Gadolinium Deposition Disease has achieved more peer-reviewed evidence of the full range of demographics, diagnosis, treatment, and prevention, than NSF and the majority of other diseases.

In case you weren't paying attention, the entity Gadolinium Deposition Disease has now achieved more evidence of its existence than NSF, and most other diseases. No treatment for NSF has been developed that can achieve any level of cure, the recent paper (that I have written a separate blog on Near Cure of GDD with iv DTPA), (abridged title) describes that in most people chelation with a chelator which has very high stability constant with Gd, and simultaneously managing the immune reaction: which presently is iv DTPA and steroid/antihistamine, can result in near cure.

Our Work

This is the time line of publications, like the building of a solid brick wall.

*Our earliest work was based on surveys, in which we documented symptoms of GDD.

*We then reported on demographics and timeline of disease development.

*We have shown that ivDTPA removes Gd, but does not perturb electrolytes if space 1 week or greater apart., This also showed administering few chelations show some benefits.

*We have shown that a small amount of Gd, additive for each GBCA injection, remains stored in the body for a long time, in my opinion forever, highlighting the need for chelation in those who are sick from Gd.

*We then together with Stanford University researchers showed cytokine profiles of GDD. Perhaps one of the most important papers I have ever written is the dynamic release of cytokines following chelation. This work has enormous impact on immunology. It shines a light on the direction of research on perhaps everything in medicine which affects the immune system (which also is everything) . A starting point with post immunization with COVID vaccines. This concept may be among the most important in all health care.

*Most recently we have shown people can achieve near-Cure of GDD with iv DTPA. This is critical because it provides hope for sufferers, which unfortunately has not been shown for NSF... although I suspect what we do combined with dialysis will show some benefit.

Other Groups Work

At least 4 other independent groups have reported on GDD. In fact individuals who have described Symptoms Associated with Gadolinium Exposure (SAGE) really are describing GDD.

Highlights are works co-authored by Larry Koran of Stanford University that reported on biomarkers of Mitochondrial injury, and the associated benefit of Low Dose Naltrexone.

This is only the start of other authors writing on this subject. It is critical in Medicine for generalizability to be shown. This has been done and will expand. It is my hope that since I have written so much on this subject, into the headwind of formal Radiology objection, that other radiologists will see they now have cover and permission to write on this subject.

Codes now exist

There is an ICD10 code for Gadolinium toxicity T56.82. CPT code for treatment (other heavy metals) 83018. Congratulations to the researchers who worked hard to come up with these codes.

Critical Work Still to Do.

Gene Discovery for the gene or gene cluster responsible for GDD.

Identification of the localization of Gd in the tissues. One study has shown that most of the retained Gd is retained in the endovascular tissue (maybe 70%) and a sizable amount in the extracellular matrix (maybe 30%). It is not clear to me how much remains extracellular, and how much is intracellular, and if intracellular how much in the critical cells (eg:neurons). My current opinion is that most of it remains extracellular. A future blog will discuss this in greater detail.

Criticism Remains

GDD does not exist. It should be now evident that to say that GDD does not exist, is tantamount to saying that the world is flat. Some people still think the world is flat, and some people still feel GDD does not exist. I can't do much about either point. At some point the criticism seems purely cynical and probably financial in nature.

Chelation does not work. I believe the criticism is because some amount of Gd is intracellular and may not be removed by chelation. I am not certain that it can't be removed - actually I believe much of it can.

Both these extremes are flawed and I use the expression : Opinion unconfounded by knowledge. Both are dangerous, but for different reasons.

The dangers of ignorance.

Denying GDD is dangerous on many levels, perhaps the worst being with that each subsequent GBCA injection after GDD has developed makes the condition worse, and progressively less treatable. As I have reported earlier, the first treatment for GDD is avoidance: never get another GBCA injection again. My primary interest is that GDD is recognized, and by all MR facilities, because if patients do not receive another GBCA injection again, after the first signs of GDD, this would reduce probably by atleast 70%, the number of individuals with serious GDD

Denying chelation works. First off, I have been doing chelation for 6 years, and many centers throughout the US and world are following (more or less) my approach of iv DTPA.

So to look at the points:

1. if you have GDD, Gd has made you sick.

2. if something makes you sick, don't get it again, and remove it by the best way possible

3. Chelation is the best way to remove Gd, but it has to be done correctly. a) use the best chelator available (most stable chelator for the metal), b) dampen the immune reaction, c) pay attention to nuances: chelator amount, spacing, etc (see below).

4. Documentation of Gd is best done with 24 hr urine. If we show Gd is removed at an amount 20 fold or greater than native elimination, how is this not helpful if you are sick from Gd.

5. Almost all of our patients get substantial improvement of GDD symptoms, and if they get sufficient chelation sessions they achieve near-Cure.. How do you explain near Cure if chelation does not work.

6. Correctly performed chelation is essential. Otherwise things will work out badly. The most common error is to use a poor chelator. The next most common is the multiple nuances: how much chelator to give, spacing chelations, how much steroids, ancillary treatments including supplements, and other subtle variations.

7. If that some amount of Gd is intracellular is your explanation why chelation does not work, then show that is the case rather than postulate that this is the case. I will address in a future blog, in my opinion the fact that chelation works so well, either relatively little Gd enters critical cells (neurons), or re-equilibration also occurs with intracellular Gd as happens with bone retention of Gd, with spaced chelation. This will be addressed at greater length in a future blog.

   
   

Denying chelation works causes enormous damage to the sufferers of GDD, as they will avoid getting the one treatment that will benefit them. Actually I find this misinformation is almost as damaging as denying that GDD exists.

This destroys hope, but does so on the foundation of ignorance. So either do studies that show how you are correct, by doing the level of expert chelation that we do, which will require hiring chemists or pharmacists with expert knowledge of chelation and show it doesn't work, or alternatively stop promulgating damaging misinformation on something that you know nothing about.

Protector Publicus

Richard Semelka, MD