Organophosphates in CFS

Significance of organophosphates in CFS is underrated!

by Janet Dauble

We are all excited about the new study which found that CFS is linked to gene changes which affect the nervous system. CDC director Julie Gerberding is quoted as saying "This is the first credible evidence for a biological basis" of the syndrome. We can be grateful for gene studies which are revealing important factors in illness, corroborating previous research findings, and giving patients hope for pertinent treatments in the future. However, I hope that the excitement about the new CDC study will not overshadow the importance of the results of another CFS gene study.

I read with interest the article "Gene pattern revealed in pilot study" as published in the Summer 2005 issue of The CFIDS Chronicle. The significance of the authors suggesting "that their results point to a role for organophosphate exposure or viral infection in CFS" may be missed by readers even though a 1996 CDC study found that there was a high correlation between CFS and pesticide exposure. (1)

PWC's often remember a flu from which they never recovered. But few people know that exposure to ordinary pesticide products can cause a case of the flu and subsequent chronic illness. Jerome Blondell, Ph.D., M.P.H., U.S. Dept. Of EPA [Pesticide] Heath Effects Division (2) said to me that "You can be poisoned by a pesticide and not realize it. You can just experience a mild [or bad] case of the flu."

Organophosphates (OP's), which attack the central nervous system, were created as insecticides in the late 1930's and developed in the 1940's as chemical warfare agents. They became more popular as insecticides for residential use after Chlordane was banned in 1988. OP's like Dursban, Lorsban, diazinon, and malathion, are used in agriculture, in lawn care, and weed control. And, they were widely used in pet pest control (flea collars, sprays, shampoos), flea, ant, fly, spider, termite and cockroach bug sprays, foggers, and pellets. They were ingredients in Raid, Black Flag, Ortho, Real-Kill and Spectracide products. And, more study will show if they are responsible for the small changes in the genes in the brain which are now linked to CFS!

With pesticide use becoming a normal part of life today - sprayed monthly in homes, offices, motels/hotels, schools, hospitals, libraries, banks, etc. and alongside roadsides and over forests, over metropolitan areas to eradicate pests like the Mediterranean Fruit Fly and mosquitoes, etc.--just about everyone has been exposed to OP's. Even the Gulf War troops were exposed to OP's in bug sprays and Sarin gas in chemical weapons. Residential areas in Lake Tahoe were fogged with OP's in the middle of the night in the 1980's to kill snow-melt mosquitoes at the time the Yuppie-Flu made headlines in nearby Incline Village. One Share, Care and Prayer member attributes her illness to being exposed to the organophosphate Dursban sprayed in her home in Lake Tahoe and sprayed in the casino where she worked in the 80's.

In January of 1997, the EPA banned the use of chlorpyrifos in Dursban (3), one of the most widely used residential pesticides, in foggers and animal products BECAUSE it caused chronic symptoms such as:

persistent unusual fatigue, muscle weakness,

mental dysfunction involving memory, concentration, depression, and irritability,

persistent headaches,

blurred vision, visual defects

and it caused:

development of a sensitivity to chemicals causing a wide variety of symptoms.

On June 8th, 2000, the EPA further restricted the use of Dursban in residential settings and on December 5, 2000, diazinon, another widely used OP, was to begin a phase-out of all home, lawn and garden uses where children could be exposed, of termiticide use on new construction, and the lowering of allowable pesticide residues on several foods regularly eaten by children.

However, Dursban and diazinon are still being used by residents who have stockpiled these products before they were banned from residential sale, and they will continue to be used to grow food, on golf courses, in greenhouses and for mosquito and fire ant control.

But, if everyone is being exposed to these toxins, and they are causing CFS and chemical sensitivity, why isn't everyone becoming ill? Gene research is proving that not everyone is equal when it comes to exposure to toxins. As some people can smoke until they are over 100 years old without developing emphysema or lung cancer, so some people can metabolize certain medications (as shown in pharmacogenomics studies), chemicals (as shown in toxicogenomics studies), etc. that others cannot. Specifically on organophosphates, as per the article "Poisons aren't toxic to everyone equally", "About one quarter of Asians and 10 percent of Caucasians have a protective form of the gene for paraoxonase, an enxyme that detoxifies organophosphates 10 times as fast as the more common enzyme. Odds are, Tokyo subway riders who survived the 1995 sarin attack by the Aum Shinrikyo cult were among them (4)." Indeed, research at Wayne State University has recently found that sick Gulf War veterans and chemically sensitive civilians do not have sufficient enzymes to metabolize (guess what?) OP's (5). One chemically sensitive patient who experiences anaphylactic shock upon exposure to pesticides was found to have lower levels of paraoxonase enzymes than the sick Gulf War veterans!

