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When to stop (DTPA, or other effective chelators for any metal with toxicity) chelation. A brief recap, and other rehashed points.

Since many/all readers of my blogs who have GDD are very anxious, I find as with all teaching, repetition is useful. Also as I find myself repeating things my messages tend to get more refined. A number of my blogs are also stimulated as responses to inquiries from sufferers. Although the bog refers to DTPA chelation, actually the principle is true for all effective chelators for all metals. Here is a current response:

One T cell dysregulation opens the door to many T cell dysregulations. So the significance of this (mild ANA elevation) I think is minor, and reflects either before or after Gd, you have the propensity for T cell dysregulation. The best treatment for you remains continued chelation therapy. If you find symptoms are at their worst beyond 10 days post chelation, then this is consistent with re-equilibration being the problem, and weekly chelation would be the treatment, especially as you have had a fair number of GBCA injections (8) so the amount of Gd in you is substantial.. Weekly with one agent (either Ca-DTPA or Zn-DTPA) also lets you assess if one or other agent seems to aggravate symptoms. If one of them is problematic, don't use it. Realistically the number of GBCA injections x 5 = the number of chelation sessions you need. Since your baseline was good, I always hope for less, but the reality is that 40 chelations is probably what you would require. Pausing is a good idea after a person gets to a certain mark, such as 20 chelations. Re-equilibration always starts in force at 3 weeks and escalates to 3 months, where it can divide into 3 groups: continue to get worse, stabilize, or gradually improve. If you are getting worse it is essential you return to chelation. If it is stable you can decide, if it is at a level of recovery you think you can live with, such as 70%, and you don't want to continue with chelation fine. Most of the time it is for financial reasons that people in category 2 stop. If you gradually are improving and you are above 80% recovery, then I generally recommend you hold off chelation and see how you are doing. You may be effectively done. You can always return to chelation at a later date, with I think no particular set-back, and the time delay will have allowed for more Gd to move from bone back to tissues where we can more easily remove Gd with chelation. So there actually is some benefit as well to the pause.

Richard Semelka, MD

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