Chronic Fatigue Syndrome and Environmental Toxicity

November 22, 2004

Tired or Toxic? Chronic Fatigue Syndrome and Environmental Toxicity

ProHealthNetwork.com

03-06-2002

http://www.prohealthnetwork.com/library/showarticle.cfm/id/3404/T/Bot

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By A. Schmidt

Editor's Note: The following is an excerpt from Tired of Being

Tired:

Overcoming Chronic Fatigue & Low Energy. For more information and to

purchase the book, see information at the end of this article.

The Environmental Protection Agency (EPA) currently recognizes more

than four million chemical compounds. More than 60,000 of these are

produced commercially, with three new compounds introduced each day.

In

1992, the EPA published the results of a study in which the urine of

7,000 randomly sampled Americans was tested for toxic chemical

residues.

Chemicals like pentachlorophenol, a wood preservative, and others

were

found in 71 percent of individuals tested. There were not people

working at chemical factories or industrial waste incinerators. This

study looked at the average citizen – you and me. It is

disconcerting

to find such a high percentage of individuals with chemical residue

in

their urine. These are all chemicals not even in existence 100 years

ago.

Many doctors who work with chronically fatigued patients and those

who

work in the field of environmental medicine, agree that chemical

exposure is a major contributor to fatigue and low vitality. For

example, if you review the symptoms of formaldehyde exposure, you

will

find fatigue, depression, and poor concentration right at the top.

The

symptoms of exposure to trichloroethylene (found in floor polish,

copy

machines, carpet cleaner, etc.) include fatigue, poor concentration,

and drowsiness, among others. Exposure to toluene, the most common

indoor air pollutant, triggers symptoms of fatigue, poor

concentration,

drowsiness, and headache.

Methylene chloride is found in paint thinner, hair spray, adhesives,

solvents, paint, flame retardants, and many other common products.

The

aerosol propellants found in hair sprays, antiperspirants, air

fresheners, and spray paint, may contain up to 5o% methylene

chloride.

Once inhaled, methylene chloride goes directly to the brain, fat

cells,

and liver. Common symptoms include fatigue, lethargy, headaches, and

chest pain.

In an article entitled " Chronic Fatigue Syndrome and Chemical

Overload, " Dr. R. A. Buist explained that there are many pieces of

evidence suggesting that chronic fatigue may be a result of toxin

exposure. He goes on to point out that toxins can disrupt muscle

metabolism, accounting for the pain and fatigability of muscles

experienced by many fatigued people. Buist also notes that in many

chronic fatigue patients, use of recreational drugs or environmental

exposure preceded the onset of their fatigue.

In an address to the Well Mind Association in Seattle, Washington,

S. Bushcer, M.D., made the following remarks: " My personal

theory

on chronic fatigue is that the increased load of pollutants in our

environment, such as pesticides, is causing people to have a

breakdown

of their immune systems…I would say that 70% of my patients with

chronic fatigue had a chemical trigger; they moved into a new home,

there was remodeling at the office, or a pesticide application, and

now

they have chronic fatigue. I think the mechanism is some kind of

cellular poisoning from these chemicals. The affected person's

detoxification system is clogged up or destroyed, they get a backlog

of

chemicals, and their immune system goes down. "

In 1992, the neurobehavioral effects of various chemicals were

reviewed

in Environmental Neurotoxicity, published by the National Research

Council. The following symptoms commonly associated with fatigue and

the number of chemicals that may cause these symptoms are

significant.

Symptom: Number of Chemicals:

Fatigue: 87

Listlessness: 30

Depression: 40

Sleep disturbances: 119

Weakness: 179

An important fact about chemical exposure is the role that

cumulative

exposure plays in causing illness. Exposure to trace amounts of one

chemical may produce few ill effects. However, when five, ten, or

even

fifty different compounds are encountered in trace amounts, which is

not unusual, the additive effects can be serious. To put this in

perspective, consider that in one Washington, D.C., home for the

elderly, 350 different volatile chemicals were found in the indoor

air.

