Gadolinium Contrast Dye Leaves Behind Toxic Metal Nanoparticles During MRIs: Study

Researchers indicate more data is needed to determine who faces the highest risks from side effects from the gadolinium contrast dye.

A new study warns that undergoing magnetic resonance imaging (MRI) with contrast may expose patients to toxic metals, which can spread to organs and cause serious side effects.

According to findings published last month in the journal Magnetic Resonance, gadolinium contrast dye used during some MRI scans, can leach into tissues and spread to the brain and kidneys, potentially even causing nephrogenic systemic fibrosis.

Gadolinium contrast agents are commonly used during an MRI exam to improve the imaging and help doctors see abnormal tissue with more detail.

The toxic rare earth metal used in the contrast dye is supposed to safely pass through the body for individuals without impaired kidney function, but there have been concerns in recent years about side effects of gadolinium, with deposits of the toxic metal found in the brain for some users.

For the new study, researchers from the University of New Mexico School of Medicine, led by Dr. Brent Wagner, studied the formation of gadolinium nanoparticles in the body. They also conducted test tube experiments using two brands of gadolinium dye, Omniscan and Dotard, to observe the process.

During the experiments, the researchers determined oxalic acid caused small amounts of gadolinium nanoparticles to form. This may make it easier for the nanoparticles to leach into cells and organs in the body, they noted.

Oxalic acid is a molecule found in some foods, including spinach, rhubarb, most nuts, berries and chocolate. When the molecule binds with calcium it can cause kidney stones to form. When the gadolinium dyes decomposed and were exposed to oxalic acid, gadolinium oxalate formed.

Researchers determined this is what can create the formation of the nanoparticles and allow them to spread into the tissue.

These kinds of nanoparticles in tissues are linked to serious health problems in the kidneys and other organs, and can lead to a serious disease known as nephrogenic systemic fibrosis, which can cause a thickening and hardening of the skin, heart and lungs. This can also lead to pain in the joints.

Researchers said more studies are needed to identify what may be driving the nanoparticles to form in some people and not others. Prior studies have shown that even though about half of patients exposed to gadolinium that has nanoparticles were only exposed to the dye once, traces of gadolinium can be detected in patient blood and urine years after exposure.

The research team called for more data to identify who faces the greatest risk from being exposed to gadolinium contrast dyes and if any other factors, like medications or dietary supplements, may play a role.

Negative Reactions to Gadolinium

Research published in 2022 linked exposure to gadolinium dyes to an increased risk of allergic-like hypersensitivity reactions. Side effects included rash, wheezing, bronchospasm, hoarseness, facial swelling, hypoxia and anaphylactic shock.

Another study conducted by researchers from the Mayo Clinic concluded that using gadolinium contrast dye during epidural steroid injections can cause serious side effects, with patients suffering severe pain, headaches, stroke and seizures.

In 2009, manufacturers paid millions to resolve about 400 settlements for individuals diagnosed with nephrogenic systemic fibrosis (NSF). However, once these were resolved, new lawsuits began to be filed over Gadolinium deposition disease.

In December 2017, the FDA issued a drug safety communication for certain types of contrast agents, providing new information about the risk of gadolinium retention and potential side effects. As a result, manufacturers were required to provide new warnings and information in a Medication Guide, which all patients receiving an MRI contrast dye will be asked to read.

Gadolinium Deposition Disease Lawsuits

Over the last decade there have also been growing concerns about the risk of gadolinium deposition disease, involving complaints of pain, brain fog and other symptoms experienced among individuals without kidney impairment, who have been found with an accumulation of the metal remaining in their body after an MRI exam. This led to another wave of gadolinium lawsuits in 2022. The release of nanoparticles found in this study appears to add more evidence to those concerns.

Some of the symptoms of Gadolinium deposition disease appear to be very similar to NSF, which can cause excessive formation of connective tissues in the skin and organs, resulting in tissue thickening and hardening, particularly in the skin, and on the limbs and trunk. It can severely limit movement of the joints, causes severe pain and can lead to death in some cases.

In recent years, the risk of NSF has largely been avoided by not using gadolinium contrast agents among individuals with kidney problems, highlighting the importance of warnings provided by the manufacturers.