GDD. DTPA chelation. Steroids/ antihistamines. Other immune system Dysregulations. Which are cause or effect. Concurrent treatment of other processes. It's complicated.

With coming on 9 years of focused diagnosis and care of Gadolinium toxicity patients, I have made, a number of incremental steps in understanding:

1. DTPA chelation is a pure cation exchange chelator and with its high stability and demonstrable high removal of Gd is extremely efficient at treating to near cure straight up GDD.

2. But, GDD is often a product of a pre-existent immune system dysregulation, or results in other dysregulations.. So although the combination of maximal Gd and lead removal (and to a lesser extent other heavy metals) with DTPA, steroids, and antihistamines, show broad treatment coverage for many other entities in a jumbled angry ball of multiple causes and effects of immune system dysregulation, not all immune system dysregulations respond to heavy metal removal, steroids, and antihistamines.

3. So, whereas DTPA is doing its job removing Gd (and lead) extremely well, and steroids/ antihistamines doing its part with GDD and most other immune dysregulators, not everyone responds very well to an entire, correct treatment protocol. Although likely 90% of failures are due to not following closely my regimens, probably 1 % of patients do not achieve full near cure, 'true' failure, because heavy metal removal, steroids, and antihistamines does not treat one or more, maybe of many other monsters lurking in the immune dysregulation. They either have a nonresponsive other dysregulation, or even a fewer number of individuals have a morphed GDD.

4. True failure of DTPA chelation is in the great majority of cases due to the presence of another unresponsive immune dysregulator. DTPA is doing its job of removing Gd and lead extremely well.

5. What to do? Some are too afraid to undergo chelation because of their fear of failure. The correct thing to do is undergo 10 properly done chelation sessions and see where you are at. If there are symptoms completely untouched then at that point look to manage issues untouched.

6. Two things are true, and as with everything else, we have to have two often competing trains of thought: i) Gd can cause virtually every type of disease/ symptom and ii) not everything is GDD. That is where the 10 chelation sessions come in.

7. When there are clearly other additional active immune dysregulators they should be treated as well.

8. in treating the whole picture of complicated detoxification status of patients, complex multiple immune dysregulators, I always start with chelation of GDD with simultaneous addressing of detoxification strategies. I never start with trying to detox patients, for a number of reasons, including I remain uncertain how effective most detox strategies are, and it is clear to me to treat the entity I am most clear about: GDD.

9. I am very nervous of trying anything (such as DMARDS) that are supposed to work well for other diseases, because with a dysregulated immune system they may have the opposite of the desired effect.

10. Presently Low Dose Naltrexone (LDN) appears to be relatively effective in many subjects with GDD. The one high potency DMARD, I feel worth trying in very success-resistant patients is low dose Rapamycin. I do not have adequate experience to be highly confident in its use.

11. It's complicated

Richard Semelka, MD