GDD: Recommended conservative measures early on, waiting to see if chelation needed. And Always.

There are a number of recent major articles reviewing multiple prior studies that have told all of us, what has been known for atl;east 50 years

Eat a healthy diet. Do at least moderate exercise routinely. Have some social connections (a dog is fine). This works for essentially 90%+ of all human diseases.

So do that is critical GDD or no GDD.

Diet. In the modern era we do have to pay attention to nuances, and these nuances may be due to what humans have done to the world: pollution. Kale should be very healthy, but since it concentrates Thallium and Cesium from primarily vehicle pollution, it should be avoided..

Natural elimination for the majority of GBCAs is primarily through the kidneys for most contrast agents, and an appreciable amount through the biliary system in a few (eovist/primovist and multihance). So fluids are important. Water is ofcourse obvious, maybe alkaline water is particularly good.

Foods known to have anti-inflammatory properties: blueberries, pineapple are two that I favor.

Magnesium-containing foods may also be helpful, such as avocados, nuts, and spinach.

A Mediterranean/ South Beach type diet is ideal. Interestingly, recent promoters of the Keto diet describe it more or less exactly like a Mediterranean diet, embracing vegetables. Classic Keto diet I am not fond of.

Supplements that are anti-inflammatory in nature I recommend to everyone: turmeric/curcumin, chlorella, spirulina, quercetin. Try adding one at a time.

I no longer recommend weak chelators, such as cilantro or oregano as these can redistribute Gd and make symptoms worse.

Sweating. Something like < 5% of Gd is removed through the skin. I want to make use of every percent that can be achieved, so sweating is of value. Standard sauna is good. I prefer sunshine, sweating, exercise outside - since this combines a number of health measures in addition to sweating. Doing this on a seaside beach, combines some skin abrasion from sand, and salt water, which may create some transmetallation with Gd. Do not engage in sweat-provoking activities if GDD has caused you to lose the ability to sweat.

Hepatobiliary elimination also occurs with eovist/primovist and multihance. Eating healthy food should facilitate this.

It is unclear to what extent Gd may be directly eliminated through the small bowel. Conventional medicine describes that direct small bowel elimination does not occur. Some individuals have felt that using bowel toxin-binding agents like activated charcoal or zeolite they have shown that stool content of Gd has gone up from pre-usage to post-consumption. So it is conceivable experience with GDD has shown that conventional medicine's understanding of what small bowel can do, is in error. I am not sure at this point since I have not studied this. I am not opposed to taking activated charcoal, it should not hurt. I myself prefer pectin-containing fruits: peaches, nectarines, and apricots. Metamucil may also be reasonable.

Exercise. I like simple exercise. Walking is very good. Also that maintain range of motion, such as yoga and Tai Chi. Walking outside, in the sunshine, with your dog, may combine a number of health=promoting effects..

For many people with mild GDD arising after 1 GBCA injection, following this strategy may obviate the need for further treatment with chelation.

Richard Semelka, MD