MRI Contrast was originally pitched as something that is temporary, something that leaves the body! But today we know that isn’t so.
Gadolinium is a type of MRI contrast and one of the most popular. It is a silvery-white heavy metal that is injected into the body through a vein and it is a contrast dye. Sometimes it is referred to as contrast media. These dyes are required sometimes, but not always. The trouble is once it’s injected into you, it may not easily leave! They told us that gadolinium would clear the body unless you had kidney trouble, the main detox organ in your body that clears 90% of it. But evidence now suggests that people with perfect kidney function might retain the contrast agent in their brain!
In fact the FDA has come out with this information, and you can read their safety warning HERE before your next MRI.
Why then is it used?
The contrast agents help the radiologist see higher contrast. They allow one to see specific areas inside the human body by highlighting and brightening tissue and organs. Gadolinium is like a flashlight in your body, and in that regard, it is pretty awesome. My husband has had over a dozen MRIs over the years starting in 1994 when they gave him Magnevist®, and over the years they’ve injected him with more GBCAs at least 4 more times!
Yes I am worried now. Especially in light of the brand new research that was just published!
Anyway, using gadolinium, doctors glean more detail about your brain, pancreas, the blood-brain barrier, breast and prostate tissue, the bladder, your heart and a special part of your brain called “the circle of Willis.”
MRIs that engage the use of gadolinium can be ordered for many reasons including migraines, coronary artery disease, stroke evaluation, brain tumors, infections and cysts/tumors. Just a few days ago, the FDA approved use of gadolinium to look at CAD (coronary artery disease).
Thousands of shots of gadolinium dye are administered to people each day. Its use is global and extensive.
It’s injected right before your MRI, just before you go into the imaging unit. Side effects may or may not occur if you’re given this drug. Symptoms stated on most of the literature (and reported by most patients who have received it) are generally very mild like a headache, dizziness, pain at the injection site, prickling or burning sensation on the skin and sometimes nausea. These issues settle down within 24 hours as your body eliminates the drug from your kidneys. It helps if you take an analgesic and some detoxification supplements like glutathione, lipoid acid, or vitamin C.
Every now and then, there’s an extremely dangerous skin problem that occurs where the skin gets very hard and fibrotic. It’s called Nephrogenic Systemic Fibrosis (NSF) and the symptoms may include:
* Thickness of skin or skin patches
* Swelling and tightening of skin
* Odd changes on the arms and legs (like patches of orange peel)
* Skin may darken or change in appearance.
Aside from NSF, there may also be rare but possible kidney complications, or life-threatening allergic reactions (anaphylaxis) to the drug itself, but predicting who has a high risk for these problems is truly impossible.
BUT ARE THESE ALL THE SYMPTOMS ARISING FROM GADOLINIUM?
No – the worst is yet to come if you are impacted.
Benign Fasciculations (ie Muscle Twitching)
Brain Fog and Disassociation from Reality
Looking through a Veil
Blurred and Weird or Altered Vision
Headache – The intense pain may move around within seconds
Head Pain like there’s a thick rubber band around your head
Pain in your bones – very deep and achy
Intense Burning – Sam used to say someone poured hot water on his leg!
Muscle Wasting or Atrophy
Deep, dark depression (loss of dopamine neurons)
Anhedonia and Apathy or Numbness
DP/DR as in Depersonalization and Derealization
Lack of Arousal or Sex Drive (diminished dopamine)
Skin discoloration and/or thickening (termed fibrosis)
(You might get pinned with MS, ALS or Parkinson’s)
Can I prove all of this? Yes, the literature includes some of these symptoms as part of GDD (I’ve boldfaced the ones that are most often acknowledged), but I can assure you that ALL of these ARE symptoms that can occur depending on how many exposures you’ve had, and the type of agent you’ve received.
Time will prove me right 🙁
Gadolinium Takes Up Residence in Your Brain
It’s like a bad renter who won’t leave your property, and you can’t evict him! Gadolinium is sticky, and we’re just finding out it can take up space in the brain, especially in the part of the brain that houses D2 receptors, for dopamine. Long-range effects might look like Parkinson’s due to dopamine depletion. It’s kind of early to tell, this is just my 2 cents, knowing about the area of the brain impacted which is the dentate nucleus and the global palladus. I believe there could be a worsening of cognitive abilities, depression, suicidal ideation, panic, anxiety, movement problems, and balance/incoordination.
