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well put Kim, on both subjects.

>

> Incidentally,

>

> FYI fungal infections of the blood can be very severe and lead to

> life threatening complications:

> http://www.anaesthetist.com/icu/infect/fungi/Findex.htm#serious.htm.

>

> As far as the CSM, I am still confused but getting there I think

even

> though I am familiar with it because my grandfather was on it when

I

> was taking care of him. There are side-effects that many people

may

> find uncomfortable. " gastrointestinal problems, constipation along

> with nausea and bloating, inhibited absorption of of various fat-

> soluble vitamins like A, K, and D which can lead to night

blindness,

> prolonged or unusual bleeding and bruising, an increase in

> triglycerides, and osteoporosis. The drug can also cause severe

> reactions when used with other families of drugs including blood

> thinners, thyroid hormones, diabetes, and heart medications. "

>

> I would think that improving nutritional status would be to improve

> the detoxification system would be better than using medication.

> Especially considering that with the problems of EI contributing to

> problems of acid/base balance, we are already at risk for mineral

and

> bone depletion. Also, since CSM is also a cholesterol inhibitor,

what

> kinds of problems does it cause in people with normal cholesterol

> levels???

>

> Kim

> Health Education Information and Resource Services

> kkramer@...

>

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Give me constipation any day over mold in my body. Nobody who hasn't

been through this understands it.

I can put up with a little constipation and heartburn to get that

stuff out of me. I can't afford to lose any more of my health. Really.

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Amen to that !

K

LiveSimply <quackadillian@...> wrote: Give

me constipation any day over mold in my body. Nobody who hasn't

been through this understands it.

I can put up with a little constipation and heartburn to get that

stuff out of me. I can't afford to lose any more of my health. Really.

---------------------------------

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Live, you might try to understand this. I can see takeing csm short

term to get what mycotoxins and other toxins out of your system.

exspecially fpr those who dont have mcs/te, those with short term

exposure and not major organ damage. some people with mcs have major

stomach problems that you obvious;y dont get. some have

allergies/sensativitys to lots of things and/or reactions to many

drugs. some have some of the symptoms already that csm can cause. some

may have problems with toxins the rest of their life, not just myco's.

you need me to go on? wtf, no body said some myco's dont stay in the

system, no body said " oh, dont take csm at all " the point was to

discuss other alturnitives or combinations to go with csm.

--- In , LiveSimply <quackadillian@...>

wrote:

>

> Give me constipation any day over mold in my body. Nobody who hasn't

> been through this understands it.

>

> I can put up with a little constipation and heartburn to get that

> stuff out of me. I can't afford to lose any more of my health. Really.

>

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I totally agree! Milk of Magnesia works wonders for the constipation. I've

taken it for 4 yrs. and that takes care of it. I take it EVERY night and have

no problems.

Sue

Give me constipation any day over mold in my body. Nobody who hasn't

been through this understands it.

**************Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

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Interesting that you raise these nutritional issues. Part of my

family's healing has included nutritional support through testing and

prescribed supplements. Somehow I guess I knew intuitively that we

were nutritionally depleted. We started that treatment before we knew

about the mold. We are careful to " schedule " our CSM seem to be doing

fine.

.. . . As far as the CSM, I am still confused but getting there I think

even

> though I am familiar with it because my grandfather was on it when I

> was taking care of him. There are side-effects that many people may

> find uncomfortable. " gastrointestinal problems, constipation along

> with nausea and bloating, inhibited absorption of of various fat-

> soluble vitamins like A, K, and D which can lead to night blindness,

> prolonged or unusual bleeding and bruising, an increase in

> triglycerides, and osteoporosis. The drug can also cause severe

> reactions when used with other families of drugs including blood

> thinners, thyroid hormones, diabetes, and heart medications. "

>

> I would think that improving nutritional status would be to improve

> the detoxification system would be better than using medication.

> Especially considering that with the problems of EI contributing to

> problems of acid/base balance, we are already at risk for mineral and

> bone depletion. Also, since CSM is also a cholesterol inhibitor, what

> kinds of problems does it cause in people with normal cholesterol

> levels???

>

> Kim

> Health Education Information and Resource Services

> kkramer@...

>

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Please do not get me wrong...I am neithering arguing or confirming the

useful of CSM in treating mycotoxicosis. I have read Shoemaker's

website and the understand the useful of CSM for treating Possible

Esuary Associated Syndrome (PEAS) from dinoflagelatte infection, ie.

Pfisteria which had marked improvement in visual contrast sensitivity

(VCS). However, I do not see anything that mentions specifically that

it is used to treat mycotoxicosis (by diagnosis of mycotoxicosis) but

is used in treating biotoxicosis...there is a difference as biotoxin is

a more general term.

In terms of the mycotoxicosis that we are speaking about here, unless

you live in a foreign country where food contamination is common, we

are talking about the build-up of mycotoxins that occur over time. I am

not refuting the damage to organ systems (including the immune system)

nor am I refuting the impact the mycotoxins cause on other tissue such

as the sinuses through necrosis. With all this in mind, the only

therapy where I can see CSM would be of benefit would be to take it for

the rest of your life. The mycotoxins that cause human illness in most

of our cases is from the daily eating of contaminated foodstuffs and

CSM would not be an effective treatment for long-term use. However, it

seems to be a short-term therapy for some biotoxins..and as I stated

earlier I have not even found published information about it being used

as therapy for a " diagnosis " of mycotoxicosis.

Here is something to think about....Mycotoxins are possible charged

which makes them stick to their host. Please tell me if I am wrong, but

in MCS patients they are finding that the mycotoxins get stuck in the

liver (and other organs) which is how they cause liver damage. In this

case, CSM would not be effective at getting rid of those mycotoxins. As

far as recycling, I am still researching that process. They do find

that there is a relationship of mycostoxicosis with high cholesterol.

Maybe this condition impairs the ability of the bodies detox system to

get rid of the mycotoxins. Since CSM is a cholesterol binding agent, it

may actually reduce mycotoxicosis by binding the cholesterol that

impairs the liver's ability to break down the mycotoxin. May be by

following a non-fat low cholesterol diet, eating 5-9 vegetable and

fruits servings a day to provide the phytonutrients and other chemicals

for the detox system, etc. you can do the same thing without the

medication?

As far as the side-effects go for CSM, osteoporosis is a very serious

disease that results in disability and possible death to the secondary

medical issues it can cause. The problems with the absorption of

nutrients in our cases can be severe because most of the research

points to many of the complications with MCS, Fibro, CFS, etc to being

nutrient deficient. I can tell you that in my case and 2 other cases

that I " know " was true.

Just so you understand, I am not trying to minimize anyone's symptoms

or disease when I point out things in my post. I have had chronic

fatigue syndrome since 1983 and have lived with the consequences of the

related PTSD for 15 years now. In addition, I was just " diagnosed " with

MCS six months ago even though I have had symptoms where I ended up in

the hospital for 10 years. Last year, they put me in the psych ward of

the hospital because they did not believe that I was having a reaction

to chemicals (as I knew I had been) and that my mother died from the

same situation when I was in high school. I had been breathing

chemicals I could not smell for several weeks that inflamed my PTSD and

an accidental (on my part but not someone else's part) acute exposure

to them made my go into a full-fledged MCS attack. My counselor who I

had been seeing for my PTSD had to spring me from the hospital psyche

ward, only after they put me on antidepressants that made the chemical

poisoning and MCS worse. Over the next year, my old doctor kept trying

to up my doses of antidepressants and put me on haldol because she

thought instead of PTSD, MCS and all the other things I had developed

including diabetes I was suffering from delusions and schizophrenic

tendencies from mental illness. All if this by the way, she documented

in my medical chart while she was treating me. I ended up taking myself

off the antidepressants when I started turning yellow and my legs

started going numb and could not sleep because of the pain and was

losing the ability to walk correctly. Currently, I am housebound to a

main extent because even slight exposures to anything makes me ill and

my MCS episodes last months not just days anymore. So yes, I know the

problems associated with MCS.

As an educator, I was trained to be as neutral as possible when

addressing medical issues. Sometimes, it is hard because I have worked

in the pharm industry and know how much drugs are used off label. From

my situation above, the consequences can be very severe. I believe MCS

and all the other associated illnesses are just really one disease and

do not believe that with the current technology and pharmaceuticals we

can effectively treat the diseases. I hate to see people spend their

money on medicine, etc for something that may end up harming them. As

an advocate for the rights of patients with these medical problems, I

believe the problem is few physicians can effectively treat the

condition, because the financial support to find a treatment is lacking

and most of those in the medical profession ignored the consequences of

these illnesses and do they do not want to admit to themselves that it

is " truly " a medical condition.

I am sorry if I offended anyone, it was not my purpose.

Kim

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One of the best things people can eat is whey protein. You can buy

whey protein in any health food store or even most drug store chains

now. Whey protein is involved in the body's synthesis of glutathione

which is the key process used by the body's natural detoxifying

pathway. n-acetylcysteine is an amino acid precursor of glutathione.

Make sure you buy N-AcetylCysteine and not cysteine. Its pretty cheap

if you shop around. I would avoid the more high tech products from the

very small manufacturers unless you know specifically what and why you

are getting. Very few people do.

Many mycotoxins rapidly destroy the body's stores of glutathione. So

these things that help glutahione are very important. Whey protein in

particular is easy to find and helps a whole bunch of things.

You could do a whole lot worse than to alternate Cholestyramine

('CSM') and healthy whey protein smoothies... Many whey protein mixes

have added vitamins which might take care of the vitamins

cholestyramine ('CSM') binds along with the dangerous mold toxins.

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Kim,

Cholestyramine is, I understand, fairly inert in the body. It binds

(removes from circulation) things like toxins (and some vitamins,

which can br replaced by taking a multivitamin pill at other times)

but it doesn't add things..

You should read some of Dr. Shoemaker's papers, like the sick building

time series article which explains cholestyramine binding toxins in

detail.

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Kim,

You are ignoring the combined wisdom of people who have a huge amount

of experience in dealing with mold and making a big mistake there. I

wrote you a long letter but my computer crashed, maybe I was typing

too hard.

Just curious, are you a defense or plaintiff attorney trying to save

yourself some work?

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Kim -

I appreciate what you've said here and will read it further so that my

mold-adled brain can try to comprehend... I wrote the following in response to

your previous post:

Nutrition is of utmost importance, no doubt. That said,

If you read Mold Warriors, Dr. Shoemaker's pivotal observation is that a

quarter of the population doesn't make the antibodies that remove this sort of

biotoxin - you gotta get the toxins OUT to get better - otherwise, toxins keep

recirculating in the body and continue to wreak havoc. Nutrition is not going

to be sufficient if a person is missing the needed antibodies - a binding agent

is prescribed and THEN nutrition can help restore the body.

