage apoptosis, causes fatty liver, is a potent blocker of calcium channels, and more. (A pdf of this Editorial is available for download). So the good news is that there are relatively few commercial uses for this dangerous metal and its compounds (1). This likely explains those patients’ symptoms of gadolinium toxicity. Reports of possible clinical symptoms experienced by patients after a contrast-enhanced MRI have been published. Coauthor of The Lighthouse Project The authors noted that, to the best of their knowledge, the study is the first to investigate a correlation between small fiber degeneration and GBCA exposure. Symptoms of NSF are very similar to the symptoms of gadolinium poisoning. Some have also described a persistent metallic taste or olfactory sensation. Researchers and the FDA want scientific evidence and not just anecdotal facts compiled from patients who have been affected by retained gadolinium. Can Symptoms of Gadolinium Toxicity be explained? They can also have chronic symptoms for years. Muscle vibrations (muscle fasciculations) and skin pins and needles/tingling (early on after GBCA). Before providing information about having your urine tested for Gadolinium, a few words about types of testing, urine collection, and results reporting are appropriate. The study, Gadolinium-Based MRI Contrast Agents Induce Mitochondrial Toxicity and Cell Death in Human Neurons, and Toxicity Increases with Reduced Kinetic Stability of the Agent, was published online ahead of print in Investigative Radiology. If you would like to learn more about the symptoms of gadolinium toxicity, read our Survey of the Chronic Effects of Retained Gadolinium from Contrast MRIs report. Nephrogenic systemic fibrosis: clinical picture and treatment. Gd-induced Systemic Fibrosis…If that name change had been made in 2009, perhaps gadolinium retention and the chronic symptoms and health issues experienced by patients with normal renal function would have been recognized much longer ago, and more time and resources could have been spent on trying to find a cure and better treatments for all affected patients. Headache is both a very common occurrence and shows tremendous variability. GDD sufferers describe it as a head pain, and unlike any other type of head-ache they have previously experienced. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2853020&tool=pmcentrez&rendertype=abstract, Williams, S. (2012). 6. Information and conclusions presented here should not be interpreted as medical advice. Nephrogenic systemic fibrosis can begin days to months after exposure to gadolinium-containing contrast. There are now 6 symptoms that stand out to Dr. Semelka as critical diagnostic findings for GDD. Gadolinium Toxicity has been linked to several medical conditions such as Nephrogenic Systemic Fibrosis, Gadolinium Deposition Disease and Gadolinium Storage Condition. Research efforts should focus on trying to find ways to mitigate the problem and treat the symptoms associated with Gadolinium Toxicity. Gadolinium (Gd) Result 1.2 Reference Interval < 0.8 ... Gadolinium has no known biological role in humans. Change ), Copyright 2014-2020, All Rights Reserved. An expansion of described symptoms for GDD. Gadolinium and systemic fibrosis: guilt by association. Our only advice is to consider symptom relief carefully, and do not try to be the hero who says “I … The reason for making my letter available to the public now is to inform doctors, researchers, and affected patients about gadolinium-related facts that do not seem to be widely recognized. Gadolinium is normally excreted by the body through the kidneys, but kidneys functioning less than optimally have trouble getting rid of all of the gadolinium, so toxic levels build up in the body’s tissues and organs, including the brain. Muscle vibrations/twitching and pins and needles skin sensations generally reflect nerve disease (neuropathy). Swelling and tightening of the skin 2. Often the joints may be peripheral but can also be large joints like the knee or hip. A preclinical study by Bower et al. Gadolinium deposition disease refers to situations in which a person has normal or adequate renal function but develops persistent and/or painful symptoms anywhere from a few hours to several weeks after being injected with a gadolinium contrast agent. Brain fog is also a prominent feature of lead toxicity, which is another heavy metal toxicity. The updated graphs show an even stronger pattern of Gadolinium urine levels based on the number of months since the participant’s last Contrast MRI. Home » Advocacy » Gadolinium Toxicity: If not NSF, then what is it? Depending on how much gadolinium someone retains and where it has been deposited in their body, the patient could experience many new symptoms or a few. For a companion editorial on this topic by Hubbs Grimm, my partner on GadoliniumToxicity.com, read “Gadolinium Toxicity – Let’s not make the same mistake again”. Second, the symptoms experienced by the patient after GBCA administration must be new, and not preexisting. Gadolinium Toxicity: If not NSF, then what is it? Several of the papers cited by Marckmann were referenced in my 2012 letter to the FDA to make my point that gadolinium retention could happen to ALL patients and they could be adversely affected by it. Any bones can have severe point pain, but rib pain is quite distinctive for