Another study conducted by the EPA found anywhere from 40 to 120

different organic compound circulating in the air of every home

tested,

regardless of whether the home was in urban Chicago or rural North

Dakota.

In an analysis of the exhaled breath of suburban New Jersey

residents,

researchers detected chloroform, trichlorethane, benzene, styrene,

xylene, carbon tetrachloride, dichlorobezene, ethyl benzene,

trichloroethylene, and other compounds. It doesn't take a chemist to

know that these chemicals do not belong in the body. However, it

does

take a doctor with sufficient knowledge of biochemistry to figure

out

what to do about this problem when illness results.

Chemical toxins affect individuals in vastly different ways,

depending

on their individual biochemical make-up. There are several key

factors

that determine how an individual will react to chemical exposure.

1. Nutritional status. Vitamins, minerals, amino acids, and other

nutrient factors play a vital role in detoxification of foreign

chemicals.

2. Total toxic load. The amount of toxin, the number of toxins, and

the

duration of exposure to toxins, determine health effects.

3. Genetics. Due to genetic differences or abnormalities of certain

enzymes, some individuals do not detoxify as readily.

4. Age. Children are more susceptible than adults.

5. State of health. Someone with chronic illness, liver disease, or

altered immunity may be less able to adequately detoxify.

6. Stress.

7. Immune system status. Some reactions to toxins are mediated by

the

immune system.

Your nutritional status has everything to do with how your

detoxification systems work and how you handle the toxins in your

environment. If you are deficient in the trace element molybdenum,

an

enzyme called aldehyde oxidase does not function properly. Under

these

circumstances, if you were exposed to a common pollutant such as

formaldehyde, it would not be properly detoxified. In fact, such

compounds are shunted into another pathway that forms other, often

more

toxic, compounds. In the case of formaldehyde, it gets converted

into

chloral hydrate – also known as " Mickey Finn " or " knockout drops. "

The

effect is a dopey, foggy, fatigued feeling, like you were drunk, but

without the euphoria. If you are deficient in magnesium, many

aspects

of the detoxification mechanism do not work. The same is true of

zinc

deficiency.

In one of your body's detoxification pathways, toxic substances are

temporarily converted into more toxic intermediate substances and

then

converted into mercapturic acids to be harmlessly eliminated.

However,

if you are deficient in vitamin E, selenium, glutathione, glycine,

vitamin C, or other nutrients, the highly toxic intermediates are

not

properly quenched and can wreak considerable havoc with your cells.

The immune system can become seriously impaired by exposure to

chemicals. Some chemical exposures may act to suppress immunity,

while

others may cause the immune system to overreact. The former

circumstance leads to susceptibility to infections and perhaps

cancer.

The latter leads to autoimmune diseases in which the immune system

attacks the body's own cells. Some arthritic conditions, lupus, and

some thyroid disorders are examples of this latter effect.

In a study published in the Archives of Environmental Health, people

who were exposed to chlordane, used to control termites, had immune

system defects that were detectable up to ten years after the

exposure.

Other studies show the devastating effect of chemicals on immune

function. Thus, toxicity not only directly causes fatigue, but can

render us more susceptible to bacterial and viral infection, both of

which are common causes of persistent fatigue.

In 1990, Sherry , M.D., wrote a book entitled Tired of Toxic?

In

which she describes in great detail how toxicity contributes to

fatigue. She mentions that the most common organ affected by

chemical

exposure is the brain, leading to drowsiness, fatigue, exhaustion,

sluggish thinking, or a host of other symptoms. She states,

" Frequently, most of these people are initially too intimidated and

embarrassed to mention how exhausted they are. Instead they

concentrate

on the more visible symptoms that can be more readily verified.

Medicine, unfortunately, delegates brain symptoms…to the

psychiatrists. "

One means by which chemicals may contribute to fatigue is by

affecting

thyroid function, a common cause of low vitality. Chlorinated

compounds

are well known for their effects on thyroid function. Many f these

compete directly with thyroid hormones or proteins that carry

thyroid

hormones. One such chemical, pentachlorophenol, was found to

significantly lower the level of both the active and inactive form

of

thyroid hormone.

