DTPA chelation in Individuals who received multiple GBCA injections. The nuanced dance with drifting Gd to figure out Flare and Treatment. Be careful of over-aggressive chelation.

The subject of treating with DTPA chelation patients with GDD, and this especially applies to those who have received multiple GBCA injections, is that the treatment really is like a dance, a dance between Gd and chelation. But this is not a dance among many sweet ballerinas, but a dance with the devil, but not just one devil, 100 million of them.

The problem is greatest in those who have received more than 5, and gets worse with each increment of 5. It reminds me of a bit in one of Jim Gaffigan's tv specials where he describes foods that Southerners eat, and the focus on grits. He says something to the effect: 'It tastes bad. I don't know if it is undercooked or overcooked'. In a more common scenario for all of us, sometimes we have plants that are not doing well, and we don't know if we have over-watered them or under-watered them.

Let us look at the issue with GDD. I have to factor in the following:

1. how many GBCAs

2. what type of GBCAs

3. if Flare is too strong, does it occur early, within 3 days (Gd removal Flare with DTPA)

4. If DTPA is not used, and a poor chelator instead (EDTA, or worse DMSA), then early Flare may also be (dominantly) Gd redistribution Flare.

5. If late Flare is occurring, which most often starts at 3 weeks (but can be as early as 1 week if the person received a large number of GBCA (>10)), this reflects re-equilibration.

6. At times when Flare is occurring, it may be uncertain even to the individual, whether it is early or late, and seems to be constant. This then may be the combination of Gd removal Flare then superimposed on re-equilibration Flare, like some unholy duo.

For me then the situation is 1,000 times worse when subjects are treated elsewhere and then they expect me to come up with what is going on. I give them my best shot at it, but ultimately I tell them, I do not know for certain, you may have to come here.. But to be frank, I am not keen on treating complex cases, especially when their complexity arose from being treated elsewhere. Some of these sufferers may require so much of my time, they are almost like a full patient load to themselves. But they probably have no choice, so I take it as my altruistic obligation to manage them... for now, while I can still manage all of it. A number of patients have told me, I don't know how you can manage it all... I don't know either quite often.

Treatment is extremely nuanced especially when things are seeming to go wrong. But there are a few critical points to understand:

1. steroid use (and to a lesser but sometimes critical extent) antihistamine use is essential.

2. why chelation can seem worse than the original onset of GDD. At GDD origin (using an example but not exact numbers) there was 1 million tissue resident memory T-cells focused on Gd, after a month or so they have replicated to 100 million of these cells, reacting to the retained Gd . So there are 100 or more times the number of cells reacting to Gd some months after GDD onset, then there were to begin with..

3. The more Gd in your body, the more Gd that will be moved with chelation. Hence more Flare reaction in principle. More Gd is available to enter the dance.

4. While the patient (and me) want as much Gd out as possible with each chelation session, with individuals with multiple GBCA injections there is a lot more Gd that will be on the move. So one has to be very careful if suddenly Flares are severe and may be worse than the original GDD, and new symptoms develop. I fall back on the Goldilocks principle, calculate how to achieve not too much removal (resulting in too severe Gd removal Flare) and not too little chelation (that may not have appreciable removement) but the sweet spot of what can be tolerable, while moving recovery forward..

5. Reconfiguring point 2 above, initial GDD symptoms may have been most prominent when Gd was deposited in some sites, Gd is now everywhere, so Flare related to removal and re-equilibration can occur anywhere. Usually the Flare symptoms replicate the original symptoms, but at times they can arise elsewhere, especially when there is more Gd in play, as seen in individuals with multiple GBCAs. The person may say: I never had heart problems before, now I have heart problems post-chelation. This is important to understand: the Gd was deposited everywhere in the body from the outset, now replicated Tcells at that site have the potential react when Gd is removed.

6. the majority of sufferers will go to the ER or see specialists about these symptoms despite me telling them: "they cannot help you"... I tell them "only someone with enormous experience with modern chelation technique can help you". In time more treating practices will gain a lot of knowledge and experience. Knowledge is aided reading my blogs.

Treatment in subjects with a history of multiple GBCA injections and reacting in complex ways to chelation, is extremely nuanced, Chelation is a dance with the devil, the more devils the more experienced you need to be with choreography.

If things are very confusing, for example there are 10 prior GBCAs on board, and there is strong Flare, not sure when it is happening. These are the steps.

1. Chelation is important to get out of Flare but it has to be done expertly. Strong Flares get worse till 3 months, then they can go in all 3 directions, including worse, in equal proportions. Think of the Odyssey by Homer, where Odysseus/ Ulysses straps himself to the mast of his ship, ears plugged, not to hear the sirens. Chelation for many people is a painful ordeal, but for these, you have to understand that you have to strap yourself to the mast. But it is critical that chelation must be done expertly.

2. Gd is still the problem so you need to keep removing it, but it must be removed thoughtfully. It is the dance with the devil.

3. Stopping chelation too early is almost always a big problem.

4. Make sure you are getting the steroids as I have recommended: iv and oral. But not too much, not too little... Goldilocks.

5. Cut back on the amount of chelation, maybe 1/2 dose Ca-DTPA for the chelation session and only 1 day. Some may need just 1/4 dose Ca-DTPA. One has to still capture Gd swirling like swirling dervishes through your body.

6. Start with going back to the baseline interval I recommend- 3-4 weeks.

7. If strong Flare continues and seems to mainly get bad starting at 1 week, decrease the interval between chelations to every 1 or 2 weeks.

8. make sure you are taking at least the gentle anti-inflammatories turmeric and chlorella/spirulina. I like ibuprophen and enteric-coated aspirin for pain, especially bone pain.

9. LDN may need to be added in. Starting with 2 mg at night then escalating from there.
   

Chelation gone bad, especially in the setting of many GBCA injections, often the problem is too aggressive chelation and compounded Flares: persistent re-equilibrium Flare building up on punctuated removal Flare:

You have to keep on with chelation, but slow it down - is most often the solution.

Richard Semelka, MD