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Antibiotics and Contrast for MRI

Posted 27 Dec 2020 at 22:09

I do not wish to cause undue anxiety but copy here what has been raised on a largely USA orientated PCa support forum which I sometimes dip into.   I declare a personal interest in respect of 'Contrast' used for MRI.  I have had at least 12 MRI scans and an unknown number of these have been with 'Contrast' which I believe was with Gadolium, although I am not sure which type.  I am due to have another with 'Contrast' in February (although I may reschedule this if I don't receive the Covid vaccine in good time meanwhile).  Naturally, I am concerned about the build up.

Anybody know what type of 'Contrast' is used in the UK and the antibiotic first given with biopsy?

The Consequences of Multiple MRI's & PCa Biopsies: Advocate for Ourselves - Prostate cancer Charlesfour's avatar Charlesfour November 15, 2020 at 9:14 pm 7 replies This is kind of a heads-up to all of us, as well as a "Did any of this happen to you?" 1. Prostate cancer biopsies: choose the least damaging prophylactic antibiotic If you've had a PCa biopsy, TRUS or otherwise, it's likely your doc prescribed an antibiotic to be taken either before, the day of, and/or the day after the biopsy. In many cases, the antibiotic was Levaquin or Cipro, the class of antibiotics known as fluoroquinolones. The American Urological Association recommends that IF Levaquin is used, the smallest possible dose of 500 mg on the day of the biopsy should be used. This recommendation, which is largely not followed by urologists, comes after years of FDA warnings and class action suits against the makers of this drug, because its side effects can be life-altering. Don't take my word for it - look it up and see. (But note that there are others here who have been affected; one woman wrote that her husband had a temporary psychotic break after taking Cipro; I have written that my peripheral neuropathy started after ingesting Levaquin). In context, Levaquin and Cipro are drugs used against the plague. They are recommended for only the worst urinary tract infections or other infections. They have been likened to using a hand grenade to kill a flea. SO if you're scheduled for a biopsy, advocate for yourself and ask for a different class of antibiotic. They are out there and exist. 2. MRI's "with and without contrast": ask your doctor to reduce the amount of contrasting agent I've had six or maybe seven MRIs in the past two and a half years; I had two MRIs within two months of each other, after the initial TRUS biopsy. When the order reads - and it always does - "with and without contrast," it means that the first 40 minutes of the MRI will be done without a contrasting agent injected into your body; but during the last 10 - 15 minutes of the MRI, you are injected with a gadolinium-based contrasting agent that is meant to highlight prostate tissue (or any tissue being MRI-ed, i.e. brain cancer, lung cancer, etc) and help distinguish between scar tissue and cancerous tissue. Diagnostically it seems to be very important. However, gadolinium is a heavy metal and is not easily excreted from the body. It can take up residence in your brain, in your nerves. (Google "Chuck Norris and gadolinium" and see what can happen). It has been recently linked to various symptoms that, like Levaquin, can be devastating; irreversible neuropathy is one of them. Radiologists know this. (Again, see Chuck Norris). I have told members of a gadolinium toxicity group about my experience, and some were aghast. BUT when I spoke to my interventional radiologist about all this, he understood my hesitancy to have more gadolinium in my body, and was willing to NOT do the contrast, but said that reading the images would be harder. He offered to reduce the amount used in the study with me by 25% (the amount you receive is based on your weight). The point here is: many of us have follow-up MRI's. Reduce the number of MRIs you have to the very minimum, and get your doctor to prescribe the minimum amount used. And how about you? Anyone else out there been affected, as far as you know, by the toxic agents I mention above? One or both of them is responsible for the polyneuropathy that has devastated me even more than prostate cancer, and I don't hear much mention of it here, so I thought it might be one of those things that's going on, that we think might be "just me," but that could be common enough to bring up for all. support (4) thanks (7) useful (8) Reply Advertisement Related Posts MRI-Guided Ultrasound Treatment Destroys Prostate Cancer (UCLA Raman)@RSNA MRI or biopsy MRI-Guided Biopsy and Fusion Biopsy AKM Shamsuddin's Cancer Research Pays Off MRI or Biopsy 3 Tesla MRI with contrast reveled nothing. Biopsy is probably coming MRI or Needle MRI results MRI provides better information than PSA level and Gleason score Finding a doc who will order an MRI, and is the endorectal coil necessary. Buyer's Remorse Post-Surgery PSA Test Is Misused, Unreliable, Says the Antigen's Discoverer New member needs your advice: Biopsy or MRI? CBD's Some general questions after a recent Dr's appointment about my prostate 7 Replies Ozzieville's avatar Ozzieville November 16, 2020 at 3:28 pm Thanks for the heads up, Charlesfour! I had a follow-up biopsy involving just two needles in July, and my doctor put me on a regimen of Levaquin before and after. My first hint that something might be amiss was when I picked up the antibiotic prescription at the pharmacy, and the pharmacist sort of winced and said Levaquin was the "nuclear option." Later I read about people having their Achilles tendon snap, etc. weeks and months after using Levaquin. When I had a knee issue and visited an orthopedic surgeon, I mentioned having recently been on Levaquin. Another wince. The surgeon ventured that my doctor was "poorly informed" if he was prescribing Levaquin. I can't say I was damaged by Levaquin (yet), but I would never have gone near it if I knew then what I know now. So yeah: educate yourself and speak up! support thanks (2) useful (1) Reply Maxzar's avatar Maxzar November 16, 2020 at 4:33 pm Thanks for bringing this to light and yes everyone should be their best advocate. Currently, there is an FDA Drug Safety Communication about gadolinium located at https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-... . According to this communication, there is two types of gadolinium Macrocyclic and Linear, Linear result in more gadolinium retention in the body than macrocyclic. If someone takes the time to read the communication it will provide you more information to discuss with your doctor and perhaps ask for the Macrocyclic instead of the Linear if it’s necessary for that you receive contrast. support thanks (1) useful (1) Reply voiceguy3's avatar voiceguy3 November 16, 2020 at 8:32 pm One thing to consider is that it appears the older patient is more prone to have a negative reaction to the fluoroquinolones, so as a prostate patient, it's especially important to be aware if and when you're prescribed Cipro or Levaquin. The syndrome has a name: floxing, or being floxed. I was damn near paralyzed after only four pills. I took it for a UTI and it worked like gangbusters. After one pill my problem started improving, but I started getting twinges in the tendon behind one knee. The tendon difficulties progressed to the point where walking became a big challenge. There was much pain and limping. Long story short, after a month or so of gradual exercise and Magnesium supplements I felt better. Many aren't that lucky. support thanks useful Reply metabolism's avatar metabolism November 19, 2020 at 3:14 pm I doubt that a SINGLE dose of an FQ at the time of biopsy is likely to cause ligamentous problems, though these have been documented with repeated dosing. Just make sure you have a rectal culture to rule out the presence of FQ-resistant bacteria in your colon. support thanks useful Reply proteusx's avatar proteusx November 20, 2020 at 5:26 pm Check out diffusion weighted MRI. It is superior to MRI with contrast material in terms of sensitivity, etc. support thanks useful Reply mjlon's avatar mjlon December 22, 2020 at 1:42 pm Yes, I believe l have suffered greatly due to both of these things. In my case antibiotics and the contrast dye ( high iodine ) used in CT scans. I believe it is not talked about much because no doctors will tell you it happens or maybe they don't even know. People have to find it out on their own by researching on the internet. All kind of terrible symtoms pop up and people would never guess in a million years that they could be be caused from just taking their prescribed medical treatments. Because "doctors tell us to do things that will make us better". ....right? There are a huge amount of sites and articles on line about this . Unfortunately most of the time they are just describing how bad the problems can be and do not provide much info on reliable treatments.

