The science of Chelation. Understanding the critical principles that pertain to all heavy metals.

Approximately 10 years ago one of my collaborator GDD subjects brought to my attention that a very prominent Internal Medicine physician refused to have his wife chelated, although she suffered from severe Gadolinium Deposition Disease (GDD), claiming it to be' junk science'. This may still remain the prevailing thought amongst many allopathic physicians. This position although wrong, is not hard to understand since very few who practice chelation actually understand or base chelation on actual scientific knowledge. This blog serves to correct many of these deficiencies.

First off, I have studied Gadolinium Based Contrast Agents (GBCAs) for 35 years, and have been one of the Radiologist experts on the subject of the science of GBCAs .Most of my peer-reviewed articles and textbooks have been describing the value of GBCAs (probably > 250 articles and 14 textbooks). I have also been one of the leading authors describing NSF (GISF), Gd deposition in brain on MRI and most recently over the last 8 years the world authority on GDD. From that vantage point, of perhaps unequalled knowledge of the combination of GBCA chelation, advantages, toxicities, I have realized over the course of the last 8 years that everything that applies to Gd also applies to all the other heavy metals.... so pay attention to what I write below. This serves to explain, demystify and science-ise chelation.

The following must be know to scientifically employ a chelator:

1. what is the log stability constant between the chelator and the metal in question ( a value of 20 is a good number for an effective chelator, 18 is fair, and 24 is very good). This is a lab-derived number.

2. does the chelator actually remove the metal in vivo in humans. I use 24 hr urine measurements shortly before chelation, and post-chelation starting very shortly after the administration of the chelator. I look to do this after the first urination either during or just after chelation. Amongst other explanations, a 24 hour collection controls for diurnal variation in native elimination of the metal. Chelators that get eliminated by hepatobiliary route, at times should also have fecal testing.

3. it must be understood how the chelator is eliminated: is it purely by renal route (most commonly), by mixed renal and hepatobiliary (some) or purely by hepatobiliary. Some may also increase skin elimination, but this generally is minor.

4. At least initially the chelation process should follow the route and method of how the metal has entered the body. Perhaps 5 sessions of this form of chelation should be performed before iv or oral chelation is used. Unless ofcourse iv or oral administration was how the metal entered the body, then start with that. This should be obvious.

5. Chelation always involves multiple sessions. It is never one and done. This is how the heavy metal is depleted from the most durable reservoirs.

6. It should be understood what reservoirs the heavy metal is maximally stored in. This allows targeting the chelation to maximize removal from the most durable stores.

7. Understand how transient or persistent various heavy metals are.

8. Just because an individual has a heavy metal in them does not mean they have toxicity (Deposition Disease state).

9. The practitioner can tell if there is metal toxicity because 3 phases of response to chelation occurs: 1. initial heavy metal removal Flare, 2. week 2 some evidence of clinical improvement, and 3. week 3. re-equilibration Flare. With continued chelation, points 1 and 3 diminish, and point 2 increases in strength, length of time and long term duration.

10. When considering the amount of heavy metal one has to consider the total body load of that metal, and not just skin or some other particular organ. By considering load, one then recognizes why multiple chelation sessions are needed, and why understanding and utilizing Le Chatelier's principle is important

11. Speciation of the heavy metal (what form it is in) must be understood. This may affect both treatment and prognosis.

These 11 points above also serve the basis for developing chelators that show better targeting of heavy metals. This will be of continued and increasing concern in an progressively more polluted world, with elevated exposure of the public to toxic heavy metals. There are a number of other chemicals proposed as chelators, such as glutathione, but it is not clear to me to what extent they work. 24 hour urine appears to not show any removal of heavy metals with glutathione, and other supplements, but this does not mean they don't have a supporting role. At this point I am not sure how helpful administering these naturally occurring chemicals in their entirety to the body, My impression is that the body often really only benefits from them if they produce these chemicals themselves. This is somewhat analogous to a young Italian man only liking how momma makes some Italian food dish... our bodies may only like these chemicals if they make them themselves, and localize them, exactly where they want them.

Detoxification is a different form of management than chelation. Chelation refers to removal of the entity. Detoxification refers to altering either the entity, or the organ systems (eg: liver) to better manage/control reaction to the offending substance. It is more difficult to quantify the effect of detoxification. This is not to mean it should not also be done.I caution not to focus too much, or exclusively on detoxification, as there is presently uncertainty how effective it may be. I consider it atleast mildly effective, and hence of value in a global treatment approach. I never start with attempting detoxification. I start with chelation and concurrent spaced detoxification.

Finally, to revisit again the concept of .treatment approaches. In general systemic treatments of invading entities, such as cancer and infections are based on killing these entities in situ in vivo. The end result of that the corpses of the invaders are still left inside the body, and this can itself cause considerable damage. In cancer treatment this can result in tumor lysis syndrome, which can be a severe and even fatal disease. This can result in hyperkalemia, hyperphosphatemia, and hyperuricemia, with end result of kidney damage, cardiac arrhythmias (including fatal), and metabolic acidosis. All this as a consequence of the immune system and body at large attempting to deal with the massive amount of dead tumor corpses in the body. It can be confused into creating a cytokine storm type reaction. Empirically the concept of removing the entity in its entirety from the body, seems a much preferrable approach to killing it in situ, if removal is achievable. Somewhat uniquely, this intact removal process (which chelation is an example of) may actually be an ideal therapy for all invading entities. A long history removal strategy and its importance well recognized, is complete surgical resection of a tumor (for example renal cancer) as a curative method.

Fundamentally therefore, chelation based on scientific knowledge is an ideal therapy. The above 11 points have to be understood and considered, even if not presently achievable, to make chelation therapy science and not quackery. By extension, it would be ideal if chelation could also be developed for all other invading entities, maybe starting with microplastics, PFAs, glyphosates. I would call this category of treatment then Raptor therapy.

Richard Semelka, MD