the disease. Materials and methods: This HIPAA-compliant, IRB-approved study consisted of an anonymous online survey of patients who believe that they suffer from gadolinium toxicity. On May 18, 2018, Dr. Richard Semelka added Head Pain to the recently revised primary clinical diagnostic findings for Gadolinium Deposition Disease (GDD) and he described two critical diagnostic features of GDD. Symptoms typically decrease in intensity over time, but many patients report that symptoms can last for years after the scan. Interestingly, as you will see in my letter, many symptoms of SFN are the same as the clinical symptoms associated with nephrogenic systemic fibrosis (NSF), which makes sense to me since the cause is the same. Some signs and symptoms of nephrogenic systemic fibrosis may include: 1. The problem has nothing to do with patients’ kidneys, but everything to do with retained gadolinium – a toxic metal like lead or mercury. I believe many symptoms of gadolinium toxicity can be explained by Gd-induced small fiber neuropathy (SFN) and long-standing neuropathic pain. Updated Gadolinium Retention test result information is also presented. Since we launched our website in 2014, there has been a significant amount of new research published that indicates that gadolinium is being deposited in the brain. Intense boring pain in bones or joints. After all, we have been down this road before with NSF/NFD. The literature also indicates that gadolinium is neurotoxic, nephrotoxic, and cytotoxic, it inhibits mitochondrial function, induces oxidative stress, triggers endoplasmic reticulum stress, increases vascular reactivity, induces macrophage apoptosis, causes fatty liver, is a potent blocker of calcium channels, and more. Gadolinium Deposition Disease (GDD) refers to patients with gadolinium accumulation having normal kidney function that show painful symptoms within few hours or weeks or two months after exposure to Gadolinium based contrast agents (GBCAs). Recently, patients who report that they suffer from chronic symptoms secondary to gadolinium exposure and retention created gadolinium-toxicity on-line support groups. Symptoms of Gadolinium Toxicity/Gadolinium Deposition Disease. Gadolinium toxicity Symptoms include pain in the skin, bones, joints or head. However, I am concerned that the diagnostic criteria for GDD could result in some patients who have been affected by retained gadolinium not being recognized and properly diagnosed. The FDA warning that came in 2015 was the one gadolinium toxicity advocates like Marcie were fighting for. Toxicity is rarely associated with Gd due to its poor gastrointestinal absorption (it is suspected that very little Gd is absorbed from the gastrointestinal tract (<0.05%). Intense boring pain in bones or joints. symptoms of Gadolinium Toxicity. Enter your email address to follow this blog and receive notifications of new posts by email. Gadolinium(Gd)-haltige Kontrastmittel (KM) werden seit 1988 in der klinischen MRT-Routinediagnostik weltweit eingesetzt. Some describe it as a burning pain and as an extreme tightness feeling (like a tight bathing cap on their head). Meist zeigen sich erste Symptome bereits innerhalb weniger Stunden nach der Verabreichung eines MRT-Kontrastmittels, verstärken sich für einige Tage bis Wochen nach dessen Erhalt und chronifizieren auf … Copyright 2014-2020, All Rights Reserved. 3. In 2012, I wrote to the FDA about gadolinium retention in all patients, but especially those with normal kidney function who were being told that the unexplained symptoms they were experiencing after MRIs with a GBCA could not be caused by gadolinium because “people with normal kidneys don’t retain gadolinium”. Like what happened with NSF, all patients affected by retained gadolinium may not be properly diagnosed, and the effects of gadolinium toxicity will continue to be underreported. Like what happened with NSF, all patients affected by retained gadolinium may not be properly diagnosed, and the effects of gadolinium toxicity will continue to be underreported. My hope is that more research will be conducted that involves evaluation and testing of patients who have retained gadolinium and are experiencing SFN-like symptoms, which, until now, have been unexplained and perplexing to clinicians who are not familiar with the potential toxic effects of retained gadolinium. Read our full post and the study here. The bad news is that its main commercial use … The symptoms in Gadolinium deposition disease are similar to nephrogenic systemic fibrosis (NSF) but are less severe. Isn’t it logical to think that lesser amounts of retained gadolinium could cause similar but perhaps less severe damage to various body systems in almost every patient who retains it? Patients exposed to Gadolinium show symptoms of heavy metal toxicity/poisoning. Could it just be that the connection has not yet been made, and when considered together, all these facts might explain how patients’ symptoms are being caused by retained Gd from gadolinium-based contrast agents (GBCAs)? It shouldn’t matter whether the evidence comes from unenhanced brain MR images, gadolinium detected in biopsy specimens, prolonged gadolinium excretion in urine specimens, or other testing methods. A healthy human body should naturally eliminate Gadolinium through the kidneys.
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