
Editor's Note New research offers a potential explanation for why some patients retain toxic metals long after undergoing an MRI. Published in the journal
April 9, 2025
Editor's Note
New research offers a potential explanation for why some patients retain toxic metals long after undergoing an MRI.
Published in the journal Magnetic Resonance Imaging, the findings show that gadolinium contrast agents used in MRI scans may react with common dietary compounds to form harmful metal nanoparticles in the body. As detailed in an April 7 Newsweek report on the study, gadolinium-based contrast agents are injected to sharpen MRI images and are typically excreted without causing harm. However, gadolinium particles have been found lingering in the brain, kidneys, blood, and urine years after exposure, and the US Food and Drug Administration links retained gadolinium to nephrogenic systemic fibrosis (NSF).
The study specifically identifies a chemical reaction between gadolinium and oxalic acid—a compound found naturally in foods and produced in the body after ingesting vitamin C—as a likely contributor, Newsweek reports. Lab tests showed oxalic acid caused gadolinium to separate from its chelating agent and form nanoparticles capable of infiltrating cells in various organs.
Lead author Dr Brent Wagner told Newsweek he personally avoids vitamin C when undergoing MRI with contrast, citing its potential to increase gadolinium reactivity. “Metabolic milieu,” including high oxalic acid levels, could explain why some individuals experience severe symptoms while others do not, he said.
According to the article, nearly half of the patients found to have gadolinium traces in the body had received the contrast agent only once, suggesting that individual biology—not dosage—may influence risk. Dr Wagner theorized that nanoparticle formation could trigger a disproportionate immune response, with affected cells sending distress signals that intensify the body’s reaction.
The research team is now building an international patient registry to further study gadolinium accumulation. According to the article, the registry will collect blood, urine, hair, and fingernail samples to help identify individuals at greatest risk and understand long-term retention patterns.
This is very interesting to see on here. My mother was the dissenting vote on an FDA panel on this. There are articles about it. I'll copy her words (as reported by something but seems legit)
> She said that the FDA's plan doesn't go far enough.
> "It's hard to dismiss an anecdotal report when you are the anecdote. When a patient is finally tested and found to have gadolinium retention, there's no FDA-approved antidote. So what does the patient do?"
And I want to reiterate that she was "the" no not "a" no. I don't know if her vote alone is what's caused more research into this. But it's probably the thing I brag about her the most. Even though everybody else said it was fine or abstained, she stood strong. If you look up the articles from the time of the panel (2017) you'll see a lot of articles about this panel and how she was the sole no vote. Included in that was a public post from Chuck Norris praising her. He was going to come out to meet us but I think it was a bad Texas hurricane season so that fell through
In case anyone is wondering what Chuck Norris has to do with all this:
> Chuck and Gena Norris filed a lawsuit against several medical companies in 2017, alleging that a gadolinium-based contrast agent used in Gena Norris's MRIs caused her to develop a condition called gadolinium deposition disease and resulted in debilitating symptoms like cognitive issues, pain, and muscle wasting. In January 2020, the Norrises, along with their attorneys, voluntarily dismissed the lawsuit with prejudice, meaning it cannot be refiled. The dismissal was made without a settlement payment, and each party paid their own legal costs.
It might give a glimpse into his worldview to mention that during the COVID pandemic Mr Norris shared an article on social media that claimed that the COVID vaccinations killed millions of people. [0]
[0] https://m.facebook.com/story.php?story_fbid=870953857718632&...
His reaction is kind of the essence of populist backlash.
People are told that the authorities have it all under control and the experts can be trusted. Then they discover that the experts are human, fallible, and sometimes incompetent or corrupt.
Since the original message was one of unqualified absolute faith in the experts, the backlash is to flip over to believing that the experts are satan incarnate and pure evil and always wrong.
It reminds me psychologically of the arc of an immature relationship. First they’re perfect, everything about them is perfect, they’re going to be your soul mate forever. Then you catch them in a lie or they do something embarrassing. Then you get the screaming breakup. Everything about them is the worst now and you never want to see them again.
I have no feeling in the top of my mouth after a “successful” deviated septum operation when I was a teenager. I was told it would resolve, it never did.
I can’t go outside in mildly brisk weather without a tissue as it’s a constant stream, and I get debilitating headaches that are almost like migraines with the pain situated right at the bridge of my nose. Also found the procedure enlarged my sinus opening for no particular reason, something my teenage self wasn’t aware of.
It seems to be getting worse over time, and I have localized pain in the area periodically. I can tell you from first hand experience, it will skew your view of medicine and the field, and I have plenty of MDs in the family.
Some people just take it a little too far.
> I was told it would resolve, it never did.
Ha, yeah, doctors say that about just about everything that's a bit abnormal just to get you out of their office. Was told similarly for two conditions I still have. It sounds better than "Uhh I have no idea what that's about, there's 68 patients waiting in line, good luck".
The way I see it, medicine is about trying to fix a black box with absurd levels of complexity that does not follow any sensible design, where every body is not even arranged in the same way. All that without a manual and only rudimentary tools. They mostly just guess based on statistics and hope for the best, they have no idea what they're doing and if at all possible they try to let your body resolve the issue on its own because it'll do less damage.
Still usually beats the alternative though (i.e. nothing).
> Ha, yeah, doctors say that about just about everything that's a bit abnormal just to get you out of their office.
Ha, "just keep waiting", knowing we all have timeouts that'll expire when we drop dead...
I don’t know if people would be happier with a more truthfull “That sucks. We don’t have a solution for that. It might get better on its own, or not.”
A large portion humanity seem incapable of embracing uncertainty and nuance and are over eager to embrace whoever is willing to peddle certainty and simplicity.
As long as that is true it seem naive to believe that nuanced institutions can exist as dominant entities in human societies.
This is true, but it is also true that "official" communication often tends to project level of certainty that just does not correspond to the actual level of knowledge, and Covid was pretty bad in this regard, because in absence of actual knowledge, hard recommendations were being issued to people.
Saying sincerely "we are not yet sure if Covid spreads by touching surfaces" etc. would have gone a long way.
I am not even touching the dirty topic of "practise societal distancing unless you go to an anti-racist demonstration, because racism is worse than Covid". That alone probably sunk the levels of trust for a generation in the US, especially among people right of the center. Politicizing science is suicidal.
Back to normal uncertainty. It was the same with various dietary recommendations. Older people remember several major overhauls thereof (are eggs fine or not, and in which amount?), and again, these were presented with a level of certainty that does not correspond to the actual - somewhat fuzzy - state of nutritional science.
You can only do this so long before unleashing an epidemics of distrust.
> This is true, but it is also true that "official" communication often tends to project level of certainty that just does not correspond to the actual level of knowledge, and Covid was pretty bad in this regard
After my SO got her first COVID vaccine she lost her period. It had been rock steady for many, many years and suddenly gone and hadn't come back for a few months. She had a GP appointment, and I accompanied her as I often do as my SO struggles with recalling important details.
My SO told the GP about her missing period, and the GP quickly tried to reassure her it wasn't something to worry about and it would come back soon enough.
Well, I had just read published studies about this and knew the medical establishment had no idea why the vaccine caused a lot of women to lose their period.
So I challenged the GP and asked if she knew what the mechanism was that caused my SO to no longer have her period, and of course she didn't know.
