Doc question......

[justacowgirl]

I haven’t posted for a loooooong time: but I come to you all with a question I just am so confused about.

After reading much info about Gadalinium Toxicity; and having had multiple MRI’s with contrast; I contacted my neuro to see about the Mayo test.

Her nurse called me back to tell me “it was not advisable” to take the test. No explanation of why it was not advisable.

What the heck is that? I have my thoughts. Yours?

Many thanks. I am very upset.

J

[Jules A]

I'm guessing they are weary of the largely unfounded hysteria when in fact GBCA can be an important diagnostic tool for people with normal renal function and MS. This was on MedScape, originally from Mayo:

by Gina Chiri-Osmond
Feb 27, 2018

There have been concerns in the United States recently about the possible harmful side effects from absorbing gadolinium-based contrast agents (GBCAs) into the body during some magnetic resonance imaging (MRI) exams. The popular press, patient advocacy groups, and a recent lawsuit continue to raise public anxiety about the use of GBCAs.

To address some of the anxiety and concerns over this issue, Paul Jannetto, Ph.D., DABCC, FAACC, and Joshua Bornhorst, Ph.D., DABCC, FAACC, Co-Directors of the Mayo Clinic Metals Laboratory and leading experts in this field, have compiled the following list of the most up-to-date information.


Why Is Gadolinium Exposure Drawing So Much Attention?

The increased media and regulatory attention is, in large part, due to several safety announcements in 2017, released by the U.S. Food and Drug Administration (FDA)—via its MedWatch system—regarding the use and retention of GBCAs in patients who have had an MRI. This attention particularly peaked after the announcement in December 2017, when the FDA, after review and consultation with the Medical Imaging Drugs Advisory Committee, decided to require a new class warning and other safety measures for all GBCAs used for MR imaging. (Note: GBCAs are only used in 30% to 50% of MRI exams—exposure is based on a clinical assessment of each patient’s risk and tolerance for this metal.) The new warning concerns the fact that gadolinium can be retained in patients’ bodies (e.g., the brain and other tissues) for months to years after receiving these drugs.

Several research studies have shown that GBCAs may be associated with some gadolinium retention in the brain and other body tissues, despite normal renal function. However, most GBCAs are cleared in the first 96 hours after being administered to a patient. Amid all the attention, experts like Dr. Jannetto remind everyone that, “At this time, regardless of the GBCAs utilized, prolonged gadolinium retention has still not been directly linked to adverse health effects in patients with normal kidney function.”

The December FDA announcement also noted that there are differences in the two types of GBCAs used (i.e., linear and macrocyclic). Of the two, linear agents result in more retention of gadolinium in patients—and retention for a longer period of time versus macrocyclic GBCAs.

Regardless of the new warning, the FDA concluded that the benefits of the approved GBCAs continue to outweigh any potential risk. And the European Medicines Agency reached a similar conclusion. Even so, a number of sources continue to cast gadolinium in an unsettling light.

[justacowgirl]

Hmmm..thank you so much for your reply.

I can not argue Gadolinium toxicity. I don’t believe anyone has the complete answer to the topic. Yet. As with similar subjects it appears the information is evolving.

Jules, if you trust the FDA information to make your decisions about your health...you are certainly a more trusting individual than I.

My disappointment lies in the complete dismissal of a patient asking for an inexpensive and reasonable test to satisfy concerns about their own health.

While it may be hysteria...the thought of injecting a heavy metal into my system and retaining any of it bothers me enough to ask for a test I ultimately pay for.

My question was why a doc would call a test “ unadvisable “ with no explanation. Perhaps you are right...the doc is just sick of being asked for the test. So I am hysterically moving on to another doc who will listen to my requests and answer my questions in an educated manner.

I am no longer confused.

Thanks.

[MarkLavelle]

My disappointment lies in the complete dismissal of a patient asking for an inexpensive and reasonable test to satisfy concerns about their own health. [...]

My question was why a doc would call a test “ unadvisable “ with no explanation.

The lack of explanation is really inexcusable, but my guess would be that it's not a common test and likely to be expensive and require processing somewhere far away...

[Jules A]

The lack of explanation is really inexcusable, but my guess would be that it's not a common test and likely to be expensive and require processing somewhere far away...

Yup and most likely the nurse just didn't know the physician's reasoning for dismissing it.

As for the FDA although not a perfect system or watchdog I absolutely do give weight to their recommendations with the understanding that this type of data is always evolving. Depending on the condition there are times when a MRI without contrast would be relatively useless so there's that.