The authors below conducted the survey and authored Signs & Symptoms after Gadolinium Administration: A Patient Survey. Report 1: Symptoms Paralleling Early-Phase NSF and have published it on this website. The abstract from the report is below, and you can download the full report PDF.
Authors:
Sharon Williams – Coauthor of GadoliniumToxicity.com, The Lighthouse Project
Hubbs Grimm – Coauthor of GadoliniumToxicity.com, The Lighthouse Project
Sarah Ratnam – Research Collaborator
Catriona Walsh (MB, BCh, BAO, MA) – The Food Phoenix, Belfast, Northern Ireland
Correspondence: Sharon Williams; Sharon@GadoliniumToxicity.com
Background: The U.S. Food & Drug Administration (FDA) has acknowledged that after MRIs with a gadolinium-based contrast agent (GBCA), patients retain an unknown amount of gadolinium (Gd) in the brain, bone, skin, and other tissues, where it can remain for months to years. Although Gd is a toxic metal recognized as the primary cause of nephrogenic systemic fibrosis (NSF), harm attributed to long-term Gd retention in patients with normal renal function has not been recognized. This Patient Survey aims to address that issue.
Method: Members of Gd-related groups were invited to participate in this Patient Survey. 316 patients with normal or near- normal renal function who had experienced symptoms after an MRI with a GBCA completed a survey online, without any knowledge of the responses of the other participants. 185 of these patients had a laboratory test that confirmed Gd retention 30 days or longer after their last MRI (WITH) and 131 patients did not have Gd testing performed (WITHOUT). A third group was formed, comprised of 8 patients with biopsy-confirmed nephrogenic systemic fibrosis (NSF). In each patient group, reported symptoms were ranked in order of frequency. In the NSF Group, due to multiple symptoms having the same frequency, the top 28 symptoms were used for comparison purposes.
Results: From a list of 60 symptoms, 19 of the 28 most frequently reported symptoms of the NSF Group were also ranked among the top symptoms reported by the two groups of Gd-exposed patients without renal impairment, indicating a substantial overlap in clinical presentation between what has been published about early-phase NSF and the post-GBCA symptom complex. Eleven of the 19 most frequently reported symptoms of the WITH, WITHOUT & NSF patient groups involve the nervous system. This pattern is also observed within a subgroup of 75 unconfounded cases (19 linear & 56 macrocyclic) comprised of patients who received a single GBCA and have confirmation of Gd retention (Tables 16 & 17). The symptoms reporting frequencies of the unconfounded subgroup strengthen the evidence presented within this Patient Survey that the symptom overlaps are genuine and not due to measurement error, exposure ambiguity, or bias. As with the clinical presentation of NSF (Table 10) and its variability in severity (Table 11), neuropathic symptoms predominate the early phase of the symptom complex reported by patients with normal renal function, and the severity of reported symptoms varies and can be life-altering in some patients.
Conclusion: These observations are consistent with the hypothesis that gadolinium exposure is associated with a spectrum of manifestations and underscore the need for standardized recognition, systematic clinical assessment, and further objective study of Gd-associated multisystem symptoms in all patient populations. Rather than a new or separate disease entity for patients with normal renal function, it seems that what we may be dealing with is one Gd-induced disease with varying degrees of severity, which is how NSF was described by Marckmann (2009). Symptom reporting frequencies indicate the nervous system may be most affected by Gd, possibly due to Gd having a particularly toxic effect on calcium channels, which was acknowledged by the FDA in a 2007 Memorandum (Appendix 4). The results of this Patient Survey warrant acknowledgement that retained gadolinium can cause harm in patients with normal renal function due to its recognized toxic effect on calcium channels.
Key Words: Gadolinium, gadolinium toxicity, GBCAs, NSF, normal renal function, symptoms, nervous system, calcium channels, unconfounded cases
Citation: Williams, S., Grimm, H., Ratnam, S., Walsh, C. (2025). Signs & Symptoms after Gadolinium Administration: A Patient Survey. Report 1: Symptoms Paralleling Early-Phase NSF.
[Online] https://gadoliniumtoxicity.com/research/ourresearch/contrast-mri-2025-patient-survey-report-1/
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