Points to Consider Before Taking Another X-Ray

Have you ever sat or stood in front of an x-ray machine, covered with a bulky lead apron, waiting for someone who was standing behind a lead wall to press a button that would send ionizing radiation through your body? I don’t know about you, but I have never felt super comfortable having that tube pointed at my head or body.

I have long believed that the widespread misuse of x-rays is one of the deadliest mistakes being committed by health practitioners. Before I get into some of the realities of how x-rays are misused, here are some startling points about x-rays and other forms of ionizing radiation that are used for diagnostic purposes, like CT scans and fluoroscopy:

• For decades, the scientific community has known that x-rays cause a variety of mutations.
• X-rays are known to cause instability in our genetic material, which is usually the central characteristic of most aggressive cancers.
• There is no risk-free dose of x-rays. Even the weakest doses of x-rays can cause cellular damage that cannot be repaired.
• There is strong epidemiological evidence that x-rays are a known cause of almost every type of human cancer.
• There is strong evidence that x-rays are a significant cause of ischemic heart disease.

If all of the points listed above are true, then how is it that our society has come to use x-rays so frequently and almost without a thought to the harmful consequences of all forms of ionizing radiation?

Part of the answer to this question is that most health care practitioners have been educated to believe that the benefits of taking x-rays for diagnostic purposes far outweigh the negative consequences of ionizing radiation. This attitude is well represented by the National Institutes of Health (NIH), who have this to say about x-rays:

For the exposures encountered in conventional radiography [x-rays], the risk of cancer or heritable defects (via damaged ovarian cells or sperm cells) is very low. Most experts feel that this low risk is largely outweighed by the benefits of information gained from appropriate imaging. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image.

I strongly disagree with the NIH on this topic.

While I believe that x-rays can be extremely useful in certain situations, I also believe that they are usually taken unnecessarily and for the wrong reasons. Here are a few examples:

Medico-legal protection
In today’s society, I believe that the majority of health practitioners think first and foremost about protecting themselves against legal action. Rather than devote all of their energy to thinking about what is absolutely best for their patients in the short and long term, they perform diagnostic tests and give recommendations that fall in line with their professional “standards of practice”. This is undoubtedly so that if the patient does not do well, the doctor has records to prove that he gave perfectly competent care according to his profession's standards of practice. In deciding whether to do an x-ray or to go without it, I believe that most doctors make this decision based on their standards of practice vs. what they would do for their own children.

The Feeling that Something Has Been Done
Many patients want their doctors to do something. They don’t want to hear about what they should be eating or how much rest they should be getting. Some patients almost feel cheated if their doctors don’t perform a blood test, take an x-ray, or do some other diagnostic test that makes them feel like answers are on the way. A doctor who does not give in to these expectations runs the risk of not having enough patients to make a living.

Marketing
If you have already read about my first working experience as a chiropractor, you may remember the chiropractor who took full-spine x-rays on all of his patients. It was absolutely clear to me that the majority of his x-rays were taken for marketing purposes. If you study radiology, you will learn that everyone develops degenerative changes around their spines as they age – this is to be expected, just like wrinkling of your skin. Perhaps you can imagine how a health practitioner can paint these normal, degenerative changes and other clinically irrelevant findings in a frightening way to persuade a patient to receive his or her treatments.

If you don’t have any training in radiology, and your health practitioner points to x-rays that show areas of your spine that are worn down or “out of alignment”, and you are told that you are in danger of developing crippling arthritis in the years ahead if you don’t receive his or her treatments, what are you to do? Many health practitioners are fully aware of the authoritative power and influence that x-rays can have on selling their treatments, and many of them don't hesitate to use this power and influence to its fullest extent. If you are skeptical about this, you need to participate in a practice management seminar to experience firsthand how some practitioners are finely trained to translate using x-rays to making money.

So what does all of this mean for you the next time that your doctor recommends taking an x-ray?

Some Practical Recommendations on Taking or Not Taking X-rays

1. If a health practitioner recommends that you have an x-ray or CT scan done, find out exactly what the health practitioner is looking for. More importantly, find out what the practitioner will recommend that you do for each possible finding. If you cannot see yourself following through on any of the practitioner’s recommendations for each possible finding, it seems logical not to expose yourself to dangerous ionizing radiation in the first place. If your practitioner is unwilling to address all of your concerns, you really need to find a practitioner who will.

2. If you decide that taking an x-ray will help you figure out what the problem is and/or help you figure out how to get better, ask the person who will take the x-ray exactly what the dose will be. If he or she cannot tell you exactly what the dose will be, it is likely that you will be exposed to a higher dose than is necessary. If this is the case, you need to find another x-ray facility, one that is fully committed to using the lowest possible dose for its x-rays.
3. If you have x-rays taken, know that these x-rays belong to you. If you don't feel good about your doctor's interpretation of your x-rays, you can take your x-rays to other practitioners to ask for as many other opinions as you wish. You may be asked to sign a form in order for your doctor or x-ray facility to release your x-rays to you, but make no mistake about it - your x-rays belong to you.
4. I believe that babies, growing children, and pregnant women should not be exposed to any x-rays – even dental x-rays – unless they are faced with a life or limb-threatening situation. Fetuses, babies, and growing children have rapidly growing cells that are much more susceptible to genetic damage when exposed to ionizing radiation than the slower growing cells of adults. A pregnant woman shouldn’t even have an x-ray taken at the dentist’s office, because her thyroid gland won’t be protected by the lead apron that covers her body. Ionizing radiation to the thyroid gland of a pregnant woman can interfere with the physical and mental development of her child.

If you want to learn more about the relationship between x-rays and your health, I highly recommend that you read Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Population, by John Gofman, MD, PhD. The harmful effects of ionizing radiation listed at the beginning of this article are from his book.

Dr. Gofman is one of the few scientists in this world who has had the courage to fight for greater public awareness of the dangers of ionizing radiation. You can read more about his life and work here and here.

Article Tools

• Add new comment
• Email this page
• Printer-friendly version
• Share

Alter Text Size: