Tired or Toxic?

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Tired or Toxic? Chronic Fatigue Syndrome and Environmental Toxicity

ImmuneSupport.com03-06-2002 By A. Schmidt Editor’s Note: The following is an excerpt from Tired of Being Tired: Overcoming Chronic Fatigue & Low Energy. For more information and to purchase the book, see information at the end of this article. The Environmental Protection Agency (EPA) currently recognizes more than four million chemical compounds. More than 60,000 of these are produced commercially, with three new compounds introduced each day. In 1992, the EPA published the results of a study in which the urine of 7,000 randomly sampled Americans was tested for toxic chemical residues. Chemicals like pentachlorophenol, a wood preservative, and others were found in 71 percent of individuals tested. There were not people working at chemical factories or industrial waste incinerators. This study looked at the average citizen – you and me. It is disconcerting to find such a high percentage of individuals with chemical residue in their urine. These are all chemicals not even in existence 100 years ago. Many doctors who work with chronically fatigued patients and those who work in the field of environmental medicine, agree that chemical exposure is a major contributor to fatigue and low vitality. For example, if you review the symptoms of formaldehyde exposure, you will find fatigue, depression, and poor concentration right at the top. The symptoms of exposure to trichloroethylene (found in floor polish, copy machines, carpet cleaner, etc.) include fatigue, poor concentration, and drowsiness, among others. Exposure to toluene, the most common indoor air pollutant, triggers symptoms of fatigue, poor concentration, drowsiness, and headache. Methylene chloride is found in paint thinner, hair spray, adhesives, solvents, paint, flame retardants, and many other common products. The aerosol propellants found in hair sprays, antiperspirants, air fresheners, and spray paint, may contain up to 5o% methylene chloride. Once inhaled, methylene chloride goes directly to the brain, fat cells, and liver. Common symptoms include fatigue, lethargy, headaches, and chest pain. In an article entitled “Chronic Fatigue Syndrome and Chemical Overload,” Dr. R. A. Buist explained that there are many pieces of evidence suggesting that chronic fatigue may be a result of toxin exposure. He goes on to point out that toxins can disrupt muscle metabolism, accounting for the pain and fatigability of muscles experienced by many fatigued people. Buist also notes that in many chronic fatigue patients, use of recreational drugs or environmental exposure preceded the onset of their fatigue. In an address to the Well Mind Association in Seattle, Washington, S. Bushcer, M.D., made the following remarks: “My personal theory on chronic fatigue is that the increased load of pollutants in our environment, such as pesticides, is causing people to have a breakdown of their immune systems…I would say that 70% of my patients with chronic fatigue had a chemical trigger; they moved into a new home, there was remodeling at the office, or a pesticide application, and now they have chronic fatigue. I think the mechanism is some kind of cellular poisoning from these chemicals. The affected person’s detoxification system is clogged up or destroyed, they get a backlog of chemicals, and their immune system goes down.” In 1992, the neurobehavioral effects of various chemicals were reviewed in Environmental Neurotoxicity, published by the National Research Council. The following symptoms commonly associated with fatigue and the number of chemicals that may cause these symptoms are significant. Symptom: Number of Chemicals: Fatigue: 87 Listlessness: 30 Depression: 40 Sleep disturbances: 119 Weakness: 179 An important fact about chemical exposure is the role that cumulative exposure plays in causing illness. Exposure to trace amounts of one chemical may produce few ill effects. However, when five, ten, or even fifty different compounds are encountered in trace amounts, which is not unusual, the additive effects can be serious. To put this in perspective, consider that in one Washington, D.C., home for the elderly, 350 different volatile chemicals were found in the indoor air. Another study conducted by the EPA found anywhere from 40 to 120 different organic compound circulating in the air of every home tested, regardless of whether the home was in urban Chicago or rural North Dakota. In an analysis of the exhaled breath of suburban New Jersey residents, researchers detected chloroform, trichlorethane, benzene, styrene, xylene, carbon tetrachloride, dichlorobezene, ethyl benzene, trichloroethylene, and other compounds. It doesn’t take a chemist to know that these chemicals do not belong in the body. However, it does take a doctor with sufficient knowledge of biochemistry to figure out what to do about this problem when illness results. Chemical toxins affect individuals in vastly different ways, depending on their individual biochemical make-up. There are several key factors that determine how an individual will react to chemical exposure. 