Gadolinium the beat goes on

Great paper by Dr. Brent Wagner 

Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC13587227/

I saw reference to Dr. Tweedle’s study from 1995, went looking and kept going…

@grok helped with research:

Tweedle studies (date + one line)

Chemistry / development

•  1988 — Wedeking & Tweedle. 153Gd-Gd(DTPA) vs Gd(DOTA) vs free Gd acetate in mice. Free Gd → liver/bone; slow clearance.

•  1989 — US Pat. 4,885,363 (Tweedle et al.). HP-DO3A ligand family → gadoteridol / ProHance.

•  1991 — Tweedle et al. Magn Reson Imaging. Chelates vs endogenous ions (Zn, Cu, Ca): in-vitro transmetallation.

•  1992 — Wedeking, Kumar, Tweedle. Magn Reson Imaging. Seven chelates in mice; acid-dissociation rate predicted 14-day residual Gd in body/liver/femur (r > 0.99).

•  1993 — Wedeking, Kumar, Tweedle. Nucl Med Biol. Free [153Gd]acetate dose map (liver, bone saturation).

•  1993–94 — Kumar/Chang/Tweedle. Inorg Chem. DOTA/DO3A thermodynamics, kinetics, crystal structures.

•  1995 — Tweedle, Wedeking, Kumar. Invest Radiol 30:372–80. Formulated Magnevist, ProHance, Dotarem, Omniscan in mice/rats. 14-day residual: gadoteridol ≈ gadoterate ≤ gadopentetate << gadodiamide. Caldiamide cut Omniscan residual but not to macrocyclic levels.

•  1997 — Tweedle. Eur Radiol. “The ProHance story.” Nonionic + macrocyclic design.

Human / commentary

•  2006 — White, Gibby, Tweedle. Invest Radiol. Human bone ICP-MS after clinical doses: Omniscan >> ProHance.

•  2007 — Tweedle. Br J Radiol. Letter on what “stability” means.

•  2012 — Hao, Runge, Tweedle et al. JMRI. Chemistry and safety review.

•  2015 — Kanal & Tweedle. Radiology. Residual Gd in normal-kidney patients; clinical meaning unknown; choose agent and dose with that in mind.

•  2016 — Tweedle. Magn Reson Imaging. Speciation: chelated vs dissociated Gd.

•  2018 — NIH/ACR/RSNA roadmap (Tweedle co-author). Retention research agenda.

•  2020–23 — Radiology editorials (next-gen agents; Kobayashi cadaver brain/bone/skin; Le Fur rat multi-organ). Same rank order; harm from leftover fraction in normal kidneys still unproven.

Credentials

Michael F. Tweedle, PhD — inorganic/coordination chemist, not a clinician.

Inventor on gadoteridol. Long career at Squibb → Bracco Research USA (1995 paper affiliation). Later Stefanie Spielman Professor of Cancer Imaging, Ohio State University / James Comprehensive Cancer Center; emeritus. High citation count on GBCA chemistry, kinetics, and residual Gd.

Conflicts of interest

Yes, especially 1988–1997.

•  Employee of Bracco Research USA when the comparative 153Gd papers were done.

•  Inventor of the ligand that became ProHance, the agent his studies ranked as lowest residual.

•  1997 “ProHance story” is company-era product writing.

•  Later OSU editorials are academic bylines; he remains the chemist most tied to that product. Contrast research in this field was routinely company-sponsored.

The residual-Gd rank order (linear nonionic highest, macrocyclics lowest) was replicated by others. The conflict is about which product that ranking was built to support, not about whether 153Gd counts existed.

When linears were used vs when macrocyclics arrived

US first approvals (not the 2003 ProHance year on your slide — that is wrong for first US approval).

Linear (open-chain) — first wave, 1988–2008

How that played out in practice

•  1988–mid-1990s: almost all clinical MRI contrast was linear (Magnevist, then Omniscan). That is the window of many older MS protocols and of Tweedle’s rodent work.

•  1992 onward: ProHance available in the US, but Magnevist/Omniscan still dominated volume for years.

•  2006–2010 NSF crisis: FDA restricted Omniscan, Magnevist, OptiMARK in severe renal failure. Use shifted toward macrocyclics + MultiHance.

•  2013+ brain T1 papers: further shift to gadoteridol, gadoterate, gadobutrol.

•  EU 2017: linear general-purpose agents largely suspended; US still allows some linears with warnings.

•  Today: routine body/CNS MRI in the US is mostly macrocyclic; MultiHance and Eovist remain as specialty linears.

Your handwritten 1–5 look like a personal ranking or order of interest (MultiHance → Gadavist → Dotarem → Eovist), not FDA chronology.

ProHance year on the slide: first US approval was December 1992 (CNS adults), with later supplements (pediatrics, etc.). 2003 on that table is not the original approval year.

More about Dr. Tweedle’s work:

Tweedle’s work on gadolinium chelates runs from the late 1980s (chemistry and early animal biodistribution at Squibb/Bracco) through human bone data, NSF-era editorials, and later commentary on retention vs. risk. He is closely associated with gadoteridol (ProHance), the first nonionic macrocyclic GBCA (US approval 1992).

Core animal / chemistry papers (retention and stability)

•  1988 — Wedeking & Tweedle. Comparison of 153Gd-labeled Gd(DTPA)2−, Gd(DOTA)−, and Gd(acetate) in mice. Early head-to-head of linear vs macrocyclic vs “free” Gd; free Gd deposits heavily in liver and bone and clears slowly.