The following statement is UGLY, so please don't read if you're feeling

sensitive.

My neighbor died of Trichothecene mycotoxicosis. I've been working with his

mother on this for several years, and it's been a tough fight to first GUESS

what happened to him from his symptoms (because his doctors sure didn't think he

would just drop dead) and then to find people who could document it... we didn't

find this group until after we had our results.

My neighbor was a guy who didn't eat any fancy diet, but he ate good enough

food and in sufficent quantity to have some extra weight on him. He had been in

car accidents which required him to rest at home where mold was growing, and

fatigue made his return to being a runner impossible.

This is the ugly part: When we got specific enough pathology, the ACTUAL

cause that brought on death was starvation. He was certainly still eating, but

his organs had been so devastated by toxins at the cellular level that they

could no longer take in nutrients to support themselves.

GOOD NUTRITION IS VITAL to recovery, BUT IT IS NOT ENOUGH BY ITSELF if the

body doesn't have a way to remove toxins.

~Haley

Kim <indypets1965@...> wrote:

Please do not get me wrong...I am neithering arguing or confirming the

useful of CSM in treating mycotoxicosis. I have read Shoemaker's

website and the understand the useful of CSM for treating Possible

Esuary Associated Syndrome (PEAS) from dinoflagelatte infection, ie.

Pfisteria which had marked improvement in visual contrast sensitivity

(VCS). However, I do not see anything that mentions specifically that

it is used to treat mycotoxicosis (by diagnosis of mycotoxicosis) but

is used in treating biotoxicosis...there is a difference as biotoxin is

a more general term.

In terms of the mycotoxicosis that we are speaking about here, unless

you live in a foreign country where food contamination is common, we

are talking about the build-up of mycotoxins that occur over time. I am

not refuting the damage to organ systems (including the immune system)

nor am I refuting the impact the mycotoxins cause on other tissue such

as the sinuses through necrosis. With all this in mind, the only

therapy where I can see CSM would be of benefit would be to take it for

the rest of your life. The mycotoxins that cause human illness in most

of our cases is from the daily eating of contaminated foodstuffs and

CSM would not be an effective treatment for long-term use. However, it

seems to be a short-term therapy for some biotoxins..and as I stated

earlier I have not even found published information about it being used

as therapy for a " diagnosis " of mycotoxicosis.

Here is something to think about....Mycotoxins are possible charged

which makes them stick to their host. Please tell me if I am wrong, but

in MCS patients they are finding that the mycotoxins get stuck in the

liver (and other organs) which is how they cause liver damage. In this

case, CSM would not be effective at getting rid of those mycotoxins. As

far as recycling, I am still researching that process. They do find

that there is a relationship of mycostoxicosis with high cholesterol.

Maybe this condition impairs the ability of the bodies detox system to

get rid of the mycotoxins. Since CSM is a cholesterol binding agent, it

may actually reduce mycotoxicosis by binding the cholesterol that

impairs the liver's ability to break down the mycotoxin. May be by

following a non-fat low cholesterol diet, eating 5-9 vegetable and

fruits servings a day to provide the phytonutrients and other chemicals

for the detox system, etc. you can do the same thing without the

medication?

As far as the side-effects go for CSM, osteoporosis is a very serious

disease that results in disability and possible death to the secondary

medical issues it can cause. The problems with the absorption of

nutrients in our cases can be severe because most of the research

points to many of the complications with MCS, Fibro, CFS, etc to being

nutrient deficient. I can tell you that in my case and 2 other cases

that I " know " was true.

Just so you understand, I am not trying to minimize anyone's symptoms

or disease when I point out things in my post. I have had chronic

fatigue syndrome since 1983 and have lived with the consequences of the

related PTSD for 15 years now. In addition, I was just " diagnosed " with

MCS six months ago even though I have had symptoms where I ended up in

the hospital for 10 years. Last year, they put me in the psych ward of

the hospital because they did not believe that I was having a reaction

to chemicals (as I knew I had been) and that my mother died from the

same situation when I was in high school. I had been breathing

chemicals I could not smell for several weeks that inflamed my PTSD and

an accidental (on my part but not someone else's part) acute exposure

to them made my go into a full-fledged MCS attack. My counselor who I

had been seeing for my PTSD had to spring me from the hospital psyche

ward, only after they put me on antidepressants that made the chemical

poisoning and MCS worse. Over the next year, my old doctor kept trying

to up my doses of antidepressants and put me on haldol because she

thought instead of PTSD, MCS and all the other things I had developed

including diabetes I was suffering from delusions and schizophrenic

tendencies from mental illness. All if this by the way, she documented

in my medical chart while she was treating me. I ended up taking myself

off the antidepressants when I started turning yellow and my legs

started going numb and could not sleep because of the pain and was

losing the ability to walk correctly. Currently, I am housebound to a

main extent because even slight exposures to anything makes me ill and

my MCS episodes last months not just days anymore. So yes, I know the

problems associated with MCS.

As an educator, I was trained to be as neutral as possible when

addressing medical issues. Sometimes, it is hard because I have worked

in the pharm industry and know how much drugs are used off label. From

my situation above, the consequences can be very severe. I believe MCS

and all the other associated illnesses are just really one disease and

do not believe that with the current technology and pharmaceuticals we

can effectively treat the diseases. I hate to see people spend their

money on medicine, etc for something that may end up harming them. As

an advocate for the rights of patients with these medical problems, I

believe the problem is few physicians can effectively treat the

condition, because the financial support to find a treatment is lacking

and most of those in the medical profession ignored the consequences of

these illnesses and do they do not want to admit to themselves that it

is " truly " a medical condition.

I am sorry if I offended anyone, it was not my purpose.

Kim

~Haley

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Kim,

I will just briefly touch on some of the things you have said. I

strongly suggest that restudy Dr.Shoemaker's explanation on The

Biotoxin pathway. He normally uses the word " biotoxin " instead of

mycotoxins, etc. because he feels that ALL chemcials whether natural

or manmade are biotoxins (biological toxins) when they affect the

body.

Also, you are incorrect as far as you observation concerning how

many of us have gotten sick, it was NOT through ingestion of toxins

but inhalation. I will post the report done by WHO (World Health

Organization) concerning inhalation.

As with any medication be it natural or manmade there can be side

effects. In all the years we have been dealing with this issue I

(we) have yet to find someone that has actually been diagnosed with

the adverse effect that you mentioned, at least not by any of the

physicians that treat this condition. Normally we find that

diagnosis like this are more " self-diagnosis. "

Sharon C.

WHO report:

Toxic Effects of Mycotoxins in Humans

http://whqlibdoc.who.int/bulletin/1999/Vol77-No9/bulletin_1999_77(9)

_754-766.pdf

September 1, 1999 Bulletin of the World Health Organization

In experimental animals, trichothecenes are 40 times more toxic when

inhaled than when given orally.

By Peraica, M.; Radic, B.; Lucic, A.; Pavlovic, M.

Mycotoxicoses are diseases caused by mycotoxins, i.e. secondary

metabolites of moulds. Although they occur more frequently in areas

with a hot and humid climate, favourable for the growth of moulds,

they can also be found in temperate zones. Exposure to mycotoxins is

mostly by ingestion, but also occurs by the dermal and inhalation

routes. Mycotoxicoses often remain unrecognized by medical

professionals, except when large numbers of people are involved. The

present article reviews outbreaks of mycotoxicoses where the

mycotoxic etiology of the disease is supported by mycotoxin analysis

or identification of mycotoxin-producing fungi. Epidemiological,

clinical and histological findings (when available) in outbreaks of

mycotoxicoses resulting from exposure to aflatoxins, ergot,

trichothecenes, ochratoxins, 3-nitropropionic acid, zearalenone and

fumonisins are discussed.

Introduction

Mycotoxins are secondary metabolites of moulds that exert toxic

effects on animals and humans. The toxic effect of mycotoxins on

animal and human health is referred to as mycotoxicosis, the

severity of which depends on the toxicity of the mycotoxin, the

extent of exposure, age and nutritional status of the individual and

possible synergistic effects of other chemicals to which the

individual is exposed. The chemical structures of mycotoxins vary

considerably, but they are all relatively low molecular mass organic

compounds. The untoward effect of moulds and fungi was known already

in ancient times. In the seventh and eighth centuries BC the

festival " Robigalia " was established to honour the god Robigus, who

had to be propitiated in order to protect grain and trees. It was

celebrated on 25 April because that was the most likely time for

crops to be attacked by rust or mildew.

In the Middle Ages, outbreaks of ergotism caused by ergot alkaloids

from Claviceps purpurea reached epidemic proportions, mutilating and

killing thousands of people in Europe. Ergotism was also known as

ignis sacer (sacred fire) or St 's fire, because at the time

it was thought that a pilgrimage to the shrine of St would

bring relief from the intense burning sensation experienced. The

victims of ergotism were exposed to lysergic acid diethylamide

(LSD), a hallucinogen, produced during the baking of bread made with

ergot-contaminated wheat, as well as to other ergot toxins and

hallucinogens, as well as belladonna alkaloids from mandragora

apple, which was used to treat ergotism. While ergotism no longer

has such important implications for public health, recent reports

indicate that outbreaks of human mycotoxicoses are still possible.

Some mycotoxicoses have disappeared owing to more rigorous hygiene

measures. For example, citreoviridin-related malignant acute cardiac

beriberi ( " yellow rice disease " or shoshin-kakke disease in

Japanese) has not been reported for several decades, following the

exclusion of mouldy rice from the markets. Citreoviridin is a

metabolic product of Penicillium citreonigrum, which grows readily

on rice during storage after harvest, especially in the colder

regions of Japan. Another mycotoxicosis not seen for decades is

alimentary toxic aleukia, common in the 1930s and 1940s in the USSR.

This disease was caused by trichothecenes produced by Fusarium

strains on unharvested grain.

General interest in mycotoxins rose in 1960 when a feed-related

mycotoxicosis called turkey X disease, which was later proved to be

caused by aflatoxins, appeared in farm animals in England.

Subsequently it was found that aflatoxins are hepatocarcinogens in

animals and humans, and this stimulated research on mycotoxins.

There is a long history of the use of certain moulds in the

production of cheese and salami and in the fermentation of beer and

wine. Moulds are also used in the production of drugs (antibiotics).

