Gadolinium DD is a multisystem disorder. Assume all symptoms may be GDD, and wait till after 10 chelations before investigating individually unchanged symptoms.

I have in the past written variations of this, but it is worth repeating. Early in my days of iv DTPA chelation of Gadolinium DD, I have heard from, consulted by, treated some, individuals who underwent various procedures, for what was part of the picture of GDD, some of them major. Small bowel resection (for hypomotility of GDD), surgical changed insertions of extra-ocular muscle of the eye to treat double vision (caused by the muscle disturbance of Gd), ablation of electrical channels in the heart (for arrhythmias caused by Gd) come to mind. It has been either patients on their own, or by physician insistence, they have undergone this more aggressive procedures. This doesw not include the frequent use of diagnostic tests, seemingly less invasive, such as PET scans or CT scans.

As a side bar, further tests I have also discouraged. Many of you are aware of the recent report in JAMA that opines 5% of cancers may arise from CT... to date the even greater risk of PET scanning ignored.. but not by me. In the mid to late 1990s I was the first major academic radiologist to point out the radiation-induced cancer risks from CT (this can be verified by looking at my cv... but I myself avoid looking at my cv, so there is no compelling need - but you can look for the article with 4 Pillars in the title). Concerns seem always to come in waves: radiation risks was a hot topic 1995-2000, and now it is back. This is human nature, like the cyclical nature of fashion. I will address the subject of radiation-induced cancer risk (again) in separate blogs.

Back on topic. GDD can cause just about everything... which has made many doubt it could be a real entity because people complain about a variety of different things. But this is the nature of multisystem/ diffuse disease processes atherosclerosis (the most common important disease), lupus, and now being recognized COVID, all can present with different patient symptoms. I hope that now with the broadly reported considerable range of afflictions that COVID can cause, this has also put to rest the thought: how can GDD cause so many different symptoms. It is a systemic disease; it just does, Just like all systemic diseases.

So some disease process need to be individually treated if they exist either independent from, or secondary to, GDD. Type 1 diabetes needs to be still treated with insulin, hypertension still needs to be treated if severe.

Of course other diseases that are not GDD, such as renal cancer, need to be treated... so there is a nuance of understanding which symptoms/ findings need still to be treated sooner than 10 chelations, and which should wait. Although surgery in general for nonmalignant disease should wait for at least 5 chelations, so a sufficient amount of Gd has been removed. Gd is drawn to regions of granulation tissue (very early precursor to scarring) and scarring

Further investigation for many things will be expensive, stressful, and potentially harmful (CT, PET). So calm yourself and wait...

Wait till you have had 10 chelations (ok sometimes at least 5) before investigating if something else. could be the cause. An interesting common symptom is right upper quadrant abdominal pain. Hard for people to resist not having this looked into. Rib pain, and in this case, right lower rib pain is extremely common in GDD (because Gd predilects going to red marrow, and red marrow in adults has retreated from most bones as present in young children, to the central vertebral bodies and the ribs. So if you and your doctors cannot restrain yourselves from getting more imaging, maybe go with ultrasound, since it does not cause cancer, and keep in the back of your mind 5% of cancers may arise from CT.

So bottom line: stay calm and wait. 10 chelations before investigating for other causes, for symptoms that GDD results in. But it helps to be guided by an expert, since not everything is GDD, just most, if you have GDD.

Richard Semelka, MD