•  1989 — Tweedle et al. US patent 4,885,363. 1-substituted-1,4,7-triscarboxymethyl-1,4,7,10-tetraazacyclododecane and analogs — the HP-DO3A ligand family that became gadoteridol.

•  1991 — Tweedle, Hagan, Kumar, Mantha, Chang. Magn Reson Imaging. Reaction of gadolinium chelates with endogenously available ions (Zn, Cu, Ca, etc.). In vitro transmetallation / dissociation risk.

•  1992 — Wedeking, Kumar, Tweedle. Magn Reson Imaging. Dissociation of gadolinium chelates in mice: relationship to chemical characteristics. Acid-dissociation rates strongly predicted long-term whole-body, liver, and femur residual 153Gd.

•  1993 — Wedeking, Kumar, Tweedle. Nucl Med Biol. Dose-dependent biodistribution of [153Gd]Gd(acetate)n in mice. Maps where unchelated Gd goes (liver, bone saturation).

•  1993 — Kumar, Chang, Tweedle. Inorg Chem. Equilibrium and kinetic studies of lanthanide complexes of macrocyclic polyaminocarboxylates.

•  1993–1994 — Chang, Francesconi, Kumar, Tweedle et al. Crystal structures and stability of Gd/Y/Fe complexes of DO3A and DOTA.

•  1995 — Tweedle, Wedeking, Kumar. Invest Radiol 30:372–380. Formulated Magnevist, ProHance, Dotarem, and Omniscan in mice and rats. Residual 14-day Gd: gadoteridol ≈ gadoterate ≤ gadopentetate << gadodiamide; caldiamide in Omniscan lowered residual Gd but not to macrocyclic levels.

•  1997 — Tweedle. Eur Radiol. “The ProHance story.” Design rationale: nonionic + macrocyclic (lower osmolality, higher kinetic stability).

Human retention and later commentary

•  2006 — White, Gibby, Tweedle. Invest Radiol. Omniscan vs ProHance residual Gd in human bone (hip surgery samples) by ICP-MS. Linear agent left substantially more Gd in bone after clinical doses.

•  2007 — Tweedle. Br J Radiol. Short letter on what “stability” of Gd chelates actually means.

•  2012 — Hao, Ai, Goerner, Hu, Runge, Tweedle. J Magn Reson Imaging. Review: basic chemistry and safety of MRI contrast agents.

•  2015 — Kanal & Tweedle. Radiology. Editorial: residual/retained Gd in patients with normal renal function; practical implications after Kanda-type brain T1 findings.

•  2016 — Tweedle. Magn Reson Imaging. “Gadolinium deposition: is it chelated or dissociated Gd? How can we tell?” Speciation methods review.

•  2018 — McDonald, Levine, Weinreb, … Tweedle (workshop co-author). Radiology. NIH/ACR/RSNA gadolinium retention research roadmap.

•  2020 — Tweedle. Radiology. “Next-generation MRI contrast agents: still including gadolinium.”

•  2021 — Tweedle. Editorial on Kobayashi et al. human cadaver brain/bone/skin comparison (gadobenate vs gadoteridol); notes higher linear retention but argues clinical toxicity of residual intact chelate or trace ion remains unproven in normal kidneys.

•  2023 — Tweedle. Editorial on Le Fur et al. rat multi-organ ICP-MS/speciation study (gadoteridol lowest among agents tested; kidney cortex highest residual).

Development thread in one line

Linear DTPA-type agents (Magnevist, then Omniscan) → kinetic-stability problem shown in 1988–1995 rodent 153Gd work → macrocyclic HP-DO3A (ProHance) designed and marketed as more inert → later human bone (2006) and brain-signal (2013+) data confirmed the same rank order: linear nonionic > linear ionic ≥ macrocyclic, with gadoteridol often at the low end of residual Gd.

Gadolinium

 

Good study. 95% of my doctors don’t believe gadolinium is a problem. That’s why I added it to my allergy list.
I particularly like the articles they cited like@Wagner_Nephro https://t.co/Pz4BNZxFug https://t.co/jRgialCpK6 pic.twitter.com/gfqV5sK5k0

— Mary Gerdt Parler:Alvarita1 (@marygerdt) August 16, 2026

Gadolinium

 Super Grok

Gadolinium

 Gadolinium

Our group of concerned patients and healthcare professionals are individually reporting our experiences regarding gadolinium. We request that each of You read Debbie Lambert’s Book and pass onto the next Doctor on the list at the end. Each subject has specific questions We want to You to consider.

Mary Gerdt RN

My Summary of Debbie Lambert’s Book:

I invite members of our group to offer their summary:

Background:

I am in an online world wide group raising awareness about the use of intravenous gadolinium for MRI Magnetic Resonance Imaging contrast.

Dr. Brent Wagner’s research has given us objective data through his studies.

https://hsc.unm.edu/directory/wagner-brent.html

Debbie Lambert is a friend who wrote this book. Debbie included experiences of patients who suspect they have Gadolinium Deposition Disease.

My Review:

Title: Gadolinium Deposition and Toxicity

by Debbie Heist Lambert and Contributors

Section 1

Beginning to Page 56:

Debbie’s Personal Journey.

Doctors and God.

Faith and Family.

Science and Pharmaceuticals.

If You don’t believe in God or 

Gadolinium Toxicity,

Skip this section.

Me: I found a comfort in our shared experiences.

Curiosity and Faith.