This is due to the suppression of dopamine, over time, which may occur with gadolinium-induced damage to the areas of the brain where deposition and retention occur. Again, my observation and professional opinion. The literature says this drug is relatively safe.
Gadolinium has been in the news a lot lately, because the popular contrast agent was shown to be retained in the brain, raising more safety concerns, especially for people who have multiple MRIs over time.
Chuck Norris’s wife has brought forth a $10 million dollar suit against makers and distributors for the harm that she endured right after her GBCA injection and MRI. The lawsuits are starting to gather steam. Back in 2008, there were only hundreds of lawsuits filed in federal court claiming GBCAs had caused Nephrogenic Systemic Fibrosis (NSF) injury.
Today, there are more suits regarding “Gadolinium Deposition Disease” in people who had absolutely no history of kidney disease. This is where I worry my husband fits in. He’s had multiple MRIs of his brain, with GBCA all of the scans normal, yet persistent symptoms 🙁
Furthermore, there has been a study regarding patients who have MS (multiple sclerosis) and these patients were tracked for five years starting from their diagnosis. Over the five years, the researchers found that a GBCA called “gadodiamide” or Omniscan® accumulates in the brain of the participants in the study.
About 9% of MS patients who received 5 doses or less did have accumulation in their dentate nucleus, which is involved in voluntary motor function and cognition. To be fair, this area is often impacted by MS disease progression. The healthy non-MS patients (the controls) did not have any accumulation though.
The study is causing controversy in the MS community for good reason. It’s because MRIs are useful to track the progression of the disease itself, however, the contrast agent might be harmful if used repeatedly due to accumulation.
The study concluded with, “DN, GP, and thalamus gadolinium deposition in early MS is associated with lifetime cumulative gadodiamide administration without clinical or radiologic correlates of more aggressive disease.”
DN = dentate nucleus
GP = globus pallidus
If you or a loved one suffer from MS, I urge you to check out my article, 8 Intriguing Solutions for Multiple Sclerosis and Pain – it might just help!
Should you get an MRI?
Of course, you should if it’s REQUIRED for your situation. But maybe you don’t need 3 per year, for example. Maybe you don’t need contrast.
The first question is to ask if all the MRIs are truly necessary. It’s also fair to ask your doctor, and even press the issue with “Do I really need the contrast agent or you to see what’s going on?”
And if the answer to that is YES, then ask, “Is there another contrast agent to choose from or is the gadolinium-based drug my only choice?”
At this point, your doctor will either be impressed with your knowledge, or upset with your inquisition, but hey, it’s your brain! You’re the one that gets the renter living up in your brain forever and ever, and it’s very hard if at all possible to chelate out!
If you know of a way to chelate this agent out of the body, please WRITE ME at firstname.lastname@example.org
The most promising of chelating agents is one that is NOT approved yet! It’s dubbed HOPO SAMMS short for 1-hydroxy-2-pyridinone. There was also this recent (Jan 2019) animal-model study that discussed an amazing method using silica beads to clear out the whole body of gadolinium – you can read about it by CLICKING HERE.
The only thing I could find available right now was maybe vitamin C or lipoic acid and glutathione. It could be helpful, but only in a mild way. There is also EDTA and DTPA as options, however, neither one works as well as the HOPO SAMM. If you’re a researcher, you can read THIS article which is about, Evaluating the Potential of Chelation Therapy to Prevent and Treat Gadolinium Deposition from MRI Contrast Agents.
Sadly, the only expert in heavy metal chelation who would truly have the answer to this question (How do you get gadolinium out!) was my friend and colleague, the late and great Dr. Walter Crinnion who recently passed away. He authored Clean, Green and Lean. He knew everything 🙁
UPDATE 7-27-19 I just spoke with Dr. David Brownstein and he knows a lot and there is more information from him below (scroll down). For now, I will point you to his article, Say No to MRIs During Pregnancy.
If there are any other environmental or heavy metal chelation experts reading this, or one of the authors of the studies I just cited, please contact me (email@example.com) so I can learn more, and then pay the gift forward to let suffering patients know how to detox from gadolinium toxicity. It can be slow, progressive, and fall totally off the radar of a physician because who would think an injection or MRI from 10 years ago could cause lingering weird or painful problems? Bone and joint pain too!