The classification of mould metabolites as antibiotics or mycotoxins

is based on their toxicity or beneficial effect in treating

diseases. Some mould metabolites that were initially considered to

be antibiotics (e.g. citrinin) were subsequently found to be highly

toxic, and are currently classified as toxins. Ergot alkaloids are

still used, inter alia, in the treatment of parkinsonism, as

prolactin inhibitors, in cerebrovascular insufficiency, migraine

treatment, venous insufficiency, thrombosis and embolisms, for the

stimulation of cerebral and peripheral metabolism, in uterine

stimulation, as a dopaminergic agonist.

The toxic effects of mycotoxins (e.g. ochratoxins, fumonisins,

zearalenone, etc.) are mostly known from veterinary practice.

Mycotoxicoses, which can occur in both industrialized and developing

countries, arise when environmental, social and economic conditions

combine with meteorological conditions (humidity., temperature)

which favour the growth of moulds.

Involvement of mycotoxins in disease causation should be considered

in instances when a disease appears in several persons, with no

obvious connection to a known etiological agent, such as

microorganisms. Given current trade patterns, mycotoxicoses

resulting from contaminated food, locally grown or imported, could

occur in developing and developed countries alike. Strict control of

food and feed and appropriate public health measures are therefore

of considerable importance in reducing the risks to human and animal

health.

This review covers only the human aspects of the untoward effects of

mycotoxins. However, owing to the frequent nonspecific effects of

mycotoxin involvement, the results of animal experiments are useful

for understanding possible effects on humans. Since review articles

and books are available dealing with specific topics such as the

chemistry, analytical procedures, metabolism, and economic aspects

of mycotoxins (9-18), these aspects of mycotoxin toxicology are not

presented here. Mycotoxicoses are usually insufficiently treated in

medical textbooks and are not covered in curricula of many medical

schools. The aim of this article is to summarize current

understanding of the clinical aspects mainly of mycotoxicoses in

humans, and to stress the importance of this class of naturally

occurring toxins.

Ergot: Ergot is the common name of the sclerotia of fungal species

within the genus Claviceps, which produce ergot alkaloids. The

sclerotium is the dark-coloured, hard fungal mass that replaces the

seed or kernel of a plant following infestation. Ergot alkaloids are

also secondary metabolites of some strains of Penicillium,

Aspergillus and Rhizopus spp.

The ca. 40 ergot alkaloids isolated from Claviceps sclerotia can be

divided into three groups:

derivatives of lysergic acid (e.g. ergotamine and ergocristine);

derivatives of isolysergic acid (e.g. ergotaminine);

derivatives of dimethylergoline (clavines, e.g. agroclavine).

The source of the ergot strongly influences the type of alkaloids

present, as well as the clinical picture of ergotism. Claviceps

purpurea produces ergotamine-ergocristine alkaloids, which cause the

gangrenous form of ergotism because of their vasoconstrictive

activity. The initial symptoms are oedema of the legs, with severe

pains. Paraesthesias are followed by gangrene at the tendons, with

painless demarcation. The last-recorded outbreak of gangrenous

ergotism occurred in Ethiopia in 1977-78; 140 persons were affected

and the mortality was high (34%).

The other type of ergotism, a convulsive form related to

intoxication with clavine alkaloids from Claviceps fusiformis was

last seen during 1975 in India when 78 persons were affected. It was

characterized by gastrointestinal symptoms (nausea, vomiting and

giddiness) followed by effects on the central nervous system

(drowsiness, prolonged sleepiness, twitching, convulsions, blindness

and paralysis). The onset of symptoms occurred 1-48 hours following

exposure; there were no fatalities.

Ergotism is extremely rare today, primarily because the normal grain

cleaning and milling processes remove most of the ergot so that only

very low levels of alkaloids remain in the resultant flours. In

addition, the alkaloids that are the causative agents of ergotism

are relatively labile and are usually destroyed during baking and

cooking.

Aflatoxins

Aflatoxins occur in nuts, cereals and rice under conditions of high

humidity and temperature and present a risk to human health that is

insufficiently recognized. The two major Aspergillus species that

produce aflatoxins are A. flavus, which produces only B aflatoxins,

and A. parasiticus, which produces both B and G aflatoxins.

Aflatoxins [M.sub.1] and [M.sub.2] are oxidative metabolic products

of aflatoxins [b.sub.1] and [b.sub.2] produced by animals following

ingestion, and so appear in milk (both animal and human), urine and

faeces. Aflatoxicol is a reductive metabolite of aflatoxin

[b.sub.1].

Aflatoxins are acutely toxic, immunosuppressive, mutagenic,

teratogenic and carcinogenic compounds. The main target organ for

toxicity and carcinogenicity is the liver. The evaluation of

epidemiological and laboratory results carried out in 1987 by the

International Agency for Research on Cancer (IARC) found that there

is sufficient evidence in humans for the carcinogenicity of

naturally occurring mixtures of aflatoxins, which are therefore

classified as Group 1 carcinogens, except for aflatoxin [M.sub.1],

which is possibly carcinogenic to humans (Group 2B). Several

outbreaks of aflatoxicosis have occurred in tropical countries,

mostly among adults in rural populations with a poor level of

nutrition for whom maize is the staple food. The clinical picture

presented by cases indicated acute toxic liver injury, which was

confirmed by morphological changes in liver autopsy specimens that

were indicative of toxic hepatitis. Mortality rates in the acute

phase were 10-60 %. At the end of one year, surviving patients had

no jaundice, and most of them had recovered clinically.

A case of attempted suicide with purified aflatoxin [b.sub.1] is

reported to have occurred in 1966 in the USA. A young woman ingested

a total of 5.5 mg of aflatoxin [b.sub.1] over 2 days and, 6 months

later, a total of 35 mg over 2 weeks. Following the first exposure,

she was admitted to hospital with a transient, nonpruritic, macular

rash, nausea and headache; the second time she reported nausea only.

On both occasions, physical, radiological and laboratory

examinations were normal and liver biopsies appeared normal by light

microscopy. A follow-up examination 14 years later did not reveal

any signs or symptoms of disease or lesions. These findings suggest

that the hepatotoxicity of aflatoxin [b.sub.1] may be lower in well

nourished persons than in experimental animals or that the latent

period for turnout formation may exceed 14 years.

Aflatoxins have been detected in the blood of pregnant women, in

neonatal umbilical cord blood, and in breast milk in African

countries, with significant seasonal variations. Levels of

aflatoxins detected in some umbilical cord bloods at birth are among

the highest levels ever recorded in human tissue and fluids.

Aflatoxins have been suggested as an etiological factor in

encephalopathy and fatty degeneration of viscera, similar to Reye

syndrome, which is common in countries with a hot and humid climate.

The clinical picture includes enlarged, pale, fatty liver and

kidneys and severe cerebral oedema. Aflatoxins have been found in

blood during the acute phase of the disease, and in the liver of

affected children. However, use of aspirin or phenothiazines is also

suspected to be involved in the etiology.

In tropical countries, clinically recognizable jaundice is frequent

during the neonatal period. In a large investigation undertaken on

327 Babies with jaundice and 80 matching controls in Nigeria, it was

found that the occurrence of glucose-6-phosphate dehydrogenase

(G6PD) deficiency together with the presence of aflatoxins in the

serum are significant risk factors for the development of neonatal

jaundice.

The geographical and seasonal prevalences of aflatoxins in food and

of kwashiorkor show a remarkable similarity. In several tropical

countries, aflatoxins have been found more frequently and in higher

concentration in liver specimens from children with kwashiorkor than

in controls. Clinical investigation of aflatoxin elimination in

children with kwashiorkor and marasmic kwashiorkor, who were fed an

aflatoxin-free diet, proved that aflatoxins in these children are

slowly eliminated. In several studies, aflatoxicol was found in the

serum, liver, urine and stools of children with kwashiorkor and

marasmic kwashiorkor, in contrast to marasmic and control children

where this metabolite was not found. It is not clear whether this

difference is causally related to kwashiorkor or is a consequence of

the disease.

In recent studies, aflatoxins were found in the brain and lungs of

children who had died from kwashiorkor and in control children who

had died from various other diseases. It was suggested that the

presence of aflatoxins in the brains of control children might be

due to metabolic imbalance or to a failure in the excretory

mechanisms of children with conditions such as measles (which in 25%

of cases precedes kwashiorkor), renal failure, pyloric stenosis,

gastroenteritis. Aflatoxins in the lungs were found in all children

diagnosed to have pneumonia, irrespective of the presence of

kwashiorkor. This could be due to a reduced clearing ability of the

lungs in pulmonary diseases or to exposure via the respiratory

route. In the Philippines, a study of the relationship between the

presence of aflatoxin in the serum and urine of children and the

outcome of acute lower respiratory infection failed to prove a

correlation. However, aflatoxin [b.sub.1] was found in the lungs of

one textile and two agricultural workers who died from pulmonary

interstitial fibrosis. These individuals were probably

occupationally exposed to aflatoxin [b.sub.1] via the respiratory

route. Aflatoxin [b.sub.1] was also detected in the lung tissue of a

chemical engineer who had worked for 3 months on a method for

sterilizing Brazilian peanut meal contaminated with Aspergillus

flavus, and who died of alveolar cell carcinoma.

In the United Kingdom, it was found that intravenous heroin users

can be exposed to aflatoxin [b.sub.1] from samples of heroin on

sale. Through intravenous administration, aflatoxin [b.sub.1]

bypasses the detoxifying mechanisms of the liver, which results in

direct systemic exposure. In the United Kingdom and the Netherlands,

analysis of 121 urine samples obtained from heroin addicts revealed

a higher proportion of samples contaminated with aflatoxins

[b.sub.1], [b.sub.2], [M.sub.1] and [M.sub.2] and aflatoxicol (20%)

than those from normal adult volunteers (2%). In addition, aflatoxin

[b.sub.1] was found at much lower concentrations in the latter

group.

3-Nitropropionic acid 3-Nitropropionic acid (3-NPA) is a secondary

metabolite of Arthrinium sp., considered to cause a form of acute

food-poisoning called " mouldy sugarcane poisoning " . The problem

occurred during winter (February and March) in 13 provinces of

northern China as a consequence of ingesting sugarcane that had been

stored for at least two months and which was infested with

Arthrinium sp. In the period 1972-88, a total of 884 persons were

involved in outbreaks, with 88 (10%) fatalities. The main

epidemiological feature is the small number of persons in one

outbreak (one to five persons), with the victims being mostly

children and young people. The incubation period is generally 2-3

hours following the ingestion of mouldy sugar-cane, and the main

clinical symptoms are vomiting, dystonia, staring to one side,

convulsions, carpopedal spasm and coma. Delayed dystonia develops in

10-50 % of patients as a consequence of bilateral symmetric necrosis

of the basal ganglia. The development of delayed symptoms can be

predicted by abnormality in the basal ganglia on cranial computed

tomography (CT) scans. In adults, 3-NPA causes gastrointestinal

symptoms; signs of severe encephalopathy are not common.