"Well, if you don't know the mechanism, how can you say it's fine this time?", I asked sincerely.
She admitted she was just going off what usually happens when women lose their periods, which can happen due to various kinds of stress. I wondered why it was so difficult to lead with that, instead of confidently stating it would be fine.
My SO did eventually get her period back, but to this day, almost 5 years later, it's still highly unregular.
Back then you could get banned from Twitter for just mentioning such a story.
> it is also true that "official" communication often tends to project level of certainty that just does not correspond to the actual level of knowledge
That reminds me of someone called Chatgpt.
> Saying sincerely "we are not yet sure if Covid spreads by touching surfaces" etc. would have gone a long
It wouldn't have, uncertainty creates general panic as well, that soon turns into disarray of chaotic recommendations among the masses.
IMHO, "short term uncertainty" > "long term distrust".
I don't like the "common people are too stupid to be told the truth" attitude (which includes uncertainities).
It is both too smug to work, and unworkable in today's networked world, where those same people will notice really fast that someone is treating them like idiots, and react with resentment and loss of trust.
Absolutely agree. I think of children as "people who don't know a lot right now". But really, we're all children to some extent. Children are always honed to look for inconsistencies, and if those inconsistencies aren't addressed, distrust builds up. "You said I can't be on my phone too long, so how come you're doing it?" Distrust leads to irrational judgements, often in a broad-brush pendulum swing towards the opposite position. Trust is built up painstakingly and organically. Distrust tears it all down instantly. As long as "the masses" (to which all of us, to some extent, belong) exhibit this asymmetry between trust and distrust, for the people who want to speak truly, the key is consistency. Never be (perceived as) the boy who cried wolf.
The common person can be told the truth. The common people, plural, cannot.
That’s what most authorities believe and there is good reason to believe it.
People in groups are irrational and tribal in ways people are not if you speak to them one on one. We don’t scale well, cognitively speaking. A whole bunch of “game of telephone” distortions happen and a bunch of legacy instincts from when we were little squirrel looking things take over.
If you look at how militaries operate it’s basically a giant set of procedures and customs designed to suppress all that shit and allow people in groups to behave somewhat more rationally. At least for a while, or in a limited domain. It kind of works. But we don’t want all of society to operate like that because it also suppresses art, invention, experience, play, etc.
The tribal parts of our nature can also be soothed by having trust in a good clan chief who is handling things. Those people can say things like "we dont know but we're working on it" because people trust them (requires integrity). Since that is almost non-existant (certainly during covid) we only get the worst parts.
I believe we can do fairly well in addressing people in groups. People are irrational, but the probability distribution of "things we say" against "what people will think and do" can be modulated for the better. The bigger issue, I think, is that the authorities can't be trusted. In what world will you find even 100 people who will agree to hold truth, justice, blah blah in high regard, and actually execute on those words? Corruption in the leaders exacerbates the illness of irrationality in the people.
" is good reason to believe it."
The results of this belief seem to be pretty catastrophic. Trust against authorities has evaporated all over the world.
"People in groups are irrational and tribal in ways people are not if you speak to them one on one. "
Sure, but why precisely do you believe that lies / deliberate misinformation will work better in such situations?
Is anybody able to craft such misinformation so soothing and so believable that the vast majority of the population will accept it indefinitely?
If not, what happens when it becomes obvious that someone in a position of authority communicated dishonestly to the public?
> It wouldn't have, uncertainty creates general panic as well, that soon turns into disarray of chaotic recommendations among the masses.
A disarray of chaotic recommendations from on high is preferable, I guess?
I especially enjoyed viewing the early covid health department stickers later on. While masks were mandatory, there were health department stickers everywhere from a couple months earlier telling us that they were unhelpful.
I know nuance is hard, but it is entirely understandable that many people have distrust in authority when the message seemed to be high confidence do A(t) and A(t) was often contradictory to A(t-1). At that point, people pick the A(t) that had the advice they like.
When there were things like tell people masks are ineffective because they actually are effective but in limited supply, that also breeds distrust. I don't know how you solve that one, other than having a functional pandemic response logistics chain, and I don't think we ever had that; we did some supply warehousing after SARS but without a process to refresh the stock, it was not effective for COVID. I suspect there's no effort to build that up again, but I'd love to be wrong; my impressions are that the US healthcare and disease control ecosystem has not learned anything from COVID, again, I hope I'm wrong. Maybe acceptance of mRNA based vaccination and some amount of deployment of genetic identification of infection from patients.
"It would create panic" is a crutch that causes more destruction than it purportedly prevents. If you treat people like children, they behave like children.
It’s why leaders often speak in certainties. X is bad, Y is good type messaging.
It’s also why some people gravitate towards overly-confident narcissists. They feel a sense of comfort when someone seems to have all the answers, even if they don’t.
A large portion of people use "nuance" as a self-serving euphemism for their own lies or corruption, and explicitly call for no nuance when demanding conformity.
"Nuance" is an elite get out of jail free card: You're just too dense to understand how I was fundamentally right about everything when I was wrong in exactly the way you said I was wrong. The fact that I agree with you now is because there's finally enough evidence. Actually, it's a sign of your stupidity that you were "right" before. You should actually be grateful that I've come to agree with you; it shows how flexible and open to new information I am, and how lucky you were.
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I understand why people do it, but in another way I don’t. If I get a car and it turns out to be a clunker and I hate it, I don’t just go “all cars are clunkers that I will hate” and swear off motor vehicles. People would claim I’m wildly overreacting (and rightfully so). And there are far more experts across a much wider spectrum than there are versions of personal motor vehicles!
If cars were people you might. We are more rational with inanimate objects. When it’s people a bunch of tribal in group out group stereotyping and group solidarity building through out group scapegoating programs take over.
Like I said, I understand why it happens. But it’s also just very easy for me to sit down and kind of talk through why it’s not a good way to operate. There are definitely types of “experts“ and certain fields that I am incredibly skeptical of or maybe even dismiss outright, but to translate that into a broader “basically every doctor and government is lying to me“ as one accepts “outsider” opinions as gospel is just such an extreme reaction.
And normally I wouldn’t really even bother acknowledging that that extreme stance exists. If you look hard enough you can find an extreme stance on anything. But the sheer percentage of the US population that has embraced an almost entirely skeptical/dismissive view of doctors and experts of any kind… it’s kind of horrifying
If you bought a jeep and it was a lemon, you may never buy a jeep again. You just don’t view all cars as fungible.
Do you think most people are capable of understanding why an expert could be wrong about gadolinium but right about vaccines? Medical advice is all seen as equivalent to most.
I guess I’m not really sure what you’re trying to say here. I agree that this is the reality. It’s just wild to me that people can’t (or rather won’t) step outside of it for a moment and think critically when it literally can be a matter of life or death. I think there’s just too much incentive to trust random Youtubers who tell you everything you already think is completely accurate and anybody who tells you to do something different is not only wrong but actively trying to hurt you.
My point is that, the reason people don’t let one bad car experience ruin all cars is because people understand that different manufacturers make cars with different levels of quality. So one bad car will ruin the perception of one manufacturer instead of cars in general.