1. Nutritional status. Vitamins, minerals, amino acids, and other nutrient factors play a vital role in detoxification of foreign chemicals. 2. Total toxic load. The amount of toxin, the number of toxins, and the duration of exposure to toxins, determine health effects. 3. Genetics. Due to genetic differences or abnormalities of certain enzymes, some individuals do not detoxify as readily. 4. Age. Children are more susceptible than adults. 5. State of health. Someone with chronic illness, liver disease, or altered immunity may be less able to adequately detoxify. 6. Stress. 7. Immune system status. Some reactions to toxins are mediated by the immune system. Your nutritional status has everything to do with how your detoxification systems work and how you handle the toxins in your environment. If you are deficient in the trace element molybdenum, an enzyme called aldehyde oxidase does not function properly. Under these circumstances, if you were exposed to a common pollutant such as formaldehyde, it would not be properly detoxified. In fact, such compounds are shunted into another pathway that forms other, often more toxic, compounds. In the case of formaldehyde, it gets converted into chloral hydrate – also known as “Mickey Finn” or “knockout drops.” The effect is a dopey, foggy, fatigued feeling, like you were drunk, but without the euphoria. If you are deficient in magnesium, many aspects of the detoxification mechanism do not work. The same is true of zinc deficiency. In one of your body’s detoxification pathways, toxic substances are temporarily converted into more toxic intermediate substances and then converted into mercapturic acids to be harmlessly eliminated. However, if you are deficient in vitamin E, selenium, glutathione, glycine, vitamin C, or other nutrients, the highly toxic intermediates are not properly quenched and can wreak considerable havoc with your cells. The immune system can become seriously impaired by exposure to chemicals. Some chemical exposures may act to suppress immunity, while others may cause the immune system to overreact. The former circumstance leads to susceptibility to infections and perhaps cancer. The latter leads to autoimmune diseases in which the immune system attacks the body’s own cells. Some arthritic conditions, lupus, and some thyroid disorders are examples of this latter effect. In a study published in the Archives of Environmental Health, people who were exposed to chlordane, used to control termites, had immune system defects that were detectable up to ten years after the exposure. Other studies show the devastating effect of chemicals on immune function. Thus, toxicity not only directly causes fatigue, but can render us more susceptible to bacterial and viral infection, both of which are common causes of persistent fatigue. In 1990, Sherry , M.D., wrote a book entitled Tired of Toxic? In which she describes in great detail how toxicity contributes to fatigue. She mentions that the most common organ affected by chemical exposure is the brain, leading to drowsiness, fatigue, exhaustion, sluggish thinking, or a host of other symptoms. She states, “Frequently, most of these people are initially too intimidated and embarrassed to mention how exhausted they are. Instead they concentrate on the more visible symptoms that can be more readily verified. Medicine, unfortunately, delegates brain symptoms…to the psychiatrists.” One means by which chemicals may contribute to fatigue is by affecting thyroid function, a common cause of low vitality. Chlorinated compounds are well known for their effects on thyroid function. Many f these compete directly with thyroid hormones or proteins that carry thyroid hormones. One such chemical, pentachlorophenol, was found to significantly lower the level of both the active and inactive form of thyroid hormone. Chemicals may also interfere with sleep, leading to chronic fatigue. Sixty-six men exposed to solvents on