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    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
    organic basis.

    2. Double blind studies confirm very high 2,3-DPG levels,
    indicating that the body is inadequately oxygenated.
    (Panjwani, 1999)

    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
    decreased peroxynitrite).

    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.

    Posts on this thread, including this one

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