Ochratoxins

Ochratoxins are secondary metabolites of Aspergillus and Penicillium

strains, found on cereals, coffee and bread, as well as on all kinds

of food commodities of animal origin in many countries. The most

frequent is ochratoxin A, which is also the most toxic. It has been

shownn to be nephrotoxic, immunosuppressive, carcinogenic and

teratogenic in all experimental animals tested so far.

Acute renal failure in one person, possibly caused by inhalation of

ochratoxin A in a granary which had been closed for 2 years, was

reported in Italy. The symptoms developed after 24 hours of

transitory epigastric tension, respiratory distress, and

retrosternal burning. Acute tubular necrosis was found on biopsy,

but the blood was not analysed for ochratoxin A. The presence of the

mycotoxin in wheat from the granary was proved qualitatively by thin-

layer chromatography.

Owing to the similarity of morphological and functional kidney

lesions in ochratoxin A-induced porcine nephropathy and endemic

nephropathy, this mycotoxin has been proposed as the causative agent

of endemic nephropathy, although the evidence for this is not

substantial. This fatal renal disease occurs among rural populations

in Croatia, Bosnia and Herzegovina, Yugoslavia, Bulgaria, and

Romania, where it has been estimated that about 20,000 people are

either suffering from or are suspected to have the disease. There is

no acute phase of the illness; the first signs and symptoms of the

disease are not specific and include fatigue, headache, loss of body

weight and pale skin. A mild low-molecular-mass proteinuria without

hypertension but with either aplastic or normochromic anaemia

gradually develops over several years. The main features of endemic

nephropathy are bilateral, primarily chronic lesions of the renal

cortex (tubular degeneration, interstitial fibrosis and

hyalinization of the glomeruli). In the advanced stage of the

disease, the size and weight of kidneys are remarkably reduced, with

diffuse cortical fibrosis, usually without signs of inflammation.

Ochratoxin A is found more frequently and in higher concentrations

in the blood of inhabitants from endemic regions than control

regions. Many samples of locally produced food and feed collected in

the endemic area contained ochratoxin A. It should be emphasized

that the grain analysed had been kept for many months in the

inadequate food stores of individual families.

In Tunisia, ochratoxin A has been detected in high concentrations in

the blood and food of patients with kidney impairment of unknown

etiology. It has also been found in several countries, both in food

and feed and in humans.

In endemic regions of Croatia, Bulgaria and Yugoslavia, the

incidence of otherwise rare urothelial tumours of the pelvis and

ureter is 50, 90 and 100 times greater, respectively, than in

nonendemic regions. It has been suggested that ochratoxin A may be

the causal agent for both endemic nephropathy and urothelial

tumours. IARC classified ochratoxin A as a compound possibly

carcinogenic to humans (Group 2B).

Trichothecenes

Trichothecenes are mycotoxins produced mostly by members of the

Fusarium genus, although other genera (e.g. Trichoderma,

Trichothecium, Myrothecium and Stachybotrys) are also known to

produce these compounds. To date, 148 trichothecenes have been

isolated, but only a few have been found to contaminate food and

feed. The most frequent contaminants are deoxynivalenol (DON), also

known as vomitoxin, nivalenol (NIV), diacetoxyscirpenol (DAS), while

T-2 toxin is rarer.

Common manifestations of trichothecene toxicity are depression of

immune responses and nausea, sometimes vomiting. The first

recognized trichothecene mycotoxicosis was alimentary toxic aleukia

in the USSR in 1932; the mortality rate was 60%. In regions where

the disease occurred, 540% of grain samples cultured showed the

presence of Fusarium sporotrichoides, while in those regions where

the disease was absent this fungus was found in only 2-8% of

samples. The severity of mycotoxicosis was related to the duration

of consumption of toxic grain. Such severe trichothecene

mycotoxicoses, the consequence of continuous ingestion of toxins,

have not been recorded since this outbreak.

In several cases, trichothecene mycotoxicosis was caused by a single

ingestion of bread containing toxic flour or rice. In experimental

animals, trichothecenes are 40 times more toxic when inhaled than

when given orally. Trichothecenes were found in air samples

collected during the drying and milling process on farms, in the

ventilation systems of private houses and office buildings, and on

the walls of houses with high humidity. There are some reports

showing trichothecene involvement in the development of " sick

building syndrome " . The symptoms of airborne toxicosis disappeared

when the buildings and ventilation systems were thoroughly cleaned.

Zearalenone Zearalenone (previously known as F-2) is produced mainly

by Fusarium graminearum and related species, principally in wheat

and maize but also in sorghum, barley and compounded feeds.

Zearalenone and its derivatives produce estrogenic effects in

various animal species (infertility, vulval oedema, vaginal prolapse

and mammary hypertrophy in females and feminization of males --

atrophy of testes and enlargement of mammary glands).

In Puerto Rico, zearalenone was found in the blood of children with

precocious sexual development exposed to contaminated food.

Zearalenone was also found together with other Fusarium mycotoxins

in " scabby grain toxicosis " in China, but the significance of this

finding is not clear.

Fumonisins

Fumonisins are mycotoxins produced throughout the world by Fusarium

moniliforme and related species when they grow in maize. Fumonisins

[b.sub.1] and [b.sub.2] are of toxicological significance, while the

others (B.sub.3], [b.sub.4], [A.sub.1] and [A.sub.2]) occur in very

low concentrations and are less toxic.

In India a single outbreak of acute foodborne disease possibly

caused by fumonisin [b.sub.1] has been reported. In the 27 villages

involved, the individuals affected were from the poorest social

strata, who had consumed maize and sorghum harvested and left in the

fields during unseasonable rains. The main features of the disease

were transient abdominal pain, borborygmus and diarrhoea, which

began half an hour to one hour following consumption of unleavened

bread prepared from mouldy sorghum or mouldy maize. Patients

recovered fully when the exposure ceased and there were no

fatalities. Fumonisin [b.sub.1] was found in much higher

concentrations in the maize and sorghum from the affected households

than from controls.

Fumonisin [b.sub.1] was found more frequently and in much higher

concentrations in maize in regions of Transkei, China and north-east

Italy with a higher incidence of oesophageal cancer than other

regions. It was postulated that the high incidence of oesophageal

cancer was related to the presence of this mycotoxin in maize, which

is a staple food in these regions. The incidence and concentration

of aflatoxin [b.sub.1], deoxynivalenol and fumonisins [b.sub.1],

[b.sub.2] and [b.sub.3] were recently determined in maize samples

from an area of China (Haimen) with a high incidence of primary

liver cancer and from an area with a low incidence (Penlai).

Aflatoxin [b.sub.1] was found in low concentrations in almost all

maize samples from both these areas, but the incidence and

concentration of deoxynivalenol and fumonisins were much higher in

the samples from the area where the incidence of primary liver

cancer was high. The authors put forward the hypothesis that

fumonisins, which have known cancer-promoting activity in rat liver,

and deoxynivalenol promote the initial lesion caused by aflatoxin

[b.sub.1]. An IARC working group classified the toxins from F.

moniliforme as possibly carcinogenic to humans (Group 2B).

Other unidentified mycotoxins

The impact of other mycotoxins on human health was reported in

persons occupationally exposed to large amounts of different

mycotoxin-producing fungi (farmers, workers in silos, etc.). In such

cases, exposure to spores via the respirator), tract seems to be of

considerable importance.

In Norway an extensive epidemiological study was undertaken between

1967 and 1991 on 192 417 births to test the hypotheses that

perinatal death was associated with parental exposure to pesticides,

Toxoplasma gondii infection from sheep or pigs, or mycotoxins found

in grain. The proportion of late-term abortions (gestational age 16-

27 weeks) was higher among farmers. The risk associated with grain

farming was higher after the harvest, in seasons with a poor quality

harvest and in pregnancies with multiple fetuses, which suggests

that mycotoxins in grain induce labour at an early stage of

pregnancy.

Pulmonary mycotoxicosis has been reported in ten persons exposed to

large quantities of fungal hyphae and spores during the cleaning of

silos. The clinical picture developed several hours afterwards, with

burning eyes, throat and chest, irritating cough and fever. There

was no wheezing, cyanosis or other sign of bronchospasm. In five

patients, chest X-rays revealed reticular and fine nodular features

compatible with interstitial pneumonitis. Histological study of a

lung biopsy from one patient showed a multifocal acute process, with

primary involvement of terminal bronchioles containing numbers of

various spores. Cultures from lung biopsy material revealed at least

five fungal species, including one Fusarium and one Penicillium.

However, blood samples were not checked for the presence of

mycotoxins. In contrast with the findings in patients with farmer's

lung disease, these patients did not develop positive serological

reactions to thermophilic actinomycetes or to extracts of fungi

obtained from hay or silage. The patients were followed for periods

of 1-10 years; they continued their work, avoiding massive re-

exposure to fungal dust, and during the observation period there

were no further incidents.

Conclusion

Acute mycotoxicoses can cause serious and sometimes fatal diseases.

The possibility of mycotoxin intoxication should be considered when

an acute disease occurs in several persons when there is no evidence

of infection with a known etiological agent, and no improvement in

the clinical picture following treatment. Most of the outbreaks of

mycotoxicoses described are a consequence of the ingestion of food

that is contaminated with mycotoxins. The strict control of food

quality, in both industrialized and developing countries, is

therefore necessary to avoid such outbreaks.

Acknowledgements We thank Dr R. Plestina for supervision and advice

in all phases of the preparation of this paper.

Trichothecene Mycotoxins (T2) Signs and Symptoms

Exposure causes skin pain, pruritus, redness, vesicles, necrosis and

sloughing of epidermis. Effects on the airway include nose and

throat pain, nasal discharge, itching and sneezing, cough, dyspnea,

wheezing, chest pain and hemoptysis. Toxin also produces effects

after ingestion or eye contact. Severe poisoning results in

prostration, weakness, ataxia, collapse, shock, and death.