What is the equivalent when it comes to medical advice? Using vaccines as an example, one concern people have is the mercury content. The FDA, doctors, and drug manufacturers have said that the mercury is safe. The same doctors, manufacturers, and FDA has said that MRI contrast containing another heavy metal, gadolinium, is safe. It turns out that, no, it is not safe.
Given these facts, is it really surprising that people would turn away from the FDA and doctors just like people would turn away from a car manufacturer after receiving a lemon? While I personally trust the FDA, I can see the logic in the distrust after events like this.
Surprising or not I think it is definitely an overreaction that fits very nicely with not having to challenge one’s priors ever. Americans really don’t like discomfort in any way, shape, or form. We just call it “rugged individualism” and belittle anyone we disagree with.
Just that they always can be until proven otherwise.
Assuming by default that (government|any) humans are working on a selfless incentive structure is arguably insane behavior.
> People are told that the authorities have it all under control and the experts can be trusted. Then they discover that the experts are human, fallible, and sometimes incompetent or corrupt.
Try
People are told that the authorities have it all under control and the experts can be trusted. Then they discover that the authorities and experts, in the name of “the greater good”, actively suppressed debate, knowingly mis-represented uncertainties, pretended reports of serious adverse reactions to vaccination were not only impossible but simply fear-mongering from the uneducated, and then pressured social-media platforms to take down factual information when it threatened the official narrative.
This without even touching on the fact that the WHO, who has one damned job, refused to even declare a pandemic and spoke against any travel restrictions or public health measures outside their lazy guidance until the virus was confirmed to be spreading out of control in nearly every nation on earth.
Having lived through this, observed it first-hand, read the studies, having dozens of anecdotal evidence on top from near friends and family, and still not able to even question the new mRNA platform publicly without knee-jerk backlash and demonisation, has done more damage to my faith in institutions and the medical community than anything else I’ve witnessed in my near forty years on this planet. Covid made crystal clear to me that we still live under tyrannical dogmatic rule devoid of scientific nuance because it’s “for the greater good”.
The claim that it is not possible to "question the new mRNA platform publicly without knee-jerk backlash and demonization" is just not accurate. There is a very well-known counterexample. Researchers identified that the mRNA COVID-19 vaccines were associated with an increased risk of myocarditis, particularly among younger males. This is rare - something like 3 excess cases per 100,000 doses. This has been studied extensively. Regulators required additional surveillance and it's included in all the guidance from regulators and physicians associations. The consensus has been that this is an acceptable risk, particularly since COVID itself is associated with an increased risk of myocarditis. Clearly you have a different view, but the consensus view is based on analyzing data from millions of patients across many countries, not on a "knee-jerk backlash".
> The consensus has been that this is an acceptable risk, particularly since COVID itself is associated with an increased risk of myocarditis.
This made more sense to me when people still believed that the shots meant getting covid was very unlikely. It's easy to find people who got lots of shots, it's hard to find people who didn't get covid.
It always seemed implied that p(shot cardio issues) < p(covid cardio issues), and nobody ever talks about p(shot cardio issues) + p(covid cardio issues).
Did anybody rigorously demonstrate that a vaccinated covid case doesn't have these risks?
The vaccine didn’t work as well as we thought it would.
It did work to some extent. It’s there in the numbers. But it was not the resounding success that, say, the smallpox or polio vaccines were. It attenuated the disease a little.
That might change some of the calculus. Or it might not. It’s hard to tell the difference between myocarditis caused by the vaccine or from COVID or from other factors.
Imagine it’s you who gets to make the call. Whatever call you make will be roundly criticized and you might be wrong. If you’re wrong more people will die.
The polio vaccine has been around for 70 years and smallpox vaccination has been around for over 200 years. If you were to assess the polio vaccine a few years after its introduction and compare it to mRNA vaccines a few years after their introduction, then the COVID-19 vaccine might actually come out better. There was a major safety problem with one company's process for manufacturing the initial polio vaccine. 11 children died. If you read contemporary reporting from 1957 - two years after the vaccine was released - you see quotes like this: "The failure of this vaccine to prevent disease and at times death in certain vaccinated individuals and its apparent inability to reduce the number of carriers clearly indicate that polio will not be "wiped out" by this vaccine."
https://www.theatlantic.com/magazine/archive/1957/02/how-goo...
>something like 3 excess cases per 100,000 doses
That was for clinical myocarditis in the overall population, but the rate of subclinical cardiac damage among young males was significantly higher, around 1% with abnormal ECGs post vaccination: https://link.springer.com/article/10.1007/s00431-022-04786-0 .
Comparing these two numbers is completely wrong. The study that you cite performed an ECG on 5000 high school students after a COVID-19 vaccine and found 50 had abnormal ECG. But having an abnormal finding on an ECG doesn't actually mean that there's any underlying heart condition. I just went through this myself - I had a bunch of ECGs for a clinical trial (unrelated to any cardiac issue). One came back abnormal. Repeating the ECG in my PCP's office showed nothing. A cardiac stress test showed nothing. About 10 other ECGs for the clinical trial showed nothing. It was just an incidental finding. Saying that 1% have "cardiac damage" because there's an abnormal ECG is just completely wrong. The test has a false positive rate that's greater than 0. And 50 abnormal findings does not mean 50 cases of "cardiac damage". In fact there were 5 - 1 myocarditis and 4 arrhythmias. All of these cleared up on their own.
And finally, you can't compare the two studies because they are looking at fundamentally different things. The 3 excess cases per 100,000 doses comes from looking at millions and millions of health records, so it will only show cases that were actually diagnosed in the real world. The paper you cite performed an ECG on everyone in the study - so of course they are going to find vastly more cases, because they are doing vastly more testing. But that study is not performing ECGs on anyone who gets COVID but has not been vaccinated. If you did that, you would also see myocarditis, because viral infection is the leading cause of myocarditis.
You cannot conclude anything from the study that you cite about the relative cardiac risks of the vaccine - it's just not a study that's designed to do that.
The most frustrating and brain damaged part about this take is that everyone pushing it ignores that not getting vaccinated has 20x higher chance of cardiac damage from covid.
It's literally people arguing not to wear seatbelts and pointing at cases were people lived because they were ejected from the car. Ignoring all the people who lived because they were wearing seatbelts.
The correct framing is "How many young people didn't get myocarditis because they got the vaccine?"
It's contrived and breaks down pretty easily, but why isnt it more like this:
- both wearing seatbelts and getting in an accident have a significant chance of causing x
- you are almost definitely going to get in an accident
- are your chances of x greater or lesser given car accident while wearing seatbelt?
I think your framing is correct (though it'd be better to just say were better off in general), but I haven't seen anyone give a convincing answer to that question in favor of the shots.
Maybe this helps? https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA....
In the paper it says 0.1%. " Cardiac symptoms are common after the second dose of BNT162b2 vaccine, but the incidences of significant arrhythmias and myocarditis are only 0.1%." Also note: "subclinical".
"Only"? COVID posed a negligible risk for young males without major preexisting conditions. By contrast, common cardiac symptoms paired alongside significant arrhythmia and myocarditis in 1 in 1000, disproportionately affecting young males, is huge.
