To: hypo/hyper re: Contrast Dye (CT scan)

[borninquisitive]

I have a question for you. It seems I recall having read that you had a reaction to contrast dye (CT scan) and if so, if you would share your experience? I mentioned this to my doctor recently and he said that he has never heard of anyone who had a reaction to it.
The reason I asked him, was that last year I had a CT scan. I think I was already feeling abit nervous (feeling bad and not knowing why)but what would come after the scan...oh boy!! I would say that for a near month, I suffered from a chronic 24x7 panic attack. I thought I was losing my mind! My then Doctor prescribed Paxil but I declined because I absolutely knew this was not at all characteristic of me. Anyway, it finally abated. I wouldn't wish this on my worst enemy.

My history: slightly elevated TgAb. Later this month, I will be getting a more comprehensive thyroid testing done. Prior, only TSH was run (lower 1. and up to 2.1).

I will be going on vacation tomorrow and do not know if I will have a chance to respond shortly but will when I am able, that is...if you see this and respond.

Best,
~Kate

[LuvAnimals]

I had this happen to me after a ct scan & a PET scan. Maybe not quite severe, but heart palps & buzzy inside all the time. It gave me hyperthyroid & now I’m on meds. Hopefully, the iodine levels will come down & I will come off the meds. I thought it was just me being nervous about the tests too. I read that people that are normal or hypo can be thrown into hyperthyroid when presented with so much iodine all at once. Didn’t know, but at least I know now.

[julielou]

Thanks.  I have been on my thyroid medicine since Monday .1mg but cutting it in half.  The shortness of breath gone since last Sunday, but now palpitations several times a day which I haven't had since I was hyper a year ago, then getting on synthroid since I went to the other end and being hypo they were gone.  I have a resting hr of 95.  Do you think I'm hyper again?  I've only been on the synthroid for 4 days, well 6 days if I count Sat. when I took a whole .1mg.  I thought it would take several weeks to see what it does on my thyroid levels?  If I did have my thyroid checked is it just going to show my thyroid levels for me since I have only been on the medication for 6 days?  At first my Endo when I saw her last Thursday she was going to have me start my synthroid slowly, didn't say how she was going to have me follow, because she changed her mind about me just going back to my original dose.

[Smilerdeb]

The shortness of breath is usaully a symptom of Hypo or Hyper.
get it checked anyway.
If you read other posts, you will find a lot suffer from it.
All the best
Debs

[julielou]

Thank you for the response, I am sitting here thinking what is the day going to be like.  Yesterday, I didn't have shortness of breath, but have a doctor appt. with my Primary doctor and post poned the CT until I discuss with him further.  I just had a chest xray done 10 days ago and reluctant to be exposed to any radiation when they should have just done a CT to begin with.  I'm looking to go to a new Primary Aug. 1st as this will be my 3rd visit in 3 weeks with no explanation of cause for the shortness of breath.  You would think my primary would offer that being an internist.  So far only my Endo. is the only one "listening".  My TSH was low the day after I stopped my medication, 4 days later, normal, at my Endo's, she told me to get back on my medication of .1mg of synthroid, which Friday was when I started it after being off 6 days but I've been only taking half.  I need to let my Endo know.  Just scared that somehow maybe the shortness of breath had to be caused by my thryroid medication being to much with the pseudophedrine boosting it.  I don't think claritan would have done it, idk, but this is not panic attacks.  I had a PA at my Primary doctor and a FNP at the ER tell me opposite things about my thryroid, scary, I will just rely on my Endo about my thryroid until I get a new Primary.

[Smilerdeb]

bumping this up as a similar posting has been posted..........

[Smilerdeb]

There are 2 types of contrast that they use for CT, MRI, X-Ray, RAIU.


MRIs and CT scans do not use radioactive dyes, but a non-radioactive
contrast media, usually gadolinium. (Gadolinium has no iodine, so it
causes few allergies.)
While SestaMIBI, used for stress testing, thyroid scans and mammograms,  is radioactive.

To have a computed tomography scan (CT scan) done, you may need to have an injection of "contrast" or "dye." This liquid is visible on X-ray pictures or CT scans, so once it is injected it will cause your blood vessels to be visible to the radiologists. This makes your anatomy very clear. "Contrast" also can highlight areas with inflammation because blood flows more generously to inflamed areas.
The reason that contrast dye is visible on X-rays is because it contains highly concentrated iodine.

Some reactions to contrast dye are allergic, but the trigger for the allergy has not been precisely identified. Doctors have noticed that older dye preparations that have a high concentration of iodine are more likely to trigger a reaction. Contrast dye has been adjusted in a variety of ways in order to make it less likely to cause a reaction.
Iodine has not been removed from contrast dye, but the dye is now prepared so that the iodine is chemically "hidden" from your immune system. Your immune system does not detect the iodine easily since each iodine particle is packaged inside a complex salt.
The newer dye is called "non-ionic" or "low-osmolar" contrast.