On the upside, I was able to find some useful information from a well-known radiologist in the field, Dr. Richard Semelka, who commented about gathering evidence in case you’ve had gadolinium exposure and now have symptoms:
“In the early months following the development of the disease patients should exhibit elevated blood, urine or other tissue gadolinium levels. The exact levels necessary are not yet determined. Bone gadolinium deposition is likely present for many years following disease development. In the early months after disease development, it may be of value to show elevated gadolinium deposition in some fluid or tissue to establish the diagnosis.”
Are Some More susceptible to MRI Contrast Accumulation Than Others?
Yes, apparently men are. Since they weigh more than women, they get higher doses, at least that’s the thinking. The molecule could also attack the thyroid, we suspect this because body temperature is lowered, and symptoms of thyroid disease are often present.
How does it harm?
When the gadolinium drug is injected, it seems to come apart molecularly speaking and it releases “free gadolinium” which elementally is known as GD3+ and this metal in it’s free form is what is actually toxic. Not the medication itself. The free gadolinium is about the same size and similarity of calcium! So your body sees it and the cell receptors that love and hug in natural calcium (a good thing, especially for bones and brain and nerve transmission) see the free gadolinium (GD3+) and get confused. Your cells suck it up thinking it’s calcium and BOOM, the damage is done! Once inside your cell, the gadolinium does not behave nicely as calcium would. You’ve been tricked!
The free gadolinium will block your calcium channels and nerve transmission, impacting blood coagulation, muscles, and mitochondrial function. That last one regarding mito damage is a big one, your mitochondria are what make ATP energy for you. We take antioxidants to protect those guys, so to have sweeping damage to your mito is disheartening. Gadolinium will displace calcium in the bone, that’s why some people with gadolinium retention disorder have bone pain and osteoporosis. The displacement of calcium and I suspect other minerals such as selenium and magnesium will occur with gadolinium injection.
According to animal studies, about 1 to 3% of injected free gadolinium is removed from the body, and the deposition may happen in bone, brain, kidney, and liver. Even though GBCAs are considered very safe, some of the dose may possibly disassociate into this free gadolinium GD3+ which again, does the damage, not the drug itself.
In regards to that study on Gadolinium
You have to remember that millions of doses are injected each day, and all-in-all, perhaps 400 million injections have been given worldwide. It’s a popular, useful medication. So the best experts are scratching their head trying to determine why the MS patients had more accumulation. They’ve wondered what you’re wondering:
Is the disease progression causing the brain to hold more, or is it ‘sticking’ to everyone’s brain that gets injected with it? Like all of us??? Is the brain of an MS patient different than a healthy control in that it would magnetize more of it to the DN or GP? No one knows these answers. There are more questions than answers as of this writing. The study did not find any clear reason for the heavier deposition of the GBCA in the brain and resulting more “aggressive” disability.
What about people getting MRIs for their heart or breast concerns… should they opt for gadolinium? It’s a good question. MRIs using gadolinium-based contrast agents have been used for more than 28 years in more than 400 million patients without too many problems. That said, the FDA sent out communications to doctors in 2017, warning them that trace amounts of the drug might be retained in the body for months to years.
Radiologists nationwide must be beside themselves because again, the dye allows them to provide more accurate results for you. But the dye itself is in question again. This is not the first time. It has been associated with kidney dysfunction in the past. It has come under fire in 2017, and there have been warnings by the FDA in 2018…today’s article by me is one of dozens (maybe hundreds?) trying to alert readers about the potential harm.
But you have to think carefully and decide what’s right for YOU. If, for example, the doctor needs to locate an aneurysm, do you really reject the contrast dye?
The study claims no discernible clinical impact of the gadolinium accumulation, however, they did find out that those who got more than 8 doses had more brain lesions and more advanced atrophy of their brain, compared to those who received fewer doses.
There are many kinds of gadolinium contrast agents, they’re termed GBCA for “Gadolinium Based Contrast Agent” and they fall into one of two categories based upon their molecular structure. See the Chart for the names and classifications.