And I expect we will eventually come to find out that the overall (particularly longer term) side effects of these drugs have been greatly underestimated. For instance excess mortality continues to remain extremely high [1], even though it would be expected to be negative following a pandemic simply because those most affected by COVID were those already near death. Put more bluntly, disproportionately get rid of the elderly and future death rates should be lower than they would be otherwise. So why are disproportionately large numbers of people continuing to die?
[1] - https://ourworldindata.org/grapher/excess-mortality-p-scores...
You may want to look at this paper to get a better idea of risk and benefits, e.g. Fig 2 and Fig 3: https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA....
One also needs to understand that myocarditis is not uncommon, and especially common after viral including COVID itself. Also "subclinical" means that this includes mild cases and here the 0.1% also included arrhythmia. Looking at the other paper above, they found 1 (!) person with subclinical myocarditis while screening for it in a population of 4928. Also interesting to put this in perspective: "Underlying disease was present in 109 (2.2%) of the patients, with simple congenital heart disease in 33, mitral valve prolapses in 36, arrhythmia in 36, Kawasaki disease in 11, and previous myocarditis in 2"
Your idea that excess mortality is caused by the vaccine rather than COVID itself seems far fetched to me.
Your own link shows 128 cases of myocarditis within 7 days of ~2m vaccinations for 12-17 year old males, against an expected rate of 0-4. That's an overall rate of 1:15,000. And that study is based entirely on people with severe enough side effects for them to end up in the hospital following vaccination and to consequently be diagnosed with myocarditis, and only within 7 days. In other words it's definitely lowballing the figure.
And it's things like this that destroy trust. Because we're already speaking of an unacceptably high rate of severe side effects, based on this single one (amongst many possible), for that demographic. Typical rate of severe side effects from vaccines are in the 1:1,000,000 rate. So why was this recommended, and defacto mandated, for that age group, again? And where's the accountability for those that made this decision, and for the trials that failed to make clear such extremely high rates of side effects?
I realize I'm going on a slight tangent instead of arguing my rather extreme claim. The point I'm making here is that the messaging on these vaccines has not been carried out in good faith, and that they do have clear and severe side effects that should have made them a non-starter for at least certain demographics. And as we continue to see excess mortality rates that are comparable to what it was mid-pandemic (during the lulls between spikes), the possibility of longer term side effects seems to me to be, at the minimum, viable.
"So why was this recommended, and defacto mandated, for that age group, again?" Because by preventing cases or even just reducing the virus load, it decreases the likelihood of spreading the virus to others.
Approximately 100% of people ended up getting COVID, the overwhelming majority - repeatedly. So once again these were claims that, while at least reasonable on the surface, were made without any evidence in support of them and turned out to be, if not false, then misleading.
So people now tend to change the goalposts - okay it didn't stop the spread or stop people from getting it at all, but helped spread out the spread - flatten the curve, and reduce the impact on hospitals. But again that also seems completely false. Here [1] are the data on cases in the US. By August 2021 the wide majority of Americans had taken one of the shots. The biggest surge, by an overwhelmingly large margin, would come on January 2022 where we went from a former peak of ~250k to a new peak of more than 900k daily cases.
So now the goal posts get shifted yet again. Okay it didn't stop the spread and it didn't flatten the curve, but it reduced the rate of severe cases. This one is a bit trickier. It's superficially true, yet subject to extreme biasing. If you look at the overall outcomes of people admitted to hospital by vaccination status, unvaccinated individuals did often have worse outcomes. But there's a rather huge bias - people inclined to vaccinate for COVID are also the type more predisposed to seek healthcare earlier, whereas those disinclined to vaccinate tend to be less inclined to seek healthcare unless it's critical. This bias (one amongst many) was repeatedly listed in the limits of various studies, but people just ignored this (and them) even though it's a major factor. There was never any study (to my knowledge at least) that tried to compensate for these biases.
I am not sure how you come to the conclusion. My link goes to paper that is a bit old, I did not do a new literature search, so I am not sure how the risk calculation may have changed since then. But at that point (2021) the benefit of vaccine was very clear also for 12-17 year old males. You seem to massively overestimate the risks of mild myocarditis compared to the risks of a covid infection in unvaccinated people.
The study only considered people who end up being diagnosed with myocarditis after seeking medical treatment at a hospital following vaccination with 7 days, and it "predominantly" resulted in subsequent hospitalization for multiple days; on top of this myocarditis can cause longterm irreparable damage. The paper classified that as mild, and perhaps that is the clinically correct term, but it's certainly not the colloquially correct one. In any case rates of all myocarditis and various cardiovascular issues are obviously going to much higher than 1 in 15,000.
As for the risk:benefit analysis, the paper created a typical false dichotomy. It compared getting the shot vs an aggregate case of getting COVID. The reality is that if you got the shot you still ended up getting COVID, often multiple times. And the aggregate comparisons were disingenuous because COVID had dramatically different typical outcomes dependent upon health status at the time of infection. Those with significant preexisting conditions made up the overwhelming majority of negative outcomes.
But even with this false dichotomy they found that they'd only prevent 1 death from COVID per million cases, which I assume was rather liberally rounded up. So that is known as 1 micromort. [1] That's a fun page because it gives some context to mortality risk. 1 micromort is a bit less than everybody experiences every day in the US of dying from a non-natural cause, excluding suicide.
This is not a study but a review article, so it seems you are bit confused. The point is very simply and confirmed by many studies: The increased risk from COVID when unvaccinated is much higher than the risk from myocarditis caused by the vaccine in rare cases. And no, I do not see how the paper made the mistake you claim. It compared the increased risk for getting myocardities after the shot to the reduced risk from COVID (and these risks also include myocarditis caused by COVID which is also know to be more severe).
The benefits cited in the paper (and most others) were based on the ultimately false claims from vaccine manufacturers. You can see the CDC slides they based their numbers on here. [1] The CDC removed it from their website, for reasons, which is why I'm linking to an archive.
The CDC is opaque about exactly what numbers they ended up using, but their slides included claims of vaccines being ~95% effective at preventing infection and ~100% effective against hospitalization/death. Obviously those claims were false, and so it completely ruins the risk:benefit analysis, because the benefits were grossly overstated.
Amusingly, you can actually see an immediate error in the study you linked to. Their figure 2 was simply ripped directly from the CDC slides, but they failed to copy/paste the data for 12-17 year old males correctly. You can see it's identical to females. You'd think that have triggered some 'ermmm?' in reviewers, to say nothing of the researchers. Alas, such is the state of science now a days.
[1] - https://web.archive.org/web/20220730093118/https://www.cdc.g... (slide/page 32)
Please specify which numbers you exactly you are referring to. Slides are also irrelevant, all these studies are published. You also need to understand that there are many independent studies confirming this (many I looked at as well as colleagues I know and trust). One also need to understand the effectiveness changes over time, so numbers which are correct in some initial setting may not apply in another setting. This does not imply that somebody "lied". You seem a little bit of a conspiracy theorist interpreting everything which seems suspicious to you as proof for that you are being lied to? Like climate change deniers you assume that all researchers of the world somehow conspired to hide the big lie?
Edit: So one of the original studies cited in slides which you seem to claim was a "lie" is this one: https://www.nejm.org/doi/full/10.1056/NEJMoa2034577 This was a large collaboration of scientists (made doctors that that swore the hippocratic oath). You think the misreported the results of this study?