You can ask your doctor to use one of the newer dyes, which while are more expensive, are far less allergenic.
You may also be prescribed an antihistamine of cortisone before the procedure to lessen the chance of an allergic reaction.


I am allergic to the Iodine based dye Pertechium so for my thyroid tests they used the newer one and I had no problems.
I had the same reaction as you did with previous tracers and felt like I was going to die!

Please ask your Doc for the 'low-osmolar' contrast.

Hope that helps.

[julielou]

Hi Kate,

Your story is mine.  I was a healthy person and on Synthroid and my thyroid was under control.  I had a procedure that only local aneshtetic was used on a Tuesday, 5 days later, Sunday Father's Day, I started having shortness of breath.  The next day, Monday I went to mY primary doctor who'd also a internist.  He did blood work, but no thyroid labs, took my bp and sent me on my way, no explanation.  That blood work came back normal, when I went back to the doctor Wednesday, the PA gave me a steroid shot thinking sinus stuff.  The next Saturday I was in ER with severe short of breath.  They did blood work and thyroid labs and T3 and T4 normal range but TSH was a little low.  Got hold of my Endo. and she told me to stop my Synthroid which actually I stopped the day before.  ER doctor's wanted to give me xanax, which I refused. and told me to start on a antibiotic since my white count was a little elevated.  The next Monday I had labs at my Endo's and my thyroid tests despite being off Synthroid for 3 days were NORMAL.  Long story short with runaround from my PA, I had xray, EKG, echo, all normal, I am also scheduled for a CT w/o contrast, but thought maybe it should be with contrast, but after searching the net I think that would be bad for me and will only do it if my Endo OK's me to have it with contrast, because of the dye.  What I had since the small in office procedure I had at a plastic surgeons office, was the local anesthetic, I was taking Claritan 24 hour and Sudafed 12 hour.  Do you or yall think it could be thyroid storm, and yesterday my Endo told me to start my Synthroid back, even though my labs were normal.  But 3 ER visits for shortness of breath, they want to put me on xanax, my Endo. thankfully is the only one that doesn't see me crazy, because I'm not taking that stuff.  This past Thursday was the better day with no shortness of breath and none yesterday until I was getting ready to go to bed.  I to was told panic attacks, but come on panic attack's 24 7, and this morning I woke up to shortness of breath for nothing!  How long does it take to get out of a storm, if that is it?  With my TSH first being low, then rising to 1. something falling in the normal range, doesn't that mean I was in a hyperthyroid state, does this go away the shortness of breath naturally.

Julie

[glamourgal73]

Hi,
I have just been doing some reading online. I have been under a lot of stress lately. So I guess being nervous and fast heart beat is normal. I have never felt the way i have been feeling lately. I mean it really feels liek you described. Like I am losing my mind. It is so not me. I went to see a doctor and he prescribed Xanax. Me too was hesitant about taking it. I took 2 and that was it. Really did not help except to make me sleep. Made me feel less in control. So I stopped it.
Anyhow he did mention I should get checked for hyperthyroid. He says to come back for a blood test. I have never been tested for it before. The reason I am writing is because I ddi have a cat scan to check for appendix. I had some paina nd it turned out to be an ovarian cyst. But I ddi have that contrast injected and drank some. So I am wondering your thoughts on this. Do you think this could be my culprit? I guess I should go get tested?
I looked up symptoms for the ailment and I do have some like fast heart beat, nervousness, hair loss and brittle, loose bowel, etc. BUT these could all be JUST the stress I have been going through.
I guess it helps to hear you are not crazy when you feel you are and people do suffer the same symptoms. Not to say I am glad you went through this. I am sorry you did knowing how it feels.
Feel free to contact me ***@****.
Laurie

[borninquisitive]

Hi Jen,

Hey...I thank you for your response! Well looky there (your link) aha!
The tech did ask me questions but I was "fine." My tsh was within range. It wasn't until this year antibodies were found to be elevated. So, it was at no fault of their own.

Hey, don't worry about the double post or fog...I'm guilty of both. lmbo

Yes, it does "make you wonder." Based on what you have said regarding yourself and contrast...yeah...it makes me wonder if it had influenced your numbers.