1. Linear – these release free gadolinium which may accumulate
2. Macrocyclic – these are tightly bound molecules so more stable
Radiologists tend to group the drugs into one category of GBCA, but there is a difference and there is evidence that some are worse at depositing in your body than others. The linear GBCAs are the ones that seem to be most associated with deposition in the body. Both categories of drugs may cause deposition in the brain, but linear GBCAs appear to be more potent at the time of this writing. The FDA has acknowledged this and you can see their warning about it by CLICKING HERE.
What I find interesting is that they require MRI centers to tell you or give you a hand-out, but to me, that’s a little late in the game. I mean, you drove over there, signed in, got in the gown, filled all the paperwork out… they hand you this thing with a warning… what are you going to do now?! Leave?
How Do You Know?
You might first be wondering if and when you were given a shot of gadolinium-based contrast agent (GBCA). You can simply look at your radiologist or lab report to see if you were injected with contrast, and what kind it was. The imaging center might also have this information in the computer, if your MRI was done in the past 7 years. See the Chart for the names and classifications of the GBCA.
The interesting thing is that even Europe has taken some agents off the market due to gadolinium toxicity, but it wasn’t until 2017. They did so due to concerns about toxicity. Makers of Ablavar and Optimark GBCA were voluntarily removed from the market as well. So this information about gadolinium toxicity is pretty well known in the medical community. I’m worried it’s not given to you though.
You might be wondering if you can TEST yourself for gadolinium levels. The answer is yes. I don’t believe that hair testing is accurate. I do believe in urine testing though.
I have two options for you. The first is my favorite because it holds the advantage of being more convenient, and more sensitive:
1. “Rare Elements – Heavy Metals & Essential Elements” dried urine test by ZRT Labs. Gadolinium is a rare element, it’s not even in the same category as lead and mercury. Exposure is very rare unless you’ve had an MRI. This panel tests 3 rare elements: Gadolinium, Thallium and Uranium. It also incluces your level of “Creatinine” which is an important biomarker of kidney function.
This “Rare Elements” by ZRT is most convenient because it only needs 2 dried urine strips (which are reflective of the older tests that required you to pee in a jug for 24 hours). It will provide the same information and it’s more convenient. You just urinate in a little cup, dip a strip, let it dry and mail it back to ZRT. To order you can click on the image below, then scroll to the bottom test that looks like this and says: “Rare Elements” and it is $80.00. Just check out like normal. You don’t need your doctor to order this, you can self purchase your own test kit. If you have a question, the email is: firstname.lastname@example.org and their phone 866-600-1636.
2. Toxic Metals 24 Hour Urine Collection (includes Gadolinium) by Doctor’s Data This test is a urine test that requires you to pee in a jug for a day, and then take a sample from that big jug, put it into a tube and mail back according to the instructions on the form (pre-paid envelope). It will test for gadolinium, as well as other heavy metals like aluminum, arsenic, bismuth, nickel, platinum, cadmium, thallium and others. I am a registered practitioner for them, that’s why you can order directly through my site for lab tests, and I do get a few dollars per test. But I still prefer test #1 listed above (and I am not their affiliate, nor do I make anything from ZRT). It is just more convenient and very accurate if gadolinium is what you’re focused on.
My best advice…
Since the relationship of gadolinium with disease severity remains unclear, talk to your doctor about whether or not the radiologist needs the contrast dye. Sometimes they can see certain areas without it. If you have a history of kidney compromise, let them know at the imaging center. The best advice I can give to you and doctors reading my article is to consider all the different contrast agents, as well as their retention characteristics (ie linear or macrocytic GBCAs) and speak to the radiologist about what is best for that particular patient.
Don’t panic. Some of you might have children requiring MRIs, some might be pregnant, some of you might require multiple lifetime doses, whereas others just require one dose for one MRI.
Sometimes the organ doesn’t even need contrast dye because it is relatively easy to zoom in on without contrast. Minimizing adverse events will allow more benefit to be derived from the drug, versus risk. It’s all about the benefit to risk ratio! The only true contraindication right now is associated with people who have any of the following:
1. A pre-existing kidney disease or impaired kidney function due to gadolinium’s rate of excretion. If you’re GFR is <30 mL/min/1.73 m)
3. Previous anaphylaxis
4. Higher risk of NFS
Last thing: You may be asked if you have an allergy to shellfish, this is because some doctors use iodine-containing contrast agents (not gadolinium). A shellfish allergy has nothing to do with iodine-containing IV contrast agents. It’s silly. A natural iodine allergy is a myth, you have this iodine in your body, it’s in your thyroid. Everyone does. Every cell in your body has iodine receptors, just like receptors for magnesium, zinc, selenium and other minerals. (There is no cell in your body that has gadolinium receptors by the way). The shellfish allergy is related to allergies to “tropomyosin” not iodine!
