Chelation is the only method that works comprehensively to improve patients with Gadolinium and other Metal Toxicities.

A GDD sufferer sent me screen shots of an interview that Deb Lambert posted on X, in which she discusses Gadolinium toxicity with Brent Wagner, MD. In it he stated that chelation is an unproven technique, possibly dangerous, and only removes Gd from blood. This may have been from a few months back, but I have just seen it now. If this is the information people are getting.....

Of course I have to respond to this. For those who do not want to read harsh words from me, don't read this.

First off, here are my credentials. I have published > 250 papers in the peer-reviewed literature starting in 1990, just on describing the value of Gadolinium Based Contrast Agents (GBCAs) in MR imaging, primarily focusing on the abdomen and pelvis. At the time CT was considered the only effective comprehensive imaging of the abdomen, so I had years of opposition to publishing on the value of MRI, by journal reviewers who were most often CT enthusiasts in the early days. I published the first major papers describing the imaging appearance of the full range of common and uncommon diseases of the abdomen, and described the most comprehensive diagnostic appearances of these diseases. As MR can show the greatest range of information on diseases, these have been the best papers on imaging of the abdomen and abdominal disease written by that date. I also wrote the majority of the original papers showing the superiority of MRI over CT in abdominal imaging by controlled direct comparative studies. MRI is now acknowledged as the most accurate and comprehensive method to image the abdomen and pelvis, if performed and interpreted well,. Most recently, thinking outside the box, I have shown that MR is the only imaging method that can show the full range of findings in Irritable Bowel Syndrome and Metabolic Syndrome. The imaging findings we have termed Splanchnic Inflammatory Syndrome. Unfortunately few know how to interpret these findings although probably 60 million Americans have some of these features. So I created the box and now the enlarged box of knowledge on MRI of the abdomen. I have worked with GBCAs since 1990, so 35 years, and have studied them and written about them over these years.

From 2007- 2009 my team and I wrote in excess of 10 peer-reviewed papers on Nephrogenic Systemic Fibrosis. From 2014- 2016 we wrote in excess of 10 papers on the demonstration of Gd in the brain on MR images. And from, 2016- present we have written more than 15 major papers on Gadolinium Deposition Disease, of which 10 and counting describe chelation.

Scholar GPS has rated my career #10 in MRI, world-wide for all time. I have extrapolated from this, and have asked Scholar GPS if they can confirm this, I am certainly in the top 3 world wide for writing about Gadolinium in humans, and the #1 in safety risks of MR contrast agents, and also #1 in overall safety risks for Radiology/ Medical Imaging in general. They have also rated me last year #12 in Medical Imaging, , somehow dropped to #16 this year.

I have spent the last 8 years of my life/ career working on and refining the rationale and medical science of chelation for Gadolinium. Our exact technique also happens to be the optimal treatment for Lead. The information of the above preamble you are welcome to cross-reference my cv. It is imperative to have objective evidence.

With this lengthy pre-amble, it brings me to this. My credentials on the entire subject of MRI, contrast, safety, treatment, chelation are essentially unmatched, in the entire world, not just in New Mexico. So some Nephrology researcher on rodents considers the work that I have done unproven? What experience does he have with performing chelations in humans.? This is the answer ZERO. What alternative rational treatment does he have for sufferers: none. So if you have never done any chelation, and have no effective alternate therapy, then all you are doing is attempting to dissuade patients from getting the only effective treatment Properly performed chelation is extremely effective as I describe below.  It is the height of folly (stupidity) to describe things you know nothing about, as if you an expert. On this subject you are a dangerous charlatan.

The dismissal of chelation by someone with no experience with chelation, no experience with MRI, and no clinical experience nor in depth knowledge of GBCAs, is as dangerous to patients welfare, as the larger group of many radiologists and other physicians that doubt the existence of Gadolinium Deposition Disease to begin with. Someone who claims to be interested in helping sufferers with Gadolinium toxicity to attempt to denigrate the leading expert, shows petty jealousy and a willingness to help the entire medico-industrial complex cast doubt on the existence of GDD, to achieve his own childish petty gains. This should not be lost on any GDD sufferer, and this includes Debbie Lambert, who posted this interview I categorize the apparent knowledge of the entire gaggle of nay-sayers of GDD and of the work I do with chelation: Opinion Unconfounded by knowledge.

