Should you chelate with DTPA if you are in a Flare? Yes, but it is nuanced.

I have written versions of this blog before, but here is a short version:

Chelating during a Flare can be important. But a combination of low dose, such as 1/2 dose Zn-DTPA, and iv steroid may be necessary. So you capture Gd if the Flare is primarily Gd re-equilibration (late onset) with DTPA. You calm and also  avoid  aggravating a Gd-removal Flare by taking steroids... and if uncertain what type of Flare, or both are occuring, you do both approaches, but with low dose DTPA, so. 1/2 dose Zn-DTPA with iv solumedrol, and steroid taper.

As much as possible, staying calm is always important for GDD and everything else.

Richard Semelka, MD