What are the long-term effects of numerous x-rays?

[Teaching3bears]

What are the long-term effects of having numerous x-rays, especially during childhood, on the core or abdominal area (rather than arms, legs)?

I know cancer risk is slightly higher.  Anything else?  Anyone know?

[Paige]

I think your telomeres would be shortened. I don't know about anything else. 

[Teaching3bears]

12 minutes ago, Paige said:

I think your telomeres would be shortened. I don't know about anything else. 

Oh, if a woman had shorter telomeres, could it affect her babies?  How?

[Lucy the Valiant]

(Sometimes kids who have lots of radiation exposure through tests over many years are given radiation badges to track that exposure over time. Not an answer to your question, but something I learned at our children's hospital.)

[prairiewindmomma]

Define lots. Xrays and not CTs? Not so concerned…

A standard X-ray is about as much exposure to normal radiation as you would get in 2-3 days—certainly much less exposure than from an airplane flight. 

 

[Teaching3bears]

Lots: about  150

Why do they take so many precautions about who they let in the room?  
what about the injected contrast dye?

 

[prairiewindmomma]

A year’s natural exposure (no flights, etc.) is roughly equivalent to 110 chest X-rays.

The contrast dye is excreted within a couple of days. There are some legacy dyes that could build up in the body; typically you have bloodwork before to make sure your liver or kidneys can process it.

 

[Faith-manor]

14 minutes ago, Teaching3bears said:

Lots: about  150

Why do they take so many precautions about who they let in the room?  
what about the injected contrast dye?

 

I think the precautions are simply because why bother to expose others anyway, and for the radiologist, it would be many many thousands of x rays across their career in addition to their regular sun and other exposures. So for them, cancer for sure unless they are protected. But for the average person it isn't such a big deal. Now that said, they don't know the medical history of other folks besides the patient on the table so if mom who has had radiation treatment 3 times for skin cancer accompanies her kid getting multiple x rays annually, they should be careful. It is easier to just be hyper careful with policy for everyone than to cherry pick risk assessment for everyone.

[Teaching3bears]

When my son was a little baby they sent him for an x-ray for asthma because he was coughing occasionally.  The nurse or radiologist at the door said she would not recommend it because it would increase his risk of cancer.  I heard that and did not do the x-ray.  Also, deep down I did not think he had asthma and he never ended up getting it.  Her comment made me think very badly of x-rays.  

[prairiewindmomma]

Radiation exposure is something we generally avoid where there are feasible alternatives. With asthma in an infant, odds are a nebulizer treatment and antibiotics would be the same course of treatment of asthma or RSV or pneumonia. Having the additional information doesn’t change treatment.

There are other times when additional information is needed. Then, choose xrays over CTs where possible and shield the rest of the body. It’s not something to be anxious about, imo.

[Lucy the Valiant]

^+1

Also, you (as a parent OR as a patient) can ask questions until you understand the risks and benefits associated with the procedure. The effects of radiation (and, tangentially, anesthesia) are cumulative, so if you have reason to be concerned, it makes sense (IMO) to study it enough to ask questions. There are reasons doctors want the information that a scan can provide, but there are also sometimes "standard operating procedures" that call for scans that are ultimately irrelevant. 

 

[Paige]

2 hours ago, Teaching3bears said:

Oh, if a woman had shorter telomeres, could it affect her babies?  How?

I don't think so. I don't think damage like that (which is minimal!!) can be inherited. But I'm not a biologist.

[ktgrok]

11 hours ago, Teaching3bears said:

Oh, if a woman had shorter telomeres, could it affect her babies?  How?

They shield the ovaries with a lead apron. That is the only place where that kind of change would be an issue for reproduction. 

[J-rap]

This doesn't answer your question, but if numerous X-rays are an essential part of keeping a person healthy and alive, I wouldn't worry about the long-term effects.  I'd just assume that any risks outweigh the other option.  I'd also assume precautions were always taken -- like other areas of the body covered up and protected when necessary, etc.

[Condessa]

My son's doctor told us that they don't worry about numbers of imaging scans until they are into the dozens for MRIs and the hundreds for X-rays.

