Discusses MRI contrast agents, how they work, the different types (linear, macrocyclic, ionic and non-ionic) and some of the controversy surrounding these agents today.
I recently learned of gadolinium retention in patients with normal renal function and decided to forgo my MRI until such time as the benefits of the study outweighs the risk of possible side effects of gadolinium. I was glad I did my homework on this issue the night before my MRI was scheduled.
Dr. Klioze and Juliana, Thanks for such a nice explanation. I am wondering if the result has been published somewhere? I need to refer to this finding at my research.
Thanks Fateme! We used a number of peer reviewed references to make the video. Unfortunately, I didn't save any of them but most were found from a simple Google search. I called Bayer medical and talked to one of their research scientists about the dative bonds in the various chelating agents. She was extremely helpful and enthusiastic. I hope that helps. Good luck with the research!
Hi, great talk! I know this is an old video, but I have a question if you don’t mind… I was wondering if there is a safer alternative to gadolinium MRI contrast.? I have a growth on my liver, which they are unsure if it is a carcinoma. My doctor wants to do another MRI with gadolinium, which I am reluctant about. I’m concerned about the long term consequences that may have on my health.. not to mention the immediate side effects. It seems like anyone who gets this contrast has a bad experience.
Unfortunately, GBCA are currently still the best option available. The good news is that most institutions have abandoned the linear, nonionic chelates that seemed to be more prone to dissociation then the more stable macrocyclic products. Please remember that, by far, the vast majority of patients that receive gadolinium contrast based agents do absolutely fine. I know that's no consolation if your the one with the bad outcome, but, statistically you most likely won't have a problem As I said in the video, it always comes down to risk versus benefit. From what you're describing, an enlarging mass in the liver is probably a good reason to proceed with the test. However, you could also consider CT or ultrasound biopsy for cell diagnosis. The problem is, with an incomplete diagnostic workup, you can't be certain that this isn't a hypervascular benign lesion like a giant hemangioma which can bleed extensively post biopsy, possibly requiring additional interventions like hepatic angiography and embolization to prevent excessive bleeding and possible death. Again- risk versus benefit. I hope that helps.
You guys should definitely look into Gadolinium retention disease. Whether you have bad kidneys or good ones, it's still retained in the body. I and a thousand others have been suffering from its retentions. Every since the brain MRI I've been suffering from all kinds of neurological issues. SAY NO TO GADOLINIUM!!!
Just had a brain MRI today; immediately after I was getting close to the end, my elbow near the site of the needle - other side, I experienced severe pain in this area as well as a bit later in my left knee area. I told the Tech & he wrapped a stretchy ace type wrap around my elbow area, and told me he did get a good scan and the contrast likely got “pooled” in that area, but should quickly disperse. It is Now 12 hours later and both my elbow and knee are still killing me. Took the tight ace off because I felt it was too tight .. still hurts extremely bad. Never experienced this before in a MRI with contrast - worried
@@tammieprintz3975 how are you feeling now? I had Gd contrast injected into my hip yesterday for an arthrogram. it felt weird! but it only ached a bit yesterday. the doctor told me to move around a lot to help disperse it. it's been exactly 24 hours as of the time I'm writing this comment and I've already walked about 4 miles and still walking. it feels alright now. no idea how many CC's I got though.
@@calebhollen5316That's hard going man, but I suppose tracking the tumour changes is seen as vital information for you that can't be gotten any other way? Still, you show that it's survivable to have 16 doses of gad in 3 years. I've had 5 in that time and had a terrible reaction to the last one and new symptoms.
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thanks for the video, it helped me understand how my MRI contrast worked which is exactly what I wanted to learn. I'm not a medical student or doctor but an engineer and I had no problem understanding this information.
Great video..do you need gadolinium to determine if you have breast cancer or can you get an MRI without contrast? I read gadolinium stays in your body. Is there a safer gadolinium? Any help appreciated.
Currently, yes. The whole science behind breast cancer detection is based on the unique enhancement pattern of cancerous versus benign lesions. I don't do mammography so I'm not familiar with the details but it has to do with the wash-in (contrast coming into the mass) enhancement (contrast in the mass) and wash-out (contrast leaving the mass) pattern that helps the radiologist distinguish benign from malignant. Currently, as far as I know, GBCA's are still the only FDA approved MRI contrast agents. With the advent of NSF in the mid 2006 and subsequent reports of concerns with gadolinium based agents, other agents have been investigated including superparamagnetic iron oxide nanoparticles and manganese but to date, none have similar pharmokinetic properties to chelated gadolinium to make them a suitable substitute for the same clinical applications and indications. There are also MR techniques that can provide an enhancement-type effect (i.e. arterial spin labeling of ASL) but these too have limited clinical application with current technologies. I'm confident that a suitable substitute is on the horizon. Even though GBCA's are used more than 10 million times a year with almost no adverse reactions, I too am a little leery and would decline contrast unless my doctor gave me a very good clinical reason why it would help with my diagnosis. I think finding an occult breast cancer would be one of the reasons. Thanks!
@@julieure6859 In general terms, occult simply means a cancer that is clinically silent. In other words, no signs or symptoms to indicate disease. It also applies to a metastatic lesion of unknown primary such as a biopsy proven axillary breast cancer with no identifiable primary in the breast itself. The primary lesion may not be detectable by standard diagnostic methodologies such as physical exam, mammography or ultrasound. In such cases, breast MRI may be used to locate the primary lesion and guide surgical and/or pharmacologic therapies. I had a friend of mine diagnosed with breast cancer over 10 years ago. She routinely obtained yearly mammograms and noticed a lump in one of her breasts a few weeks after obtaining a negative screening mammogram. She was brought back for more views (diagnostic mammogram) and an ultrasound of the affected breast with still no identifiable lesion despite a clearly palpable mass lesion. The contrasted breast MRI identified the lesion and helped with surgical planning. The other breast was also imaged to exclude an additional metastatic or synchronous (a second primary cancer in the opposite breast) lesion. She underwent surgery and chemo. Since her particular cancer was only identified with MRI, she underwent yearly breast MRI for 5-7 years to screen for recurrence. Thankfully, she is still cancer free to date. Breast MRI is not generally used as screening tool for breast cancer with some exceptions. If there is a strong family history of breast cancer, especially at a younger age and/or a known BRCA1 or BRCA2 gene mutation, MRI screening may be offered for early detection. Does all that make sense?
Hoping time is a gradual healer. Gadolinium is definitely more harmful than the mainstream literature shows and it's sad that it's not recognised. I've seen people with your symptoms who end up getting more gad to investigate, and you can imagine how that works out.
@Jack Burton that's what happen to me I had to have another mri in 2022 from a nuerologist. The whole time it was heavy metal poisoning from the 1st mri.
I agree with you! Initial data is VERY promising. I'm an ardent advocate of the old saying "the poison is in the dose". Less is better, especially if your not losing any diagnostic accuracy with the smaller dose (and at least for brain tumors, the data suggests your not...)
