GDD. An Important Brief Repetition of Issues in Treatment with Chelation
Some important points require being repeated again... and again.... and etc.
1. Presently the most effective chelator available is DTPA. The reason is it has the highest stability constant of all other agents on the market, This means it attracts Gd, and holds onto Gd, better than any other chelator available.
Other chelators have higher stability constant than DTPA, such as BOPTA (the ligand of Multihance) or HOPO. So they theoretically should be even more effective than DTPA. They are not yet available.
2. If someone is not sick from Gd, the definition of GSC, then since they did not react to receiving the GBCA to begin with, they will not react to its removal. So chelation does not require concurrent immune dampening. They can also withstand more volume of chelator and more frequency of chelation. Attention though paid, if high dose and high frequency chelation is performed, to serum electrolytes.
3. In someone with GDD, they have an immune mediated inflammatory disease. This means effective chelation must be paired with some form of dampening the immune response. Our present approach is to start with the first session with low dose DTPA and relatively high dose steroids, both oral and iv. Chelation. effectively is like an Acute Hypersensitivity Reaction (AHR) to Gd being remobilized. So I treat it exactly as that. Over future chelation sessions, I gradually increase the amount of chelator and decrease the amount of steroid. I still consider that even with well tolerated chelation oral steroids should still be used for at least the days of chelation and at least one day later, in low dose. The intention to continue to mitigate the tendency of T-cells (and others) to react to the passage of Gd both leaving the tissues and moving in the blood stream.
4. When being treated, other activities you do will effect the overall success and rapidity of success of chelation, some good (such as appropriate diet and some supplements, and some other treatments for select individuals eg : HBOT and sauna), but many bad (excess alcohol intake, excess travel, and other activities that have the tendency to stress the immune system). If you are drinking a lot of alcohol, do not expect to get terrific results, and also do not misinterpret that the problem is with chelation > the problem is with the other activities you are engaged in. Also it is critical to stay calm and not have high anxiety. Issues that you may have during chelation therapy, if the therapy is done well, may be secondary to anxiety and not to chelation. That is why I instruct all individuals. Stay calm - if you need assistance in doing that explore activities like meditation.
5. Chelation therapy requires at least 5 chelation sessions, spaced 1-4 weeks apart, I prefer 2-3 if possible. This is because of re-equilibration, that starts to occur in earnest around 3 weeks post chelation and plateaus around 3 months. If you had 1 chelation session and massive amount of Gd is removed (eg: 80 times greater than precontrast). Then the re-equilibration Flare will also be intense. The treatment is to get chelation. session 1-4 weeks apart. If you are not doing that, then you are not getting optimal treatment. Do not blame chelation if you then have symptoms developing 6 weeks + post chelation. It is because you either stopped chelation or had too long intervals.
At a minimum, chelation therapy is a commitment of 5 sessions spaced 1-4 weeks apart. This generally is potentially sufficient if you had 1 -3 GBCA injections. If you have had more GBCA injections, or a more complicated picture, then you should expect 15 chelation sessions. If you are doing exceedingly well, and started with minimal symptoms, then maybe 3 sessions may be sufficient. It is never a 1 and done scenario, because of re-equilibration Flare. Re-equilbration Flare is actually a good thing - because it reflects Gd moving from more durable reservoirs (bone) to less durable (skin) which actually aids the treatment.
6. Many individuals unfortunately have additional immune mediated inflammatory diseases (IMID). Most thankfully are not a complication for chelation, and chelation may also help with those conditions. 1-5% of patients may have an IMID that does not do well with chelation, and some of these IMIDs may be unique to them - so 1 in 1 billion. Unfortunately that is a risk we have to take. I have previously written a blog on understanding relative weightings of risk.
A brief repetition, worth repeating.
Richard Semelka, MD