Section 2

Page 57-Page 98

Chelation. Controversial. My 8 Academic Specialty Doctors don’t even believe I could have gadolinium deposits worsening MS, Seizures, Heart issues, Dermatology issues.

If You are already skeptical, you’re not alone. 

Fellow Patients I know have been going through Chelation Protocols. 

Some are posting and sharing their lab results, experiences with Chelation. Positive results. Multiple Treatments. Gradual subjective improvements.

Resource for Gadolinium Retention and chelation protocols:

Dr. Richard Semelka

https://www.richardsemelka.com/

Page 99-104 Religion

Belief in God or Your Savior.

When the world darkens You need a shining light.

Patients often turn to faith when their lives are turned upside down. 

Courage is a recurring theme.

“Courage is the Human virtue that counts the most,

Courage to act on limited knowledge and

Insufficient evidence.

That’s all any of us have.”

Robert Frost

Page 105-214 Patient’s Journeys

Unique with Differences and

Common Themes,

Similarities,

Can You Visualize the Subjective Symptoms?

Page 215-222 Patient Support Groups,

Patient led Questions and Polls 

Page 223-228 Grief, Social Media Connections,

Finding your support.

Page 229-230 Informed Consent. Should really be at the beginning of any Injection of Gadolinium prior to an MRI. In my opinion the Informed Consent discussion must begin in the Doctor Examination room. Explain:

The reason for the MRI.

Why use Gadolinium as contrast.

Side effects like those described in the FDA warning messages:

@Grok:

Gadolinium-based contrast agents (GBCAs) are injectable drugs used to enhance the quality of magnetic resonance imaging (MRI) scans by improving visibility of internal structures, such as blood vessels, tumors, or inflammation.

Yes, the U.S. Food and Drug Administration (FDA) requires black box warnings—the agency's strongest safety alert—on the labeling for all GBCAs. These warnings have evolved over time based on emerging safety data.

### Key Elements of the Black Box Warnings

The boxed warnings primarily address two major risks:<- Nephrogenic Systemic Fibrosis (NSF): GBCAs increase the risk of this rare but serious condition, which can cause debilitating or fatal fibrosis (thickening and hardening) of the skin, muscles, and internal organs. The risk is highest in patients with impaired kidney function, such as those with chronic severe kidney disease (glomerular filtration rate [GFR] < 30 mL/min/1.73m²) or acute kidney injury. The FDA first mandated this black box warning in 2007 after linking NSF to GBCAs in vulnerable patients. Healthcare providers must screen patients for kidney issues, estimate GFR if needed, and avoid GBCAs in high-risk individuals unless essential and no alternatives exist. For those at risk, providers should not exceed recommended doses and allow time for drug elimination before repeat administration. Hemodialysis may be considered post-administration for patients already on it, though its preventive value for NSF is unproven.

- Intrathecal Administration Risks: GBCAs are not approved for injection into the spinal canal (intrathecal use) and can cause severe adverse reactions, including death, coma, encephalopathy, seizures, or other neurological issues if administered this way.

### Additional Class Warnings (Not in the Boxed Section)

Beyond the black box, the FDA requires class-wide warnings in the labeling for all GBCAs, including:- Gadolinium Retention: Gadolinium from GBCAs can remain in the body (e.g., brain, bone, skin, kidneys, liver, and spleen) for months or years after administration, even in patients with normal kidney function. Linear GBCAs (e.g., Omniscan, OptiMARK) cause higher and longer retention than macrocyclic ones (e.g., Dotarem, 

Gadavist, ProHance). While no direct causal link to adverse effects has been established in those with normal kidneys, rare reports of multi-organ symptoms exist without proven ties to retention. Higher-risk groups (e.g., those needing multiple doses, pregnant women, children, or patients with inflammatory conditions) should have retention characteristics considered when selecting a GBCA. Minimize repeated or closely spaced MRI scans when possible. This warning was added in 2017 based on evidence of long-term deposition.- Hypersensitivity Reactions: Anaphylactic or allergic reactions can occur, ranging from mild to severe (including death), involving the heart, lungs, or skin. Patients with a history of allergies, asthma, or prior contrast reactions are at higher risk. Immediate medical support must be available during administration.

- Other Updates: In 2025, warnings were expanded for some GBCAs to include risks of severe lung issues, such as acute respiratory distress syndrome (ARDS) or pulmonary edema. Manufacturers must provide patient Medication Guides explaining these risks, and further studies on safety are required.

These warnings apply to all FDA-approved GBCAs, though risks vary by agent type (linear vs. macrocyclic). No harmful effects from retention have been confirmed in patients with normal kidney function, but ongoing monitoring and research continue. If you're a patient or provider, consult the specific product's labeling or the FDA website for the latest details, and discuss risks with a healthcare professional before any MRI with contrast.

For reporting adverse effects of Gadolinium:

https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program

Page 231-234 What about the MRI Machine?

Who thought of this machine, now used for a wide spectrum of uses. 

Page 235-239 Holistic Health

Might make you feel better.

Might not. Sometimes all you have.

Me: No kale.

Page 241-244 Documenting Issues

Side effects. I found my journals. My memory shot. Glad I wrote down my old nurse charts.

Photos, sketches, subjective, objective, assessment, plan.