Diagnosis: Should be suspected if an aerosol attack occurs in the

form of " yellow rain " with droplets of yellow fluid contaminating

clothes and the environment. Confirmation requires testing of blood,

tissue and environmental samples. Treatment: There is no specific

antidote. Superactivated charcoal should be given orally if

swallowed. Prophylaxis: The only defense is to wear a protective

mask and clothing during an attack. No specific immunotherapy or

chemotherapy is available for use in the field. Decontamination: The

outer uniform should be removed and exposed skin should be

decontaminated with soap and water. Eye exposure should be treated

with copious saline irrigation. Once decontamination is complete,

isolation is not required.

Overview The trichothecene mycotoxins are low molecular weight (250-

500 daltons) nonvolatile compounds produced by filamentous fungi

(molds) of the genera Fusarium, Myrotecium, Trichoderma,

Stachybotrys and others. The structures of approximately 150

trichothecene derivatives have been described in the literature.

These substances are relatively insoluble in water but are highly

soluble in ethanol, methanol and propylene glycol. The

trichothecenes are extremely stable to heat and ultraviolet light

inactivation. Heating to 500o F for 30 minutes is required for

inactivation, while brief exposure to NaOH destroys toxic activity.

The potential for use as a BW toxin was demonstrated to the Russian

military shortly after World War II when flour contaminated with

species of Fusarium was baked into bread that was ingested by

civilians. Some developed a protracted lethal illness called

alimentary toxic aleukia (ATA) characterized by initial symptoms of

abdominal pain, diarrhea, vomiting, prostration, and within days

fever, chills, myalgias and bone marrow depression with

granulocytopenia and secondary sepsis. Survival beyond this point

allowed the development of painful pharyngeal/laryngeal ulceration

and diffuse bleeding into the skin (petechiae and ecchymoses),

melena, bloody diarrhea, hematuria, hematemesis, epistaxis and

vaginal bleeding. Pancytopenia, and gastrointestinal ulceration and

erosion were secondary to the ability of these toxins to profoundly

arrest bone marrow and mucosal protein synthesis and cell cycle

progression through DNA replication.

History and Significance Mycotoxins allegedly have been used in

aerosol form ( " yellow rain " ) to produce lethal and nonlethal

casualties in Laos (1975-81), Kampuchea (1979-81), and Afghanistan

(1979-81). It has been estimated that there were more than 6,300

deaths in Laos, 1,000 in Kampuchea, and 3,042 in Afghanistan. The

alleged victims were usually unarmed civilians or guerrilla forces.

These groups were not protected with masks and chemical protective

clothing and had little or no capability of destroying the attacking

enemy aircraft. These attacks were alleged to have occurred in

remote jungle areas which made confirmation of attacks and recovery

of agent extremely difficult. Much controversy has centered about

the veracity of eyewitness and victim accounts, but there is enough

evidence to make agent use in these areas highly probable.

Clinical Features T2 and other mycotoxins may enter the body through

the skin and aerodigestive epithelium. They are fast acting potent

inhibitors of protein and nucleic acid synthesis. Their main effects

are on rapidly proliferating tissues such as the bone marrow, skin,

mucosal epithelia, and germ cells. In a successful BW attack with

trichothecene toxin (T2), the toxin(s) will adhere to and penetrate

skin, be inhaled, and swallowed. Clothing will be contaminated and

serve as a reservoir for further toxin exposure. Early symptoms

beginning within minutes of exposure include burning skin pain,

redness, tenderness, blistering, and progression to skin necrosis

with leathery blackening and sloughing of large areas of skin in

lethal cases. Nasal contact is manifested by nasal itching and pain,

sneezing, epistaxis and rhinorrhea; pulmonary/tracheobronchial

toxicity by dyspnea, wheezing, and cough; and mouth and throat

exposure by pain and blood tinged saliva and sputum. Anorexia,

nausea, vomiting and watery or bloody diarrhea with abdominal crampy

pain occurs with gastrointestinal toxicity. Eye pain, tearing,

redness, foreign body sensation and blurred vision may follow entry

of toxin into the eyes. Skin symptoms occur in minutes to hours and

eye symptoms in minutes. Systemic toxicity is manifested by

weakness, prostration, dizziness, ataxia, and loss of coordination.

Tachycardia, hypothermia, and hypotension follow in fatal cases.

Death may occur in minutes, hours or days. The commonest symptoms

were vomiting, diarrhea, skin involvement with burning pain, redness

and pruritus, rash or blisters, bleeding, and dyspnea.

Diagnosis Rapid onset of symptoms in minutes to hours supports a

diagnosis of a chemical or toxin attack. Mustard agents must be

considered but they have an odor, are visible, and can be rapidly

detected by a field available chemical test. Symptoms from mustard

toxicity are also delayed for several hours after which mustard can

cause skin, eye and respiratory symptoms. Staphylococcal enterotoxin

B delivered by an aerosol attack can cause fever, cough, dyspnea and

wheezing but does not involve the skin and eyes. Nausea, vomiting,

and diarrhea may follow swallowing of inhaled toxin. Ricin

inhalation can cause severe respiratory distress, cough, nausea and

arthralgias. Swallowed agent can cause vomiting, diarrhea, and

gastrointestinal bleeding, but it spares the skin, nose and eyes.

Specific diagnosis of T-2 mycotoxins in the form of a rapid

diagnostic test is not presently available in the field. Removal of

blood, tissue from fatal cases, and environmental samples for

testing using a gas liquid chromatography-mass spectrometry

technique will confirm the toxic exposure. This system can detect as

little as 0.1-1.0 ppb of T-2. This degree of sensitivity is capable

of measuring T-2 levels in the plasma of toxin victims.

Medical Management Use of a chemical protective mask and clothing

prior to and during a mycotoxin aerosol attack will prevent illness.

If a soldier is unprotected during an attack the outer uniform

should be discarded within 4 hours and decontaminated by exposure to

5% hypochlorite for 6-10 hours. The skin should be thoroughly washed

with soap and uncontaminated water if available. The M291 skin

decontamination kit should also be used to remove skin adherent T-2.

Superactive charcoal can absorb swallowed T-2 and should be

administered to victims of an unprotected aerosol attack. The eyes

should be irrigated with normal saline or water to remove toxin. No

specific antidote or therapeutic regimen is currently field

available. All therapy is symptomatic and supportive.

Prophylaxis

Physical protection of the skin and airway are the only proven

effective methods of protection during an attack. Immunological

(vaccines) and chemoprotective pretreatments are being studied in

animal models, but are not available for field use by the

warfighter.

Staphylococcal Enterotoxin B Summary Signs and Symptoms

From 3-12 hours after aerosol exposure, sudden onset of fever,

chills, headache, myalgia, and nonproductive cough. Some patients

may develop shortness of breath and retrosternal chest pain. Fever

may last 2 to 5 days, and cough may persist for up to 4 weeks.

Patients may also present with nausea, vomiting, and diarrhea if

they swallow toxin. Higher exposure can lead to septic shock and

death. Diagnosis: Diagnosis is clinical. Patients present with a

febrile respiratory syndrome without CXR abnormalities. Large

numbers of soldiers presenting with typical symptoms and signs of

SEB pulmonary exposure would suggest an intentional attack with this

toxin.

Treatment

Treatment is limited to supportive care. Artificial ventilation

might be needed for very severe cases, and attention to fluid

management is important. Prophylaxis: Use of protective mask. There

is currently no human vaccine available to prevent SEB intoxication.

Decontamination: Hypochlorite (0.5% for 10-15 minutes) and/or soap

and water. Destroy any food that may have been contaminated.

Overview Staphylococcus aureus produces a number of exotoxins, one

of which is Staphylococcal enterotoxin B, or SEB. Such toxins are

referred to as exotoxins since they are excreted from the organism;

however, they normally exert their effects on the intestines and

thereby are called enterotoxins. SEB is one of the pyrogenic toxins

that commonly causes food poisoning in humans after the toxin is

produced in improperly handled foodstuffs and subsequently ingested.

SEB has a very broad spectrum of biological activity. This toxin

causes a markedly different clinical syndrome when inhaled than it

characteristically produces when ingested. Significant morbidity is

produced in individuals who are exposed to SEB by either portal of

entry to the body.

History and Significance SEB has caused countless endemic cases of

food poisoning. Often these cases have been clustered, due to common

source exposure in a setting such as a church picnic or passengers

eating the same toxin-contaminated food on an airliner. Although

this toxin would not be likely to produce significant mortality on

the battlefield, it could render up to 80 percent or more of exposed

personnel clinically ill and unable to perform their mission for a

fairly prolonged period of time. Therefore, even though SEB is not

generally thought of as a lethal agent, it may incapacitate soldiers

for up to two weeks, making it an extremely important toxin to

consider.

Toxin Characteristics Staphylococcal enterotoxins are extracellular

products produced by coagulase-positive staphylococci. They are

produced in culture media and also in foods when there is overgrowth

of the staph organisms. At least five antigenically distinct

enterotoxins have been identified, SEB being one of them. These

toxins are heat stable. SEB causes symptoms when inhaled at very low

doses in humans: a dose of several logs lower than the lethal dose

by the inhaled route would be sufficient to incapacitate 50 percent

of those soldiers so exposed. This toxin could also be used

(theoretically) in a special forces or terrorist mode to sabotage

food or low volume water supplies.

Mechanism of Toxicity Staphylococcal enterotoxins produce a variety

of toxic effects. Inhalation of SEB can induce extensive

pathophysiological changes to include widespread systemic damage and

even septic shock. Many of the effects of staphylococcal

enterotoxins are mediated by interactions with the host's own immune

system. The mechanisms of toxicity are complex, but are related to

toxin binding directly to the major histocompatibility complex that

subsequently stimulates the proliferation of large numbers of T cell

lymphocytes. Because these exotoxins are extremely potent activators

of T cells, they are commonly referred to as bacterial

superantigens. These superantigens stimulate the production and

secretion of various cytokines, such as tumor necrosis factor,

interferon-(, interleukin-1 and interleukin-2, from immune system

cells. Released cytokines are thought to mediate many of the toxic

effects of SEB.

Clinical Features Relevant battlefield exposures to SEB are

projected to cause primarily clinical illness and incapacitation.

However, higher exposure levels can lead to septic shock and death.

Intoxication with SEB begins 3 to 12 hours after inhalation of the

toxin. Victims may experience the sudden onset of fever, headache,

chills, myalgias, and a nonproductive cough. More severe cases may

develop dyspnea and retrosternal chest pain. Nausea, vomiting, and

diarrhea will also occur in many patients due to inadvertently

swallowed toxin, and fluid losses can be marked. The fever may last

up to five days and range from 103 to 106o F, with variable degrees

of chills and prostration. The cough may persist up to four weeks,

and patients may not be able to return to duty for two weeks.