That's a v helpful video... I came here searching for something about Gadolinium that still puzzles me... I tired an MRI scan with Gadolinium and some other test contrast agents... I'm unable to understand why did the Gd(III) vial appear BRIGHT in T2... (The media contained a gelling agent in water) Could this be an issue? I'm new to this Out of what I've read, I understand Gd would appear DARK in T2 (Although it is not commonly used for this purpose and is more popular as a T1 positive contrast agent)... Any help in understanding this would mean a lot Thanks !
I think your results will depend on your Gd concentration. At nominal concentrations, I believe the T2* effects would be minimal and the water vial would be bright on the T2WI. However, if you add enough gadolinium to the vial, T2* relaxation will shorten with resulting T2 signal dropoff.
How I think it works: NMR or MRI is an imaging technique where radio-frequency light is emitted into a sample and the absorption, which depends on the electronic state of each nucleus, is measured. Absorption occurs when there are nuclei present in the sample that have a net magnetic moment due to an odd number of nucleons, which means that one spin state will be unpaired. In the presence of a strong magnetic field, all of these nuclei will align with the field due to their net magnetic moment. During imaging, the radio frequency light shines into the sample with all the nuclei aligned with the magnetic field, and depending on the magnetic field strength (which ramps up during NMR for chemistry), certain frequencies will produce photons which are absorbed by the nuclei, analogous to electron excitation. In the case of NMR, the nuclear excited state is actually the "spin flip," or an alignment opposing the external magnetic field. See, in quantum and statistical mechanics, there are certain "quantum states" or "energy levels" an object can take, with higher energy required to achieve the less favorable states. So, just as it takes more energy for you to force two like magnetic poles together, the magnetic alignment opposite the one induced by the external magnetic field represents a high-energy state, and the particles must absorb energy to get there. Due to the very minute amount of energy this takes, and due to the quantum nature of reality, it requires very specific low-energy, radio-frequency photons to cause a spin flip. In the case of the gadolinium contrast agent, the NMR or MRI takes place in an aqueous environment, using O-17 water, which is water that exists with an isotope of oxygen that has a nuclear magnetic moment. In the presence of an external magnetic field, the nuclei align with this field. Then radio frequency light is emitted into the sample, and some of it is absorbed in order to excite the nuclei into their magnet-opposing alignment. When light is absorbed, less of it reaches the reciever or photosensor, causing a signal (just like in regular photography or X-ray). Eventually, the nucleus re-emits that absorbed photon either as heat or as low-energy light that is not detected by the detector. However, there is a problem to this: that is, each absorption event only absorbs one photon, and the nucleus must wait until it has emitted that photon until it can absorb another. In this way, only small amounts of light are absorbed at any one time, because the rate-limiting step is the emission of the photon, termed "relaxation". It's kind of like how, if you're playing catch and someone throws you a ball and you catch it, if they throw you another ball you can't catch that one unless you get rid of the first one somehow. This is where gadolinium contrast agent comes in. Essentially, the gadolinium ion helps release these balls so that the nucleus can catch more, thus increasing the net absorption of radio frequency light, and thus making the image more visible becuase areas that absorbed more photons are now even darker (though on the image, these will appear lighter if the machine inverts image). How does the gadolinium "release more balls?" In quantum mechanics, each energy state or quantum state is at a particular level. Once a particle absorbs enough energy to each this level, it will stay at that level until it can either absorb more energy or release the energy and go back to its original state, the "ground state." Energy levels can interact-- a high and low energy level can come together to produce an intermediate state. And often times, this intermediate state will act as a bridge to a new, more stable arrangement, such as the excited particle returning to ground state. Substances that can act as a bridge like this are called catalysts (they're one type of catalyst). Energy levels don't interact very well unless they are relatively close together. The further apart they are, the less they will interact. Because in the case of NMR/MRI the energy levels are actually created by alignment with an external magnetic field, gadolinium ions, which are very paramagnetic themselves and thus want to align with the magnetic field themselves similar to the ground-state O-17, act as catalysts to help the O-17 water to return to its ground state. They do this by allowing excited (and non-excited) water molecules to bind to them as polar ligands (water is an excellent polar ligand), which causes the gadolinium and water molecules orbitals to interact (the orbitals "contain" the energy levels). The orbital interaction allows for an alternative, easier pathway for the energy of the excited O-17 nuclei to release their energy. Thus, the energy is released as heat (perhaps bond vibrations), and the O-17 nucleii return to their ground state rapidly, opening them up for another absorption event.
What happened?! That's pretty scary, because, yes, gadolinium can be toxic! If you still have it in your system, you should talk to a doctor about chelation. Typically, the gadolinium is introduced to the body bound to a chelator, which prevents toxicity. A chelator, such as disodium EDTA, should be able to bind up the Gd ions in vivo, as well, allowing you to pee them out without toxicity.
Is pelvic MRI with contrast even necessary before the operative hysteroscopy? They saw some polyps during the diagnostic hysteroscopy and im asked to do MRI with contrast but im afraid of the side effects of gandolinium to my body and for my fertility journey (ivf)
To answer your question, I think I have to ask you a few questions first. What is the clinical issue that prompted the scan in the first place? Is it bleeding? Pain? If they suspect fibroids, are they planning a uterine sparing myomectomy, uterine fibroid embolization or hysterectomy? If you're ultimately getting a hysterectomy, my answer would be "no". At that point, the pathologist will tell you if any lesions are benign or malignant. For any of the other procedures, I would say "yes". With any uterine sparing intervention, need to make sure nodules and polyps have a benign appearance before the procedure. Don't want to miss or ignore a potential malignant process as a cause of your clinical symptoms. I hope that helps...
@@DoctorKlioze Thanks for the reply. Im not really sure why the doctor suddenly wants an MRI with contrast. I was asked by my fertility doctor to visit a bigger hospital with an OBGYNE department to have it checked after he saw some polyps after the diagnostic hysteroscopy (my ivf doctor said he couldnt do operative hysteroscopy) I dont have any complaints, no heavy bleeding symptoms, no endometriosis symptoms, no fibroids shown after the diagnostic hysteroscopy, etc. When my fertility clinic referred me to the bigger hospital I was expecting that i would be scheduled for the operative hysteroscopy due to the polyps seen after the diagnostic hysteroscopy and I want to have them (polyps) removed before the FET with our last embryo. Im not really sure what the other doctor from that bigger hospital wants to see. I just want the schedule for the surgery so that I can have my embryo transfer after surgery. I have to cancel my FET because of this MRI which for me doesnt make sense.
@@jodettehattori4177 I can definitely see your concern. I would call the ordering doctors office and ask them to clarify what information they need from the scan and can that information be obtained from a noncontrasted pelvic MRI.
What is your opinion on prehydration's role in preventing contrast induced damage ? I'm a student and have heard a number of conflicting statements. During school I was taught to always prehydrate, but now it seems there is growing contention to its efficacy?
