Post: Terr's new review article
Posted by Pat on 11/23/03
Terr very recently published a literature review on MCS
[Immunol Allergy Clin North Am. 2003 May;23(2):311-28].
In the paper, Terr makes some bold comments, as well as
comments I commend.
Terr wrote, >>> The concept of environmental sensitivity is
popular among a small group of physicians who believe that
exposure to low levels of numerous environmental chemicals
can cause a disease with numerous symptoms but no objective
physical or laboratory abnormalities. <<< [END QUOTE]
Later on Terr wrote, >>> In spite of the lack of physical
illness and absence of pathology, patients often experience
extreme disability, because their symptoms are triggered by
common environmental exposures.<<< [END QUOTE]
I wonder what Terr’s definition of "objective" is since he
claimed there are no "objective" physical/laboratory
abnormalities associated with MCS. There are, of course,
several reports to the contrary:
1. A. Before and after challenge brain scans (of PET and
SPECT) consistently illustrate abnormal brains in the
chemically sensitive. (Heuser, 1998, 2001; etc.)
B. A study of MRS brain imaging on chemically sensitive Gulf
War Veterans shows that they have up to 25% of their brain
cells depleted, whereas the control group did not. (Baxter,
C. One brain-mapping study showed P300 abnormality upon
challenge—the P300 is not influenced by emotions, proving
that particular group was indeed chemically sensitive on an
2. Double blind studies confirm very high 2,3-DPG levels,
indicating that the body is inadequately oxygenated.
3. Excessive NMDA activity has been reported in MCS (Pall,
[Excessive NMDA can lead to impairment of brain function and
death of neurons. Excessive NMDA activity also depletes
cells of Adenosine Triphosphate (ATP), and it is known that
NMDA-containing cells depleted of ATP become hypersensitive
to stimuli (Pall, 2002).]
4. Excessive oxidative stress/ free radical activity has
been reported in MCS (Pall, 2002).
(Some reports indicate that antioxidant therapy improves
5. A marker of the induction of iNOS has been reported to be
elevated in MCS sufferers (Pall, 2002).
This indicates elevated levels of Nitric oxide. Nitric oxide
production, when elevated, leads to increased production of
peroxynitrite. Pathology then results from the elevated
levels of NO and peroxynitrite. (This, among other things,
would lead to elevated 2,3-DPGs)
(Interestingly, excessive NO leads to excessive NMDA, which
then makes more NO, which then makes more NMDA, etc. Thus we
have the potential for a serious pathological cycle)
There is a lot of other (some powerful, some suggestive)
evidence supporting the organic view of etiology. There is
almost no solid evidence supporting the view of psychosocial
So Terr was either unaware of these things, or was being
Terr says, >>> Most (Clinical Ecologist employed) methods of
diagnosis and treatment have been disproved, and the
concepts underlying these theories are not scientific. <<<
A lot of the treatment offered by Clinical Ecologists
consists of high doses of Vitamins and minerals.
They offer B12 in the form of Hydroxocobalamin via
injections. B12 in the form of Hydroxocobalamin is a potent
NO scavenger (resulting in decreased NO, leading to
Vitamin C supports antioxidant activity and helps the body
heal from wounds. It also supports immune function (which
can be abnormal in MCS as a result of abnormal CNS functioning).
They also offer a multiplicity of antioxidants, and it has
been proven that antioxidants in synergistic form are more
effective (and this synergistic activity would be supported
by Vitamin C).
They sometimes recommend CoenzymeQ10, which is a powerful
immunologic stimulant that increases circulation as well as
the production of adenosine Triphosphate (ATP) via
converting un-converted ATP precursors via electrical charge
in the mitochondria.
They offer zinc, depleted levels of which have the potential
for elevating levels of Chloral Hydrate, which is the
chemical used in "slipping mickeys" that makes people pass out.
So I do not know what he is talking about in claiming AAEM'S
treatments have been disproved.
Terr also fails to consider Ashford and Miller’s
comprehensive literature review—which is, in fact, the most
comprehensive book on the issue, and yet was published 5
years priors to Terr’s review. This is even more startling
when one notes that that book provided a critique of
Staudenmayer’s work (even though a critique is not really
necessary since even if Staudenmayer’s work were correct it
could not be applied to all alleged MCS sufferers).
It is disgraceful that the US medical system is producing so
many sloppy reports and literature reviews pertaining to
this issue. Our War Veterans and the tax-paying citizens
deserve much more.
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