Due to its magnetic properties, Gadolinium has been used in MRI contrast media since 1988. It makes it possible to visualize pathological changes in tissue or bones and to better detect hidden centres of inflammation, for example in the case of multiple sclerosis or metastases in cancer. Since pure gadolinium is highly toxic, it can be chemically bound in so-called chelates for use in contrast media. Researchers have long assumed that in this form it can be excreted easily via the kidneys within a few hours after administration.
In 2017 however, the European Medicines Agency (EMA) confirmed that both gadolinium ion and gadolinium complexes can remain in the body for many months, even up to a year and a half, after an MRI has been performed – in the skin, bones, liver or brain. These deposits indicate that the toxic gadolinium does not remain as stably bound to its carrier substances as was long assumed. For this reason, most linear contrast media were withdrawn from the market in Germany by the EMA. Here, a higher amount of gadolinium was found in the brain than in the case of macrocyclic contrast media. Nevertheless, health risks cannot be ruled out even with the latter.
It is known that contrast media containing gadolinium can lead to nephrogenic, systemic fibrosis in patients with pre-existing kidney disease – also known as tissue scarring. These not only lead to a significant reduction in quality of life, but in extreme cases can even be fatal if the skin around the organs is affected. Another problem is that gadolinium has partly identical chemical properties to calcium ions. This means that it is able to block all metabolic processes in which calcium is used.
There are more and more patients suffering from gadolinium poisoning. The symptoms are different for each patient. Since many patients meet all criteria of fibromyalgia, gadolinium poisoning is considered one of the many triggers of this disease.
Again and again, patients report complaints after the administration of contrast media containing gadolinium, such as
- Kidney problems
- Skin changes
- Neurological disorders such as headaches, dizziness and sensory disturbances
- Muscle aches
Not only is the direct administration of gadolinium dangerous, but as Gadolinium is excreted via the urine, it also enters the sewage system. Sewage treatment plants are currently not able to remove the rare earth element. As a result, the metal is released into the environment and in this way into the groundwater. Concentrations are particularly high in areas that obtain their drinking water by filtering river water.
A study by Jacobs University in Bremen last year found gadolinium even in the soft drinks of a well-known fast-food chain (Science of The Total Environment (2019; 687: 1401-1408). Here the metal is probably harmless as long as it is bound to chelates. Researchers at Tokyo Metropolitan University, however, point out that gadolinium can dissolve from the chelates under the influence of UV light and be presented again in its natural, toxic form.
As we have recently received an increasing number of reports of complaints related to gadolinium from various practices, we have decided to develop a special ampoule to support you in your practice.