To take a brief aside to naysayers of GDD. I have certainly written more than you, or anyone else you know on the value of GBCAs in MRI. One of the things a thoughtful scientist or physician learns to do In writing major papers is how to employ critical thinking. Part of critical thinking I use on myself, is to have in the back of my mind 'may be I could be wrong'. A truly great scientist must always have this consideration.

Start with this: if GDD does not exist, how do you explain these symptoms, that are very similar to those for other heavy metals, that develop soon after GBCA injection? Often within 1 day. What is your explanation? Sudden appearance of post COVID syndrome or ALS? Have any of you actually interviewed patients with GDD? The answer would be no. So your opinion is founded on pure ignorance, which in my opinion is no longer excusable. What makes this ignorance so dangerous is that still to this day, many people who develop GDD, often after the first GBCA injection, then undergo repeat GBCA injections at the request of their physicians to try to figure out what is causing the neurological disease. With each additional GBCA injection, GDD becomes worse, and more difficult to treat, and eventually after enough follow-up GBCAs, probably untreatable.. Because of this importance: that repeat GBCA injections worsen the disease, this ignorance is extremely dangerous to the health of patients, and it is unconscionable. In my opinion. This deviates far from Standard of Care,

Returning to the theme of doubters of chelation. My original work with chelators was with Michael Jay PhD chair of Molecular Pharmacy at University of North Carolina. Mike is a world authority on chelation, and you can look up his cv..

Historically chelation has suffered from the fact that many practitioners did not apply rigorous science to their work. Here below is some of that rigorous science.

In a nut shell: it is critical that a chelator has high stability with the metal in question. Historically this point was not well understood. The log stability constant of DTPA with Gd is reported as 21-22. For comparison EDTA is 17, so this translates to DTPA is 300,000 times more stable than EDTA with Gd.

A separate data point, simultaneous chelation occurs with both Omniscan and Optimark. A much lower incidence of NSF with Optimark was evident, principally because Optimark includes 10% free ligand (chelator) and Omniscan 5%. DTPA itself has been used in at least 120 million doses, Gd-DTPA is basically the MR agent Magnevist (Omniscan also uses DTPA as the framework for its ligand). EDTA had been studied as a ligand for Gd in the 1970s by Schering but was found to be too unstable to be safe as an MR contrast agent, so never used. The ligand/chelator is the safe part of the molecule. With 45 years of experience with the ligand DTPA there have been no studies showing that it poses a toxicity risk on its own. It is the safe part of the molecule.

So the work we do is essentially an exact mirror reflection to the entire concept for the creation and improvement of GBCAs to begin with. The improvement of GBCAs has been driven by looking to create ligands with greater stability with Gd. So this is extremely far from being unproven. The one important difference is the recognition that the binding of a chelator has to be achievable in vivo. It is unlikely that a macrocyclic ligand/ chelator can accomplish this.

We use Steroids/ antihistamines in recognition that if someone actually is sick from Gd then they will react when it is remobilized into the circulation. Basically all GDD sufferers (and Lead toxicity sufferers) experience an Acute Hypersensitivity Reaction (AHR) with this remobilization. The treatment for AHRs is steroids and antihistamines. The steroid/ antihistamine regimen has been employed in the millions of doses for a great variety of settings, notably AHR in chemotherapy drugs and Radiology contrast agents Iodine and Gd based. . This controls then what we term Gadolinium removal Flare. Many sufferers also have additional immune mediated inflammatory diseases (IMID), so these drugs are commonly used for most diseases of this type. So like the chelator, the regimen of steroids/ antihistamines have been used on millions of subjects. This is the strategy to protect against severe reaction.

