Chelation Strategies. Follow the route of acquisition.

It is straight-forward that since Gd is presently

acquired in disease levels by intravenous route or direction injection route, that chelation needs to follow the route of administration. Studies looking at the electron micrographs of deposited Gd, find the metal primarily in the perivascular space... It is deposited in the fashion it was administered: in around vessels.

The same is true of metals acquired by other routes, that much of the deposition should follow the pathway of how it was acquired. Many metals are acquired by ingestion, so peri-intestinal and intrahepatic deposition should be quite high. Therefore oral administration of chelators is important, not only food items (like pectin containing fruits) but also specific chelators (like Prussian Blue for Thallium). For many heavy metals the combined strategy ultimately will be important. Lead for example, much of the deposition follows the pattern of Gd, such as bone deposition (my theory because bone marrow cell infiltrates corral these metals to bone to keep away from vital organs (as best they can)) like the brain. So lead probably requires oral administration of chelator, to follow the route of acquisition, and iv administration to tackle the bone deposition.

The extreme importance of stability constants for selecting the appropriate chelating agents, is surprisingly not that well recognized at present among treating practices for heavy metal. I plan to change this for the betterment of patient care.

Richard Semelka, MD