In order to calculate the benefits of a vaccine, you need to know the efficacy of a vaccine. The study's efficacy figures were using the CDC's data to try to assess this. The CDC, in turn, was basing their estimates on false claims from big pharma. The study then misrepresented the CDC's data (at least in the study's figure 2) through incompetence.
You are right that there seems to be a copy mistake in Figure 2. But the mistake is the wrong direction, i.e. the risk from COVID actually is even higher as shown on the figure. But again, the main problem is that you pick such an inconsistency and mistake (which you will always find somewhere), and take it as "proof" that your conspiracy theory is right, completely missing the big picture that basically all scientists and doctors working in these field would need to be part of it over many years - still faking studies. Pretty unlikely.
My pointing out the mistake is to emphasize the frequently low quality of these studies and their reviewers. Think about the fact that nobody caught a glaring (and self-revealing) mistake on one of the highlight figures. A random anon should not be finding mistakes in peer-reviewed studies in a 5 minute skim for some completely pointless argument on the internet. Yet here we are...
And I think you're increasingly turning to ad hominem and strawman because of cognitive dissonance. You want to believe their claims were true - 95% efficacy, near 100% against hospitalization and effectively 100% against death, yet you obviously know they were not. Basically everybody ended up getting COVID, usually multiple times, and hundreds of thousands of fully vaccinated individuals died of COVID in the US alone.
Why exactly they were ultimately wrong is largely inconsequential. All that matters is that they were.
You say this as if you discovered some major flaw. And is, of course, expected that also some vaccinated people die from COVID. The point is that the risk of dying substantially decreased with vaccination. Something one can only find out by doing a scientific study. And that this risk decreases was confirmed many times in many studies by many independent scientists. For example, here is a recent meta-review summarizing results from 33 studies: https://publications.ersnet.org/content/errev/34/175/240222....
Of course, I am very sure you will also find some flaw or inconsistency in this or in all of the 33 studies that you take as proof as why this is all "ultimately" wrong. But at some point you need to ask yourself: Are basically all scientists that look into this professionally incompetent or correct? Or maybe, just maybe, it is me who got worked up a little bit in a conspiracy theory and not every flaw or inconsistency is clear proof that I am right and science is wrong.
I'm not entirely sure what you're trying to argue at this point. What, if anything, and please be specific, do you even disagree with that I've said?
Basically you linked to a paper showing high rates of myocarditis following injection in the US and claimed it had a net benefit because the paper claimed so. It turns out the papers claimed benefits were based on the early exaggerated claims of vaccine efficacy, and now you're linking to something from Europe that indeed shows dramatically lower benefits than the original paper assumed.
The 1 in 1000 figure comes from a study where they did an ECG on 5000 high school students. They found one case of myocarditis and four cases of arrhythmia, all of which improved on their own. You can't compare that 0.1% figure with figures from studies that look at millions of people and see how many were diagnosed with myocarditis, because the act of giving everyone an ECG will lead to diagnosing more cases of myocarditis. The proper comparison is how many cases of myocarditis and arrhythmia would they have found if they did an ECG on 5000 high school students who got COVID-19 without being vaccinated. And the answer to that is they would have found at least a comparable number of cases because viral infection is the most common cause of myocarditis and because our population-level studies show excess cases of myocarditis after COVID-19 infection in unvaccinated people.
If I understand you correctly, your hypothesis is that a COVID-19 vaccination, while it doesn't immediately kill someone, can cause conditions which lead to increased mortality.
With people still being re-infected by COVID, despite the pandemic being "over," could a COVID infection, itself, cause conditions which lead to increased mortality (for people who don't die from acute infection)?
I'm not proposing this as an either/or; I'm just saying that the vaccine wasn't the only change since 2020 :)
Exactly this - vaccinate even a small town and cardiovascular issues will start popping amongst the neighbors, there is very good reason why there has been, and is, a public backlash on the MRNA vaccine usage among those who have eyes to see and ears to hear.
Please do not spread misinformation. Nobody expects "cardiovascular issues" "popping amongst the neighbors" and there is no evidence supporting this.
> The claim that it is not possible to "question the new mRNA platform publicly without knee-jerk backlash and demonization" is just not accurate
I’m not a Covid truther, anti-vaxxer, or anything of the sort, but let’s be honest here. Mainstream urban society will absolutely attack anyone who doesn’t adhere to the consensus view on covid (among many other topics). It’s an overreaction stemming from years of dealing with bad-faith trolls. But the net result is an enforcement of a specific political orthodoxy.
> It’s an overreaction stemming from years of dealing with bad-faith trolls.
A billion billion billion times this.
It makes me wonder about the inquisition. There’s a subset of Catholic inquisition apologists who argue it was an overreaction to social breakdown and an explosion of cults, some of which were very harmful. Having seen the rise of mass social media I am no longer able to dismiss this argument as easily. Still don’t quite buy it but there is, as you’d say in criminal law, reasonable doubt.
Every time I question it on social media I get downvoted to oblivion, flagged and/or reported. Ten times out of ten.
That’s because most people who question it are bad faith trolls or crazy ideologues who think you can treat cancer with a juice cleanse.
We have a very flawed class of experts who do know things but sometimes fuck up or are sometimes corrupt.
We have a few good faith critics of said experts.
We have a vast number of cranks and con men and trolls.
Category three vastly outnumbers and out-volumes category two, to the point that to most people it looks like there’s only two categories.
A ton of other topics are like this: climate change, anything anywhere near gender or sexuality, etc. The more politically charged something is the more the middle is excluded and the more people circle the wagons against bad faith actors.
This is particularly funny because:
a) the risk is not acceptable and several countries switched young males to Biontech from Moderna
b) every time I pointed this out on HN I got downvoted or some vaccinesplainer downplayed it.
But yes, if the “trust the science” stuff one used to suppress criticism would turn out to be wrong, then rewriting history to edit out the massive censorship of perfectly logical ideas starts making sense.
Covid was the West’s critical moment when it decided that propaganda and top-down messaging are more important than critical thinking and democracy. The poisonous fruit of this approach can be seem in the authoritarian handling of other controversial topics like migration, gender, the Ukraine war, etc.
Based on your comment history it's clear why you were downvoted. Your views on many subjects are very clear now.
I just had my second child and I refused to give him the Hep-B shot on the first day of his life. The acting pediatrician (not his) asked if I was going to do it "in-office" the following week and I said no. She became visually bothered by this and I told her that I didn't think I could consent for him since I didn't understand the reason for him to get the shot. She said it is without risk and a public health issue.
Last week we went for his first office visit and my son's actual pediatrician explained that public health means that it's good for the population if they get everyone to get it but individually it has no value to him until he's much older and sexually active or sharing needles. Bonkers...
The fact that people are aware of the Norris's claims, but not aware that they dropped their suit without a settlement, is itself the subject of research about how celebrity publicity poisons the popular discourse regarding health care and science.
Is it, really, when the claims look to be true?
As somebody not aware of the claims or that they were dropped, what it makes me think is that no matter how wealthy and famous you are, or how legitimate your claim, you're doomed when going against powerful interests in the US medical industry.
Even worse, people will comment under the study that says that you were probably right, under the comment of the child of the only doctor at the FDA to vote no on the treatment you were suing over, about how people listen too much to what celebrities say.