Page 246 QR code for resource links

Page 247-248 Curiosity welcome

Page 249-252 Terminology and Definitions 

Page 253 FDA.gov resources

Page 255-257 Commonly Reported Side Effects

Page 259 Be your own advocate

Page 261 Confirming Toxicity

Page 263 Reporting Adverse Reactions

Page 265-267 Patient online groups

Page 269-272 Educational and Medical

Research Resources

Page 273 Cures(?)

Antidotes(?)

Treatment Options(If my doctors believe me)

Status 2025…needs more work.

Page 275-276 Environmental impact of

REE-Rare Earth Elements.

MG-I add the human toll of ethnic slaves,

including children mining REE’s using picks and shovels in China and some African nations.

Page 277-278 Final Thoughts

Page 279 About the Author

Summary of My Medical Path

Mary E. Gerdt

67 years old in 2025

I had symptoms of Multiple Sclerosis beginning at

age 37 in 1995. I had right hemibody numbness. I saw my Primary Care Doctor who felt like it was

Multiple Sclerosis. I had an MRI without contrast which was negative I was told. My second episode was several years later and diagnosed as right optic neuritis. My ophthalmologist treated me with 3 days of IV steroids once a day. Neurology wouldn’t diagnose me yet. I Needed to have 2 episodes. I did but they didn’t. I called it 3 neurologists separated by time. My neurologists changed in the middle of my path. My third episode was several years later. I had right hemibody numbness. My MRI without contrast was negative as told to me. Doctor asked me if I had ever had an MRI of my cervical spine.

In 2007, I had gadolinium, my 5th cervical lesion glowed. It looked like a knife cut. The doctor said I had many old scars in my brain. I asked her if they were new. She said they were there all the time, Every scan. They never saw

the Glow.

My doctor asked me to be on a study called CombiRx.

I had another Gadolinium MRI as a baseline,

at 6 months, then yearly. I don’t know which gadolinium drug I received, dose or MRI reports during the study duration: 2007-2016. I had 11 gadolinium doses in 9 years.

The radiology technician said gadolinium is not toxic, is excreted rapidly via kidneys and hydration isn’t necessary. 

My Journals.

I started to journal in 2007, the year diagnosed

with Multiple Sclerosis. Reading through my journals was both a learning experience and a realization that You would find them too full of details that are

not scientific, sketches of skin issues, subjective experiences like “brain is on fire”,

“white hard shards piercing the ends of my toes and fingers, fingernails and toenails gone”.

“Severe constant pain all over”.

All the homemade tinctures, salves, CBD, THC, hash gummies, baclofen, tizanidine.

You might find my path unconventional, reckless,

foolish, interesting. Every page, however explains everything that didn’t work to resolve my issues.

If you ever want to see them, send me an email:

alvarita1@aol.com

As my MS progresses, my journals have turned to art scribbles, zentangling, blogging, X’ing.

Temporal Lobe seizures have altered my brains electrical circuitry. 3 seizure medications failed to correct my damaged memory. Deja vu is extremely brief and now infrequent. Third med did the trick.

Regarding Multiple Sclerosis, my  path has been in 

slow, steady decline since age 49, after my third exacerbation in 12 years-undiagnosed.

Perhaps ironically, it was my first dose of gadolinium contrast that helped visualize my fresh 5th cervical nerve demyelination.

More of my journals will likely be too subjective to validate any of my feelings as related to gadolinium and MS.   

When I started suspecting gadolinium as a toxic

contrast agent, I realized I was fighting big pharma,

big radiology, the status quo, pretty pictures, standards,

protocols, billing, forms with checkmarks,

while also not sounding kooky.

Not alone I found out. The world wide connections are

invaluable.

My neurologist and his nurse were friends, coworkers,

supporters. I enrolled in the CombiRx study in 2007.

This study required a diagnostic MRI with gadolinium contrast.Then I had another as the baseline MRI with gadolinium contrast.Then at 6 months after, then yearly. 

The study extended to 2016. It required 11 gadolinium doses in 9 years.

I was randomized to subcutaneous copaxone

every day and still take it.

My MS progression has, thankfully, been gradual

yet steady. At 67, finally needing a wheelchair and supervision with transfers. Several falls this year,

several 911 transfers to the hospital. Discovering more

memories I have lost, vanished, gone, evaporated.

Can Multiple Sclerosis be responsible for each and every single nerve demyelination, interrupting nerve function?

Could retained metal cross through demyelinated scars, gateways, cross the blood brain barrier and into the glymphatic system.

Rare Earth Toxic Nonbiological Nanoparticles of metal,

Known to be retained in our vital organs for perhaps years, or possibly forever?

Summary of My MRI’s with and without Gadolinium

Dates, Location, Reason, With or Without Gadolinium, Brand and dose if You know.

Informed consent?

I had a total of 11 Gadolinium contrasted MRI’s in 9 years. From 2007-2016. Then yearly Non contrasted MRI’s until 2022. I never received informed consent. I was told more than once that Gadolinium is excreted rapidly and hydration is not necessary.

I don’t know the drugs I was administered.

FDA black box warnings, Who knew?

Dr. Michael Tweedle

Gadolinium Contrast Developer, Academic, Expert, Pharmaceutical Representative.

References and Doctors studying Gadolinium:

Grok responses:

### Key Researchers on Gadolinium Ill Effects

Several researchers have contributed to understanding the adverse effects of gadolinium, primarily from gadolinium-based contrast agents (GBCAs) used in MRI scans. These include toxicity mechanisms, tissue retention, nephrogenic systemic fibrosis (NSF), gadolinium deposition disease (GDD), and other symptoms like pain, cognitive impairment, and fibrosis. Below is a summary of prominent researchers, their affiliations (where available), and their key contributions based on published work.

