Truth: Gadolinium is retained in the body. It has been found in various organs, tissues, and bones.

Supporting Evidence:

Dr. McDonald et al. (2018) state:

"In humans with normal renal function, only approximately 90% of injected GBCA [gadolinium-based contrast agents] is excreted within 24 hours, but this varies with the specific GBCA. Hence, the exposure time that allows GBCA time to approach equilibrium is naturally longer in humans than in small animals. The human findings may reflect different experimental conditions and suggest that the biodistribution properties of GBCAs are more heterogeneous and complex in humans than in animals.

Further, delayed renal excretion as a result of impaired renal function can significantly increase the amount of circulating GBCA (by as much as a factor of 12), potentially altering the biodistribution of these agents. Clearance data beyond 24 hours in humans are limited. The existence of a long-lasting residual excretion phase, demonstrated by detection of the GBCA in urine for long periods of time after administration, suggests the presence of one or more deep compartments from which the GBCA is slowly released. Bone, liver, and other organs are possible reservoirs for the slow-releasing pool of GBCA. Bone retention was detected up to 8 years after injection."

Additional Considerations:

Detoxification pathways vary significantly among individuals. Factors that may affect gadolinium retention include:

• Immune conditions

• Alterations in tissue pH

• Pregnancy

• Immunotherapy treatments

• Pro-fibrotic predisposition

• Endogenous chelators, such as citrate, which may alter gadolinium speciation

These variables highlight the complexity of gadolinium retention and storage, and the risks associated with its prolonged presence in the body.

Truth: Gadolinium can still be present in the body even if it is not detected in a urine test.

Gadolinium is retained in the human body and can undergo a process called speciation, forming new molecular complexes. This occurs when the gadolinium detaches from its manufactured ligand (the chemical complex designed to stabilize it) and binds to biological ligands. These new molecular complexes are no longer in blood circulation, making them unavailable for excretion through urine. Instead, the gadolinium is stored in various tissues, organs, and bones.

Despite being out of circulation, the newly-formed complexes can still interact with the immune system, triggering inflammation and potentially leading to disease.

(This author’s kappa light chain elevated, and galectin-3 (pro-fibrotic marker) levels became dangerously high and eosinophils escalated after gadolinium injection.)

Gadolinium is excreted through multiple pathways, including urine, stool, and sweat. It can also be detected in nail and hair clippings. However, urine tests are not a reliable measure of total gadolinium in the body, as they only capture gadolinium actively being excreted through the kidneys, not the amount stored in brain, soft tissue, muscles, liver, or bone.

Truth: Chelation is proven to remove some amount of gadolinium from the body and may alleviate symptoms in some patients.

One must remember that gadolinium is toxic due to its paramagnetic nature, which creates disruptions in the body's normal physiochemical reactions. This is why gadolinium must be bound to a chelator in order to be injected. When gadolinium breaks free from the manufactured chemical bond (linear or macrocyclic), it creates new speciation, which can lead to intracellular accumulation and degradation into nanoparticles.

Before gadolinium becomes intracellular or degrades, there may still be some free gadolinium in the body. This free gadolinium can attract the immune system, causing eosinophil, cytokine, and interleukin aggregation, which may trigger inflammation and disease.

Dangers of chelation including “clawing” back of essential minerals into the blood for excretion. Imbalances can occur, and so careful consideration of vitamins and minerals must be considered. It is a complex process, and precision nutrients may need replaced. Chelation therapy can also sequester other heavy metals that are in the body and prepare the metals for excretion, which can be hard on the kidneys. This is why it is critical to be aware of how much heavy metals accumulate in our bodies, and that includes gadolinium.

Truth: Other heavy metal intoxication utilizes IV chelation therapy. Retained heavy metal has risks, too.

Evidence of Chelation's Effectiveness:

• IV Chelation: Intravenous chelation is a known treatment for heavy metal toxicity, including gadolinium retention. Although gadolinium poses additional challenges due to its stronger paramagnetic properties, chelation can remove some gadolinium from the body.

• Urine Testing: By comparing unprovoked (before chelation) urine gadolinium levels and provoked (after chelation) urine test results, more gadolinium is found in the post chelation urine, confirming that chelation removes some gadolinium, albeit in small amounts. This is thought to be due to the availability of gadolinium in circulation.

• Symptom Relief: Some patients report relief from symptoms after chelation. For example, one documented case of a 51-year-old female showed a marked decrease in elevated eosinophils following IV calcium DTPA treatment. These eosinophil levels did not return after two IV chelation treatments.

Timing and Application:

Timing of IV chelation after gadolinium injection and symptom onset are also important areas to study. DTPA appears to help some. Further governmental studies, independent of manufacturers, are needed.

Clinical Questions:

It would be wise to study the patients that received IV Calcium DTPA within certain time allotments. At what point do patients recognize issues with gadolinium toxicity? If gadolinium excretion is delayed after MRI GBCA, if and when should a patient seek medical counsel? What serum labs are affected? Can this also be a clue for gadolinium toxicity treatment guidance?