Physical examination in patients with SEB intoxication is often

unremarkable. Conjunctival injection may be present, and postural

hypotension may develop due to fluid losses. Chest examination is

unremarkable except in the unusual case where pulmonary edema

develops. The chest X-ray is also generally normal, but in severe

cases increased interstitial markings, atelectasis, and possibly

overt pulmonary edema or an ARDS picture may develop.

Diagnosis As is the case with botulinum toxins, intoxication due to

SEB inhalation is a clinical and epidemiologic diagnosis. Because

the symptoms of SEB intoxication may be similar to several

respiratory pathogens such as influenza, adenovirus, and mycoplasma,

the diagnosis may initially be unclear. All of these might present

with fever, nonproductive cough, myalgia, and headache. SEB attack

would cause cases to present in large numbers over a very short

period of time, probably within a single 24 hour period. Naturally

occurring pneumonias or influenza would involve patients presenting

over a more prolonged interval of time. Naturally occurring

staphylococcal food poisoning cases would not present with pulmonary

symptoms. SEB intoxication tends to progress rapidly to a fairly

stable clinical state, whereas pulmonary anthrax, tularemia

pneumonia, or pneumonic plague would all progress if left untreated.

Tularemia and plague, as well as Q fever, would be associated with

infiltrates on chest radiographs. Nerve agent intoxication would

cause fasciculations and copious secretions, and mustard would cause

skin lesions in addition to pulmonary findings; SEB inhalation would

not be characterized by these findings. The dyspnea associated with

botulinum intoxication is associated with obvious signs of muscular

paralysis, bulbar palsies, lack of fever, and a dry pulmonary tree

due to cholinergic blockade; respiratory difficulties occur late

rather than early as with SEB inhalation. Laboratory findings are

not very helpful in the diagnosis of SEB intoxication. A nonspecific

neutrophilic leukocytosis and an elevated erythrocyte sedimentation

rate may be seen, but these abnormalities are present in many

illnesses. Toxin is very difficult to detect in the serum by the

time symptoms occur; however, a serum specimen should be drawn as

early as possible after exposure. Data from rabbit studies clearly

show that SEB in the serum is transient; however, it accumulates in

the urine and can be detected for several hours post exposure.

Therefore, urine samples should be obtained and tested for SEB. High

SEB concentrations inhibit kidney function. Because most patients

will develop a significant antibody response to the toxin, acute and

convalescent serum should be drawn which may be helpful

retrospectively in the diagnosis.

Medical Management Currently, therapy is limited to supportive care.

Close attention to oxygenation and hydration are important, and in

severe cases with pulmonary edema, ventilation with positive end

expiratory pressure and diuretics might be necessary. Acetaminophen

for fever, and cough suppressants may make the patient more

comfortable. The value of steroids is unknown. Most patients would

be expected to do quite well after the initial acute phase of their

illness, but most would generally be unfit for duty for one to two

weeks.

Prophylaxis

Although there is currently no human vaccine for immunization

against SEB intoxication, several vaccine candidates are in

development. Preliminary animal studies have been encouraging and a

vaccine candidate is nearing transition to advanced development and

safety and immunogenicity testing in man. Experimentally, passive

immunotherapy can reduce mortality, but only when given within 4-8

hours after inhaling SEB.

Source: U.S. Army Handbook on infectious Diseases August 1996

>

> Please do not get me wrong...I am neithering arguing or confirming

the

> useful of CSM in treating mycotoxicosis. I have read Shoemaker's

> website and the understand the useful of CSM for treating Possible

> Esuary Associated Syndrome (PEAS) from dinoflagelatte infection,

ie.

> Pfisteria which had marked improvement in visual contrast

sensitivity

> (VCS). However, I do not see anything that mentions specifically

that

> it is used to treat mycotoxicosis (by diagnosis of mycotoxicosis)

but

> is used in treating biotoxicosis...there is a difference as

biotoxin is

> a more general term.

>

> In terms of the mycotoxicosis that we are speaking about here,

unless

> you live in a foreign country where food contamination is common,

we

> are talking about the build-up of mycotoxins that occur over time.

I am

> not refuting the damage to organ systems (including the immune

system)

> nor am I refuting the impact the mycotoxins cause on other tissue

such

> as the sinuses through necrosis. With all this in mind, the only

> therapy where I can see CSM would be of benefit would be to take

it for

> the rest of your life. The mycotoxins that cause human illness in

most

> of our cases is from the daily eating of contaminated foodstuffs

and

> CSM would not be an effective treatment for long-term use.

However, it

> seems to be a short-term therapy for some biotoxins..and as I

stated

> earlier I have not even found published information about it being

used

> as therapy for a " diagnosis " of mycotoxicosis.

>

> Here is something to think about....Mycotoxins are possible charged

> which makes them stick to their host. Please tell me if I am

wrong, but

> in MCS patients they are finding that the mycotoxins get stuck in

the

> liver (and other organs) which is how they cause liver damage. In

this

> case, CSM would not be effective at getting rid of those

mycotoxins. As

> far as recycling, I am still researching that process. They do find

> that there is a relationship of mycostoxicosis with high

cholesterol.

> Maybe this condition impairs the ability of the bodies detox

system to

> get rid of the mycotoxins. Since CSM is a cholesterol binding

agent, it

> may actually reduce mycotoxicosis by binding the cholesterol that

> impairs the liver's ability to break down the mycotoxin. May be by

> following a non-fat low cholesterol diet, eating 5-9 vegetable and

> fruits servings a day to provide the phytonutrients and other

chemicals

> for the detox system, etc. you can do the same thing without the

> medication?

>

> As far as the side-effects go for CSM, osteoporosis is a very

serious

> disease that results in disability and possible death to the

secondary

> medical issues it can cause. The problems with the absorption of

> nutrients in our cases can be severe because most of the research

> points to many of the complications with MCS, Fibro, CFS, etc to

being

> nutrient deficient. I can tell you that in my case and 2 other

cases

> that I " know " was true.

>

> Just so you understand, I am not trying to minimize anyone's

symptoms

> or disease when I point out things in my post. I have had chronic

> fatigue syndrome since 1983 and have lived with the consequences

of the

> related PTSD for 15 years now. In addition, I was just " diagnosed "

with

> MCS six months ago even though I have had symptoms where I ended

up in

> the hospital for 10 years. Last year, they put me in the psych

ward of

> the hospital because they did not believe that I was having a

reaction

> to chemicals (as I knew I had been) and that my mother died from

the

> same situation when I was in high school. I had been breathing

> chemicals I could not smell for several weeks that inflamed my

PTSD and

> an accidental (on my part but not someone else's part) acute

exposure

> to them made my go into a full-fledged MCS attack. My counselor

who I

> had been seeing for my PTSD had to spring me from the hospital

psyche

> ward, only after they put me on antidepressants that made the

chemical

> poisoning and MCS worse. Over the next year, my old doctor kept

trying

> to up my doses of antidepressants and put me on haldol because she

> thought instead of PTSD, MCS and all the other things I had

developed

> including diabetes I was suffering from delusions and schizophrenic

> tendencies from mental illness. All if this by the way, she

documented

> in my medical chart while she was treating me. I ended up taking

myself

> off the antidepressants when I started turning yellow and my legs

> started going numb and could not sleep because of the pain and was

> losing the ability to walk correctly. Currently, I am housebound

to a

> main extent because even slight exposures to anything makes me ill

and

> my MCS episodes last months not just days anymore. So yes, I know

the

> problems associated with MCS.

>

> As an educator, I was trained to be as neutral as possible when

> addressing medical issues. Sometimes, it is hard because I have

worked

> in the pharm industry and know how much drugs are used off label.

From

> my situation above, the consequences can be very severe. I believe

MCS

> and all the other associated illnesses are just really one disease

and

> do not believe that with the current technology and

pharmaceuticals we

> can effectively treat the diseases. I hate to see people spend

their

> money on medicine, etc for something that may end up harming them.

As

> an advocate for the rights of patients with these medical

problems, I

> believe the problem is few physicians can effectively treat the

> condition, because the financial support to find a treatment is

lacking

> and most of those in the medical profession ignored the

consequences of

> these illnesses and do they do not want to admit to themselves

that it

> is " truly " a medical condition.

>

> I am sorry if I offended anyone, it was not my purpose.

>

> Kim

>

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Regular magnesium works for many people and also vit c. Your

intestines will only tolerate so much and diahrea if too much. If you

experiment you can find the amount of magnesium (active ingredient to

milk of magnesia) will relieve constipation, without getting diahrea;

same with vit c. My doctor has me take vit c powder buffered w calcium

and she told me to increase it to 'bowel tolerance'/diahrea. When I

got to there, back off until it doesn't produce the diahrea any more

and then you know how maximum your bowel will accept and then take that

3X a day...3 times a day for me, for fighting Epstein Bar virus that I

have; so specific to what she is treating, but if you are sick and vit

c might help, you could try that instead of an otc constipation

product.

>

>

> I totally agree! Milk of Magnesia works wonders for the

constipation.

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Live, with all your wisdom, do you think you could possably use the

term fungi instead of saying mold in one post than mycotoxins in the

next?

--- In , LiveSimply <quackadillian@...>

wrote:

>

> Kim,

>

> You are ignoring the combined wisdom of people who have a huge amount

> of experience in dealing with mold and making a big mistake there. I

> wrote you a long letter but my computer crashed, maybe I was typing

> too hard.

>

> Just curious, are you a defense or plaintiff attorney trying to save

> yourself some work?

>

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Kim, when toxins do not bind to the poo they get reabsorded into the

omentum than recirculated through the blood stream and back to the

liver. when the liver cant keep up with the amount of toxins being

inhaled, absorded through the skin and swallowed to the stomach

because of inhalation of toxins that get trapped in the mucus, let

alone the fact that they land on everything includeing what you eat,

you get toxin induced loss of tolerance/mcs because your liver is not

detoxing fast enough and the toxins can do major damage to all

organs. cholesteral from the omentum patches the holes in the blood

vessels that are punched in them from the toxic vasculitis -

toxin/perioxide effects. like alcoholics the omentum grows to store

the toxins because the liver is damaged. there are many levels of

damage with mcs and even some here do not understand just how severe

it can be. there is no one answer to fit all as we all have different

levels of damage. with mcs, adcoidance plays a big role, advoidance

of all toxins includeing scented products. after you have tottally

rid your space of everything that may be aggervateing your

condiction, you will skowly start makeing the connections by reaction

of things you need to advoid to fell better.for some that means

stores, other peoples houses, even other people and their scented

shamppoo's, deoderant ect. even their breath and what comes out of

their pores ect. if your married and/or have kids the whole family

needs to accomadate your illness. it really all depends on your own

level of organ damage. no, csm can not stop toxins from entering your

system it can only help to allimanate them.