Thank you Jen. I think it's going to be a rough ride...but it surely will be nice once we get there.
I hope you soon find yourself at your comfortable level regarding health and meds. Be talking to you again, sometime later...no doubt. =-)

Take care and thanks again!
~Kate

[hypo/hyper]

Hello,

Yes, I truely believe that the contrast dye that I received for my head CT was the thing that helped precipitate my already failing thyroid.  I have had varying support from my doctors, though, with their theories.  I had been having nerve conductive hearing loss in my right ear and they were trying to get to the bottom of it.  They did a head CT to r/o sinus involvement.  It ended up being an abcessed tooth.  Turns out I had a small crack in my tooth.  Besides the point though.  I had been completely healthy prior to all this.  Anyway, a couple weeks after the contrast dye, ironically enough while on vacation eating seafood, I ended up with MAJOR panic attacks.  Heart palpitations were really bad, and at one point my heart rate was in the 150's for half a day.  Very scary.  They threw around the idea that I may have developed an allergy to seafood.  I might have agreed, but on a weekly basis I am eating crab in some form or another.  I did some research and I read that contrast dye can flare up an already failing thyroid.  So I figure it relates to iodine content?  Then I compounded it by eating a lot of seafood while on vacation.  What all my doctors agree on is that I should avoid contrast dye from now on unless it is an emergent case.  Besides, I went through the hyper symptoms after that for about 1-2 months.  Totally not worth it in my mind for THAT kind of trade off.  Also, check out this link
http://imaginis.com/ct-scan/contrast.asp    
Look under the "Is it safe"  section.  It talks a little bit about the trouble with thyroid patients.  What type of CT will you be having?  If the benefits of the CT outweigh the risks, then it may be worth it to have the contrast.  But if you have any doubts about it, and they can do the CT without, then I would ask not to have it.  Whatever the case, do what you feel is best in order for you to be healthy!  Hope this helps.  
Take care,
Angela

[hypo/hyper]

Kate,

Sorry I misread and thought that you were to have another CT.  Oops.  Well, info is still relevant if you do happen to need another one.  Take care!

[Jenipeni]

Sorry - I'm having a foggy morning and don't know what just happened then - just about to go for a brisk walk to try and properly wake up so I can concentrate on studying for exams. Eek!

Anyway I found another article (just the abstract) on this topic where a lady got thyroid storm from CT contrast medium.
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=2319111&dopt=Abstract

Thyroid storm is a extreme form of hyperthyoidism - hyperthyroidism symptoms could have contributed to the panic attacks.  Perhaps you had a case of transient hyperthyroidism?  But without having had blood tests at the time this is all just guessing - it could have also just been anxiety,

Sometimes doctors don't know (or remember) about all the in's and out's and risks of the different tests the send us for - after all they are just interested in the results.

I had a CT scan 7 weeks after a Total Thyroidectomy - you'd think that because my thyroid was removed that I'd have no side effects.  Hmm that is debatable.  There is always some residual thyroid tissue left even after a total thyroidectomy - but you wouldn't think it would be enough to start functioning again.  I think the contrast did have a slight effect at suppressing my TSH further - which is not the aim of my replacement treatment.  Anyway we reduced my dose and subsequent tests a few months later revealed under-replacement and now I'm going back towards that intial dosage when I had the CT scan.  By now the effects of the CT contrast should have all gone - so I wouldn't be surprised if I end up on exactly that dose I was on then because before the CT scan I had really good TSH results.  

It might have also just been the natural process/rollercoaster ride of getting dosage right.  Who knows??  But it does make you wonder.

Have a lovely vacation - you lucky thing!!!  And best wishes when you go for the rest of the tests.

Cheers!
~Jen

[Jenipeni]

Hi Kate,

Sorry - I'm not hypo/hyper - so I hope you don't mind me replying to your question.  It is a very interesting topic.

The contrast media that is injected when you have a CT scan (not the stuff you swallow) is iodine based.  As you'd know the thyroid gland takes up iodine.  Because it is injected directly into the blood vessels this is a much bigger dose than you would have ever experienced before because usually you'd absorb it from the food you'd eaten in your stomach.  

This is why one of the checklist questions always is do you have a history of thyroid problems when you have a CT scan.  History of thyroid problems increases your risk of a reaction to the contrast media.

This is a link to the Mayo Clinic's info on CT scans; have a look at the section under the heading of Risks;
http://www.mayoclinic.com/health/ct-scan/FL00065

[Jenipeni]

Hi Kate,

Sorry - I'm not hypo/hyper - so I hope you don't mind me replying to your question.  It is a very interesting topic.

The contrast media that is injected when you have a CT scan (not the stuff you swallow) is iodine based.  As you'd know the thyroid gland takes up iodine.  Because it is injected directly into the blood vessels this is a much bigger dose than you would have ever experienced before because usually you'd absorb it from the food you'd eaten in your stomach.  

This is why one of the checklist questions always is do you have a history of thyroid problems when you have a CT scan.  History of thyroid problems increases your risk of a reaction to the contrast media.

This is a link to the Mayo Clinic's info on CT scans; have a look at the section under the heading of Risks;
http://www.mayoclinic.com/health/ct-scan/FL00065