Wow, for once Chuck didn't win
I mean there have been no reported cases of NSF in the last ten years after certain gadolinium agents were removed from the market.
Brag-worthy!
Every time I've gotten an MRI the doctors and techs have sworn up and down it's impossible for this stuff to stick around. Getting tired of not being able to believe what doctors say...
That's surprising, it's at least casually known that they're bio accumulative to some extent. I've joked to the techs before about gadolinium eventually accumulating enough to not be necessary if you do it with enough frequency. Realistically though any situation that you're doing the contrast you're probably at a lot more risk of whatever they've found than from the contrast agent.
I had to have contrast to diagnose a simple cyst, which is entirely asymptomatic and was discovered by accident in the background of a cardiac MRI (family history of SCD, but my own heart is fine).
You're making me feel lucky about what was otherwise a very unpleasant experience!
Yes.
A chemist gave a great talk about this at a big MRI conference (ISMRM) in Paris 10ish years ago. His explanation was that gad behaves a lot like iron does in the body. It deposits where iron does and like iron it lacks a metabolic route for removal (though menstruating females lose iron).
He stated that deposition was entirely predictable. However the harm caused is still debated.
The article here says ‘ Dr Wagner theorized that nanoparticle formation could trigger a disproportionate immune response, with affected cells sending distress signals that intensify the body’s reaction.’
Emphasis on ‘theorised’.
Deposition is discussed in the below link, and the comparison with iron is briefly mentioned.
Nah, they used it on me when I cracked a toe. If I knew that this may be that dangerous I’d go the way without the contrast agent.
Based on what I've read I'm quite sure a cracked toe is way more dangerous than a contrast agent.
Maybe, but I was taking an immense amount of vitamin C as prescribed by the doc to bootstrap the healing process.
So this reveals to me two issues
1. In general side effects of the contrast agent are not communicated properly. If I knew, I might have asked - hey can you do the analysis without the agent?
2. There’s no recommendation to avoid vitamin C prior and right after the MRI, heightening the risk.
Maybe donate some plasma afterward. There was a study about firefighters exposed to microplastics that had a statistical reduction after regular donations.
Pretty much just diluting it out of your system.
Materials like these accumulate in other parts of your body, like bones. Letting some blood out is not gonna change it.
The other day I had to get a CT scan, I was kind of annoyed I wasn't offered and MRI, and here we are.
I hold a different opinion to you though, I'm glad doctors are always learning more while generally operating with good /extremely good intentions.
> I was kind of annoyed I wasn't offered and MRI, and here we are.
This paper isn’t saying that MRI contrast agent is high risk in general.
There’s a risk in misinterpreting these niche papers to overstate their relative risk. This is a common mistake when people start reading medical papers and begin overweighting the things they’ve read about as the most significant risks.
Really wish more people had that mind set. Practicing medicine isn't easy, especially in the US when you have to battle the insane insurance industry.
CT is cheaper than MRI, and it's harder to get insurance to pay for the latter. There are some legitimate diagnostic reasons to prefer CT imagery, but I think cost may be a more common deciding factor.
The most common factor is that they see different things. There may be some overlap but you want one or the other depending
But yes cts are cheaper.
> I hold a different opinion to you though, I'm glad doctors are always learning more while generally operating with good /extremely good intentions.
I agree. Expecting perfection from humans, even experts, is not reasonable and is frankly counterproductive.
Willful ignorance is one thing, but people who genuinely attempt to do the right thing at worst just need to be steered slightly differently.
expecting humbleness and willingness to be wrong from medical personnel is reasonably though
> I agree. Expecting perfection from humans, even experts, is not reasonable and is frankly counterproductive.
There's a big difference between perfection and "Statistical Literacy Among Doctors Now Lower Than Chance"[1]. I don't think their intentions are bad, but they are woefully incompetent at many basic things.
[1] https://slatestarcodex.com/2013/12/17/statistical-literacy-a...
> There's a big difference between perfection and "Statistical Literacy Among Doctors Now Lower Than Chance"[1]. I don't think their intentions are bad, but they are woefully incompetent at many basic things.
As it happens, the daily practice of medicine does not require interpretation of p-values. Indeed, medicine existed before the p-value.
The people who create studies that ultimately guide policy decisions are specialized (much like people who write GPU drivers are different from those who run inference)
> As it happens, the daily practice of medicine does not require interpretation of p-values. Indeed, medicine existed before the p-value.
What are you talking about? Doctors refer people based on test results every single day. From what I've seen, hardly any of them understand the precision/recall of the tests that they then use to refer you (or not) to screening procedures (which are not all harmless).
> What are you talking about?
What are you talking about? How is a single lab value going to generate a p-value? Why are you presuming that your family med doc should be calculating an ROC for each of her 1,500 patients?
The selection of lab critical values is performed by experts in clinical pathology. Exactly the people who were not included in the paper you cited.
You can find links to support any argument you want on the internet.
To place this in clearer HN terms, you're saying that a front end dev is trash because he didn't write his own web browser in assembly.
To be fair, being knowledgeable about the pre-test probability of a patient having a certain disease vs the sensitivity/specificity of a test IS part of the ideal practice of medicine, although how important it is in practice varies somewhat between specialities. In rheumatology for instance, it is front and center to how you make diagnoses. I was in primary care for a short while myself, and on more than one occasion regretted deeply ordering certain rheumatological screening panels (which you get without asking for it when looking for certain antibodies).
Explaining to a parent the fact that their child did in fact not have a rare, deadly and incurable multi-system disorder even though an antibody which is 98% specific for it showed up on the antibody assay, that we took for an entirely different reason, is the kind of thing thats hard to explain without understanding it yourself.
Bayesian thinking isn’t about p-values and doesn’t need to be presented that way.
If you use the centor criteria before resting for strep, is that worse than getting out a piece of paper and researching background population prevalence?
The OP is being dogmatic about doctors needing to know things he does which is obviously silly.
Edit - but yes, I agree that we should think about sensitivity and specificity, I just don’t think you need to be a statistician, just to have a helpful script and resources for patients who wish to know more.
Except that a disturbing number of doctors insist that they are always right and you are always wrong.
A year ago, one insisted vehemently—to the point of yelling—that I shouldn't be supplementing Vitamin K because my potassium levels were fine.
OMG! This doctor shouldn't be practicing medicine if he thinks Vitamin K is potassium.
OTOH Vitamin K can cause blood clots.* I assume you know this and are being appropriately attentive to the issue.
* The K comes from Koagulationsvitamin which it was called in Danish when first discovered.
vit k does not cause blood clots
As opposed to what group of humans?
I can only presume that they got the atomic symbol for potassium (K) mixed up with vitamin K. That’s so wrong it crosses over into being “not even wrong” but entirely wrong and beside the point. I hope they aren’t your doctor anymore, or anyone’s. Please tell me you reported this incident to the state medical board.
https://en.wikipedia.org/wiki/Not_even_wrong
> "What you said was so confused that one could not tell whether it was nonsense or not."
The data until recently suggested that, so thats the risk you take. Would you rather be living in ancient greece and shoved full of hemlock leaves for arthritis? Or have a 19th century surgeon remove your appendix?
There's risk in life and odds-wise if you're in the developed West, you're going to get care and medicine that will greatly prolong your life.
