How Often Can You Safely Get X-Rays? Risks and Concerns

How often can X-rays be taken?

Hello, doctor.
Last year, I had hematuria and underwent an intravenous pyelogram (IVP) at Linkou Chang Gung Memorial Hospital, where I had over ten abdominal X-rays taken.
This year, due to a cough, I would like to see a pulmonologist, but I may need to have a chest X-ray.
I am concerned that having so many X-rays last year, along with another one now, could have adverse effects on my health.
Although the previous X-rays were of the abdomen, I worry that there might still be some impact on my body.
Additionally, as someone with anxiety disorder, I've heard that chronic anxiety can lower immunity.
Does this mean I might be more susceptible to the effects of X-rays compared to others?

Xiao Hong, 30~39 year old female. Ask Date: 2009/02/19

Dr. Zhang Fudi reply Radiology

Dear Mr.
Hsiao-Hung,
According to the literature, the radiation dose received from a round-trip flight between Taipei and Sydney is 0.05 millisieverts (mSv).
The natural background radiation dose received from living in Taiwan for one year is 2.0 mSv.
In terms of effective dose from diagnostic X-rays (which includes a series of examinations), the doses are as follows: 0.01 mSv for the limbs, 0.54 mSv for the abdomen, 0.66 mSv for the pelvis, 1.4 mSv for the lumbar spine, and 2.55 mSv for the upper gastrointestinal tract.
A chest X-ray has an effective dose of only 0.06 mSv, which is very low compared to natural background radiation.

The Atomic Energy Commission stipulates that, in addition to natural background radiation, the additional annual effective dose that the general public can safely receive is 1 mSv (approximately half of the background value).
The amount of X-ray exposure that the human body can tolerate does not significantly affect anxiety levels or immune function, so there is no need for you to worry excessively! The doses you have received are within standard limits (last year's abdominal examination was 0.54 mSv, and assuming this year’s X-ray is 0.06 mSv).
Moreover, X-rays are necessary for a more detailed examination of your health, allowing for more accurate assessments and treatments.
Please do not let minor concerns lead to major losses!
Hsinchu Hospital cares about your health!

Reply Date: 2009/02/19

More Info

When it comes to the safety and frequency of X-ray examinations, it's essential to understand both the benefits and the risks associated with radiation exposure. X-rays are a valuable diagnostic tool that can help detect various medical conditions, but they do expose patients to a certain level of ionizing radiation, which has been linked to an increased risk of cancer over time.

Understanding X-Ray Exposure
X-rays work by passing radiation through the body to create images of internal structures. The amount of radiation exposure from a single X-ray is relatively low. For example, a chest X-ray typically delivers about 0.1 to 0.2 millisieverts (mSv) of radiation, while a CT scan of the abdomen can deliver around 10 mSv. To put this into perspective, the average person is exposed to about 3 mSv of natural background radiation each year from sources like cosmic rays and radon gas.

Cumulative Radiation Exposure
The concern with X-rays arises from cumulative exposure. While a single X-ray may not pose a significant risk, repeated exposures can accumulate over time, potentially increasing the risk of radiation-induced health issues, including cancer. The International Commission on Radiological Protection (ICRP) suggests that any exposure to radiation carries some risk, and the likelihood of adverse effects increases with the total dose received.

Recommendations for X-Ray Frequency
There are no strict guidelines on how often one can safely receive X-rays, as it largely depends on individual circumstances, including medical necessity. If a healthcare provider recommends an X-ray, it is typically because the benefits of obtaining the diagnostic information outweigh the risks associated with radiation exposure. However, patients should always feel empowered to discuss their concerns with their healthcare provider, especially if they have had multiple X-rays in a short period.

Special Considerations for Anxiety Patients
As you mentioned, you are a patient with anxiety disorder. While anxiety itself does not increase the biological effects of radiation, it can affect how you perceive and react to medical procedures. Chronic anxiety can lead to heightened stress responses, which may impact your overall health and immune function. However, the direct impact of anxiety on radiation sensitivity is not well established in medical literature.

What You Can Do
1. Discuss with Your Doctor: Before undergoing any new X-ray examinations, especially after having multiple ones in a short time, discuss your concerns with your healthcare provider. They can help assess whether the new X-ray is necessary and if there are alternative diagnostic methods available that do not involve radiation.

2. Keep a Record: Maintain a record of all your X-ray and other imaging studies. This can help both you and your healthcare provider make informed decisions about future imaging needs.

3. Limit Unnecessary Exposures: Always question the necessity of any imaging study. If it is not essential for your diagnosis or treatment, it may be worth postponing or seeking alternatives.

4. Manage Anxiety: Consider seeking support for your anxiety, as managing stress can improve your overall health and well-being. Techniques such as mindfulness, therapy, and relaxation exercises can be beneficial.

Conclusion
In summary, while X-rays are an essential diagnostic tool, it is crucial to be mindful of the cumulative radiation exposure over time. Regular communication with your healthcare provider about the necessity of X-rays and any concerns you may have is vital. Remember that the goal of any medical imaging is to provide valuable information for your health while minimizing risks. If you have had multiple X-rays recently, it is reasonable to discuss your concerns and ensure that any further imaging is warranted.

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