Gadolinium Toxicity

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Doctors with self-diagnosed Gadolinium Deposition Disease

A recent study by Semelka and Ramalho allowed 9 physicians with self-diagnosed gadolinium deposition disease (GDD) to report their own experience. The physicians included 7 females and 2 males. Symptoms developed after a single injection in one doctor and after multiple injections in the other eight. The precipitating agent included both linear and macrocyclic gadolinium-based contrast agents (GBCAs). Eight of the physicians reported that they were compelled to change their practice of medicine.

The study, Physicians with self-diagnosed gadolinium deposition disease: a case series, found that in various physicians, GDD showed common features and had a substantial impact on daily activity. The most consistent symptoms reported were a burning sensation, brain fog, fatigue, distal paresthesia, fasciculations, headache, and insomnia.

My thoughts –

The symptoms described by the physicians are similar to those reported in our 2014 Symptom Survey, and those symptoms continue to be reported by newly affected people who join our Gadolinium Toxicity support group or one of the other online patient groups.

If we accept that these self-reported cases of gadolinium deposition disease were induced by the toxic effects of retained gadolinium, which I believe that they were, then it seems that the symptoms reported by patients after their MRIs with a GBCA must also be recognized as being gadolinium-induced.

As Drs. Semelka and Ramalho said in their conclusion, “physicians are educated reporters on disease, so their personal descriptions should spark interest in further research.” I agree.

Interestingly, Hubbs Grimm and I concluded our 2014 Symptom Survey paper by saying, “the results of the Symptom Survey and Gadolinium Retention Update presented here should stimulate further professional investigation into gadolinium retention in all patient populations including those with normal renal function.” Here we are 7 years later in 2021 and researchers still have not connected patient symptoms after contrast-enhanced MRIs to the known toxic effects of gadolinium.  Why is that?

Sharon Williams

Semelka, R., & Ramalho, M. (2021). Physicians with self-diagnosed gadolinium deposition disease: a case series. Radiol Bras. Retrieved from

Williams, S., & Grimm, H. (2014). Gadolinium Toxicity: A Survey of the Chronic Effects of Retained Gadolinium from Contrast MRIs. Retrieved from

Study reports elevated cytokine levels in patients with confirmed gadolinium retention

Results of a study to determine whether individuals with proposed gadolinium deposition disease (GDD) have elevated serum levels of pro-inflammatory and pro-fibrotic cytokines were recently published. GDD has been reported in patients with normal renal function after MRIs with a gadolinium-based contrast agent (GBCA). The study by Maecker et al., “An initial investigation of serum cytokine levels in patients with gadolinium retention”, also sought to determine whether specific cytokines are correlated with certain symptoms considered to be characteristic of GDD.  The study involved 24 participants who were recruited between May 2016 and June 2017 and met the proposed GDD diagnostic criteria. Some of the participants were recruited from our MRI-Gadolinium-Toxicity support group.  A control group of 64 subjects provided serum samples before their flu vaccination.  Serum cytokine levels were obtained with Luminex serum cytokine assay using eBiosciences/Affymetrix human 62-plex kits.

In patients who had retained gadolinium, serum levels of 14 cytokines, including 9 pro-inflammatory cytokines, were “statistically significantly elevated” compared to controls (p ≤ 0.05).  (more…)

Gadolinium Toxicity – Let’s not make the same mistake again

An Editorial by Hubbs Grimm
August 2018

(A pdf of this Editorial is available for download)

I want to talk about the unfortunate results of the early studies of gadolinium toxicity that defined NSF and the parallels I see today in the effort to define Gadolinium Deposition Disease (GDD).  I will also propose an alternative view of how to describe gadolinium toxicity in a way that reflects what we currently know and do not know that will recognize all patients who have been affected by retained gadolinium.

Before I begin, I want to be clear that I believe all those who have contributed in the past and those who are contributing today are doing so with the best of intentions and working from the basis of their experience and perspective.  But that does not mean that the result or proposals are necessarily best for meeting the needs of the people who are suffering from the toxic effects of gadolinium.


Head Pain is a diagnostic feature of Gadolinium Deposition Disease

On May 18, 2018, Dr. Richard Semelka added Head Pain to the recently revised primary clinical diagnostic findings for Gadolinium Deposition Disease (GDD) and he described two critical diagnostic features of GDD.  First, symptoms of GDD must start within minutes to one month after administration of a gadolinium-based contrast agent (GBCA).  Second, the symptoms experienced by the patient after GBCA administration must be new, and not preexisting.

There are now 6 symptoms that stand out to Dr. Semelka as critical diagnostic findings for GDD.  He said that it is imperative that individuals have at least 3 of the symptoms, but he prefers to see 5/6 to be certain of the diagnosis.

The 6 main clinical criteria for Gadolinium Deposition Disease, as described by Dr. Semelka are:

1.  Intense burning of the skin and skin substrate.  Arising in early stage (early on after GBCA): This can be an all over feeling in the body, but often may be localized to the trunk region or distal extremities.

2.  Intense boring pain in bones or joints.  Arising in early stage (early on after GBCA):  This can be any bones or any joints. Often the joints may be peripheral but can also be large joints like the knee or hip. Any bones can have severe point pain, but rib pain is quite distinctive for the disease.

3.  Brain fog.  Arising in early stage (early on after GBCA): Many terms have been used for this: mental confusion sounds more scientific, but brain fog gets the point across well and succinctly. Brain fog is also a prominent feature of lead toxicity, which is another heavy metal toxicity.

4.  Muscle vibrations (muscle fasciculations) and skin pins and needles/tingling (early on after GBCA).  These symptoms may represent part of the same process that is causing brain fog. Muscle vibrations/twitching and pins and needles skin sensations generally reflect nerve disease (neuropathy).

5.  Head pain (early on after GBCA).  Headache is both a very common occurrence and shows tremendous variability.  GDD sufferers describe it as a head pain, and unlike any other type of head-ache they have previously experienced. These two properties provide differentiating features for this entity.  Some describe it as a burning pain and as an extreme tightness feeling (like a tight bathing cap on their head).

6.  Distal arm and leg skin/skin substrate thickening, discoloration, and pain. Arising in the subacute stage (2 weeks +): This is very much like the principal features of NSF, but generally less severe. Instead of woodiness, doughiness; instead of redness, pinkness; instead of extreme joint contractures, stiffness of joints and decreased range of motion. Skin tightness is a feature of GDD as well.  This symptom complex should be expected.


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