Great question! When I was in training, we also encouraged patients to hydrate before any contrasted exam (CT or MRI) to help eliminate contrast material from the body, especially in individuals with borderline renal function. In fact, we would bring patients to the hospital to hydrate with a bicarbonate solution prior to CTA if renal function was really borderline and the patient wasn't on dialysis. Anecdotally, I think it helped, probably merely from the volume and hydration effect rather than the minuscule effect on blood pH from the bicarbonate itself. We still encourage patients to reasonably hydrate both before and after their contrasted exams to help maintain renal function and contrast excretion. Even though the majority of individuals with healthy kidneys and normal renal function will probably do just fine without the extra measure, in general, I think it's prudent to maintain adequate hydration throughout the day to keep the kidneys working properly.
Yes. Essentially all of the current MRI contrast agents contain Gadolinium. The different names are attributed to the particular chelating agent which binds the Gadolinium ion. Gadobenate is also known as Multihance, a linear, ionic molecule with a Benzene ring on one of it's nitrogen side chains. This particular molecule is unique because a small portion (4-5%) of it is picked up by liver cells and excreted into the bile (most gadolinium chelates are removed from the body by the kidneys) and, therefore, can be used in imaging of the liver to look for tumors.
@@NaturalMeAmerica Lets put this in perspective. Every year over 30 million doses of Gadolinium contrast agents are administered to patient's around the world. The vast majority of them do absolutely fine. A few may have an allergic reaction or adverse event immediately after their test and I suspect even fewer will have long term issues like clinically symptomatic gadolinium deposition disease. From your one MR arthrogram, I would assume your risk is negligible or infinitesimally small. However, I wouldn't get a contrasted MR exam every year. Remember in medicine, everything is risk versus benefit. As humans, we are constantly exposed to pathogens, poisons and environmental hazards such as bacteria and viruses, glyphosate and heavy metals such as lead, mercury, arsenic, cadmium, chromium and, in the case of medical imaging, Gadolinium. In small, infrequent doses, our bodies can handle the exposure without difficulty. In the case of Gadolinium, the heavy metal is chelated to a molecule that allows it to be eliminated from the body. There is some variability in the ability of the particular molecule to bind tightly to the metal ion and prevent dissociation. When the metal ion dissociates from the chelating agent, it gets deposited into the tissues and can't be eliminated. Experimentally, the chelates that bind the tightest with negligible dissociation are the macrocyclic ionic compounds and those with the highest dissociation are the linear, non-ionic. The latter are no longer used clinically. You received a linear ionic agent which demonstrates very little dissociation and, therefore, highly unlikely to result in significant heavy metal deposition from one dose. In your particular case, I would assume your doctor was looking for a subtle labral, ligamentous or tendinous injury to explain ongoing shoulder pain and would plan a corrective surgery if something was found. So, in your particular case I would venture that the negligible risk of Gadolinium deposition disease from a single MR arthrogram is far less then the misery of living with constant shoulder pain for the rest of your life! Hope this helps and good luck with your shoulder.
So let me see if I understand ,gadobenate is a linear ion, and linear ions dissasociate easier. When there is disassociation , the molecule can stay in the body, but when the molecule does not dissasociate it can be eliminated?
So...in layman terms, if you've had multiple SCANS with contrast' in your life, there is indeed a cumulative deposit of these extremely highly toxic gadolinium molecules in your brain. If someone experiences a TIA event or a stroke, the first thing doctors do is order gadolinium-enhanced imaging of the patient's brain, without first inquiring whether the patient had prior MRI's, MRA's or CT scans with contrast. The question is whether the gadolinium-enhanced imaging actually causes more damage to the brain than what the initial TIA or stroke actually caused. I've had multiple MRI's and a couple CT scans 'with contrast' in my life, due to a severe back injury that occurred over a decade ago. NEVER has any doctor or MRI technologist EVER warned me about the dangers of gadolinium, much less the cumulative effects of multiple prior scans with gadolinium contrast.
We use Multihance which is linear at the hospital i work. I have done renal mra on pts with totalrenal failure, gfr of 3. I brought it to the attn of Radgy mngr, he said, it's safe, just do it. Go figure. Excellent video. Thanks.
You need to put this in perspective. Every decision we make in medicine, every single day has an associated risk and benefit. The decision to proceed with a recommended therapy or diagnostic test needs to be determined after carefully considering the inherent risks and weighing those against the benefits of intervention. If, in your mind, the risks out weigh the benefits, you shouldn't do it. A 65 year old with a history of lung cancer and new mental status changes would probably benefit from a gadolinium enhanced MRI of the brain to evaluate for metastatic disease and plan therapy. Similarly, a 26 year old professional athlete with intractable hip pain that limits performance would likely befit from a gadolinium MR arthrogram to evaluate for a possible labral tear. However, an 18 year old college student with new onset headaches probably doesn't need contrast to evaluate the brain. Hopefully the future will offer some contrast options but as for now, with 10's of millions of administered gadolinium doses world wild and the relatively few reported cases of NSF and GDD, I personally have no problem recommending gadolinium contrast in the appropriate clinical setting.
Hey Roscoe. In 2017, Europe banned all linear Gadolinium contrast agents when the data became indisputable that these molecular configurations were associated with the gadolinium deposition disease seen in normal individuals with intact blood-brain-barriers. The macrocycylic compounds are still utilized but the indications and dosing have been tightly regulated to ensure the benefit of the exam out-ways the presumed risk (as it always should be).
@@DoctorKlioze The problem is there is no human living in a typical modern environment, with an intact blood brain barrier. That's a flawed fundamental assumption. Look into the effect of pulsed microwave fields on blood barriers. Blood testis, blood brain, blood eye, and so on. All of them are affected. A higher degree of permeability and leakage should just be expected.
That is a great question, Samaneh! I’ve wondered the same thing myself. I’ll tell you what I came up with but his is just conjecture as I am definitely not a chemist. Remember the electron configuration of Gadolinium is [Xe] 4f75d16s2. In gadolinium contrast, the metal exists in its cation form of +3, where three electrons are given up from the 6s and 5d subshells making the electron configuration [Xe] 4f7. Based on the Aufbau principle, the 6s subshell fills first, then 4f and then 5d. So, my assumption is the cation is complete when it fills the rest of the 4f subshell (7 electrons) and then the 6s subshell (2 electrons) for a total of 9 coordinate site. If there are any real chemists out there, feel free to opine!
@@Imagon100 To maintain the paramagnetic properties of the Gd ion, I agree- the 7 4f electrons should remain unpaired. I like the sub-shell math the gives the 9 coordinate sites (1 orbital in s, 3 in p and 5 in d). Brilliant explanation! Thanks!!
Hold on. I just went back and did the orbital accounting. The 5p sub-shell should be full, even in the +3 cation form of the atom. I don't think we have it quite yet....