To describe our treatment process in its simplest sense: if a person is sick from Gadolinium, the best treatment for this (and anything else) is to remove as best as possible the thing that is making them sick (this is chelation), and as safe as possible (this is with steroids and antihistamines, and tailoring amount of chelator). This we document with 24 hr urine pre- and post-chelation. Gd goes up in the urine in all individuals who have received GBCAs regardless of how long ago and regardless of type (Prohance, Dotarem/Clariscan experience lower Gd removal than other agents). So clear documentation that chelation works is always achievable with objective data. Virtually no other treatment in all of Medicine has this clear evidence of results. Furthermore patients who are sick from Gd, experience 3 clinical phases: Gd removal Flare (week 1), clinical improvement (week 2), Gd re-equilibration Flare (week 3). Chleations are generally spaced 3-4 weeks apart to employ le Chatelier's principle (everything strives to be in equilibrium) to remove Gd from the largest and most durable reservoir. bone. Gd redistribution Flare is an additional Flare that arises when a poor chelator has been used.

To address the false statement that chelation only removes Gd in blood. I will rely on the most recent publication of duration of detectable Gd in blood and urine (in the absence of chelation) by Robert MacDonald, et al from Mayo published in 2025 in Investigative Radiology. They showed that Gd is detectable in blood till 2 months after GBCA injection, and 3 months in urine. So if Gd is only removable if it is in blood, how can you explain that Gd is removed in individuals many years after the last GBCA injection? I will use myself as an example, I have not received a GBCA injection for at least 10 years, when I have undergone Ca-DTPA chelation (without steroids/ antihistamines since I am not sick from Gd, that is I have Gadolinium, Storage Condition) the results are 24 mcg/ 24 hours (chelations 8-10 years after the last GBCA). This is true for me, but more importantly, every single patient that I have studied and treated (100%). How can this be explained if Gd can only be chelated out, if it is only in blood? The answer is, that saying Gd is only chelated if it is in blood, is both false and dangerous. Furthermore for someone who has no experience with performing chelation to make false and dangerous claims is unconscionable. This is doing patients an enormous injury.

To provide more information on our approach. GBCAs are administered at a rate of 2 ml/sec. this means Gd is deposited not only along and into the vessel walls ( a drip injection of GBCA would result in primarily this, vessel wall deposition) but also into the deep extracellular matrix ECM, this latter is due to the fast rate of injection. This is why we employ a bolus technique, to capture Gd left behind in the deep ECM. A drip adminisatration of DTPA would capture just Gd along the vessel walls. Drip technique though has its place. We emulate the manner in which Gd was administered in the first place.

Some Gd though is taken up into the cytoplasm of cells. Gd has been well documented as being taken up by immunological cells (such as macrophages) which makes empiric sense because this is their function, however parenchymal cells have also been shown to take up Gd. When cells take up foreign substances into the cytoplasm, they generally package them into lysosomes. to contain potentially ill effects Here is the critical point that Wagner is missing, lysosomes often discharge their content back to the extracellular space. This is what they do to preserve the cells. Gd then is expelled and is readily removed by chelation. I do not know to what extent le Chatelier's principle (see below) also results in further Gd return from cells to ECM. Actually at this point I do not know how much of the deposited Gd remains in the ECM relative to intracellular, nor does anyone else. My current opinion, is that most of it is in the ECM, and has not entered cells. Nanoparticles are not Gd, these may also be protein reactions from the presence of Gd. One final point I have been previously gentle on, focusing on oxalates I think is folly. Also dangerous if you are instructing patients not to eat, what are many of the healthiest foods: spinach, beets, etc.

Treating the root cause of disease is always the best way to treat a disease, if it can be achieved. It can be with Gd, as the root cause is the presence of Gd,, and chelation removes it, Hence chelation removes the root cause. Gd causes at least 100 different chemical dysregulations in the body, so if the alternative approach is to treat 1 of these 100, or a few of the different symptoms, not only is the root cause left untouched, but addressing one deposition or one set of symptoms, may have the effect of causing others to increase in importance, and this may worsen toxicity. The best treatment for anything is to remove the root cause. This is chelation of Gd with the highest stability chelator available. Morphed GDD is one category that we have recently described as a consequence of poor and non comprehensive treatment.