• Brent Wagner, MD (University of New Mexico Department of Internal Medicine; Raymond G. Murphy Veterans Affairs Medical Center): Focuses on gadolinium's role in triggering inflammatory responses and fibrosis. His lab demonstrated that gadolinium exposure induces fibrocyte accumulation in skin tissue and that bone marrow retains a "memory" of exposure, exacerbating fibrosis. He leads studies on animal models, human tissue, and pilot clinical trials exploring treatments, emphasizing risks even in patients with normal kidney function.

• Richard C. Semelka, MD (University of North Carolina at Chapel Hill, Radiology): A leading voice on GDD and gadolinium retention. His work documents symptoms like pain, skin changes, fatigue, and cognitive issues in patients with normal renal function after GBCA exposure. He has co-authored reviews on mechanisms, including dechelation and inflammation, and small 

• 
  
• trials on chelation therapy (e.g., Ca/Zn-DTPA) to reduce gadolinium levels and symptoms. Semelka advocates for minimizing GBCA use and informed consent.

• Jose L. Domingo, PhD (Universitat Rovira i Virgili, Toxicology): Co-authors reviews on gadolinium toxicity, highlighting NSF in renal-impaired patients, GDD symptoms, brain deposition, and mechanisms like transmetallation and nanoparticle formation. His 2025 review emphasizes cumulative biological interactions and calls for non-gadolinium alternatives like manganese-based agents.

- Moshe Rogosnitzky (MedInsight Research Institute): Authored a 2016 review on GBCA toxicity mechanisms, including NSF, tissue accumulation (brain, bone, kidneys), and effects like nephrotoxicity, neurotoxicity (e.g., encephalopathy), hepatotoxicity, and oxidative stress. He discusses Gd³⁺ dissociation from chelates and potential chronic symptoms from patient surveys.

• Tomonori Kanda, MD, PhD (Teikyo University School of Medicine, Radiology): Pioneered studies on brain gadolinium retention, showing T1 hyperintensity in regions like the dentate nucleus linked to cumulative GBCA doses, even without blood-brain barrier damage. Autopsy work confirmed deposition in patients with normal kidneys.
• 
  
• Robert J. McDonald, MD, PhD (Mayo Clinic, Radiology): Conducted autopsy studies detecting gadolinium in brain tissue years after exposure, with higher levels from linear GBCAs. His research notes 

• 
  
• retention in bones and other tissues but questions direct harmful effects, though it contributes to deposition evidence.

• Diana Zuckerman, PhD, and Stephanie Fox-Rawlings, PhD (National Center for Health Research): Authored a 2019 report synthesizing risks like NSF, brain retention, GDD, and potential prenatal effects. They review studies showing metabolic changes in exposed brains and call for more research on treatments and environmental impacts.

• Jan O. Aaseth, MD, PhD (Innlandet Hospital Trust, Norway): Co-authored a 2022 review on Gd chemistry, chelates, and toxicity, covering NSF, fetal risks (e.g., motor impairments in animal offspring), and retention mechanisms. Emphasizes chelate stability to prevent Gd³⁺ release.

Other notable contributors include Gunnar F. Nordberg (Umeå University, Environmental Medicine), Valeria M. Nurchi (University of Cagliari, Chemistry), and Nebal Iyad (Palestine Polytechnic University), who have reviewed deposition diseases, chelate challenges, and alternatives.

### Summary of Key Scientific Papers

Here are summaries of influential papers on gadolinium's ill effects, focusing on toxicity, retention, and clinical manifestations. These highlight risks like NSF (primarily in renal impairment), GDD (in normal renal function), brain deposition, and mechanisms such as Gd³⁺ dechelation.

Rogosnitzky M, Branch S. (2016). "Gadolinium-based contrast agent toxicity: a review of known and proposed mechanisms." Biometals.  

  Comprehensive review of GBCA risks, including NSF from impaired clearance, Gd accumulation in brain/bone/kidneys (persistent up to 8 years), nephrotoxicity (tubular necrosis), neurotoxicity (encephalopathy, ataxia), hepatotoxicity, and oxidative stress. Mechanisms: Gd³⁺ dissociation (worse in linear agents), calcium disruption, and fibrosis via cytokines. Calls for Gd testing in exposed patients.

- Domingo JL, Semelka RC. (2025). "Gadolinium toxicity: mechanisms, clinical manifestations, and nanoparticle role." Archives of Toxicology.  

  Synthesizes evidence on Gd retention across tissues (brain hyperintensity, bone reservoir), NSF (fibrosis in renal patients), GDD (pain, cognitive issues, fatigue), and rare acute effects like hypersensitivity. Introduces nanoparticle formation as a release mechanism, challenging macrocyclic stability; recommends alternatives like Mn-based agents and chelation trials.

- Blomqvist L, et al. (2022). "Gadolinium in Medical Imaging—Usefulness, Toxic Reactions and Possible Countermeasures—A Review." Biomolecules.  

  Covers Gd chelate properties, NSF (Gd phosphate deposits in tissues), retention in normal kidneys (linked to linear agents), rare anaphylaxis, minimal nephropathy risk, and fetal toxicity (anxiety/motor issues in animals; potential human stillbirth risks). Stresses restricting use in at-risk groups to eliminate NSF.

- Iyad N, et al. (2023). "Gadolinium contrast agents- challenges and opportunities of a multidisciplinary approach: Literature review." Journal of Radiation Research and Applied Sciences.  