[Pawz4me]

33 minutes ago, Condessa said:

My son's doctor told us that they don't worry about numbers of imaging scans until they are into the dozens for MRIs and the hundreds for X-rays.

That's weird.

MRIs don't involve radiation.

Unless he gave some other reason for (eventually) worrying about them? Contrast can be a concern, but AFAIK mostly for those with reduced/poor kidney function. Even then it's pretty easy to flush the stuff out quickly with good hydration.

[Kassia]

14 hours ago, prairiewindmomma said:

Define lots. Xrays and not CTs? Not so concerned…

A standard X-ray is about as much exposure to normal radiation as you would get in 2-3 days—certainly much less exposure than from an airplane flight. 

 

what are your thoughts about multiple abdominal CT scans for an adult?  

 

 

[prairiewindmomma]

1 hour ago, Kassia said:

what are your thoughts about multiple abdominal CT scans for an adult?  

 

 

I have had them, and I am not wild about it. Wherever we could get a MRI with contrast that provided the same information, we’ve done that instead. I am also careful to bring old images to new practitioners so series aren’t reordered.

That said, these were medically necessary for my care, and so I consented. I balance that—I am not working a job with a lot of trans-oceanic travel (I shifted out of the field of my original studies). I eat well and exercise. 

Similarly, if I needed radiation treatment for cancer—which is a huge amount of exposure compared to CTs, I would do it if there wasn’t a good alternative.

There are lots of exposure calculators out there. You might find it helpful to play around on them.

Edited September 6, 2021 by prairiewindmomma
Autocorrect corrections…

[Teaching3bears]

8 hours ago, ktgrok said:

They shield the ovaries with a lead apron. That is the only place where that kind of change would be an issue for reproduction. 

What about in a small child where the x-rays were in the ovary area?  Could many X-rays affect her telomeres and could shorter telomeres affect her future children?

[Tanaqui]

If your situation is such that you need a lot of x-rays, the long term effects of the x-rays is probably not as bad as the short term effects of not getting them. *shrugs*

[Condessa]

6 hours ago, Pawz4me said:

That's weird.

MRIs don't involve radiation.

Unless he gave some other reason for (eventually) worrying about them? Contrast can be a concern, but AFAIK mostly for those with reduced/poor kidney function. Even then it's pretty easy to flush the stuff out quickly with good hydration.

 

She didn't say it was for radiation, but I didn't ask about what the specific concern was.  It might well have been the contrast she was thinking of, though we were not discussing contrast specifically at that time.  My son has to do his MRI scans with and without contrast every time, and the gadolinium buildup in kids' systems from many uses of the contrast over time can be bad, but not nearly as bad as not getting those scans.  He is supposed to have lots of fluids before and especially after his scans, because it will flush out more of the heavy metals and leave less of them permanently in his system.  

It is a little scary to tally it up and realize my kid has already had ten MRIs in less than a year, but now that things are more stable it should be only four times a year going forward.

[prairiewindmomma]

12 minutes ago, Condessa said:

 

She didn't say it was for radiation, but I didn't ask about what the specific concern was.  It might well have been the contrast she was thinking of, though we were not discussing contrast specifically at that time.  My son has to do his MRI scans with and without contrast every time, and the gadolinium buildup in kids' systems from many uses of the contrast over time can be bad, but not nearly as bad as not getting those scans.  He is supposed to have lots of fluids before and especially after his scans, because it will flush out more of the heavy metals and leave less of them permanently in his system.  

It is a little scary to tally it up and realize my kid has already had ten MRIs in less than a year, but now that things are more stable it should be only four times a year going forward.

Even then, while they tend to use gadolinium because of its long and safe history, you can always do chelation therapy to reverse toxicity. Or, I hear there's a new manganese based contrast agent out there, but I haven't had that yet.

[EKS]

10 hours ago, Kassia said:

what are your thoughts about multiple abdominal CT scans for an adult?  

This is something I worry about with my son.  Though I guess if it's between that and a cancer recurrence, I'll take the scans.