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It started out with GDD, and it ended up like this: Mixed Metal Deposition Disease. Chelation and Diet.




My journey began with Gadolinium Deposition Disease (GDD). With further investigation and attention to detail I realized, that GDD was part of the picture of a much larger picture Mixed Metal Toxicity, or Mixed Metal Deposition Disease. I have written blogs on this.

A recent highly educated patient of mine drew my attention to this article, which I had not seen before:



The concluding sentence describes what I have come to realize and write blogs on: the interaction of multiple metals in toxicity. The article focuses on Reactive Oxygen Species (ROS), oxidative stress, and mitochondrial damage. The article finished with:


To date, most studies have focused on the neurotoxic mechanisms of single metals; however, in real life, the exposure environment of human metal exposure is complex, and metals may interact with each other and influence their homeostasis. It is therefore imperative to further explore the effects of metal mixtures in the etiology of neurological disorders.


So, many authors have focused on Mitochondrial damage, including this article, as a core problem with toxicity. As I have written in prior blogs, there is the mitochondrial damage, but then there are atleast 10 additional damages recognized to occur, which, as I have also said, means there are at least 100 damages.


Then there is the compounding problem. A number of treatments have been proposed for Mitochondrial damage, and also the other dysregulations that occur.... but how effective are any of these treatments. My impression at best, the best of any of them have 10% benefit/ improvement... And a number of investigators have focused on chasing down a couple of the approximately 100 damages that have occur.


I am a huge opponent to the chasing down of individual symptoms and treating them. with a few exceptions, such as out-of-control hypertension.


This then returns to my core treatment: If something is making you sick, the root cause treatment is to get it out..


Actually a limitation in the thinking of others that I could not fully understand till recently. I could not been able to understand how centers that claim to be experts at performing chelation on subjects for heavy metals, even for decades, have been so utterly clueless about the concept of chelation. Many have thought themselves experts because they used the chelator that they could get their hands on, as far as the amount of scientific thinking they employed. I had not realized until recently is that they did not have the background that I have had for the decades of using GBCA contrast agents. The focus on MR GBCA agents since atleast 2006 is that the critical importance is the stability of the Gd with the ligand in MR contrast agents. This actually has been the mantra to a certain extent amongst radiologists (and certainly among scientists developing these agents. Stability is the crucial determinant of ligand with chelator. Interestingly, on the other end, I have also been unable to understand how radiologists who know this to be the case, are apparently clueless that actually what I am doing with chelation, is applying the exact same scientific reasoning as the manufacture of the GBCA agents to begin with (you knuckle heads).

Here is the treatment principle:


Two principles: 1. stability constant of chelator for metal and 2. demonstration of efficaciousness in vivo.


I believe the number of chelation experts who understand this core principle are close to 1, that is myself, and I think some of the centers who were closely with me have learned this.


If you don't know the stability constant and don't know its efficaciousness in vivo, then you are shooting in the dark. Maybe some good comes of what you are doing, but with significant harm along the road.


The other thing this article describes is that metals may act in concert, so a good idea to get a bunch of them out.


So let me also be clear on this: the most effective treatment for Gd is exactly what we do: DTPA chelation with steroids/AH. This same treatment is also the most effective treatment for lead toxicity (LeadDD). I do not advise other treatments, although I have written on the caveat, cut out, if you don't have the money to pay for DTPA chelation. Look for those blogs. DTPA is also excellent at removing the metals it is FDA approved for: Plutonium, Curium, and Americium. The extent to which it is effective for other metals often is a reflection of the species it is in. For example, inorganic Mercury, DTPA is optimal treatment, but is not necessarily effective for a number of the organic species. Pre- and post 24 hour urine is the key to learning in vivo efficaciousness.


The other important fact is that just because you may have a metal in you (for example all of us have lead in us, at least in 90% of the planet) but only a small fraction have Deposition DIsease, which is the same for Gd. The concept that I developed:


If you are sick from a metal, you will Flare with symptoms on its effective mobilization and removal. No Flare, No Deposition Disease. The operative word is 'effective' if the chelation is not effective then there will be no Flare, because you have effectively done nothing.


The future is the concept of use of chelators with even broader high stability constant for more metals (which may be HOPO), and others yet to be developed; and the concept of use of more than 1 chelator in combination. These are what I am currently focusing on.


The other critical aspect, that turns out to be a partial panacea for all diseases is a good diet.


Richard Semelka, MD

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