What is the significance of this for PWC's? If exposure to pesticide (or another sensitizing chemical such as formaldehyde in construction materials) caused debilitating and painful illness in the first place, there is hope for alleviating symptoms. Many PWC's and Fibromyalgia (FM) sufferers are aware of the overlap of symptoms with people with chemical sensitivity because of survey studies done by Dr. Buchwald, Dr. Clauw, etc. (6) And, many happily believe they do not have food/chemical sensitivity, as CFS is bad enough. However, most people with food, mold and chemical sensitivity did not know that they were sensitive until they were tested. It was only through blood tests, Provocative/Neutralization, or avoidance-and-challenge that they found out that they were sensitive. This is because reactions can be delayed up to three weeks, thus hidden, or reactions can be experienced on a chronic basis as the patient is chronically exposed to the same foods and chemicals.

As published in Volume III of Chemical Sensitivity by William J. Rea, M.D., a 1984 study of thirty patients with fibrositis at the Environmental Health Center-Dallas found that 100% had food allergies (chicken, potatoes, corn, eggs, turkey) and 83% had chemical allergies (phenol, formaldehyde, ethanol, chlorine, pesticide and saline.) "Stiffness and pain rapidly cleared in the patients in this series once the triggering agents were identified and eliminated. These symptoms only returned when re-exposures occurred. Over 200 similar patients with fibrositis and fibromyositis have now been studied at the EHC-Dallas with similar results. These patients do extremely well over long-term follow-up of 5 years, remaining free of their symptoms without medications as long as they avoid their triggering agents."

The late Theron Randolph, M..D. recognized that due to the principles of symptom-suppressed adaption, masking to the environment, addiction/withdrawal, and delayed reactions, it is almost impossible for most chronically ill people to connect their symptoms with exposures to foods and chemicals. Dr. Randolph published papers on the diagnosis and treatment of CFS and FM in the 40's, 50's, and 60's. Of course this was before they were so named. Dr. Randolph listened to and trusted his patients. He took elaborate histories. He found this syndrome more prevalent in women, that each patient was different, and he could turn their symptoms on and off by fasting and food challenges. His published works include papers on fatigue/weakness, myalgia/musculoskeletal pain, unrefreshed sleep, restless leg syndrome, and cognitive dysfunction--what he called "brain-fag," an actual term found in psychiatric dictionaries (7).

I recently convinced a new member of Share, Care and Prayer to read Dr. Randolph's classic book An Alternative Approach to Allergies (8). After a couple of weeks, he told me: "I am so glad that there are people like you out there. I have been reading Randolph's book and couldn't lay it down. I have read about myself on every page." As an aside, he also turned off his gas stove and found that his depression and the weird feeling that he got in his head while eating in the kitchen went away. The significance of exposure to natural gas fumes in CFS and FM is also underrated. While it seems to be a given that PWC's and FM sufferers do worse in cold weather, the connection between the use of gas heat and gas appliances along with other pollutants in an enclosed environment is not made.

Some people diagnosed with CFS and FM do not want to know if they have food and chemical sensitivities for a variety of reasons. Obviously, no one wants to go on a diet or to have to change household and personal care products, etc. when he is ill and life is difficult enough to handle as it is. However, it is very important to find out as quickly as possible because:

Sensitivities must be treated and/or avoided. Otherwise, more symptoms will develop and the degeneration of health will progress to permanent organ damage.

The development of more symptoms may result in the need for medicine (made from chemicals, mold and food binders), and/or surgery (a stress to the body and exposure to chemical anesthesia).

More noticeable, disabling sensitivity like the smaller percentage of chemically sensitive people have may develop. One woman who suffered from CFS for 13 years used a lot of bleach to clean her bathroom due to her fear of germs. She subsequently became so sensitive that she could experience anaphylactic shock upon exposure to cigarette smoke and latex. She also had a difficult time finding any water or writing paper that she could tolerate.

Better health will develop automatically when allergens are avoided or treated. Thus life will be easier to handle even with lifestyle change and an avoidance diet.

Since conventional allergy tests are only 40% accurate for this type of sensitivity (9), patients would need to be tested by intradermal testing on the upper arm which provokes symptoms during testing (10), and/or have blood testing for delayed food, chemical and mold sensitivity (11). Again, symptoms/reactions can be delayed for three weeks!

The use of a Diet/Environment Diary (to record all food eaten, exposures to chemicals, and symptoms) can help some patients connect food and chemical exposures to symptoms for more immediate reactions along with the following diets:

the "Multiple Food Elimination Diet" (go off the most common allergenic foods for one to two weeks and add back one food at a time)

the "Rotation Diet" (rotate individual grains, meats, fruit, vegetables, etc. so none are eaten more than once every four days) (12).

These diets allow the system to clear of a food. Then when the food is eaten again, a more noticeable reaction is experienced. In recommending food elimination diets, Paul Cheney, M.D. said "The more I get into the issue of diet and food sensitivities, it's obvious to me that the single most common antigen to which we are exposed is food proteins. Elimination diets, and improving digestion and gut epithelial function can pay high dividends....I've seen people in 30 days have huge clinical responses simply by this very simplest of moves (13)."

Avoiding chemical exposure in everyday products can make a great deal of difference for people with chronic illness. Avoidance of fragranced products (perfume, aftershave lotion, cosmetics, soaps, laundry dryer sheets, candles, potpourri, incense, air fresheners) which contain a vast number of chemical ingredients should move the health of PWC's and FM sufferers to a higher plateau.