  Discusses Gd deposition in brain/bones leading to lesions, NSF, and GDD. Notes free Gd release concerns and explores non-Gd alternatives or improved GBCAs to mitigate toxicity.

- Kanda T, et al. (2014/2015). Multiple papers on brain gadolinium deposition in Radiology and Investigative Radiology.  

  Linked cumulative GBCA doses to T1 hyperintensity in dentate nucleus/globus pallidus; autopsy confirmation of Gd in brain tissue without renal issues or barrier damage.

- McDonald RJ, et al. (2015/2017). Autopsy studies in Radiology.  

  Detected Gd in brain regions years post-exposure, higher with linear agents; bone levels 23x brain, but no proven harm.

- Semelka RC, et al. (2016). "Gadolinium in humans: A family of disorders." American Journal of Roentgenology.  

  Survey-based study on GDD symptoms (pain, skin changes, cognitive fog) in self-reported patients post-GBCA.- Fox-Rawlings S, Zuckerman D. (2019). "The Health Risks of MRIs with Gadolinium-Based Contrast Agents." NCHR Report.  

  Compiles evidence on NSF decline via guidelines, retention in normal patients (metabolic brain changes), GDD, prenatal risks, and environmental contamination; urges more studies on chelation and alternatives.

These works substantiate gadolinium risks, particularly with linear GBCAs and repeated exposures, though some studies (e.g., Mayo Clinic) note no clear harm from brain deposition. Regulatory changes, like FDA warnings and European suspensions, stem from this research.

Contacts for Doctors testing patients for

Gadolinium Retention and Therapeutic Chelation Techniques. Individual responses.

### Doctors and Clinics Specializing in Testing for Gadolinium Retention and Therapeutic Chelation

Gadolinium retention testing typically involves provoked or 24-hour urine tests for gadolinium levels, often combined with symptom assessment. Therapeutic chelation, primarily using IV Ca-DTPA and Zn-DTPA, is experimental and off-label for gadolinium deposition disease (GDD) or related symptoms, as it is not an FDA-approved standard treatment. It is offered by select integrative medicine practitioners and specialists familiar with heavy metal toxicity. Availability is limited, and patients should consult directly for current services, costs, and eligibility.

#### Richard C. Semelka, MD

- Specialty: Leading expert on Gadolinium Deposition Disease (GDD); pioneered research and clinical description of the condition. Offers consultations, diagnosis, and DTPA chelation therapy.

- Location: North Carolina (clinic in the Raleigh-Durham-Chapel Hill area; previously affiliated with UNC).

- Contact: Website: https://www.richardsemelka.com/ (includes consulting information and blog on gadolinium toxicity). Associated with GadTTRAC nonprofit for patient support: https://gadttrac.org/.

- Notes: Treats patients worldwide; often recommends initial chelations under his care. Charges apply for consultations and treatments.

#### Vitality Integrative Medicine

- Specialty: Comprehensive evaluation and treatment of gadolinium toxicity, including DTPA chelation (Ca-DTPA and Zn-DTPA protocol over two days, repeated as needed). Monitors gadolinium levels in blood/urine and symptoms.

- Location: Los Angeles area (serving Sherman Oaks, Studio City, Encino, and surrounding regions).

- Contact: Website: https://vitalityintegrative.com/gadolinium-toxicity/ (includes scheduling and consultation info). Practitioners include naturopathic and integrative doctors.

- Notes: Tailored plans with ongoing monitoring; emphasizes personalized care for symptom improvement.

#### Integrative Medicine Center of Western Colorado

- Specialty: Diagnosis and chelation therapy for GDD, preferring DTPA agents for gadolinium removal.

- Location: Western Colorado.

- Contact: Website: https://imcwc.com/gadolinium-deposition-disease-gdd/ (details on services).

- Notes: Focuses on heavy metal detoxification protocols.

#### Other Potential Providers

- GadTTRAC-Listed Practices: The nonprofit GadTTRAC (associated with Dr. Semelka) maintains a list of treating physicians using similar DTPA protocols. Examples include:

  - William D. Kracht, DO (Family & Integrative Medicine).

  - Isabel Sharkar, NMD (Indigo Integrative Health Clinic, Washington, DC area: 1010 Wisconsin Ave., NW).

- Contact for List: Visit https://gadttrac.org/gdd-treating-practices or contact via Dr. Semelka's site for referrals.

- Notes: Centers can be added upon request; focuses on physicians experienced in GDD chelation.

#### General Notes

- Testing: Many integrative/heavy metal toxicity clinics offer provoked urine testing for gadolinium (e.g., via labs like Quest Diagnostics or specialized toxic metal panels).

- Chelation Networks: Sites like chelationdoctors.com offer general heavy metal chelation (including gadolinium testing) through affiliates, but confirm if they use DTPA specifically.

- Caution: Chelation carries risks (e.g., mineral depletion, flare reactions). Mainstream medical organizations note limited evidence linking retention to symptoms in normal kidney function patients and do not endorse routine chelation.

- Recommendations: Start with a consultation from the above specialists. Patient support groups (e.g., MRI-Gadolinium Toxicity on gadoliniumtoxicity.com) often share updated experiences.

For the most current information, visit the listed websites or contact the clinics directly, as services may evolve.