the job were assessed for sleep apnea. Sleep apnea is a disorder of interrupted breathing during sleep that leaves many sufferers chronically tired. Sleep apnea occurred in roughly one-fifth of the men, which prompted the investigators to conclude that some of the cases of sleep apnea may be solvent-induced encephalopathy. In 112 individuals evaluated for exposure to organic solvents (house paints, spray finishers, printing), there was a significantly higher prevalence of insomnia. In Environmental Neurotoxicology, it is reported that any of 119 different chemicals can cause sleep disturbance. Because of the pervasive use of chemicals in our society, a new disease has emerged known as multiple chemical sensitivity (MCS). While chemical exposure affects all of us to one degree or another, people with MCS are severely affected. People with chemical sensitivity often become ill from being in the presence of only minute amounts of a chemical. To them, a faint of formaldehyde cam cause devastating symptoms of fatigue. Unfortunately, others around them who cannot smell the odors label them as hypochondriacs, often noting, “If I can’t smell it you must be imagining it.” This is far from the truth, and chemically sensitive people can take some comfort in the fact that the health effects of low level chemical exposure are becoming more documentable. For example, Dr. Dudley, at the Washington Institute of Neurosciences in Seattle, found that when patients were exposed to chemicals to which they reported sensitivity, they showed significant changes in their visual and auditory evoked potential readings – a measure of the ray at which nerves transmit messages from the eyes and ears to the brain. Schwartz, Ph.D., and his research team at the University of Arizona showed that the brain registers exposure to a chemical odor even though the nose does not sense its presence. Jaffe, M.D., of Reston, Virginia, has demonstrated that a variety of immune reactions to chemicals occur in people with chronic illness. Toxic minerals are another important cause of fatigue in some people. Included are lead, mercury, cadmium, arsenic, aluminum, nickel, silver, beryllium, and tin. Recall the interview with Dr. Majid Ali who estimated that roughly 40 percent of his patients with chronic fatigue suffer from heavy metal toxicity. He observed that aluminum toxicity was most common, with lead and mercury toxicity not far behind. Aluminum toxicity would be expected to cause fatigue because it blocks the major energy molecule in the body, ATP. Lead and mercury impair immune function, block enzyme function, inflammatory substances, and alter certain metabolic pathways. Researchers at Upssala University Medical School in Sweden reported that patients with chronic fatigue contain abnormal levels of mercury within their cells. Another group tested sensitivity to metals such as lead and mercury using a method of testing known as MELISA (Memory Lymphocyte Immuno Stimulation Assay). Of patients with chronic fatigue, 45 percent showed mercury hypersensitivity and 49 percent showed lead hypersensitivity. When the metal burden was removed from the body (in many cases by removing mercury-containing silver dental fillings), 77 percent of patients reported improved health. Signs and Symptoms The symptoms of chemical toxicity are far too numerous to mention. In general, chemical exposure affects different people in different ways, depending on their individual biochemistry, nutritional status, stress levels, level of exposure, and many other factors. Conditions ranging from thyroid disease, cardiovascular disease, kidney disease, endocrine diseases, depression, psychosis, and many other disorders can be triggered or caused by chemical exposure or toxicity. Fatigue, sluggishness, and low energy are among the most common symptoms of toxicity. If you experience these symptoms and your health problems seem to defy identifications or do not respond to treatment, it may be that you are ill because of toxicity. Certainly, those who work in occupations where chemicals are used should be screened for toxicity. However, many people who have no contact with industrial chemicals whatsoever experience exposure that seriously impairs their health. Laboratory Tests Below are a number of tests that can be used to determine if you suffer from toxic exposure, if your detoxification system is working or overloaded, if you have immune reactivity to environmental chemicals, if you have adequate antioxidant capacity, and if you have fatty tissue damage. To run all of these