In conclusion, many PWC's and FM sufferers may have been injured by exposure to widely used organophosphate pesticides and/or sensitizing chemicals in construction materials, and then developed UNKNOWN food, chemical and mold sensitivities. Testing, avoidance-and-challenge, special diets, and keeping a diary could reveal the truth behind their fatigue, pain and other symptoms. Avoidance of fragranced products, harsh commercial cleansers (14), the use of gas for heating and cooking, and the use of pesticide, and testing and treatment of unknown allergens could alleviate their symptoms, prevent them from getting worse, and set them free to live a more normal life.

Janet Dauble is the founder and director of Share, Care and Prayer, Inc. She suffered from the symptoms of CFS, FM, Irritable Bowel Syndrome, etc. for 15 years. In 1978, a RAST test for food allergies found she was highly allergic to common foods, and time has shown that she is sensitive to some chemicals. A careful diet and lifestyle have allowed her to live a fairly normal life, serving thousands of chronically ill people--first as a support group leader in 1983 and then full time since 1987 as director of Share, Care and Prayer. For many years she also managed her elderly father's care, and took care of him on the weekends.

For the free brochure "Anyone Can Have Environmental Illness. Even You," or a free copy of the Share, Care and Prayer newsletter, write to Share, Care and Prayer, P.O. Box 2080, Frazier Park, CA 93225

Environmental Allergies

References

1. "Risk Factors for Chronic Fatigue Syndrome: A Case-Control Study, Odds Ratios for CFS Cases Compared with Control: Chemical Exposures," published in the Vol 2(4) 1996 Journal of Chronic Fatigue Syndrome.

2. Dr. Blondell's full title is: Health Statistician Special Review and Registration Section, Occupational and Residential Exposure Branch, U.S. Dept. Of EPA [Pesticide] Heath Effects Division.

3. A 60-page Memorandum from Jerome Blondell, Ph.D., "Subject: Review of Chlorpyrifos Poisoning Data," January 14, 1997

4. "Poisons aren't toxic to everyone equally," by Sharon Begley, The Wall Street Journal, January 24, 2003

5. "Gulf War Research Sheds Light on Source of Chemical Sensitivities," by Kevin Lamb, Dayton Daily News, October 6, 2005.

6. These surveys are flawed because they record only the allergies of which the patient is aware. He could be very food, mold, and chemically sensitive and not know it. People enrolled in these studies should be tested for unknown, delayed, chronic allergies/sensitivities.

7. Order the following papers by Dr. Theron Randolph from Share, Care and Prayer:

"Fatigue and Weakness of Allergic Origin (Allergic Toxemia) to be Differentiated from 'Nervous Fatigue' or Neurasthenia"

"The Coincidence of Allergic Disease, Unexplained Fatigue, and Lymphadenopathy; Possible Diagnostic Confusion with Infectious Mononucleosis"

"Ecologically Oriented Myalgia and Related Musculoskeletal Painful Syndromes"

"Environmental Incitants of Chest, Neck and Shoulder Pains"

"Restless Legs-Brainfog Syndrome"

8. An Alternative Approach to Allergies, by Theron Randolph, M.D. Share, Care and Prayer sells this book for $16.00 + $2.13 shipping.

9. An Alternative Approach to Allergies, by Theron Randolph, M.D., page 198. "Clinical Ecologists [now known as Environmental Medicine Specialists], it should be noted, do not generally use the familiar scratch or skin tests employed by most conventional allergists, since they do not give definitive results. According to Albert Rowe, M.D., 'It is generally agreed that clinical allergy may exist in the absence of positive skin reactions, especially those to the scratch test. This is true primarily in food allergy and to a lesser extent in inhalent allergy.' In a statistical study of intradermal skin tests, Rinkel found such tests to be only forty percent accurate, and often less so."

10. Intradermal skin testing can be done by members of The American Academy of Environmental Medicine, 316-684-5500 and the members of the American Society of Ophthalmologic and Otolaryngic Allergy, 202-955-5010.

11. Blood tests for delayed reaction to 305 items can be done by blood draw kit from ELISA/ACT Biotechnologies, Inc. 800-553-5472.

A blood test for immediate and delayed reactions to some foods and inhalants can be done by a blood draw kit from Genova Diagnostics, 63 Zillicoa St., Asheville, NC 28801, 800-522-4762.

12. Write to Share, Care and Prayer for copies of the "Multiple Food Elimination Diet" or the "Four-Day Rotation Diet".

13. Winter 2000 HEALTHwatch

14. Vinegar, Bon Ami, 20 Mule Team Borax, fragrance-free detergents such as All Free Clear, and baking soda can be substituted for commercial cleaners to improve health and save money at the same time. Contact the American Environmental Health Foundation to purchase less toxic personal products, soaps, cleaners, bedding, water and air purifiers, etc.: 8345 Walnut Hill Lane, Suite 225, Dallas, Texas 75231, 800-428-2343