There is nothing more important then persons health, I have been injected with Gd (omniscan contrast sgent), ever since that mri I have developed balance problem, muscle twitching, skin bumps, headaches. today it’s almost 70-75 days since the contrast was injected but no improvement of symptoms, it’s effecting the quality of my life.how long does Gd stays with chelating molecule in omniscan contrast after administration into body?
Unfortunately, Omniscan is a linear, nonionic chelated molecule and was the agent most often associated with NSF in renal patients. As stated in the video, this configuration also seems to be more prone to dissociation over the linear ionic and macrocyclic molecules although the latest research suggests that all of these agents show some dissociation with Gd soft tissue and bone deposition even in normal patient's. Again, there may be a subset of patients (like yourself) who may be highly sensitive to this relative minute but discrete heavy metal deposition in the various tissues. In compliance with the latest ACR recommendations we have switched completely to a Group II macrocyclic agent (Gadovist) which, to date, does not appear to be associated with cases of NSF. As always, I would make absolutely sure that gadolinium contrast is necessary for your particular scan. I think the majority of MRI's can give sufficient info without the additional contrast. As far as your current clinical symptoms, please see your doctor and discuss with him/her. If everyone agrees that there may be a cause and effect relationship with the recently administered contrast, could consider chelating therapy. I agree 100% with your opening statement- Nothing is more important then your health!! Good luck and I hope you feel better soon.
I would try N-acetyl-cysteine, vitamin C (as sodium ascorbate) ~15 grams per day for a week or so mixed with magnesium, potassium, calcium. Make sure your diet is good, you're getting proper nutrition especially B-vitamins and vitamin E. Essentially you want to make sure your endogenous antioxidant defense and chelation systems, particularly glutathione, are well maintained. There are various herbs you can try, dandelion leaf and root, burdock root, ashwagandha, hemidesmus indicus, angelica. Just look into herbalism relative to detoxification and nervous system support. Ultimately, you could try water or juice fasting for 7 days or so. I did this and took NAC and vitamin C (6 grams twice per day) with minerals throughout, helped me with many issues. Your balance issues probably come from the fact that gadolinium is a decent calcium channel blocker, and it tends to deposit in the cerebellum. I also eat a massive amount of cacao, so my zinc and magnesium levels are probably pretty high. which may enhance the displacement of any tissue bound gadolinium. Don't know. To my knowledge IV chelation has its own set of risks. Letting / having the medical-chemical complex inject that garbage into me marked the end of my relationship with so-called medical care. My experience was that ~7 or so hours after injection, you can feel it disrupting and damaging the brain. If it does truly return to baseline, it takes many months. This is distinct from the transient change in brain function from exposure to the static magnetic field and RF. Put bluntly, there will likely never be a means by which you can safely put gadolinium in the body and have it maintain useful imaging properties. Whenever these people are found out on one level they just backpedal a bit, ride the next wave of dissociative delusions, get found out and act surprised again. Really it's all built on posturing and nonsense. They knew Gd readily dissociated from its chelate and was toxic long before these agents were in use, it was in the literature. It always is.
To add on to what I said, in addition to sodium ascorbate flushes and herbs to clear out the spleen and gallbladder, try garlic. Cook with a lot of fresh garlic, onion, cilantro. Try fasting as well, protect your liver with NAC and vitamin C during, take minerals with it. Look up water fasting (and any contraindications), I fasted for ~7 days, took ~3g sodium ascorbate twice daily with potassium citrate, magnesium citrate, and NAC ~1700mg one per day. I'm not sure what minerals will be apt to displace Gd. Perhaps magnesium? I know Gd acts as a calcium channel blocker, which suggests Mg mimicry. regardless. Nutrition, fasting, supplements. Report back if you have any improvement so others can benefit. Edit, one addition I'd make has to do with the structure of water when it encounters hydrophilic materials. This could explain a number of things for me about the other effects of electromagnetic fields on biological systems.. Look up Gerald Pollack. I'll add another comment if I find anything useful with this, as far as more efficiently removing garbage from the body.
To wear the Optune device, my insurance requires me to have a MRI with contrast every 3 months. I have grade 4 glioblastoma brain cancer. The Gadolinium is killing my kidneys
The father really does a disservice by downplaying the continually emerging risks of gadolinium toxicity. I’m quite certain there are millions of people, particularly older individuals who have symptoms of gadolinium toxicity and are simply not aware it is from the gadolinium
@legendarnyziomal soon as I got up from table I was off sports. Short problem balance walking. Was few hours later started. Woke up sound in left ear. Kind on.deaf slight right. Pinchy skin. ..
Great video
Your series makes difficult concepts in MR techniques easier to grasp
The visuals are very well done, and make this complex topic much easier to digest.
Excellent talk. Thank you to father and daughter.
Terrific lecture, one of the best I have seen on the topic. Extremely useful for helping in resident education.
Great video not only for the didactic purpose but also for the wise suggestions at the end of it. Thank you sincerely for this
Very informative and made a big difference to my decision... thank you both very much.
thank you for sharing your knowledge, sir
I recently learned of gadolinium retention in patients with normal renal function and decided to forgo my MRI until such time as the benefits of the study outweighs the risk of possible side effects of gadolinium. I was glad I did my homework on this issue the night before my MRI was scheduled.
That's very wise, and sadly most doctors would disagree with you but then be nowhere to be seen when it all goes wrong.
Awesome and fascinating explorations
Excellent talk, Thank you!
This was a great video. Thank you for it.
Superb video!
I noticed one thing:
In 8:20 should be [Xe] 4f7 5d1 6s2
thank you extremly helpful
Your Video Series are Laying the Foundations of an Online Medical University
Music to my ears! Hope you a fantastic 2022.
Hi! Does anyone know what's the time stamp where they speak on the actual side effects of Gadolinium??
Dr. Klioze and Juliana, Thanks for such a nice explanation. I am wondering if the result has been published somewhere? I need to refer to this finding at my research.
Thanks Fateme! We used a number of peer reviewed references to make the video. Unfortunately, I didn't save any of them but most were found from a simple Google search. I called Bayer medical and talked to one of their research scientists about the dative bonds in the various chelating agents. She was extremely helpful and enthusiastic. I hope that helps. Good luck with the research!
Thank you sir.such a great information about Gd based MRI Contrasts. Please share about Mn (Manganese) based MRI Contrasts agents.
I too would like to know the side effects of Gadolinium and how to detox it out of the body after its use.
I'm glad to know the chemistry behind this.
PS. Julianna should be a voice actress. She has an adorable voice
You are awesome sir.
extremely thank u sir and madam 🙏
Excellent ... Well done ...
Thanks you very much for the knowledge
How can i remove gadolinium from the body please.
I like your video! What software do you use to draw these structures? For example, the orbitals and the spins?
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Hi, great talk! I know this is an old video, but I have a question if you don’t mind… I was wondering if there is a safer alternative to gadolinium MRI contrast.? I have a growth on my liver, which they are unsure if it is a carcinoma. My doctor wants to do another MRI with gadolinium, which I am reluctant about. I’m concerned about the long term consequences that may have on my health.. not to mention the immediate side effects. It seems like anyone who gets this contrast has a bad experience.