Also this paper is super vague. What percent of people even get this? How long does it last? They havent even done a study to see how long it lasts yet. I have a feeling this isnt going to be our generation's asbestos or thalidomide.
That being said, you should decide your own risk profile. If MRI gives you concerns there are alternatives that dont involve contrast.
No one is asking to go back to Ancient Greece.
But given our track record, a little humility would go along way.
When a highly educated doctor tells you that something is safe, a person is going to assume that means that someone somewhere has proven that the substance is safe. If what they really mean is that no one really knows, but so far, no experiments have been able to prove danger, then we should say that instead.
> When a highly educated doctor tells you that something is safe, a person is going to assume that means that someone somewhere has proven that the substance is safe.
Contrast agent has been widely studied and determined to be reasonably safe. You’re not going to be administered any routine procedures or compounds that are known to be dangerous without an examination of the risks and benefits.
> If what they really mean is that no one really knows, but so far, no experiments have been able to prove danger, then we should say that instead.
“No experiments have been able to prove danger” is too generic to be usefully different than saying that it’s understood to be reasonably safe.
Even this paper isn’t saying that contrast agent is bad or dangerous in general. It’s exploring a potential effect that we can now detect and study.
Exactly...it's also not reasonable to be asked to prove a negative. "Prove it's safe" (equivalent to "prove there isn't any danger") is "prove there isn't a teapot orbiting Venus" territory.
Every procedure has some negligible risk, and doctors are trained to mitigate major risks to peoples' health with screenings, medications and surgeries that are of lesser risk than the alternative of inaction. "Safe" is a reasonable explanation for the vast majority of laymen they have to communicate with.
My point is not that you must prove it safe. My point is that it is dangerous to communicate to people that something is safe, and simply assume that they understand that negatives can’t be proven, and you don’t literally mean that someone has proven it to be safe.
This is pretty much how we get into the territory of "this product may contain peanuts" even if it has never even been near peanuts, but that warning is need because if in the offcase it has touched peanuts the company can't be sued. But this makes pretty much every other warning worthless.
We shouldn't have to clarify that everything is only 99.999% safe and assume that everything carries some form of risk even if small.
By that standards everything we do is unsafe. Every single activity we do carry some neglible risk. Explaining all of these would be lot more trouble than value in general.
By that definition there is literally no substance in existence that has been proven safe. Because the definition of safe is that no experiments have been able to demonstrate danger.
You can’t prove a negative.
You know that you can’t prove a negative. I know that you can’t prove a negative. Probably most people on HN know that you can’t prove a negative.
But when a person who doesn’t spend their time nerding out on science goes to the doctor and hears, “the substance is safe”, it is not a guarantee that they know that you can’t prove a negative. If you can’t be sure that your audience knows that it’s not possible to prove a negative, then you should be pretty cautious with your words.
Safe, in the context of living on Earth, means an acceptably low risk of a bad outcome.
Tylenol is safe. Tylenol can also permanently damage your kidneys.
Walking is safe. Walking can also permanently damage your cartilage.
Food is safe. Thousands of people die from choking.
We all know this, colloquially. When it comes to medicine, it is as if one's brain hops and skips right out of their ear. It's not magic, it works like everything else on Earth works.
I think there is a non-insignificant number of people who would understand the word safe as no risk, who if something bad happened to them after submitting themselves to such a safe procedure, would find themselves deceived. Technically, I think they would be correct. Therefore, it should be explained that there is a risk but that it is on some order that they can relate to, like the risk of walking down the street.
A doctor will 100% explain that a procedure has a risk. They will say something like this procedure is “generally safe” but there is a very small risk of complications. Then they will make them sign a consent form spelling out those risks.
> I think there is a non-insignificant number of people who would understand the word safe as no risk, who if something bad happened to them after submitting themselves to such a safe procedure, would find themselves deceived.
These people are then dishonest, because they know, deep down in their heart of hearts, this is absolutely not what safe means.
Again, everyone agrees eating an apple is safe. It's even good for you! But they also know every time they take a bite, there is a risk that they can choke and die. They know that. I know that. You know that. Everybody knows that.
Colloquially, even to the most naive, we know that zero risk does not exist, and that "safe" merely means "an acceptably small amount of risk". If we are changing our definitions based on the context, for example, everything on Earth and then medicine, that is dishonesty. If we are dishonest to ourselves, then we are delusional.
>no experiments have been able to prove danger
Which is strong evidence that the danger is very small, very rare, or takes a very long time to develop.
You don't need a large clinical trial to prove that being shot in the head is harmful; you do need a very large trial to detect that, say, a drug increases the risk of cardiovascular disease by 4% in a specific sub-population.
Yes, exactly, but that is the definition that people who are not doctors are going to use when doctors tell them that something is safe. So we shouldn’t do that.
Nobody has proven that not taking an action is safe.
There is nothing mathematically 100% safe, the human meaning of the word inherently involves some kind of uncertainty.
Going for a test itself via car has a quite significant risk itself, should the doctor say that you shouldn't move out of this room, it's not safe?
Like even regularly used medicine has some slight chance of an adverse reaction, that's how minuscule side effects multiplied to human population times the number it's taken results in.
Guess what often has many orders of magnitude greater risk? Continuing having the disease you went to the doctor with in the first place, or having it lie undiscovered.
Which country do you live in?
Here in Germany you have to sign something if they give you "stuff" informing you of possible risks. Something that always exists.
Yup. You can get MRI here for "free", AND you can refuse contrast material, and indeed it requires your signature.
Literally every single medical procedure, down to the most mundane, has risks.
That's why we don't give MRI's out the wazoo. We actually gatekeep them a lot, and most research will tell you that investigative MRIs without chief complaints are a bad idea and we don't do them.
I had cancer. I had no MRIs, but multiple CT and PET scans. CT scans and PET scans have risk - they don't just do those for kicks. But you know what else has risks? Cancer. So there's a calculus here.
Every single medical procedure, down to getting your blood drawn, has this calculus. Nothing is risk free.
> That's why we don't give MRI's out the wazoo
Why? What are the risks of MRIs without contrast?
The biggest risk is false findings for a lot of diagnostic procedures. A false finding may cause enormous psychological stress, but more importantly it usually causes further, more invasive testing, which may pose much higher risks than the original procedure did. It's real statistical risk, which individual patients emotionally often can't relate to. Eg. an MRI shows clear signs of a tumor, you consequently get an endoscopic biopsy through your stomach, or colon, and then happen to die from anesthesia, intestinal perforation, sepsis... The "tumor" turned out to be a cryptic but harmless extra intestinal loop. Sounds made up, but this sort of thing happens enough to make unnecessary diagnostic procedures more harmful than beneficial.
However, I do think the reason MRI aren't used more often is because they are fucking expensive to operate. They need to run more or less 24/7 to be economical, which means they are commonly not scheduled with slack for "optional" investigations.
Or biopsy goes fine, turns benign but something malignant grows from the scar tissue from the biopsy
Not sure, if that's a reasonable possibility, but it's kind of irrelevant, since I would still consider a detected benign tumor a true positive for an MRI scan.
MRIs involve very powerful magnets and inattention around them has led to several widely-publicized deaths.
They’re also loud and can give patients a sense of claustrophobia or panic.
