February 21, 2024
February 21, 2024

Should you get a full body MRI?

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Should you get a full body MRI?

Robin Berzin, MD is the Founder and CEO of Parsley Health, the nation's leading functional medical practice. Available online nationwide, Parsley's top physicians have helped over 40,000 people diagnose unexplained symptoms, treat chronic disease, and optimize their health. Get your free Symptom Score with Parsley Health today. This article originally appeared in Robin's newsletter which you can subscribe to here and you can follow her here.

Prevention is everything when it comes to health, which is why I got a full body MRI with Ezra last week, one of the many companies offering elective MRI’s direct-to-consumer that you may have seen peppering your social media feed.

I was proud of myself for doing it. As someone with claustrophobia, I wasn't sure if I could handle 45 minutes in a clacking and clonking metal tube. When I got there, I informed the tech that there was only a 10% chance I'd make it through the MRI without issue. I requested updates every 5 minutes on how much time was left to avoid panicking. Despite having Xanax with me, I chose not to take it. It was 9am, and I had to be fully alert for work afterward. Additionally, this medication sometimes paradoxically heightens my anxiety, a risk I wasn't willing to take. Still, I completed the MRI from start to finish without any breaks and am glad for it.

Is Getting An Elective MRI Worth It?

Ever since I mentioned my MRI experience on Instagram, people have been asking if it's worth it. My answer is that it's a highly personal decision. It depends on your willingness to undergo an optional medical procedure, your sensitivity to the costs involved, and your emotional capacity to deal with potentially adverse findings. For instance, how would you feel if you discovered you needed brain surgery for an aneurysm or had cancer? For some of my patients, the psychological burden of such information is overwhelming, leading them to prefer avoiding the risk of lifelong medical surveillance and the associated continuous testing.

In my case, I prefer having the data to proactively manage my health. As a mother of three, I'd rather know and confront any issue head-on.

One of my patients, who got an MRI through Prenuvo, another direct-to-consumer MRI company, discovered she had lung cancer despite being a nonsmoker. Fortunately, it was localized, and she had it successfully removed. She, and I, are grateful for the early detection.

What Does The Medical Community Think of Elective MRIs?

The medical community's views on elective MRIs are divided. The prevailing opinion is that they are financially wasteful and often lead to the discovery of insignificant 'incidentalomas' – minor anomalies that could result in unnecessary further investigations and expenses. There's also a concern about the medical system's hyper-vigilance in avoiding unnecessary tests, which can drive up healthcare costs.

My Take

I believe that the issue lies in the over-testing of sick patients, driven by a highly litigious society that pressures doctors and health systems to avoid lawsuits. This leads to exorbitant costs, especially in hospital settings. Stronger controls and legal protections are needed to mitigate this issue.

However, we shouldn't allow the problem of over-testing in medical settings to discourage proactive, preventive screenings. Early disease detection, before symptoms appear, is less costly to treat. Most blood tests are inexpensive to conduct; it's the lab charges to insurance companies that are high. Even more expensive tests, like a full-body MRI starting at $2,500, or the Grail liquid cancer biopsy at $950, are considerably cheaper than treating advanced cancer.

It's puzzling to argue against tests like MRIs and Grail when expensive, invasive screenings like colonoscopies are considered valuable for their life-saving potential. While colonoscopies have established evidence supporting their effectiveness, elective MRIs and Grail are in their early stages. Without conducting these tests, we can't build the evidence to determine their value or identify when they shouldn't be used.

As demand increases, costs decrease. DNA sequencing once cost $100,000; now, it's under $100, and companies like Ancestry and 23&Me offer it for less than $200. Many services start as luxuries but become accessible to all over time.

This was my inspiration for Parsley – to make root cause medicine, once a luxury, affordable for everyone.

In the next decade or two, MRIs and liquid biopsies, along with other screening technologies, will become cheaper, faster, more accurate with AI diagnostics, and widely available. Therefore, I believe the medical community should quickly establish standard protocols for recommending these tests and interpreting their results.

So What Did I Learn From My MRI?

My notable results:

  • Confirmed I have an angiomyolipoma, a benign tumor, on one of my kidneys, which I knew about.
  • Turned up a 4mm thyroid nodule, flagging it as a cancer risk.

My next steps:

  • I test my thyroid levels every year (my results are currently pending) and have never had any antibodies to my thyroid or levels that are off, so I have never had a reason to get a thyroid ultrasound. A 4 millimeter nodule is tiny, and likely to be benign. In addition as many as one in 3 people have a papillary thyroid cancer that they walk around with unknowing, that never causes problems. But from here I’ve referred myself for a biopsy (perk of being a doctor!) and if I were someone other than me I’d go to my PCP to refer me.
  • I’ll get a repeat scan (likely ultrasound next time) to monitor my kidneys every couple of years, as in very rare instances these types of benign angiomyolipomas transform into cancer.

Will I Get Another MRI?

Yes, probably in 5 years, but I don’t feel the need to do it any time soon.

If you’re interested in an MRI use the code PARSLEY200 for $200 off with Ezra. I have no formal affiliation with this company, but the company was kind enough to offer me the MRI for free to give them feedback on the experience.

I do hope we are on a path to a faster, stand-up, less loud and clunky (and less claustrophobic!) experience for all. When we get there — imagine zipping in, standing up for a 2 min MRI much like at the airport security machines — we will have actually democratized this service for all, and we won’t be putting such a hefty price on prevention.