Unfortunately, GBCA are currently still the best option available. The good news is that most institutions have abandoned the linear, nonionic chelates that seemed to be more prone to dissociation then the more stable macrocyclic products.
Please remember that, by far, the vast majority of patients that receive gadolinium contrast based agents do absolutely fine. I know that's no consolation if your the one with the bad outcome, but, statistically you most likely won't have a problem
As I said in the video, it always comes down to risk versus benefit. From what you're describing, an enlarging mass in the liver is probably a good reason to proceed with the test. However, you could also consider CT or ultrasound biopsy for cell diagnosis. The problem is, with an incomplete diagnostic workup, you can't be certain that this isn't a hypervascular benign lesion like a giant hemangioma which can bleed extensively post biopsy, possibly requiring additional interventions like hepatic angiography and embolization to prevent excessive bleeding and possible death. Again- risk versus benefit. I hope that helps.
You guys should definitely look into Gadolinium retention disease. Whether you have bad kidneys or good ones, it's still retained in the body. I and a thousand others have been suffering from its retentions. Every since the brain MRI I've been suffering from all kinds of neurological issues. SAY NO TO GADOLINIUM!!!
Just had a brain MRI today; immediately after I was getting close to the end, my elbow near the site of the needle - other side, I experienced severe pain in this area as well as a bit later in my left knee area. I told the Tech & he wrapped a stretchy ace type wrap around my elbow area, and told me he did get a good scan and the contrast likely got “pooled” in that area, but should quickly disperse. It is Now 12 hours later and both my elbow and knee are still killing me. Took the tight ace off because I felt it was too tight .. still hurts extremely bad. Never experienced this before in a MRI with contrast - worried
@@tammieprintz3975 how are you feeling now? I had Gd contrast injected into my hip yesterday for an arthrogram. it felt weird! but it only ached a bit yesterday. the doctor told me to move around a lot to help disperse it. it's been exactly 24 hours as of the time I'm writing this comment and I've already walked about 4 miles and still walking. it feels alright now. no idea how many CC's I got though.
@@spindleblood feeling ok now, but unsure about future MRI’s with this contrast!
MRI with contrast every 2 months for 2 years then 3 months in the past year. I have grade 4 GBM. The Gadolinium is killing my kidneys
@@calebhollen5316That's hard going man, but I suppose tracking the tumour changes is seen as vital information for you that can't be gotten any other way? Still, you show that it's survivable to have 16 doses of gad in 3 years. I've had 5 in that time and had a terrible reaction to the last one and new symptoms.
I just had a brain mri with contrast yesterday? What can I do to help myself immediately?
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thanks for the video, it helped me understand how my MRI contrast worked which is exactly what I wanted to learn. I'm not a medical student or doctor but an engineer and I had no problem understanding this information.
Great video..do you need gadolinium to determine if you have breast cancer or can you get an MRI without contrast? I read gadolinium stays in your body.
Is there a safer gadolinium?
Any help appreciated.
Currently, yes. The whole science behind breast cancer detection is based on the unique enhancement pattern of cancerous versus benign lesions. I don't do mammography so I'm not familiar with the details but it has to do with the wash-in (contrast coming into the mass) enhancement (contrast in the mass) and wash-out (contrast leaving the mass) pattern that helps the radiologist distinguish benign from malignant.
Currently, as far as I know, GBCA's are still the only FDA approved MRI contrast agents. With the advent of NSF in the mid 2006 and subsequent reports of concerns with gadolinium based agents, other agents have been investigated including superparamagnetic iron oxide nanoparticles and manganese but to date, none have similar pharmokinetic properties to chelated gadolinium to make them a suitable substitute for the same clinical applications and indications. There are also MR techniques that can provide an enhancement-type effect (i.e. arterial spin labeling of ASL) but these too have limited clinical application with current technologies. I'm confident that a suitable substitute is on the horizon.
Even though GBCA's are used more than 10 million times a year with almost no adverse reactions, I too am a little leery and would decline contrast unless my doctor gave me a very good clinical reason why it would help with my diagnosis. I think finding an occult breast cancer would be one of the reasons. Thanks!
@@DoctorKlioze what does an occult breast cancer mean exactly?
@@julieure6859 In general terms, occult simply means a cancer that is clinically silent. In other words, no signs or symptoms to indicate disease. It also applies to a metastatic lesion of unknown primary such as a biopsy proven axillary breast cancer with no identifiable primary in the breast itself. The primary lesion may not be detectable by standard diagnostic methodologies such as physical exam, mammography or ultrasound. In such cases, breast MRI may be used to locate the primary lesion and guide surgical and/or pharmacologic therapies.
I had a friend of mine diagnosed with breast cancer over 10 years ago. She routinely obtained yearly mammograms and noticed a lump in one of her breasts a few weeks after obtaining a negative screening mammogram. She was brought back for more views (diagnostic mammogram) and an ultrasound of the affected breast with still no identifiable lesion despite a clearly palpable mass lesion. The contrasted breast MRI identified the lesion and helped with surgical planning. The other breast was also imaged to exclude an additional metastatic or synchronous (a second primary cancer in the opposite breast) lesion. She underwent surgery and chemo. Since her particular cancer was only identified with MRI, she underwent yearly breast MRI for 5-7 years to screen for recurrence. Thankfully, she is still cancer free to date.
Breast MRI is not generally used as screening tool for breast cancer with some exceptions. If there is a strong family history of breast cancer, especially at a younger age and/or a known BRCA1 or BRCA2 gene mutation, MRI screening may be offered for early detection. Does all that make sense?
Gadolinium ruined my nervous system. I was injected on 3/15/21 now my muscles twitch all over my body 24/7 it's a very miserable condition.
Hoping time is a gradual healer. Gadolinium is definitely more harmful than the mainstream literature shows and it's sad that it's not recognised. I've seen people with your symptoms who end up getting more gad to investigate, and you can imagine how that works out.
@Jack Burton that's what happen to me I had to have another mri in 2022 from a nuerologist. The whole time it was heavy metal poisoning from the 1st mri.
Truly fantastic, doc! Any thoughts on half-dosing? Some promising literature available.
I agree with you! Initial data is VERY promising. I'm an ardent advocate of the old saying "the poison is in the dose". Less is better, especially if your not losing any diagnostic accuracy with the smaller dose (and at least for brain tumors, the data suggests your not...)
That's a v helpful video... I came here searching for something about Gadolinium that still puzzles me... I tired an MRI scan with Gadolinium and some other test contrast agents... I'm unable to understand why did the Gd(III) vial appear BRIGHT in T2... (The media contained a gelling agent in water) Could this be an issue? I'm new to this
Out of what I've read, I understand Gd would appear DARK in T2 (Although it is not commonly used for this purpose and is more popular as a T1 positive contrast agent)...
Any help in understanding this would mean a lot
Thanks !
I think your results will depend on your Gd concentration. At nominal concentrations, I believe the T2* effects would be minimal and the water vial would be bright on the T2WI. However, if you add enough gadolinium to the vial, T2* relaxation will shorten with resulting T2 signal dropoff.
Super! Thank you very much!
Great stuff
How I think it works:
NMR or MRI is an imaging technique where radio-frequency light is emitted into a sample and the absorption, which depends on the electronic state of each nucleus, is measured. Absorption occurs when there are nuclei present in the sample that have a net magnetic moment due to an odd number of nucleons, which means that one spin state will be unpaired. In the presence of a strong magnetic field, all of these nuclei will align with the field due to their net magnetic moment. During imaging, the radio frequency light shines into the sample with all the nuclei aligned with the magnetic field, and depending on the magnetic field strength (which ramps up during NMR for chemistry), certain frequencies will produce photons which are absorbed by the nuclei, analogous to electron excitation. In the case of NMR, the nuclear excited state is actually the "spin flip," or an alignment opposing the external magnetic field. See, in quantum and statistical mechanics, there are certain "quantum states" or "energy levels" an object can take, with higher energy required to achieve the less favorable states. So, just as it takes more energy for you to force two like magnetic poles together, the magnetic alignment opposite the one induced by the external magnetic field represents a high-energy state, and the particles must absorb energy to get there. Due to the very minute amount of energy this takes, and due to the quantum nature of reality, it requires very specific low-energy, radio-frequency photons to cause a spin flip.
In the case of the gadolinium contrast agent, the NMR or MRI takes place in an aqueous environment, using O-17 water, which is water that exists with an isotope of oxygen that has a nuclear magnetic moment. In the presence of an external magnetic field, the nuclei align with this field. Then radio frequency light is emitted into the sample, and some of it is absorbed in order to excite the nuclei into their magnet-opposing alignment. When light is absorbed, less of it reaches the reciever or photosensor, causing a signal (just like in regular photography or X-ray). Eventually, the nucleus re-emits that absorbed photon either as heat or as low-energy light that is not detected by the detector. However, there is a problem to this: that is, each absorption event only absorbs one photon, and the nucleus must wait until it has emitted that photon until it can absorb another. In this way, only small amounts of light are absorbed at any one time, because the rate-limiting step is the emission of the photon, termed "relaxation". It's kind of like how, if you're playing catch and someone throws you a ball and you catch it, if they throw you another ball you can't catch that one unless you get rid of the first one somehow. This is where gadolinium contrast agent comes in. Essentially, the gadolinium ion helps release these balls so that the nucleus can catch more, thus increasing the net absorption of radio frequency light, and thus making the image more visible becuase areas that absorbed more photons are now even darker (though on the image, these will appear lighter if the machine inverts image).
How does the gadolinium "release more balls?" In quantum mechanics, each energy state or quantum state is at a particular level. Once a particle absorbs enough energy to each this level, it will stay at that level until it can either absorb more energy or release the energy and go back to its original state, the "ground state." Energy levels can interact-- a high and low energy level can come together to produce an intermediate state. And often times, this intermediate state will act as a bridge to a new, more stable arrangement, such as the excited particle returning to ground state. Substances that can act as a bridge like this are called catalysts (they're one type of catalyst). Energy levels don't interact very well unless they are relatively close together. The further apart they are, the less they will interact. Because in the case of NMR/MRI the energy levels are actually created by alignment with an external magnetic field, gadolinium ions, which are very paramagnetic themselves and thus want to align with the magnetic field themselves similar to the ground-state O-17, act as catalysts to help the O-17 water to return to its ground state. They do this by allowing excited (and non-excited) water molecules to bind to them as polar ligands (water is an excellent polar ligand), which causes the gadolinium and water molecules orbitals to interact (the orbitals "contain" the energy levels). The orbital interaction allows for an alternative, easier pathway for the energy of the excited O-17 nuclei to release their energy. Thus, the energy is released as heat (perhaps bond vibrations), and the O-17 nucleii return to their ground state rapidly, opening them up for another absorption event.
How do you get the poison out? Please, please tell those whose life it has stolen. It is just a money making nightmare!
What happened?! That's pretty scary, because, yes, gadolinium can be toxic! If you still have it in your system, you should talk to a doctor about chelation. Typically, the gadolinium is introduced to the body bound to a chelator, which prevents toxicity. A chelator, such as disodium EDTA, should be able to bind up the Gd ions in vivo, as well, allowing you to pee them out without toxicity.
@@VyvienneEauxn theory yes, but in practice it hasn't shown worthwhile results.
Is pelvic MRI with contrast even necessary before the operative hysteroscopy? They saw some polyps during the diagnostic hysteroscopy and im asked to do MRI with contrast but im afraid of the side effects of gandolinium to my body and for my fertility journey (ivf)
To answer your question, I think I have to ask you a few questions first. What is the clinical issue that prompted the scan in the first place? Is it bleeding? Pain? If they suspect fibroids, are they planning a uterine sparing myomectomy, uterine fibroid embolization or hysterectomy? If you're ultimately getting a hysterectomy, my answer would be "no". At that point, the pathologist will tell you if any lesions are benign or malignant. For any of the other procedures, I would say "yes". With any uterine sparing intervention, need to make sure nodules and polyps have a benign appearance before the procedure. Don't want to miss or ignore a potential malignant process as a cause of your clinical symptoms. I hope that helps...
@@DoctorKlioze Thanks for the reply. Im not really sure why the doctor suddenly wants an MRI with contrast. I was asked by my fertility doctor to visit a bigger hospital with an OBGYNE department to have it checked after he saw some polyps after the diagnostic hysteroscopy (my ivf doctor said he couldnt do operative hysteroscopy) I dont have any complaints, no heavy bleeding symptoms, no endometriosis symptoms, no fibroids shown after the diagnostic hysteroscopy, etc. When my fertility clinic referred me to the bigger hospital I was expecting that i would be scheduled for the operative hysteroscopy due to the polyps seen after the diagnostic hysteroscopy and I want to have them (polyps) removed before the FET with our last embryo. Im not really sure what the other doctor from that bigger hospital wants to see. I just want the schedule for the surgery so that I can have my embryo transfer after surgery. I have to cancel my FET because of this MRI which for me doesnt make sense.
@@jodettehattori4177 I can definitely see your concern. I would call the ordering doctors office and ask them to clarify what information they need from the scan and can that information be obtained from a noncontrasted pelvic MRI.
8:20 typo, but super informative video.
Gadolinium can drop out of the chelation and patients should be warned of side effects.
What is your opinion on prehydration's role in preventing contrast induced damage ? I'm a student and have heard a number of conflicting statements. During school I was taught to always prehydrate, but now it seems there is growing contention to its efficacy?
