Why do some patients appear to feel worse after correctly performed iv DTPA chelation for GDD, than they did before chelation.... Here is why: The Gd body content tipping point.

Things can go wrong for a great number of reasons: as I look back over > 8 years of dedicated clinical practice and research into Gd toxicity (GDD), the reasons why patients seem to do worse are for a variety of reasons. The most common, despite what the practice or patient thinks: they are not doing chelation the way I have described how it is to be done. That is by far the most common reason. Another cause is, Gd is causing maybe 100 physiological injuries, maybe a couple of them removing Gd is causing the opposite effect of what is desired. This is rare: 1-5 %, probably 1% have this.

The subject of the blog however is not these two, but one which I do not believe I have addressed before:

why do a number of people feel crummier after DTPA chelation (you can substitute for crummier the profane word, starts with sh), and for honestly portrayed reasons.

As background, the vast majority of these individuals have received multiple GBCA injections over a number of years: greater than 5 (or 10) GBCAs over greater than 5 (or 10) years

This is the most common cause:

. Gd is not moving much and is stable in location after about 1 yr post GBCA injection, and only about 1% of the total comes out every year, after the first year post the last GBCA injection. What happens, the removal of Gd though chelation, the bringing back of Gd into the circulation, causes Gd removal Flare which can be intense and sustained, beyond the standard first week postchelation, merges with Gd re-equilibration Flare which usually manifests at 3 weeks, but can be apparent much earlier. So even though the great majority of Gd is now being removed, the immune system is reminded to react more to the presence of moving Gd, compared to the static retained Gd< Thus they feel crummier. This is compounded by any number of triggering events; which most commonly are excess exercise or new development of new disease such as viral infections.

Now overall this general circumstance of Gd removal Flare and Gd re-equilibration Flare is seen in everyone, and it is effectively controlled by adequate steroid and antihistamine use, and consistently spacing chelation in 1- 4 week intervals. But in a very few individuals these Flares are so severe they are merged into one, hence the individual seems to feel crummier even if everything is done correctly. To be frank though, my suspicion is for the majority of individuals who complain of this, the chelation has not been done correctly.

But that said, I think this feeling crummier after DTPA chelation does rarely occur. My theory therefore, is that the individual is so sensitive to the presence of Gd and hence by extension the movement of Gd (even if most of the movement is Gd coming out in urine) they feel worse. To overcome this: the Gd content of the body has to reach a tipping point, that the amount left in the body, and hence the amount removed by chelation, has diminished to the point that chelation no longer sets off the cascade of immune reaction , and toxicity stimulation. This tipping point may be 10 chelations before they actually feel better, or 20, or 30... depending on their sensitivity to Gd and the amount of Gd in the body

One individual in particular (who was not a patient I was actually treating, but a consulting patient) was doing horribly with all forms of Gd treatment, including a course of 5 or 10 DTPA chelations, but when he finally did a dedicated DTPA chelation schedule of 25 DTPA chelations spaced 1-2 weeks apart. After 25 he felt considerably improved.

Another, a current patient, who received 50 GBCA injections, has something like 300 mcg/ 24 hours consistently coming out post Ca-DTPA chelation... this is like experiencing an entire GBCA injection with each chelation.. She felt stable but very horrible before starting the DTPA chelation regimen, but for the first 10 properly done Ca-DTPA day 1/ Zn-DTPA day 2, she felt like she was dying. She felt this way because she was re-mobilizing the equivalent of a full GBCA injection with each chelation. She had asked me whether because she had received so much GBCAs she should undergo hemodialysis or some form of blood filtering (eg Plasmapheresis). My response- you feel like you are dying because you are moving, and (critically for recovery) eliminating an enormous amount of Gd in urine, essentially a full GBCA injection. You are already removing a tremendous amount of Gd, there is no need to try to remove more - and these procedures (especially hemodialysis) will introduce a whole new set of potential medical procedures that can go wrong, terribly wrong.

In summary: In a very few patients, reflecting extreme sensitivity to Gd (comparable concept to peanut allergy: individuals with extreme immune sensitivity may eat one peanut and die) and/or an enormous amount of Gd is coming out in urine, because they have so much Gd retained in their body, they are feeling very sick. They feel so sick because Gd is coming out in an amount that is causing their immune system to hyper-over-react, creating a merged Gd removal and Gd-re-equilibration Flare. If your kidney function is good, and a lot of Gd is coming out in the urine following chelation, the thing you must do to get a lot better (maybe near cure) is to keep going with properly done and spaced chelation. You can decrease the sense of impending death by receiving less chelator, space at 4 weeks and not 1 week, and increase the amount of steroid/antihistamine. Or accept this feeling until you reach the tipping point.

As an aside, to address the "I feel like I am dying from chelation" impression by sufferers. This is why extremely early on in my practice of chelation I have insisted on steroid/ antihistamine concurrent treatment with chelation. I received emails 8-9 years ago from patients getting DTPA chelation without steroids and antihistamines elsewhere, a number stopped chelation right away after one because it caused them to feel as badly as whn GDD started, So maybe 5 people were emailing me they were dying from chelation. One asked where she could donate her body. To my recollection, all of these had 1 or atleast few GBCA injections, so even if they stopped after just one chelation, the benefit from having. I only chelated that amount of Gd, long term would have resulted in clinical benefit, usually significant benefit. I have only chelated one person,, in the era prior to my understanding of the critical importance of using steroid/ antihistamine. I avoid not giving steroids to patients especially with the first 3 chelations, knowing how the Flare symptoms can be unpredictably severe, until the person has received at least 5 chelations. .I have never seen or experienced the situation of a person dying from this situation of "feeling like they are dying from chelation" (again this impression is due to the removal of a lot of Gd). Feeling like you are dying is not rare with GDD, and even with chelation. I have never had anyone die from anything, which therefore also means chelation. There are reports in the on-line Gd tox community of 1 or 2 patients who died despite getting a number of 'correctly performed DTPA chelation'. My impression is: 1. chelation was probably not done the way I do it, 2, people do die, that happens to all of us, and 3. people may have GDD but have in addition something like ALS When I am asked about these unfortunate people I tell the requestor; I do not have the time to investigate what went wrong (or the 3 above points), I have to look after everyone I am actually treating or consulted by... then of course there also is the time required to do research, write blogs, etc.

So to end with repetition: if you have GDD and a fair amount of Gd is coming out in urine:properly done iv DTPA chelation is the best treatment for your condition PERIOD Generally best evidence that a person has GDD is symptoms starting after GBCA injection; the typical symptoms of GD feeling; and critically feeling worse with DTPA chelation in Gd removal phase and/or Gd re-equilibration phase, with intervening period of feeling better.

A very few individuals, and you may be among them, may feel worse till the tipping point (enough Gd already removed from your body, and by extension less Gd removed with each chelation) is reached. The tipping point may be 10 chelations, may be 20 chelations, maybe be 30 or more. This largely reflects the number of GBCA injections you have had, but also your sensitivity to Gd.

Richard Semelka, MD