tests would be quite expensive. Most doctors working in environmental medicine would likely choose specific tests based on your individual circumstances. This list shows the varied tests that are available to any doctor who wishes to do more detective work. -Urinary D-glucaric acid. Helps determine if toxic exposure has taken place or whether your detoxification system is working properly. -Urinary mercapturic acid. A byproduct of one of the body’s detoxification pathways. Determines if toxic exposure has taken place. -Whole blood glutathione or glutathione peroxidase. Shows the levels of an important nutrient involved in detoxification and its functional enzyme. -Total lipid peroxides. Shows whether the lipids (or fats) that comprise your cell membranes are being damaged by free radicals. -Formic acid. Shows whether your body is able to detoxify aldehydes such as formaldehyde. -ELISA/ACT. A blood test that looks at delayed immune system reactivity to various substances including foreign chemicals, food allergens, food additives, molds, pollens, etc. -Amino acid analysis. Assesses many aspects of metabolism and function. Shows amino acid deficiencies, and vitamin and mineral deficiencies. -Organic acid analysis. Measures aspects of energy metabolism. -Serum and red blood cell vitamins and minerals. -Provocation-neutralization test. Done in a physician’s office, this test determines sensitivity to chemicals and identifies a neutralizing dose that can be helpful in reducing symptoms. -Hair mineral analysis. Assesses level of toxic metals and some trace elements. Other tests used to test for toxic metals include: --Whole blood heavy element. Assesses toxic minerals in blood. --RBC or WBC heavy element. Assesses toxic minerals in cells. --Urine or post-challenge urine. Challenge substance, such as DMPS (dimercaptopropane sulfate) is given to purge metals from the body, which can then be measured in urine. --MELISA (Memory Lymphocyte Immuno Stimulation Assay). Assesses immune reactivity to metals. --Blood levels of toxic substances such as benzene, toluene, and others. A beginning laboratory panel that one might consider to assess toxicity might include: Mercapturic acid D-glucaric acid Formic acid Glutathione peroxidase Lipid peroxides Treatment Toxicity is a very complicated phenomenon that requires the guidance of a doctor trained in environmental medicine and nutritional biochemistry. Toxic mineral exposure is treated differently than exposure to organic chemical compounds. Specific nutrients are necessary to enhance biochemical detoxification pathways of the body. Any recommendations made in this book [see book details at end of this article] could only be considered superficial and general. When dealing with toxicity problems, the following areas must be addressed: Reduce the total toxic load be removing toxins from your environment and by removing offending foods and additives from your diet. Identify functional nutrient deficiencies related to detoxification and general metabolism. Restore your body’s pH to its normal balance so that cellular systems being to function normally. Begin a supervised detoxification program aimed at removing toxins stored in body tissues. Nutrients important in detoxification include: L-glutathione, vitamin E, vitamin C, N-acetylcysteine, selenium, beta-carotene, coenzyme Q10, taurine, zinc, copper, magnesium, molybdenum, bioflavonoids. 5. Utilize a low temperature sauna. Some doctors who treat patients with toxic exposure recommend that patients sit in a low temperature sauna for several hours each day. The low temperature encourages a “fat sweat” to eliminate toxins that are stored in the body’s fat. 6. Support the endocrine, immune, and hepatic (liver) system. 7. Begin a program of behavioral therapy and stress management. 8. Restore gastrointestinal function. Suggested Reading If you would like more information about environmental toxicity and health effects obtain a copy of Tired or Toxic by Sherry , M.D. (Prestige Publishing, Syracuse, New York, 1990). For health professionals interested in a textbook of environmental medicine, obtain the four-part series by Rea, M.D., entitled Chemical Sensitivity ( Publishers, Boca Raton, Florida, 1993). The preceding is from Chapter 17 of Tired of Being Tired: Overcoming Chronic Fatigue & Low Energy, by A. Schmidt (published by Frog, Ltd., North Atlantic Books, Berkeley, California). ISBN 1-883319-16-1. © A. Schmidt. All rights reserved. This book can be purchased at http://www.northatlanticbooks.com/ or by calling (510) 559.8277.