Great question! When I was in training, we also encouraged patients to hydrate before any contrasted exam (CT or MRI) to help eliminate contrast material from the body, especially in individuals with borderline renal function. In fact, we would bring patients to the hospital to hydrate with a bicarbonate solution prior to CTA if renal function was really borderline and the patient wasn't on dialysis. Anecdotally, I think it helped, probably merely from the volume and hydration effect rather than the minuscule effect on blood pH from the bicarbonate itself.
We still encourage patients to reasonably hydrate both before and after their contrasted exams to help maintain renal function and contrast excretion. Even though the majority of individuals with healthy kidneys and normal renal function will probably do just fine without the extra measure, in general, I think it's prudent to maintain adequate hydration throughout the day to keep the kidneys working properly.
I think prehydration is only necessary in patients with renal issues. I would recommend it for anyone undergoing any contrasted exam, however.
Is Gadobenate the same as gandolineum? I received Gadobenate before an arthrogram
Yes. Essentially all of the current MRI contrast agents contain Gadolinium. The different names are attributed to the particular chelating agent which binds the Gadolinium ion.
Gadobenate is also known as Multihance, a linear, ionic molecule with a Benzene ring on one of it's nitrogen side chains. This particular molecule is unique because a small portion (4-5%) of it is picked up by liver cells and excreted into the bile (most gadolinium chelates are removed from the body by the kidneys) and, therefore, can be used in imaging of the liver to look for tumors.
So Dr.,am I in danger of gandolineum build up in my body over time? Is there a test I can do to see if my body has gandolineum?
@@NaturalMeAmerica Lets put this in perspective. Every year over 30 million doses of Gadolinium contrast agents are administered to patient's around the world. The vast majority of them do absolutely fine. A few may have an allergic reaction or adverse event immediately after their test and I suspect even fewer will have long term issues like clinically symptomatic gadolinium deposition disease. From your one MR arthrogram, I would assume your risk is negligible or infinitesimally small. However, I wouldn't get a contrasted MR exam every year.
Remember in medicine, everything is risk versus benefit. As humans, we are constantly exposed to pathogens, poisons and environmental hazards such as bacteria and viruses, glyphosate and heavy metals such as lead, mercury, arsenic, cadmium, chromium and, in the case of medical imaging, Gadolinium. In small, infrequent doses, our bodies can handle the exposure without difficulty.
In the case of Gadolinium, the heavy metal is chelated to a molecule that allows it to be eliminated from the body. There is some variability in the ability of the particular molecule to bind tightly to the metal ion and prevent dissociation. When the metal ion dissociates from the chelating agent, it gets deposited into the tissues and can't be eliminated.
Experimentally, the chelates that bind the tightest with negligible dissociation are the macrocyclic ionic compounds and those with the highest dissociation are the linear, non-ionic. The latter are no longer used clinically. You received a linear ionic agent which demonstrates very little dissociation and, therefore, highly unlikely to result in significant heavy metal deposition from one dose.
In your particular case, I would assume your doctor was looking for a subtle labral, ligamentous or tendinous injury to explain ongoing shoulder pain and would plan a corrective surgery if something was found. So, in your particular case I would venture that the negligible risk of Gadolinium deposition disease from a single MR arthrogram is far less then the misery of living with constant shoulder pain for the rest of your life! Hope this helps and good luck with your shoulder.
So let me see if I understand ,gadobenate is a linear ion, and linear ions dissasociate easier. When there is disassociation , the molecule can stay in the body, but when the molecule does not dissasociate it can be eliminated?
@@DoctorKlioze But mine is linear,and doesn't linear dissasociate?
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Great video.....above all, what a beautiful girl presenting it!
So...in layman terms, if you've had multiple SCANS with contrast' in your life, there is indeed a cumulative deposit of these extremely highly toxic gadolinium molecules in your brain.
If someone experiences a TIA event or a stroke, the first thing doctors do is order gadolinium-enhanced imaging of the patient's brain, without first inquiring whether the patient had prior MRI's, MRA's or CT scans with contrast.
The question is whether the gadolinium-enhanced imaging actually causes more damage to the brain than what the initial TIA or stroke actually caused.
I've had multiple MRI's and a couple CT scans 'with contrast' in my life, due to a severe back injury that occurred over a decade ago. NEVER has any doctor or MRI technologist EVER warned me about the dangers of gadolinium, much less the cumulative effects of multiple prior scans with gadolinium contrast.
It gave me severe symptoms and I was perfectly healthy before that, this stuff is worse than rat poison.
this is poison and I would never let this stuff run through my veins
We use Multihance which is linear at the hospital i work. I have done renal mra on pts with totalrenal failure, gfr of 3. I brought it to the attn of Radgy mngr, he said, it's safe, just do it. Go figure. Excellent video. Thanks.
Dangerous
Asymptomatic doesn't imply without underlying concerns that Gd deposition has not manifested, any problems yet.
Why not test the folks for the generic mutation prior to dosing them with this hell?
You need to put this in perspective. Every decision we make in medicine, every single day has an associated risk and benefit. The decision to proceed with a recommended therapy or diagnostic test needs to be determined after carefully considering the inherent risks and weighing those against the benefits of intervention. If, in your mind, the risks out weigh the benefits, you shouldn't do it.
A 65 year old with a history of lung cancer and new mental status changes would probably benefit from a gadolinium enhanced MRI of the brain to evaluate for metastatic disease and plan therapy. Similarly, a 26 year old professional athlete with intractable hip pain that limits performance would likely befit from a gadolinium MR arthrogram to evaluate for a possible labral tear. However, an 18 year old college student with new onset headaches probably doesn't need contrast to evaluate the brain.
Hopefully the future will offer some contrast options but as for now, with 10's of millions of administered gadolinium doses world wild and the relatively few reported cases of NSF and GDD, I personally have no problem recommending gadolinium contrast in the appropriate clinical setting.
Why is Gadolinium contrast banned in Europe?
Hey Roscoe. In 2017, Europe banned all linear Gadolinium contrast agents when the data became indisputable that these molecular configurations were associated with the gadolinium deposition disease seen in normal individuals with intact blood-brain-barriers. The macrocycylic compounds are still utilized but the indications and dosing have been tightly regulated to ensure the benefit of the exam out-ways the presumed risk (as it always should be).
@@DoctorKlioze The problem is there is no human living in a typical modern environment, with an intact blood brain barrier. That's a flawed fundamental assumption. Look into the effect of pulsed microwave fields on blood barriers. Blood testis, blood brain, blood eye, and so on. All of them are affected. A higher degree of permeability and leakage should just be expected.
Because its poison.
Because I nearly died from it in 2013, nobody knew I built an allergy to the reaction of these protons
@@Speedfighter313 I'm sorry.
8:27 [Xe] 4s7 5d1 6s2 should be read as [Xe] 4f7 5d1 6s2
Sorry for the late replay but you're absolutely right! I don't know what I was thinking when I typed that out. Thanks
@@DoctorKlioze you are human as we all are.
Why does gadolinium have 9 coordinate sites?