Here is illustration of what a wise scientist/physician reflects on: how much Gd is left behind in the nucleus of parenchymal cells, and can this be removed? My opinion is very little Gd is left behind in nuclei of cells, such as neurons. It is possible that the 1% of patients who do not respond well to effective chelation may have a higher amount of Gd in parenchymal nuclei than everyone else.

So unlike individuals who deny that GDD exists (and by extension then I would expect also DTPA works) and the fewer but equally dangerous characters who doubt DTPA (or other chelator with very high stability and shown to remove Gd in urine or bile), then how do you explain that I have treated well over 200 subjects with DTPA chelation, and the great majority respond very well, and the majority experience near-cure, if they have undergone a full regimen of chelations at my center? Lesser success than near cure stems primarily from not getting sufficient chelations under my care., Although there is a smaller group that have other severe IMIDs that DTPA + steroids/antihistamines does not counteract. In most individuals with other diseases, the combination we employ also treats other entities. Furthermore we now also incorporate other treatments to manage additional IMIDs. There are other centers though that do perform chelation well, and these are listed on GadTTRAC.

How can you naysayers explain then:

1. the existence of patients with GDD symptoms within 1 day of GBCA injection?

2. DTPA chelation with sufficient number of chelations (generally this is 5 chelations for every 1 GBCA injection) results in considerable improvement in the great majority, and near cure in many? I work with the patient, and they decide how many chelations is enough

3. Documentation that most often 20- 100 times more Gd comes out in 24 hour urine post-chelation compared to pre-chelation.? Also well beyond the two months that Gd is circulating in blood.

4. A comprehensive description of removal, redistribution, re-equilibration which I have taken 8 years to elucidate well.

   
   

Scholar GPS has rated my career as in the top 0.05% of all scholars in all fields. To the various scoundrels and miscreants who are nay-sayers, what is your status? Is it even close? I will give you the answer, no it is not close. I have generally done this in opposition to the medico-industrial complex. Do you think it is something I have relished, going from a celebrated MR expert, to the apostate calling out safety issues, and creating enemies of erstwhile friends? No it has not been. Do you think 8 years of intense work by one of the most accomplished scholars in medicine and all fields is somehow risky or unproven? No actually, it cannot possibly be more proven and less risky. One of the greatest scholars, who had previously been the greatest proponent of GBCAs, came up with all of this safety issues and derived the best and only effective treatment for the condition. Why would I do this, make all these enemies, and also (which many may find hard to believe) at considerable loss of income? Also paying for the studies myself. This is why: every time a person with GDD comes to me, they tell me invariably a similar story: ' I received a GBCA and am terribly sick. My doctors don't believe me and often kick me out of their office. I am desperate '. I tell them ' I can help you and most people I can get back to normal'. After a series of chelations then they tell me 'Doctor you have saved my life'. In my earlier iteration as the most accomplished abdominal imager of all time and most accomplisher body imager' 27 years in that role, I do not think I ever heard that once, even though I probably did that thousands of times for patients. Now I hear it frequently. So that gratification is worth more than money or fame from my peers. But what especially drives me is to see such patient suffering, met with abject lack of knowledge or care from other physicians. This enrages me each time. I want to be that defender of all these victims, since few others do. It is the simple fact of knowing right from wrong, and being prepared to sacrifice and fight for others.

My findings are based on careful observation of years of work. Unlike random statements from individuals of far lesser accomplishments whose base of knowledge on these subjects is ZERO, and just blow out through the seat of their pants, random dangerous false ideas.

Finally to the patients with GDD:

1. GDD is real

2. the best and only effective treatment is chelation with the strongest available chelator, that is shown to work. There is hope. You are not crazy. Chelation in expert hands works for the great majority of people.

   
   

   Richard Semelka, MD

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