Chemicals may also interfere with sleep, leading to chronic fatigue.

Sixty-six men exposed to solvents on the job were assessed for sleep

apnea. Sleep apnea is a disorder of interrupted breathing during

sleep

that leaves many sufferers chronically tired. Sleep apnea occurred

in

roughly one-fifth of the men, which prompted the investigators to

conclude that some of the cases of sleep apnea may be solvent-

induced

encephalopathy. In 112 individuals evaluated for exposure to organic

solvents (house paints, spray finishers, printing), there was a

significantly higher prevalence of insomnia. In Environmental

Neurotoxicology, it is reported that any of 119 different chemicals

can

cause sleep disturbance.

Because of the pervasive use of chemicals in our society, a new

disease

has emerged known as multiple chemical sensitivity (MCS). While

chemical exposure affects all of us to one degree or another, people

with MCS are severely affected. People with chemical sensitivity

often

become ill from being in the presence of only minute amounts of a

chemical. To them, a faint of formaldehyde cam cause devastating

symptoms of fatigue. Unfortunately, others around them who cannot

smell

the odors label them as hypochondriacs, often noting, " If I can't

smell

it you must be imagining it. " This is far from the truth, and

chemically sensitive people can take some comfort in the fact that

the

health effects of low level chemical exposure are becoming more

documentable.

For example, Dr. Dudley, at the Washington Institute of

Neurosciences in Seattle, found that when patients were exposed to

chemicals to which they reported sensitivity, they showed

significant

changes in their visual and auditory evoked potential readings – a

measure of the ray at which nerves transmit messages from the eyes

and

ears to the brain. Schwartz, Ph.D., and his research team at

the

University of Arizona showed that the brain registers exposure to a

chemical odor even though the nose does not sense its presence.

Jaffe, M.D., of Reston, Virginia, has demonstrated that a variety of

immune reactions to chemicals occur in people with chronic illness.

Toxic minerals are another important cause of fatigue in some

people.

Included are lead, mercury, cadmium, arsenic, aluminum, nickel,

silver,

beryllium, and tin. Recall the interview with Dr. Majid Ali who

estimated that roughly 40 percent of his patients with chronic

fatigue

suffer from heavy metal toxicity. He observed that aluminum toxicity

was most common, with lead and mercury toxicity not far behind.

Aluminum toxicity would be expected to cause fatigue because it

blocks

the major energy molecule in the body, ATP. Lead and mercury impair

immune function, block enzyme function, inflammatory substances, and

alter certain metabolic pathways.

Researchers at Upssala University Medical School in Sweden reported

that patients with chronic fatigue contain abnormal levels of

mercury

within their cells. Another group tested sensitivity to metals such

as

lead and mercury using a method of testing known as MELISA (Memory

Lymphocyte Immuno Stimulation Assay). Of patients with chronic

fatigue,

45 percent showed mercury hypersensitivity and 49 percent showed

lead

hypersensitivity. When the metal burden was removed from the body

(in

many cases by removing mercury-containing silver dental fillings),

77

percent of patients reported improved health.

Signs and Symptoms

The symptoms of chemical toxicity are far too numerous to mention.

In

general, chemical exposure affects different people in different

ways,

depending on their individual biochemistry, nutritional status,

stress

levels, level of exposure, and many other factors. Conditions

ranging

from thyroid disease, cardiovascular disease, kidney disease,

endocrine

diseases, depression, psychosis, and many other disorders can be

triggered or caused by chemical exposure or toxicity.

Fatigue, sluggishness, and low energy are among the most common

symptoms of toxicity. If you experience these symptoms and your

health

problems seem to defy identifications or do not respond to

treatment,

it may be that you are ill because of toxicity. Certainly, those who

work in occupations where chemicals are used should be screened for

toxicity. However, many people who have no contact with industrial

chemicals whatsoever experience exposure that seriously impairs

their

health.