This can be tested for by the way! Now, all that being said, you could very well be allergic to the synthetic radioactive iodine contrast used in MRIs. That is a whole other type of iodine, it is not natural, and there are allergies. This type of allergy has nothing to do with shellfish either. Contrast media based in iodine is not found in shellfish. Hope this makes sense.
And not to gross you out, but tropomyosin is also present in both cockroaches and lobsters! Man, sorry I messed with your dinner. They’re very similar, and distant relatives both being arthropods.
Resources About MRI Contrast
In summary, some people may do better with iodine-based contrast agents, than with gadolinium. It’s impossible to know what’s right, just know that shellfish allergies are NOT a contraindication to either GBCAs or iodine-based agents.
As I mentioned earlier in this article, I just hung up with my brilliant friend and colleague Dr. David Brownstein. He is an expert in holistic medicine, especially with thyroid disorders, and he told me that he has been following gadolinium problems for years. He sees patients with Gadolinium Retention Disease, and he uses several methods of chelation, usually EDTA based (he has experience with both oral and IV methods depending on the situation). If you’d like to reach his clinic “Center for Holistic Medicine the number is 248-851-1600. You can also learn more about him by visiting his website by CLICKING HERE.
If you’d like to learn more about iodine and why you may want to consider iodine supplementation, check out my article Why Salt is Not Enough- Clearing the Iodine Confusion.
SOME MORE COMMENTS from MYSELF AND READERS TRYING TO HELP:
1. Suzy- I just finished reading your article and had to laugh about being in the gown on the table ready for the MRI and then they pull out the gad (gadolinium) and want you to sign [a consent form] at that time. Happened to me when I went in for a fMRI of my brain after a TBI. I said “I’m not doing that” and got off the table to leave. The technician was shocked and told me to wait. He talked to the radiologist and said they could do the study without contrast just fine and the results of the study were plenty good to get the info they needed.
2. A very knowledgeable Naturopath told me that cilantro can help rid the body of heavy metals.
3. Loved your article on Gadolinium not leaving. It is what I have always suspected and known in my heart. Our son had this injected into him at the children’s hospital when he was a toddler (he is now 21). I had a feeling it was gonna be trouble. Homeopathic gadolinium was used which helped. Aslo working with a top-tier NAET practitioners helped ultimately rid his body of gadolinium according to muscle testing. The NAET site is here: https://www.naet.com/about/what-is-naet/
4. Hello Suzy,
My son had toxic black mold poisening as well as mercury from almalgams and other heavy metals. He detoxed with Dr Pompa who seems to know a lot about detoxing, partly due to personal experience. You can google his name. He has several videos on you tube about this subject.
5. Hi Suzy, I read your article on gadolinium. I am taking a product called Advanced TRS. It removes it and other heavy metals as well as anything positively charged. Find the Facebook group called TRS a safe heavy metal detox for more info. Please pass it on to others. (Teryl)
6. I have read cilantro helps the body clear heavy metals.
Heavy metals and our accumulation of them from many sources is a big focus of the Medical Medium. It’s not just a small, casual consideration since he feels heavy metals can rust in the brain and that they feed viruses. One of his staples is the heavy metal detox smoothie, which includes cilantro, barley grass juice powder, spirulina, Atlantic dulse, and WILD blueberries (frozen if possible, powdered if not). He doesn’t sell supplements. He only sells books and he gives away a lot of information. He’s not a money-making machine. (Miki)
His main claim to fame in terms of popularity right now is his introduction of celery juicing as a means of detoxing. All the best for your husband.