Incorrect, there is risk associated with performing MRIs without chief complaints.
These types of MRIs often cause anxiety and can lead to riskier medical procedures that are not necessary. This is because imaging is actually not perfect. There is always a risk you see something there that is not a big deal, or that you misinterpret the image. That potentially means unnecessary surgery or medicine. That can kill you.
That's why if you go to any doctor in the US and say "I want an MRI, no, nothing is currently wrong with me" they won't do it.
I do not buy this argument. The error would be in misinterpreting the image and taking the unnecessary treatment, not in doing the test in the first place. How is there any benefit in having less information?
It's not an argument, it's just true.
In medicine, there is obviously a benefit in having less data. If I told you that you have a vein in your brain that could aneurysm at any point and instantly kill you, but no, we can't do anything about that - would that help you?
No, that would exclusively make your life worse, at least for the vast majority of people. It's also true for a lot of people. It could be true for you, right now.
Also, just because the error is in interpreting DOES NOT mean that the MRI is somehow magically off the hook. The risk came from the MRI. If you never did the MRI, then it would be impossible for that scenario to happen. That's just plainly true.
So therefore, if you do the MRI, there is a risk of that happening. Taking that risk without any complaints is deemed not worth it, so we don't do it.
> I do not buy this argument. The error would be in misinterpreting the image and taking the unnecessary treatment, not in doing the test in the first place. How is there any benefit in having less information?
There is no 'perfect information' but instead there is noise with every signal. It feels like that shouldn't be true ('the picture shows exactly what is happening, right?') but there are several levels at which the 'truth' that is assessed in an MRI can be degraded that have nothing to do with misinterpretation.
Even 'misinterpretation' is tricky - if something is only sometimes going to cause a clinically bad outcome, commenting or not commenting isn't a question of interpretation but of personal practice standards.
It’s definitely an imperfect signal, but we are capable of making decisions under conditions of noise and uncertainty. In other fields we would quantify the uncertainty, the consequences of making the error in either direction, and then act accordingly.
As a thought experiment, if MRI was as cheap and fast as testing blood pressure, do you think they’d still be given as rarely?
I think if we had a perfect tool where you can get MRI (and CT) data in the time it takes to get a blood pressure reading, it would only be used to detect slam-dunk diagnoses for further screening which is how we use blood pressure.
You’re assuming that we would skip this step, implicitly.
Now when would we do further screening? In a Bayesian framework, when we have a certain pre-test probability that we think we can improve to our desired level of post-test probability in order to take an action.
The fact that this is all automated doesn’t change our uncertainty about whether borderline calls should be targeted. Indeed, we’ll likely have more stringent criteria about things to ignore than are used today, and that may be worse for the small number of times we currently catch an actionable incidental finding.
And we’re not even beginning to consider cost, resource misuse, and the risks we’re incurring (an MRI machine isn’t safe to be around and costs a lot to maintain)
Edit: the things that kill people are smoking, heart disease, lack of exercise and poor diet. Targeting these is so much more useful than detecting a larger number of incidental findings
With a couple of exceptions, MRI screening of ‘worried well’ populations causes more harm than good.
https://www.linkedin.com/posts/gunnmartin_ranzcr-activity-72...
Around 10 years ago, I had an brain MRI with contrast. I specifically googled it and found a paper saying it builds up in the brain. I asked the MRI specialist about it, she was surprised I knew this and said she was familiar with the research. She mentioned that her professor also knew about it, but that the paper had other motivations, some conflict of interest, and that I shouldn't be worried. FFS.
Why did you have a brain MRI with contrast?
Contrast isn't always necessary. Am not a doctor, but I have MS and get them regularly.
I've only had a couple with contrast. My understanding is that contrast highlights abnormal stuff and some tissue sorts more than without contrast. Specifically, they use it in MS to get a better look at an active lesion in the brain. You can still see the lesion without the contrast, though, so most of the MRIs are taken without contrast and then another with contrast if necessary. They have known about various side effects of contrast for some years (allergies, etc).
I’m also not a doctor but am an MR tech and the above explanation is good.
With MS, active lesions enhance and old, inactive ones don’t.
There are a lot uses for contrast in brain imaging and it is very helpful.
Gadolinium deposition obviously isn’t great.
Is this a study in rats? Is there any data beyond 48 hours?
The concentrations outside of the injection site are vanishingly small. And I would consider 48 hours to be pretty quick. If it was still around after a week I would be concerned. Not really sure what I'm supposed to take away from this.
I pulled a bad source, my fault. Thought more people were familiar with this. Here are three published human sources.
mRNA vaccination stimulates robust GCs containing vaccine mRNA and spike antigen up to 8 weeks postvaccination in some cases. https://www.cell.com/cell/fulltext/S0092-8674(22)00076-9?rss...
The vaccine mRNA was detectable and quantifiable up to 14–15 days postvaccination in 37% of subjects. The decay kinetics of the intact mRNA and ionizable lipid were identical, suggesting the intact lipid nanoparticle recirculates in blood. https://pubs.acs.org/doi/10.1021/acsnano.4c11652
A significant number of those who died within 30 days post-vaccination had detectable vaccine in their lymph nodes. All patients with detectable vaccine in their heart also had healing myocardial injury, which started before or at the time of their last vaccine dose. https://www.nature.com/articles/s41541-023-00742-7
Who said? You are posting a link that also makes an unverified claim. I personally never heard this claim about mRNA vaccines.
I posted a terrible source, my fault, moving too quickly. Here are three published human sources. Now you have heard the claim and seen some evidence.
mRNA vaccination stimulates robust GCs containing vaccine mRNA and spike antigen up to 8 weeks postvaccination in some cases. https://www.cell.com/cell/fulltext/S0092-8674(22)00076-9?rss...
The vaccine mRNA was detectable and quantifiable up to 14–15 days postvaccination in 37% of subjects. The decay kinetics of the intact mRNA and ionizable lipid were identical, suggesting the intact lipid nanoparticle recirculates in blood. https://pubs.acs.org/doi/10.1021/acsnano.4c11652
A significant number of those who died within 30 days post-vaccination had detectable vaccine in their lymph nodes. All patients with detectable vaccine in their heart also had healing myocardial injury, which started before or at the time of their last vaccine dose. https://www.nature.com/articles/s41541-023-00742-7
The first study also shows there was basically no detectable vaccine mRNA outside of lymphatic germinal centers, which contradicts your following claims. Almost as if you can't cherry-pick study statements to make some argument.
The “following” are not my claims but quotes from the studies, which are independent of each other and free to make their own claims. My claim (if I made one) is that we were misled about how much we know whether the jab stays at the injection site and degrades quickly. I have not contradicted myself.
Or people genuinely believed to have a solid understanding of something, but later evidence changed that? I mean, most people are "misled" on every topic, if that boils down to being underinformed. School also misled you about biology, physics and chemistry. How do you feel about that?
But sure, it may be evidence of some grand conspiracy to genetically turn white people gay, or something.
This is a poor explanation of an older publication, when the actual new work has a good description:
https://www.frontiersin.org/journals/toxicology/articles/10....
Thanks - I've put that link in the toptext above. I'm not sure it makes sense to swap out the submitted URL with it. Hopefully people will take a look at both.