Burn Pit Exposure: How I Would Treat It.

Burn Pit Exposure is a hot and important topic in the military and VA. Heat and smoke alone cause damage to the lungs, but then there are the chemicals, and what I deal with currently: all the different metals.

Treating heat and smoke damage to the lungs as presently reported in pulmonology literature is obviously important. Treatment of all the various nonmetal or non-cation toxic chemicals has to be considered at some point> but at present is not part of my knowledge base.

But the metals. That I know about.

It gets back to the basics, that I started with Gd, and have continued with essentially all other heavy metals (but lead [Pb] being the easiest). The first is to learn what metals the sufferer has in them. The way to do this is how we manage Gd and recommend strongly for Pb. Obtain baseline 24 hr urine for a panel of heavy metals (by Doctors Data or other labs, Genova, for example). Measure 24 hour baseline unprovoked (I prefer 'native') urine. 1 to 2 days later, perform 5 ml iv chelation with Ca-DTPA. The first urine after chelation discard, then collect urine for 24 hours, and see what metals increase from pre- to post-chelation (or static metals not chelatable by DTPA). Undoubtably there will be radioactive metals present, and virtually certainly Pb, but it will be interesting to see what other metals are present. What I have pointed out with Gd, and observed must be true for all metals- if you are sick from a metal, your symptoms will Flare post strong chelator administration, with urine amount of that metal goes up 4 x, often with Gd up to 40 x, from native to Ca-DTPA provoked. It may not be possible though to distinguish which of the heavy metals has caused the Flare symptoms, if there are a number that elevate post chelation. Mercury may be the easiest to separately recognize, because Hg Deposition Disease patients get very crazy and paranoid with Flaring. A number of metals have distinctive symptoms described, but most are quite similar (Pb is quite similar to Gd symptoms in Deposition Disease states). At some level it may not matter which metal is primarily responsible for the symptoms if many of them are being removed by chelation. Since we have worked out GDD, and comparatively it is much more straightforward than any of the other metal Deposition States - because it is a controlled state: we know exactly when the Gd exposure occurred and how much was administered. This is uniquely accurate for essentially all metal Deposition States.

A year or so ago some GDD sufferers asked why I called GDD, GDD, and not gadolinium toxicity, which is the term used for other heavy metals: Pb, Hg (mercury), etc - and my main explanation is Gd toxicity is an umbrella description which includes Acute Hypersensitivity Reaction, GDD, and NSF. It turns out now from my further research and experience- all these other metals should be called Deposition Disease if the patient is sick from it, and Storage Condition if they are not. I suspect essentially everyone in the US has Pb in them - by which I mean 100% of the population. Are they all sick from it? I suspect (and hope) not. The formula is probably the same as my theory for Gd: 1 in 10,000 are mildly sick, and 1 in 100,000 are very sick.... rare but if you consider the denominator is 350 million people, that is a lot of people.

So if you are senior in the DoD or the VA system - if you want to find out if Burn Pit exposure patients are sick from heavy metals, I can do that.

Early research with DTPA and Plutonium used in a number of studies nebulized DTPA (inhaled). This is interesting because I suspect they recognized that it makes sense that the chelator follow the path of the original toxic exposure... So Gd treatment will likely always have to start with iv chelation treatment (following the path of the metal entry in the body) Burn Pit exposure, likely nebulized chelating agent will also have to be part of the treatment strategy.

Richard Semelka, MD