Q&A: full body MRIs; new Paxlovid data; tapering antidepressants; & screening for aortic aneurisms

A spring shower of subscriber questions! ☔️

ICYMI 👉

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The first question (about full-body MRIs) is free for all subscribers. Questions 2-4 (on new Paxlovid data; tapering antidepressants; & screening for aortic aneurisms) are for paid subscribers only. If you would like a paid subscription but it’s not in your budget, please message me directly.

Click here to submit your questions (about anything) for future Q&A posts!

Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

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QUESTION #1: FULL BODY MRIS

Are full body MRIs a good idea? For health screening? I have seen a bunch of celebrities promoting them - but are they just trying to make more money?  

-Carson P.

Dear Carson,

Great question. I hope someday we have evidence-backed, cost-effective imaging technology to assess the structure and function of our major organ systems. But right now, I don’t think full-body screening MRIs are ready for primetime. 

MRIs are a sensitive, high-tech way to detect and diagnose a wide range of medical problems. I order MRIs for specific reasons; for example, to get a more detailed anatomic assessment (more than an X-ray will show) for skeletal problems like a torn knee ACL or herniated disc in the spine. MRIs sometimes can do a better job than mammograms of detecting certain breast cancers in patients with dense breast tissue. However, using an total body MRI as a screening tool is not evidence-based, nor is it generally a good idea.

Here’s why:

• Full body MRIs detect many abnormalities that are not clinically significant, leading to unnecessary anxiety, testing, and medical interventions.

• It is a relatively expensive and time-consuming test, and insurance may not cover the cost.

• Full body MRI is not always accurate or sensitive enough to detect all conditions. For example, it may miss early-stage cancers.

• This type of scan can give people a false sense of security. Structure and function are two different things. Scans are only a snapshot—a point in time—without much-needed context.

The American College of Radiology and other medical organizations do not recommend routine full-body MRI for asymptomatic individuals, as the risks tend to outweigh the benefits. Better than any snapshot to assess your health is getting regular check-ups and targeted screening tests based on your age, family history, unique risk factors and symptoms.

Photo by Accuray on Unsplash

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QUESTION #2: NEW PAXLOVID DATA

Do you still recommend Paxlovid to anyone with COVID? I saw that a new study came out and wonder what you think? Is there any other specific way to treat COVID? -Anne

Dear Anne,