That is a great question, Samaneh! I’ve wondered the same thing myself. I’ll tell you what I came up with but his is just conjecture as I am definitely not a chemist. Remember the electron configuration of Gadolinium is [Xe] 4f75d16s2. In gadolinium contrast, the metal exists in its cation form of +3, where three electrons are given up from the 6s and 5d subshells making the electron configuration [Xe] 4f7. Based on the Aufbau principle, the 6s subshell fills first, then 4f and then 5d. So, my assumption is the cation is complete when it fills the rest of the 4f subshell (7 electrons) and then the 6s subshell (2 electrons) for a total of 9 coordinate site. If there are any real chemists out there, feel free to opine!
@@DoctorKlioze The 4f shell should stay as it is with unpaired electrons, I think. Empty 6s + 5p + 5d then give you 9 orbitals for complaxation.
@@Imagon100 To maintain the paramagnetic properties of the Gd ion, I agree- the 7 4f electrons should remain unpaired. I like the sub-shell math the gives the 9 coordinate sites (1 orbital in s, 3 in p and 5 in d). Brilliant explanation! Thanks!!
Hold on. I just went back and did the orbital accounting. The 5p sub-shell should be full, even in the +3 cation form of the atom. I don't think we have it quite yet....
@@scottklioze1160True, it is just 6p and not 5p. After all we have the empty 6s and 5d after ionization. The next lowest energy orbitals are 6p.
There is nothing more important then persons health, I have been injected with Gd (omniscan contrast sgent), ever since that mri I have developed balance problem, muscle twitching, skin bumps, headaches. today it’s almost 70-75 days since the contrast was injected but no improvement of symptoms, it’s effecting the quality of my life.how long does Gd stays with chelating molecule in omniscan contrast after administration into body?
Unfortunately, Omniscan is a linear, nonionic chelated molecule and was the agent most often associated with NSF in renal patients. As stated in the video, this configuration also seems to be more prone to dissociation over the linear ionic and macrocyclic molecules although the latest research suggests that all of these agents show some dissociation with Gd soft tissue and bone deposition even in normal patient's. Again, there may be a subset of patients (like yourself) who may be highly sensitive to this relative minute but discrete heavy metal deposition in the various tissues.
In compliance with the latest ACR recommendations we have switched completely to a Group II macrocyclic agent (Gadovist) which, to date, does not appear to be associated with cases of NSF. As always, I would make absolutely sure that gadolinium contrast is necessary for your particular scan. I think the majority of MRI's can give sufficient info without the additional contrast.
As far as your current clinical symptoms, please see your doctor and discuss with him/her. If everyone agrees that there may be a cause and effect relationship with the recently administered contrast, could consider chelating therapy.
I agree 100% with your opening statement- Nothing is more important then your health!! Good luck and I hope you feel better soon.
@@DoctorKlioze WE ARE BEING IGNORED BY DRS, I TO WAS POISONED. SO WHAT DO YOU SUGGEST ARE TREATMENT TO BE?
I would try N-acetyl-cysteine, vitamin C (as sodium ascorbate) ~15 grams per day for a week or so mixed with magnesium, potassium, calcium. Make sure your diet is good, you're getting proper nutrition especially B-vitamins and vitamin E. Essentially you want to make sure your endogenous antioxidant defense and chelation systems, particularly glutathione, are well maintained. There are various herbs you can try, dandelion leaf and root, burdock root, ashwagandha, hemidesmus indicus, angelica. Just look into herbalism relative to detoxification and nervous system support.
Ultimately, you could try water or juice fasting for 7 days or so. I did this and took NAC and vitamin C (6 grams twice per day) with minerals throughout, helped me with many issues.
Your balance issues probably come from the fact that gadolinium is a decent calcium channel blocker, and it tends to deposit in the cerebellum. I also eat a massive amount of cacao, so my zinc and magnesium levels are probably pretty high. which may enhance the displacement of any tissue bound gadolinium. Don't know. To my knowledge IV chelation has its own set of risks.
Letting / having the medical-chemical complex inject that garbage into me marked the end of my relationship with so-called medical care. My experience was that ~7 or so hours after injection, you can feel it disrupting and damaging the brain. If it does truly return to baseline, it takes many months. This is distinct from the transient change in brain function from exposure to the static magnetic field and RF. Put bluntly, there will likely never be a means by which you can safely put gadolinium in the body and have it maintain useful imaging properties. Whenever these people are found out on one level they just backpedal a bit, ride the next wave of dissociative delusions, get found out and act surprised again. Really it's all built on posturing and nonsense. They knew Gd readily dissociated from its chelate and was toxic long before these agents were in use, it was in the literature. It always is.
To add on to what I said, in addition to sodium ascorbate flushes and herbs to clear out the spleen and gallbladder, try garlic. Cook with a lot of fresh garlic, onion, cilantro. Try fasting as well, protect your liver with NAC and vitamin C during, take minerals with it. Look up water fasting (and any contraindications), I fasted for ~7 days, took ~3g sodium ascorbate twice daily with potassium citrate, magnesium citrate, and NAC ~1700mg one per day.
I'm not sure what minerals will be apt to displace Gd. Perhaps magnesium? I know Gd acts as a calcium channel blocker, which suggests Mg mimicry. regardless. Nutrition, fasting, supplements. Report back if you have any improvement so others can benefit.
Edit, one addition I'd make has to do with the structure of water when it encounters hydrophilic materials. This could explain a number of things for me about the other effects of electromagnetic fields on biological systems.. Look up Gerald Pollack. I'll add another comment if I find anything useful with this, as far as more efficiently removing garbage from the body.
Me too. Ton bad side effects.
Get dizzy. Ears. Skin. Coordination.
201 564 8901. Catherine
ARE YOU PRO OR CON TO MRI contrast ?
that peanut butter comment was so uneccesary
To wear the Optune device, my insurance requires me to have a MRI with contrast every 3 months. I have grade 4 glioblastoma brain cancer. The Gadolinium is killing my kidneys
The father really does a disservice by downplaying the continually emerging risks of gadolinium toxicity. I’m quite certain there are millions of people, particularly older individuals who have symptoms of gadolinium toxicity and are simply not aware it is from the gadolinium
I had a brutal.mri with contrast
Worse experience of my life first
Rather die
Left with tinnitus
Tingling skin
Cant coordinate
Horrific
@legendarnyziomal mri is brutal
Still can't coordinate hand at piano
Tingling skin. Ear problems.
Horrible scary experience.
3 weeks.
@legendarnyziomal soon as I got up from table I was off sports. Short problem balance walking. Was few hours later started. Woke up sound in left ear. Kind on.deaf slight right. Pinchy skin.
..
Off sorts
@legendarnyziomal over 3 weeks since I had mri
@legendarnyziomal I had MRI with contrast. Machine noise everything was BRUTAL. I WILL NEVER EVER HAVE THAT DONE AGAIN.
daddy keep that gal locked up. shes too beautiful