Posted 27 Dec 2020 at 22:54

Hi Barry

The antibiotic I had was Ciprofloxacin, yes I have heard bad things about it. I had a trus biopsy thankfully they are going out of fashion. A biopsy were the needle is first smeared with sh*t really is a bad idea and needs a strong antibiotic. Hopefully transperenium biopsy don't need strong antibiotics.

I felt quite nauseous on my MRI after the contrast was injected. Almost to the point of giving the emergency stop signal. 


Posted 27 Dec 2020 at 23:01

The MRI contrast is Gadolinium and the standard biopsy antibiotic is Ciprofloxacin.

Yes, these are both concerns in the US, but probably driven by ambulance chasing lawyers to a slightly higher extent than is really justified.

There are a number of Gadolinium formulations and I heard we didn't use the worse ones. The fear of UK law suits is causing some of those institutions with 3T scanners to move back to bi-parametric scans, and skip the diffusion scans with Gadolinium contrast. This has always been necessary for patients with reduced kidney function in any case (although I doubt they were all done on 3T scanners).

Ciprofloxacin has some rare side effects of concern, but there are rather few antibiotics which work well in the prostate, so it's not like there are many alternatives. Without it, deaths from sepsis after TRUS would have been higher. It is a black label drug in the US. (I did mention recently to someone in this forum taking it for prostatitis not to put large strain on tendons, but that's not the only side effect.)

It does have to be pointed out that these have been in frequent use for a long time, and there are relatively few cases of the bad side effects.

Edited by member 28 Dec 2020 at 14:29  | Reason: Not specified

Posted 28 Dec 2020 at 08:55
Both my knees only really started to deteriorate ( and quickly ) after 2 TRUS and then trans-perennial , and then a drain infection in hospital , all of which required anti biotics. Oddly in 5 1/2 yrs I only ever had one MRI with contrast , but am up to about 8 CT scans with injected contrast , at least 6 bone scans , 2 PETS with radioactive tracers. I’m sure harm must have been done by all these. How can it not be ? And it hasn’t changed my treatment options either !
Posted 28 Dec 2020 at 09:02
I think it's pretty common for the contrast medium to make you feel a bit nauseous. I have 6 monthly CT scans with contrast to monitor my (former) kidney cancer, and the medium injection always makes me feel very nauseous.



Posted 28 Dec 2020 at 09:32

Originally Posted by: Online Community Member
am up to about 8 CT scans with injected contrast , at least 6 bone scans , 2 PETS with radioactive tracers.

None of those are gadolinium - that's just for MRI scans.

As with any any tracer though, it's probably best to drink lots of water to help flush it out afterwards (check with the radiographer).

I did get tennis elbow doing pull-ups just after TRUS, which is only just about gone 2+ years later, but any connection is going to be rather tenuous - I think I over-did the pull-ups.

Posted 28 Dec 2020 at 12:58
Sorry what I copied has come out as a long unbroken paragraph when it was in fact a post with replies. However, it seems it has been understood and I wish to thank you for your comments.

I am well aware that almost all medication can have side effects and its usefulness has to be balanced against potential risk. Naturally, those that have had very severe side effects from any medication or treatment may wish they had not had it or been given something else. But although we are warned about certain medical procedures before hand, surgery and RT for example, we are not generally warned of possible long term side effects of Gadolinium other than being told something like "You may feel a change of temperature in your arm for a short time" or similar. However, nobody has ever warned me of the cumulative risk, if they had I would have noted which of my many MRI scans I had had used it and looked to see if there was an alternative as has been suggested in one of the replies in the thread I have copied.

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