>

> Please do not get me wrong...I am neithering arguing or confirming

the

> useful of CSM in treating mycotoxicosis. I have read Shoemaker's

> website and the understand the useful of CSM for treating Possible

> Esuary Associated Syndrome (PEAS) from dinoflagelatte infection, ie.

> Pfisteria which had marked improvement in visual contrast

sensitivity

> (VCS). However, I do not see anything that mentions specifically

that

> it is used to treat mycotoxicosis (by diagnosis of mycotoxicosis)

but

> is used in treating biotoxicosis...there is a difference as

biotoxin is

> a more general term.

>

> In terms of the mycotoxicosis that we are speaking about here,

unless

> you live in a foreign country where food contamination is common, we

> are talking about the build-up of mycotoxins that occur over time.

I am

> not refuting the damage to organ systems (including the immune

system)

> nor am I refuting the impact the mycotoxins cause on other tissue

such

> as the sinuses through necrosis. With all this in mind, the only

> therapy where I can see CSM would be of benefit would be to take it

for

> the rest of your life. The mycotoxins that cause human illness in

most

> of our cases is from the daily eating of contaminated foodstuffs and

> CSM would not be an effective treatment for long-term use. However,

it

> seems to be a short-term therapy for some biotoxins..and as I stated

> earlier I have not even found published information about it being

used

> as therapy for a " diagnosis " of mycotoxicosis.

>

> Here is something to think about....Mycotoxins are possible charged

> which makes them stick to their host. Please tell me if I am wrong,

but

> in MCS patients they are finding that the mycotoxins get stuck in

the

> liver (and other organs) which is how they cause liver damage. In

this

> case, CSM would not be effective at getting rid of those

mycotoxins. As

> far as recycling, I am still researching that process. They do find

> that there is a relationship of mycostoxicosis with high

cholesterol.

> Maybe this condition impairs the ability of the bodies detox system

to

> get rid of the mycotoxins. Since CSM is a cholesterol binding

agent, it

> may actually reduce mycotoxicosis by binding the cholesterol that

> impairs the liver's ability to break down the mycotoxin. May be by

> following a non-fat low cholesterol diet, eating 5-9 vegetable and

> fruits servings a day to provide the phytonutrients and other

chemicals

> for the detox system, etc. you can do the same thing without the

> medication?

>

> As far as the side-effects go for CSM, osteoporosis is a very

serious

> disease that results in disability and possible death to the

secondary

> medical issues it can cause. The problems with the absorption of

> nutrients in our cases can be severe because most of the research

> points to many of the complications with MCS, Fibro, CFS, etc to

being

> nutrient deficient. I can tell you that in my case and 2 other cases

> that I " know " was true.

>

> Just so you understand, I am not trying to minimize anyone's

symptoms

> or disease when I point out things in my post. I have had chronic

> fatigue syndrome since 1983 and have lived with the consequences of

the

> related PTSD for 15 years now. In addition, I was just " diagnosed "

with

> MCS six months ago even though I have had symptoms where I ended up

in

> the hospital for 10 years. Last year, they put me in the psych ward

of

> the hospital because they did not believe that I was having a

reaction

> to chemicals (as I knew I had been) and that my mother died from the

> same situation when I was in high school. I had been breathing

> chemicals I could not smell for several weeks that inflamed my PTSD

and

> an accidental (on my part but not someone else's part) acute

exposure

> to them made my go into a full-fledged MCS attack. My counselor who

I

> had been seeing for my PTSD had to spring me from the hospital

psyche

> ward, only after they put me on antidepressants that made the

chemical

> poisoning and MCS worse. Over the next year, my old doctor kept

trying

> to up my doses of antidepressants and put me on haldol because she

> thought instead of PTSD, MCS and all the other things I had

developed

> including diabetes I was suffering from delusions and schizophrenic

> tendencies from mental illness. All if this by the way, she

documented

> in my medical chart while she was treating me. I ended up taking

myself

> off the antidepressants when I started turning yellow and my legs

> started going numb and could not sleep because of the pain and was

> losing the ability to walk correctly. Currently, I am housebound to

a

> main extent because even slight exposures to anything makes me ill

and

> my MCS episodes last months not just days anymore. So yes, I know

the

> problems associated with MCS.

>

> As an educator, I was trained to be as neutral as possible when

> addressing medical issues. Sometimes, it is hard because I have

worked

> in the pharm industry and know how much drugs are used off label.

From

> my situation above, the consequences can be very severe. I believe

MCS

> and all the other associated illnesses are just really one disease

and

> do not believe that with the current technology and pharmaceuticals

we

> can effectively treat the diseases. I hate to see people spend their

> money on medicine, etc for something that may end up harming them.

As

> an advocate for the rights of patients with these medical problems,

I

> believe the problem is few physicians can effectively treat the

> condition, because the financial support to find a treatment is

lacking

> and most of those in the medical profession ignored the

consequences of

> these illnesses and do they do not want to admit to themselves that

it

> is " truly " a medical condition.

>

> I am sorry if I offended anyone, it was not my purpose.

>

> Kim

>

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So sorry, Kim, that you have had to go through trauma. It's wonderful

that you seem to have risen above it. Your input is appreciated. Very

interesting.

Barth

---

K> Please do not get me wrong...I am neithering arguing or confirming the

K> useful of CSM in treating mycotoxicosis. I have read Shoemaker's

K> website and the understand the useful of CSM for treating Possible

K> Esuary Associated Syndrome (PEAS) from dinoflagelatte infection, ie.

K> Pfisteria which had marked improvement in visual contrast sensitivity

K> (VCS). However, I do not see anything that mentions specifically that

K> it is used to treat mycotoxicosis (by diagnosis of mycotoxicosis) but

K> is used in treating biotoxicosis...there is a difference as biotoxin is

K> a more general term.

K> In terms of the mycotoxicosis that we are speaking about here, unless

K> you live in a foreign country where food contamination is common, we

K> are talking about the build-up of mycotoxins that occur over time. I am

K> not refuting the damage to organ systems (including the immune system)

K> nor am I refuting the impact the mycotoxins cause on other tissue such

K> as the sinuses through necrosis. With all this in mind, the only

K> therapy where I can see CSM would be of benefit would be to take it for

K> the rest of your life. The mycotoxins that cause human illness in most

K> of our cases is from the daily eating of contaminated foodstuffs and

K> CSM would not be an effective treatment for long-term use. However, it

K> seems to be a short-term therapy for some biotoxins..and as I stated

K> earlier I have not even found published information about it being used

K> as therapy for a " diagnosis " of mycotoxicosis.

K> Here is something to think about....Mycotoxins are possible charged

K> which makes them stick to their host. Please tell me if I am wrong, but

K> in MCS patients they are finding that the mycotoxins get stuck in the

K> liver (and other organs) which is how they cause liver damage. In this

K> case, CSM would not be effective at getting rid of those mycotoxins. As

K> far as recycling, I am still researching that process. They do find

K> that there is a relationship of mycostoxicosis with high cholesterol.

K> Maybe this condition impairs the ability of the bodies detox system to

K> get rid of the mycotoxins. Since CSM is a cholesterol binding agent, it

K> may actually reduce mycotoxicosis by binding the cholesterol that

K> impairs the liver's ability to break down the mycotoxin. May be by

K> following a non-fat low cholesterol diet, eating 5-9 vegetable and

K> fruits servings a day to provide the phytonutrients and other chemicals

K> for the detox system, etc. you can do the same thing without the

K> medication?

K> As far as the side-effects go for CSM, osteoporosis is a very serious

K> disease that results in disability and possible death to the secondary

K> medical issues it can cause. The problems with the absorption of

K> nutrients in our cases can be severe because most of the research

K> points to many of the complications with MCS, Fibro, CFS, etc to being

K> nutrient deficient. I can tell you that in my case and 2 other cases

K> that I " know " was true.

K> Just so you understand, I am not trying to minimize anyone's symptoms

K> or disease when I point out things in my post. I have had chronic

K> fatigue syndrome since 1983 and have lived with the consequences of the

K> related PTSD for 15 years now. In addition, I was just " diagnosed " with

K> MCS six months ago even though I have had symptoms where I ended up in

K> the hospital for 10 years. Last year, they put me in the psych ward of

K> the hospital because they did not believe that I was having a reaction

K> to chemicals (as I knew I had been) and that my mother died from the

K> same situation when I was in high school. I had been breathing

K> chemicals I could not smell for several weeks that inflamed my PTSD and

K> an accidental (on my part but not someone else's part) acute exposure

K> to them made my go into a full-fledged MCS attack. My counselor who I

K> had been seeing for my PTSD had to spring me from the hospital psyche

K> ward, only after they put me on antidepressants that made the chemical

K> poisoning and MCS worse. Over the next year, my old doctor kept trying

K> to up my doses of antidepressants and put me on haldol because she

K> thought instead of PTSD, MCS and all the other things I had developed

K> including diabetes I was suffering from delusions and schizophrenic

K> tendencies from mental illness. All if this by the way, she documented

K> in my medical chart while she was treating me. I ended up taking myself

K> off the antidepressants when I started turning yellow and my legs

K> started going numb and could not sleep because of the pain and was

K> losing the ability to walk correctly. Currently, I am housebound to a

K> main extent because even slight exposures to anything makes me ill and

K> my MCS episodes last months not just days anymore. So yes, I know the

K> problems associated with MCS.

K> As an educator, I was trained to be as neutral as possible when

K> addressing medical issues. Sometimes, it is hard because I have worked

K> in the pharm industry and know how much drugs are used off label. From

K> my situation above, the consequences can be very severe. I believe MCS

K> and all the other associated illnesses are just really one disease and

K> do not believe that with the current technology and pharmaceuticals we

K> can effectively treat the diseases. I hate to see people spend their

K> money on medicine, etc for something that may end up harming them. As

K> an advocate for the rights of patients with these medical problems, I

K> believe the problem is few physicians can effectively treat the

K> condition, because the financial support to find a treatment is lacking

K> and most of those in the medical profession ignored the consequences of

K> these illnesses and do they do not want to admit to themselves that it

K> is " truly " a medical condition.

K> I am sorry if I offended anyone, it was not my purpose.