### Contact Information for Key Gadolinium Researchers

Researchers studying gadolinium toxicity, retention, and related effects (e.g., nephrogenic systemic fibrosis, gadolinium deposition disease) are primarily academic or clinical experts. Direct patient contact is rare unless they offer consultations (e.g., for diagnosis or treatment). Most can be reached via institutional emails, department directories, or professional profiles. Information is based on publicly available sources as of late 2025.

#### Brent Wagner, MD, MS

- Affiliation: Director, Kidney Institute of New Mexico; Associate Professor, Division of Nephrology, University of New Mexico Health Sciences Center; Associate Chief of Staff for Research, New Mexico VA Health Care System (Albuquerque/San Antonio affiliations noted).

- Focus: Mechanisms of gadolinium-induced fibrosis, nanotoxicology, retention in tissues (including bone marrow "memory"), and potential treatments.

- Contact:

  - Email: brwagner@salud.unm.edu (primary correspondence address from publications).

  - Institutional directory: https://hsc.unm.edu/directory/wagner-brent.html

  - ResearchGate: https://www.researchgate.net/profile/Brent-Wagner-4 (for collaboration requests).

  - Google Scholar: https://scholar.google.com/citations?user=LnnSF7sAAAAJ

- Notes: Primarily research-focused; not known for direct patient consultations.

#### Richard C. Semelka, MD

- Affiliation: Independent consultant (formerly University of North Carolina at Chapel Hill); Leading expert on Gadolinium Deposition Disease (GDD).

- Focus: Clinical manifestations of GDD, chelation therapy, patient advocacy.

- Contact:

  - Website: https://www.richardsemelka.com/ (for consultations, including gadolinium toxicity; booking and fees available).

  - Email: richardsemelka@gmail.com (from publications and site).

  - Associated nonprofit: GadTTRAC (https://gadttrac.org/) for referrals and treating practices.

  - LinkedIn/Facebook: Search "Richard Semelka MD Consulting".

- Notes: Offers paid consultations worldwide for gadolinium-related issues.

#### Tomonori Kanda, MD, PhD

- Affiliation: Department of Radiology, Kobe University School of Medicine (or previously Teikyo University).

- Focus: Pioneering studies on brain gadolinium deposition (T1 hyperintensity in dentate nucleus), autopsy confirmation.

- Contact:

  - Email: k_a@hotmail.co.jp (from publications).

  - ResearchGate: https://www.researchgate.net/profile/Tomonori-Kanda

  - Institutional: Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan (older affiliation; verify via Kobe University).

- Notes: Academic researcher; contact for scientific collaboration.

#### Robert J. McDonald, MD, PhD

- Affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.

- Focus: Autopsy studies on brain and tissue gadolinium retention, safety assessments.

- Contact:

  - Institutional address: Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.

  - Directory/Profile: https://www.mayoclinic.org/biographies/mcdonald-robert-james-m-d-ph-d/bio-20213582

  - Pure/Elsevier profile: https://mayoclinic.elsevierpure.com/en/persons/robert-mcdonald (for publications and potential contact).

- Notes: Clinical and research role at Mayo Clinic; use official channels for inquiries.

#### Jose L. Domingo, PhD

- Affiliation: Professor Emeritus of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili (Reus/Tarragona, Catalonia, Spain).

- Focus: Reviews on gadolinium toxicity mechanisms, clinical manifestations, alternatives to GBCAs.

- Contact:

  - Institutional: Laboratory of Toxicology and Environmental Health, Universitat Rovira i Virgili.

  - ResearchGate: https://www.researchgate.net/profile/Jose-Domingo-2

  - Google Scholar: https://scholar.google.com/citations?user=0t5nSUcAAAAJ

  - ORCID: https://orcid.org/0000-0001-6647-9470

- Notes: Emeritus status; best for academic correspondence via university or profiles.

#### General Notes

- For patient support or referrals: Patient advocacy sites like https://gadoliniumtoxicity.com/ or GadTTRAC often list treating physicians.

- Researchers may not respond to individual patient inquiries due to focus on science; use institutional emails professionally.

• Contact details can change; verify via university websites or recent publications. For clinical advice, consult a healthcare provider.

Questions for you to think about:

Have You:

Ever had an MRI test?

What part of your body?

Location of MRI machine.

Ordering physician.

Purpose.

Were you given informed Consent regarding risk factors, possible side effects, how to report possible side effects and to whom? Were you given information about the documented side effects patients experienced?

Did you receive Contrast?

Was it Gadolinium?

Specific brand name, Date and dose if you know.

Follow up MRI’s?

Were results reviewed with you by the ordering doctor?

If You felt you might have experienced or are 

experiencing ill effects you might suspect are related to Gadolinium,

Did you report to your doctor?

How did your doctor respond?

Did you make a report to the FDA?

How did they respond?

Do you list gadolinium as an allergy?

Have you been advised you will need more MRI’s

with gadolinium contrast?

Human Rights Abuses and 

Environmental Destruction

REE Rare Earth Element Mining with Grok’s help:

### Human Rights Abuses Associated with Gadolinium Mining

Gadolinium is a rare earth element (REE), primarily extracted as a byproduct from REE deposits like bastnäsite and monazite (e.g., Bayan Obo in China) or ion-adsorption clays (southern China). No standalone gadolinium mines exist; its production ties directly to broader REE mining, which links to significant human rights and environmental abuses. These include health impacts from pollution (affecting rights to health and clean environment), poor labor conditions, and indirect ties to forced labor.