Laboratory Tests

Below are a number of tests that can be used to determine if you

suffer

from toxic exposure, if your detoxification system is working or

overloaded, if you have immune reactivity to environmental

chemicals,

if you have adequate antioxidant capacity, and if you have fatty

tissue

damage. To run all of these tests would be quite expensive. Most

doctors working in environmental medicine would likely choose

specific

tests based on your individual circumstances. This list shows the

varied tests that are available to any doctor who wishes to do more

detective work.

-Urinary D-glucaric acid. Helps determine if toxic exposure has

taken

place or whether your detoxification system is working properly.

-Urinary mercapturic acid. A byproduct of one of the body's

detoxification pathways. Determines if toxic exposure has taken

place.

-Whole blood glutathione or glutathione peroxidase. Shows the levels

of

an important nutrient involved in detoxification and its functional

enzyme.

-Total lipid peroxides. Shows whether the lipids (or fats) that

comprise your cell membranes are being damaged by free radicals.

-Formic acid. Shows whether your body is able to detoxify aldehydes

such as formaldehyde.

-ELISA/ACT. A blood test that looks at delayed immune system

reactivity

to various substances including foreign chemicals, food allergens,

food

additives, molds, pollens, etc.

-Amino acid analysis. Assesses many aspects of metabolism and

function.

Shows amino acid deficiencies, and vitamin and mineral deficiencies.

-Organic acid analysis. Measures aspects of energy metabolism.

-Serum and red blood cell vitamins and minerals.

-Provocation-neutralization test. Done in a physician's office, this

test determines sensitivity to chemicals and identifies a

neutralizing

dose that can be helpful in reducing symptoms.

-Hair mineral analysis. Assesses level of toxic metals and some

trace

elements. Other tests used to test for toxic metals include:

--Whole blood heavy element. Assesses toxic minerals in blood.

--RBC or WBC heavy element. Assesses toxic minerals in cells.

--Urine or post-challenge urine. Challenge substance, such as DMPS

(dimercaptopropane sulfate) is given to purge metals from the body,

which can then be measured in urine.

--MELISA (Memory Lymphocyte Immuno Stimulation Assay). Assesses

immune

reactivity to metals.

--Blood levels of toxic substances such as benzene, toluene, and

others.

A beginning laboratory panel that one might consider to assess

toxicity

might include:

Mercapturic acid

D-glucaric acid

Formic acid

Glutathione peroxidase

Lipid peroxides

Treatment

Toxicity is a very complicated phenomenon that requires the guidance

of

a doctor trained in environmental medicine and nutritional

biochemistry. Toxic mineral exposure is treated differently than

exposure to organic chemical compounds. Specific nutrients are

necessary to enhance biochemical detoxification pathways of the

body.

Any recommendations made in this book [see book details at end of

this

article] could only be considered superficial and general.

When dealing with toxicity problems, the following areas must be

addressed:

Reduce the total toxic load be removing toxins from your environment

and by removing offending foods and additives from your diet.

Identify functional nutrient deficiencies related to detoxification

and

general metabolism.

Restore your body's pH to its normal balance so that cellular

systems

being to function normally.

Begin a supervised detoxification program aimed at removing toxins

stored in body tissues.

Nutrients important in detoxification include:

L-glutathione, vitamin E, vitamin C, N-acetylcysteine, selenium,

beta-carotene, coenzyme Q10, taurine, zinc, copper, magnesium,

molybdenum, bioflavonoids.

5. Utilize a low temperature sauna. Some doctors who treat patients

with toxic exposure recommend that patients sit in a low temperature

sauna for several hours each day. The low temperature encourages

a " fat

sweat " to eliminate toxins that are stored in the body's fat.

6. Support the endocrine, immune, and hepatic (liver) system.

7. Begin a program of behavioral therapy and stress management.

8. Restore gastrointestinal function.

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