K> Kim

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I really wanted to respond to the issue of gastrointestinal symptoms

and mold illness. This was a major symptom for me. So, when I started

CSM and read the " warnings, " I asked myself whether it could get

worse. I started with very small amounts of CSM, I think 1/2 scoop.

As I increased the CSM, I actually got relief from my digestive

" woes. " I now assume the recirculating toxins contributed to my

discomfort. Over the years I have had to employ other treatments to

aid my digestion, and found that even the allergy shots I take have

helped.

>

> Live, you might try to understand this. I can see takeing csm short

> term to get what mycotoxins and other toxins out of your system.

> exspecially fpr those who dont have mcs/te, those with short term

> exposure and not major organ damage. some people with mcs have major

> stomach problems that you obvious;y dont get. some have

> allergies/sensativitys to lots of things and/or reactions to many

> drugs. some have some of the symptoms already that csm can cause. some

> may have problems with toxins the rest of their life, not just myco's.

> you need me to go on? wtf, no body said some myco's dont stay in the

> system, no body said " oh, dont take csm at all " the point was to

> discuss other alturnitives or combinations to go with csm.

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Have you seen this?

http://www.biotoxin.info/docs/CSM_colonic%20apoptosis.pdf

On Jan 21, 2008 7:25 PM, <smarshwar@...> wrote:

>

> I really wanted to respond to the issue of gastrointestinal symptoms

> and mold illness. This was a major symptom for me. So, when I started

> CSM and read the " warnings, " I asked myself whether it could get

> worse. I started with very small amounts of CSM, I think 1/2 scoop.

> As I increased the CSM, I actually got relief from my digestive

> " woes. " I now assume the recirculating toxins contributed to my

> discomfort. Over the years I have had to employ other treatments to

> aid my digestion, and found that even the allergy shots I take have

> helped.

>

>

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Thanks , I have madahed to get my stomach/GI problems under

more contrill so hopefully I well be able to tolerate csm, and

combine it with other methods. hopefully no allergic reaction or drug

reactions well keep me from tolerateing it.

> >

> > Live, you might try to understand this. I can see takeing csm

short

> > term to get what mycotoxins and other toxins out of your system.

> > exspecially fpr those who dont have mcs/te, those with short term

> > exposure and not major organ damage. some people with mcs have

major

> > stomach problems that you obvious;y dont get. some have

> > allergies/sensativitys to lots of things and/or reactions to many

> > drugs. some have some of the symptoms already that csm can cause.

some

> > may have problems with toxins the rest of their life, not just

myco's.

> > you need me to go on? wtf, no body said some myco's dont stay in

the

> > system, no body said " oh, dont take csm at all " the point was to

> > discuss other alturnitives or combinations to go with csm.

>

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> I would think that improving nutritional status would be to improve

> the detoxification system would be better than using medication.

> Especially considering that with the problems of EI contributing to

> problems of acid/base balance, we are already at risk for mineral and

> bone depletion. Also, since CSM is also a cholesterol inhibitor, what

> kinds of problems does it cause in people with normal cholesterol

> levels???

> Kim

Kim, I saw the list of side effects of CSM. I can only tell you from

my own exp. (I have normal cholesterol); CSM has been a God-send for

me. I have constipation issues anyway, from other meds, so I took my

CSM w/ Citracel (I do have a very poor appetite), but CSM was only

thing that got me back to almost normal functioning. I wish you well;

I know how frustrating it is to deal w/ cross contamination (feels like

no where is safe!)>

Hugs, Cheryl

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Cheryl,

I agree with you on this 100%. The cholestyramine pulls a tiny amount

of toxin out of your bile each time you take it. Cholestyramine itself

doesn't go into your body, it remains in your gut. Cholestyramine is

not a cholesterol inhibitor. You are confusing it with other drugs. It

BINDS with some of the cholesterol in your gut. When I discovered it,

I was VERY ill and I used the same word as Cheryl. " Godsend "

Thats how much of s difference it makes for me. I get sick from mold

exposure and if I did not have cholestyramine, I'd be in much worse

shape now than I am.

On Jan 23, 2008 10:33 AM, Cheryl <sunbum256@...> wrote:

>

> > I would think that improving nutritional status would be to improve

> > the detoxification system would be better than using medication.

> > Especially considering that with the problems of EI contributing to

> > problems of acid/base balance, we are already at risk for mineral and

> > bone depletion. Also, since CSM is also a cholesterol inhibitor, what

> > kinds of problems does it cause in people with normal cholesterol

> > levels???

> > Kim

>

> Kim, I saw the list of side effects of CSM. I can only tell you from

> my own exp. (I have normal cholesterol); CSM has been a God-send for

> me. I have constipation issues anyway, from other meds, so I took my

> CSM w/ Citracel (I do have a very poor appetite), but CSM was only

> thing that got me back to almost normal functioning. I wish you well;

> I know how frustrating it is to deal w/ cross contamination (feels like

> no where is safe!)>

> Hugs, Cheryl

>

>

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When I said " you " I meant Kim, not Cheryl, was confusing the effects

of other cholesterol drugs with cholestyramine.

I'm sorry, I agree with everything that Cheryl said. It was Kim I was

disageeing with.

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Kim, sorry for the harshness of some of the responses. People tend to

get offended but it's just a lack of communication and understanding

of what one is saying. Everything is subject to individual

interpretation. I am not one who is on CSM but have obviously heard

enough about it from this site. Personally, I would not want to try

it due to the side effects and how sensitive I am to ingesting

anything. I emapthize with your situation and what you've been

through. I, too, have been through things very similar. And I agree

with most, if not all, of what you are saying. Thanks for the post.

Dana

>

> Please do not get me wrong...I am neithering arguing or confirming

the

> useful of CSM in treating mycotoxicosis. I have read Shoemaker's

> website and the understand the useful of CSM for treating Possible

> Esuary Associated Syndrome (PEAS) from dinoflagelatte infection, ie.

> Pfisteria which had marked improvement in visual contrast

sensitivity

> (VCS). However, I do not see anything that mentions specifically

that

> it is used to treat mycotoxicosis (by diagnosis of mycotoxicosis)

but

> is used in treating biotoxicosis...there is a difference as

biotoxin is

> a more general term.

>

> In terms of the mycotoxicosis that we are speaking about here,

unless

> you live in a foreign country where food contamination is common, we

> are talking about the build-up of mycotoxins that occur over time.

I am

> not refuting the damage to organ systems (including the immune

system)

> nor am I refuting the impact the mycotoxins cause on other tissue

such

> as the sinuses through necrosis. With all this in mind, the only

> therapy where I can see CSM would be of benefit would be to take it

for

> the rest of your life. The mycotoxins that cause human illness in

most

> of our cases is from the daily eating of contaminated foodstuffs and

> CSM would not be an effective treatment for long-term use. However,

it

> seems to be a short-term therapy for some biotoxins..and as I stated

> earlier I have not even found published information about it being

used

> as therapy for a " diagnosis " of mycotoxicosis.

>

> Here is something to think about....Mycotoxins are possible charged

> which makes them stick to their host. Please tell me if I am wrong,

but

> in MCS patients they are finding that the mycotoxins get stuck in

the

> liver (and other organs) which is how they cause liver damage. In

this

> case, CSM would not be effective at getting rid of those

mycotoxins. As

> far as recycling, I am still researching that process. They do find

> that there is a relationship of mycostoxicosis with high

cholesterol.

> Maybe this condition impairs the ability of the bodies detox system

to

> get rid of the mycotoxins. Since CSM is a cholesterol binding

agent, it

> may actually reduce mycotoxicosis by binding the cholesterol that

> impairs the liver's ability to break down the mycotoxin. May be by

> following a non-fat low cholesterol diet, eating 5-9 vegetable and

> fruits servings a day to provide the phytonutrients and other

chemicals

> for the detox system, etc. you can do the same thing without the

> medication?

>

> As far as the side-effects go for CSM, osteoporosis is a very

serious

> disease that results in disability and possible death to the

secondary

> medical issues it can cause. The problems with the absorption of

> nutrients in our cases can be severe because most of the research

> points to many of the complications with MCS, Fibro, CFS, etc to

being

> nutrient deficient. I can tell you that in my case and 2 other cases

> that I " know " was true.

>

> Just so you understand, I am not trying to minimize anyone's

symptoms

> or disease when I point out things in my post. I have had chronic

> fatigue syndrome since 1983 and have lived with the consequences of

the

> related PTSD for 15 years now. In addition, I was just " diagnosed "

with

> MCS six months ago even though I have had symptoms where I ended up

in

> the hospital for 10 years. Last year, they put me in the psych ward

of

> the hospital because they did not believe that I was having a

reaction

> to chemicals (as I knew I had been) and that my mother died from the

> same situation when I was in high school. I had been breathing

> chemicals I could not smell for several weeks that inflamed my PTSD

and

> an accidental (on my part but not someone else's part) acute

exposure

> to them made my go into a full-fledged MCS attack. My counselor who

I

> had been seeing for my PTSD had to spring me from the hospital

psyche

> ward, only after they put me on antidepressants that made the

chemical

> poisoning and MCS worse. Over the next year, my old doctor kept

trying

> to up my doses of antidepressants and put me on haldol because she

> thought instead of PTSD, MCS and all the other things I had

developed

> including diabetes I was suffering from delusions and schizophrenic

> tendencies from mental illness. All if this by the way, she

documented

> in my medical chart while she was treating me. I ended up taking

myself

> off the antidepressants when I started turning yellow and my legs

> started going numb and could not sleep because of the pain and was

> losing the ability to walk correctly. Currently, I am housebound to

a

> main extent because even slight exposures to anything makes me ill

and

> my MCS episodes last months not just days anymore. So yes, I know

the

> problems associated with MCS.

>

> As an educator, I was trained to be as neutral as possible when

> addressing medical issues. Sometimes, it is hard because I have

worked

> in the pharm industry and know how much drugs are used off label.

From

> my situation above, the consequences can be very severe. I believe

MCS

> and all the other associated illnesses are just really one disease

and

> do not believe that with the current technology and pharmaceuticals

we

> can effectively treat the diseases. I hate to see people spend their

> money on medicine, etc for something that may end up harming them.

As

> an advocate for the rights of patients with these medical problems,

I

> believe the problem is few physicians can effectively treat the

> condition, because the financial support to find a treatment is

lacking

> and most of those in the medical profession ignored the

consequences of

> these illnesses and do they do not want to admit to themselves that

it

> is " truly " a medical condition.

>

> I am sorry if I offended anyone, it was not my purpose.

>

> Kim

>

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