Anticipating Oral Chelation with an Effective Chelator for Gd (and Other Heavy Metals)

With an oral chelator there are two basic strategies you can follow, with also a blend of them.

Daily low dose. The first is daily low dose administration without interruption. This approach basically just amplifies the amount of Gd (or other heavy metal) that is naturally coming out of your body. It may also be a low amount of constant  concurrent steroids is needed (such as 4 mg of methylprednisolone) to manage an ongoing Gd removal Flare if this is occurring. It may be wise to take enough of the oral chelator that you feel a little worse than standard, because this indirectly tells you that you are removing a meaningful amount of Gd. The more the removal Flare, the more likely you should take steroids.

It should be noted that when you intend to stop the oral chelation of continuous daily low dose, you will need to taper over a long stretch. This is because although you may have achieved constant removal of Gd, the great majority is coming from loosely bound reservoirs, and the more tightly bound reservoir (bone for Gd and lead) will be relatively untouched by direct removal. At this point, I am not sure if/ when re-equilibration removal occurs with a daily routine. It may well be that after a few months of daily chelation, re-equilibration removal also begins to occur in a substantial amount. This would be of critical importance, because without re-equilibration removal also ongoing, over a period of months the gradient of Gd amount in bone would be massively greater than that of Gd content in soft tissues, so that there would be an intense rapid re-equilibration process that would result in severe re-equilibration Flare, that may feel worse than the original disease, symptom-wise.  In any event a taper will be important. So going for oral chelator every day to every second day for 1 month, then every third day for 1 month, every 4th day for 1 month, and every 5th day for one month. By that time the various reservoirs of Gd will have re-equilibrated to a low stable level. Overall this strategy may take 1.5 years to achieve an effective level of improvement. The concept of the importance of tapering medications is well recognized, and for similar physiological reasons, with steroids, benzodiazepines,  and narcotics.

Intermittent large bolus. The second strategy for oral chelator is to use an approach similar to what I have established for iv chelation with DTPA:  large bolus administration of chelator (with iv/oral steroids to manage Gd removal Flare). Tapered oral steroids immediately after chelation for several days. Wait 1-4 weeks between chelation sessions to allow time for re-equilibration. Since oral chelator is much easier to administer than with iv, a longer period of chelator administration, than our standard two day iv chelation could be done.  A similar approach can be used where the first day is the largest Gd removal dose to remove and 'loosen' Gd in tissues, and days 2, or 2-4 be a progressively lower dose of chelator to capture Gd loosened by the earlier chelation the day(s) before. This approach may be more time efficient, effectively treating individuals in 6 months.

A blended combination of the two strategies could also be performed. The obvious is a daily routine with some spacing of days or a week to allow for re-equilibration. Another approach would be sequential large bolus dose with weekly spacing followed with the continuous strategy.

Ultimately an oral chelator for heavy metals with broad coverage and very good safety profile may be the essential daily pill (or gummy) that we all need to take, to keep down the level of heavy metals that our bodies have incorporated from industrial (hopefully not also from nuclear armageddon) human activity.

Richard Semelka, MD