#### Primary Production Sites and Key Abuses

- China (Dominant Producer: ~98% of Global REEs, Including Gadolinium):

  - Bayan Obo Mine (Inner Mongolia): The world's largest REE mine, a major gadolinium source.

    - Severe environmental pollution: Radioactive thorium tailings, toxic waste contaminating soil, water (Yellow River watershed), and air. Communities report livestock deaths, birth defects, cancers, and respiratory/nervous system issues — violating rights to health and a healthy environment.

    - Worker abuses: Overwork, underpayment, lack of safety monitoring; exposure to radiation and toxins causes skin, respiratory, and cardiovascular problems.

    - Historical forced labor: Reports of prison labor in Baotou facilities linked to REE processing.

    - Broader context: REE processing in Xinjiang tied to Uyghur forced labor (e.g., polysilicon for related tech, but extending to minerals).

  - Ion-Adsorption Clays (Southern China): Key for heavy REEs like gadolinium.

    - Inefficient leaching causes deforestation, soil erosion, and ammonium sulfate/heavy metal wastewater pollution.

    - Local communities face health risks from contaminated water and land, with limited transparency or compensation.

- Myanmar (Emerging Source for Heavy REEs, Including Gadolinium-Rich Compounds):

  - Rapid post-2021 coup expansion in Kachin State, controlled by militias and ethnic armed groups.

    - Revenues likely fund military/junta abuses (atrocities, civilian killings).

    - Environmental devastation and threats/violence against locals opposing mining on ancestral lands.

    - High risk of conflict financing and human rights violations.

#### Broader REE Mining Abuses Relevant to Gadolinium Supply Chains

REE mining globally links to:

- Forced and Child Labor: In China (Uyghurs in processing); DRC (cobalt, but overlapping supply chains); other sites.

- Indigenous and Community Rights Violations: Displacement, lack of consent, violence against defenders.

- Health and Safety: Occupational hazards (radiation, toxins); community exposure leading to diseases.

- Conflict Financing: In Myanmar and high-risk areas.

While gadolinium-specific abuses are not isolated (due to co-production), its supply chain inherits these issues. Demand for REEs in green tech (e.g., MRI contrast from gadolinium, magnets) exacerbates mining pressures. Reports from Human Rights Watch, Global Witness, and others highlight that voluntary standards fail; mandatory due diligence is needed.

Efforts like UN guidelines and proposed treaties aim to address these, but enforcement lags. Diversifying sources (e.g., Australia, US) and recycling could reduce reliance on high-risk sites.

Environmental impacts of patients urinating into the wastewater stream by grok.

Yes, the excretion of gadolinium-based contrast agents (GBCAs) from patients' urinary tract into wastewater contributes to environmental pollution, primarily as an emerging micropollutant in aquatic systems.

### Pathway and Persistence

Patients excrete most GBCAs (up to 98% within 24 hours) unmetabolized via urine after MRI scans. These stable chelates enter municipal wastewater systems. Conventional wastewater treatment plants (WWTPs) remove only about 10-40% of gadolinium, as the complexes resist biological degradation, adsorption, or precipitation. The remaining anthropogenic gadolinium (Gd_anth) discharges into rivers, lakes, estuaries, and coastal waters via WWTP effluents.

### Environmental Distribution and Detection

This results in widespread "gadolinium anomalies" (elevated Gd relative to natural rare earth element patterns) in surface waters worldwide, often used as a tracer for wastewater contamination. Concentrations rise near urban areas with high MRI usage, reaching levels orders of magnitude above natural backgrounds (e.g., ng/L to μg/L in rivers like Tokyo's or Europe's). Gd_anth has been detected in:

- Drinking water sources

- Tap water

- Groundwater via bank filtration

- Marine environments (e.g., North Sea, San Francisco Bay)

- Even remote coastal sites

### Potential Ecological Impacts

While chelated GBCAs are relatively inert and non-toxic initially, environmental processes (e.g., UV radiation, biodegradation) can partially degrade them, releasing free Gd³⁺ ions, which are more toxic. Studies show effects on aquatic organisms, including:

- Toxicity to algae (primary producers, high sensitivity)

- Mussels and macroalgae (bioaccumulation, biochemical stress)

- Invertebrates (alterations at cellular/biological levels)

- Potential disruption of rare earth element balances in ecosystems

Long-term risks include bioaccumulation in food chains and mixture effects with other pollutants, though ecotoxicology data remain limited and call for more research.

### Mitigation Considerations

Advanced treatments like reverse osmosis (>99% removal) or adsorption (e.g., activated carbon, ~85%) are effective but not widely implemented due to cost. Proposals include on-site urine collection post-MRI or enhanced WWTP upgrades to reduce releases.

Overall, this represents a growing environmental concern tied to increasing MRI usage, with Gd_anth serving as a marker for persistent pharmaceutical micropollutants in water cycles.Grok helped me assemble this story.

My worldwide group of like minded people are

United in hope that one day,

Injected Metals will,

One fine day,

Be banned.

Please help our group by reading Debbie Lambert’s Book,

Read this paper and consider the scientists who are 

listed here. Going against the tide of

Pharma, Billing and that excited feeling when 

a doctor points to your MRI and says,

“Look, Your 5th Cervical Nerve is demyelinated.”

I saw it. A kindergarten student could have seen it.

A glowing slice. MS has been validated.

Could my diagnosis have been possible without seeing it?

Read this paper and pass the paper and book along

to the next doctor on the list.

Mary Gerdt

342 Charles Lane

Louisa, VA 23093