There are more questions than there are answers. Perhaps the GBCA companies will study this important patient care underrecognized condition. Depending on the GBCA companies to provide all the answers may prove inadequate.

Specialist Involvement:

Understanding and addressing gadolinium toxicity requires collaboration among various medical disciplines, including:

• Internists

• Nephrologists

• Rheumatologists

• Metallurgists

• Environmental Toxicologists

• Immunologists

• Dermatologists

These specialists can help better understand the pathophysiology of gadolinium toxicity and its impact on patients, especially those who are symptomatic or highly symptomatic.

Truth: Chelation may be essential for improved health outcomes, but it does not take all gadolinium out of the body. Chelation therapy may or may not help when someone has GDD.

There are many variables involved in determining whether IV chelation therapy will be helpful. It is also important to remember that some patients are exposed to multiple GBCA administrations before developing sensitivity or recognizing that these agents are causing unusual symptoms, such as small nerve neuropathy. Chelation can help remove free gadolinium or gadolinium that is readily accessible in the body.

Research by Dr. Brent Wagner demonstrates that bone marrow possesses a "memory" of gadolinium exposure, which complicates the treatment of gadolinium induced systemic fibrosis. Gadolinium exposure activates bone marrow-derived fibrocytes, which migrate to tissues and contribute to fibrosis. With repeated exposures, the bone marrow becomes sensitized, producing fibrocytes with heightened responses, which can exacerbate fibrotic damage in the body (Drel, et al., 2016).

While this study focuses on fibrosis, similar immunological changes could hypothetically be possible in individuals with Gadolinium Deposition Disease (GDD), driven by immune system activation rather than fibrocyte involvement. These immune responses could lead to systemic inflammation and damage that chelation alone cannot address. Additionally, the damage caused by gadolinium exposure, whether fibrotic or immune-related, may not necessarily be reversible, further highlighting the complexity of injecting gadolinium into the human body.

It is because of the complexity of the immune system’s heightened response to gadolinium that some IV chelation prescribers choose to use steroids during chelation therapy, as to not further provoke an already-inflamed immune system.

Truth: Most gadolinium toxicity sufferers were unaware of the full scope of risks associated with gadolinium exposure.

Key Points:

• Lack of Awareness: Many sufferers had no knowledge of the extensive studies showing gadolinium toxicity in rats or the significant gaps in long-term human studies. Comparisons of cancer patients monitored with and without gadolinium-enhanced MRIs have not been adequately studied, leaving patients without critical safety data.

• Informed Consent Issues: While written consent is typically obtained, patients are often verbally reassured with vague instructions like “drink lots of water,” implying that adequate hydration minimizes or eliminates risks. These reassurances, combined with statements from the industry about “millions of doses given safely every year,” create a subconscious assurance of safety and minimize perceived risks.

• Emerging Variables: Factors such as the Covid-19 mRNA vaccines may have altered immune responses, potentially changing how some individuals react to gadolinium exposure.

Underrecognition of Risks:

There are many reasons for the underrecognition of gadolinium toxicity, including gaps in research, limitations in diagnostic criteria, and industry influence. For more details, visit gadolinium64.com/reasons.

Truth: Most gadolinium sufferers are not pursuing lawsuits but are instead seeking acknowledgment, proper medical care, and solutions for the devastating effects of gadolinium toxicity.

Financial and Occupational Impact:

Many gadolinium toxicity sufferers are financially crippled due to job loss and disability. In a survey of 51 individuals with gadolinium toxicity, 50% reported being unable to work at all, including those who are disabled or retired due to their condition. An additional 12% indicated they could only work part-time, highlighting the severe toll on their earning potential and quality of life.

Legal Precedents:

• NSF Lawsuits: Lawsuits for Nephrogenic Systemic Fibrosis (NSF) were successful because a dermatology study provided clear evidence. The study demonstrated that CD-34-positive biopsies revealed fibrocytes activated by gadolinium in combination with high phosphate levels, linking gadolinium exposure to the condition.

• GDD Lawsuits: For sufferers of Gadolinium Deposition Disease (GDD), legal action has been far more challenging. A series of lawsuits in 2017 set a troubling precedent. According to one patient, a lawyer representing hundreds of GDD sufferers allowed their statutes of limitations to expire, effectively ending their cases. These lawsuits were subsequently dropped without further explanation, leaving patients without legal recourse.

Scientific Advances and Future Implications:

Fortunately, technological advancements are shedding light on the damaging effects of gadolinium. Studies now demonstrate that gadolinium nanoparticles can significantly harm mitochondrial health, and new disease entities related to gadolinium exposure are being identified. These findings underscore the need to update informed consent forms to reflect current scientific knowledge, ensuring patients are fully aware of potential risks before undergoing gadolinium-based procedures.