8. I just got off the phone with Dr. David Brownstein and said he has had good results with his patients using IV Ca EDTA and oral Lipoic Acid, however to ask your own physician if these are right for you as he cannot treat over the Internet. (Suzy)
9. A new friend of mine who has GDD lives in Orlando and told me he goes to a clinic and receives IV DTPA and saunas, as well as CoQ10, Magnesium and it has taken months but he’s feeling better. (Suzy)
10. Hi Dr. Suzy, I get your newsletter and was just reading the latest on the research about Gadolinium…I have known [in my own medical practice] that it’s such a toxic metal for the body and so glad that the research is catching up! So Sorry that your husband has had this several times too. Anyway, I do know that the best defense is to flush flush flush within the first 24 hrs [of being given the contrast agent] to help remove it from the system – Cucumber juice, melon juice, celery juice. But I can offer a more long term solution is something called the Heavy Metal Detox Smoothie….I have found incredible results with my patients over time. It’s origin is from Anthony William, not sure if you know about him but the smoothie is here:https://www.medicalmedium.com/blog/heavy-metal-detox-smoothie
Also zeolites can be of support as well as consuming radishes and radish greens. Thanks for putting out good messages for all. Be well.
Dr. Sherri Greene
11. Hi Suzy,
I am sorry to hear that your loved one might be affected by the side effects of the gadolinium residuals. I heard there is a detox doctor from Germany. His name is Dr. Dietrich Klinghardt. His detox protocol emphasizes on removing mercury, glyphosate, and heavy metals using natural ingredients such as wild garlic, cilantro tincture, and chlorella. (William)
This is the website:
12. Suzy….post this for your readers:
Rule 1: Don’t put freakin metals into bloodstream, unless autoimmune diseases are desired! Metals are positively charged, so to remove them starts with charge mobilizing them into bloodstream, then chelating and getting them out through the intestines, loss via sweat, kidneys via urine.
A hair analysis is the thing. So Vit C in large frequent bowel tolerance doses before meals to start…then add chlorella/charcoal/clay wit meals.
Add NAC, R-Alpha Lopoic Acid, and K2.
Also, sauna/sun/exercise…helpful polyphenols from curcumin, cilantro, cannabis. Silica is more specific for Aluminum, Fiji water/horsetail/cucumber see Chris Exeley….Al the most detected by hair labs followed by Hg, Cd, Pb, As and others… See Klinghardt; https://phibetaiota.net/2019/06/yoda-video-10856-world-renowned-doctor-addresses-geoengineering-dangers/
And my website; http://www.forbiddenhealingforum.com/forum-comments/Best, Randall
13. Dr Cohen – I’m a big fan!
My moms doctor specializes in heavy metals. Dr Jane Hightower in San Francisco. Thanks Suzette.
14. Hello Suzy,
I am not a doctor but my very knowledgeable Naturopath told me that cilantro can help rid the body of heavy metals. (You probably already know this.) There does seem to be some research about cilantro online. Some sites also include chlorella as being helpful. Thank you for all the information you share on your website. I have used my copy of Drug Muggers often. Warm Regards from Emily
Hi Suzy, Thank you for your article on gadolinium/ MRI contrast. Chelation seems to be a tricky thing when it comes to Gd. I personally feel that things like cilantro & zeolite might be best for people who have mild heavy metal toxicity. I think the more severe reaction, the more we need to be guaranteed that the chelator will not redistribute Gd- it’s just too dangerous. I had 4 rounds of zn-DTPA IV chelation & 1 EDTA. My doctor was following Dr. Semelka’s protocol (minus the EDTA, we tried that after DTPA didn’t work/made my symptoms worse). I almost lost my ability to walk during this process. It seems like people who received linear contrast agents do better with this type of chelation than someone, like me, who only received macrocyclic. But it might even be more complicated than that, really not sure. After watching many hours of lectures by Dr. Boyd Haley on his substance NBMI (aka Irminix). I decided this was what I needed to try. It’s fat soluble so it can get into the tissues, brain, & cells. It clears through the liver instead of the kidneys. No invasive IVs, you take it orally- therefore it’s in your system 24hrs a day constantly capturing (instead of a few hours of cleanup once a week). It does not deplete essential minerals. Most importantly, the metals it has been study on, it irreversibly binds to them. So, I took it upon myself to see how it might work on gadolinium & posted my results below:
Suzy Cohen, has been a licensed pharmacist for over 30 years and believes the best approach to chronic illness is a combination of natural medicine and conventional. She founded her own dietary supplement company specializing in custom-formulas, some of which have patents. With a special focus on functional medicine, thyroid health and drug nutrient depletion, Suzy is the author of several related books including Thyroid Healthy, Drug Muggers, Diabetes Without Drugs, and a nationally syndicated column.