MCSA NEWS
– Online Edition
July 2008, Volume
3, Issue 7
INSIDE THIS ISSUE:
Graded Exercise Recommended for Chronic Fatigue Syndrome
Reconstructive Screws Cause
Unexplained Allergy
Environmental Causes of Disease Often Missed by Doctors
Mercury Migrates from Dental Amalgams to the
Human Body
Head-In-The-Sand
Disorder A
Critical Review of Psychology in Relation to Electrosensitivity
Air
Filters Get Clean Bill of Health
Sal’s
Place – Encouragement: Shifting
Paradigms
Inside
MCS America: Activist’s Corner
Patients Declare Grounds for Medical
Skepticism: Complementary &
Alternative Medicine Gaining Popularity
Medical skepticism is
defined as doubt in the ability of conventional medical care to appreciably
alter health status. Callahan and
colleagues (2008) set out to determine whether medical skepticism was
associated with the use of complementary and alternative medicine (
According to the
Patients often turn to
The U.S. Department of
Health and Human Services, National Institutes of Health released news from
NCCAM on June 6, 2008 entitled, “Time to Talk About CAM: Health Care Providers and Patients Need To
Ask and Tell”. NCCAM’s mission is “to explore complementary and
alternative medical practices in the context of rigorous science, train
In the news release, NCCAM introduces an educational
campaign to encourage patients and their conventional health care providers to
openly discuss the use of
Conversing about CAM use
with a conventional provider is important to ensure safe, coordinated care among
all conventional and
Doctors are not always
willing to discuss
Most patients find
validation and relief of what ails them when they turn to
Conventional doctors
spend less than seven minutes with each patient, relying heavily on first
proving an ailment exists via clinical testing before making a diagnosis or
offering any helpful treatment. The very
nature of conventional medicine is evidence oriented and dismisses patient
testimony until an ailment is extreme enough to show up on a clinical
test. By the time clinical tests reveal
an ailment, it is far more advanced than necessitated. Major life disruption often occurs, time may have
been lost from work or school, and countless “all your tests are all normal;
try relaxing a little” reports leave the patient feeling lost, invalidated, and
may lead to depression and anxiety in the face of uncertainty.
Ultimately, it is the
patient whose body and health is at stake… something the patient owns outright
and has every right to command control of.
Patients, therefore, must be empowered to choose between conventional
medicine,
NCCAM says that doctors
can help by including a question about CAM use on medical history forms, asking
patients to bring a list of all therapies they use (including prescription,
over-the-counter, herbal therapies, and other CAM practices), and training
medical staff to initiate conversation regarding CAM.
Patients can help by
ensuring they include all therapies and treatments when completing patient
history forms, making a list in advance, and mentioning all therapies and
treatments during the examination.
Patients who are
dissatisfied with conventional medicine are entitled to seek
Providers interested in
tools and resources, such as wallet cards, posters, and tip sheets, may obtain
them free on the NCCAM Web site http://www.nccam.nih.gov or order them from NCCAM's information Clearinghouse at 1-888-644-6226.
References
Callahan LF, Freburger JK, Mielenz TJ, Wiley-Exley EK. Medical skepticism and the use of
complementary and alternative health care providers by patients followed by
rheumatologists. J Clin Rheumatol. 2008 Jun;14(3):143-7.
http://www.nih.gov/news/health/jun2008/nccam-06.htm
Graded Exercise Recommended for Chronic Fatigue Syndrome
According to the Centers
for Disease Control and Prevention (CDC), chronic fatigue syndrome (CFS)
is a serious illness and poses a dilemma for patients, their families, and
health care providers.
The CDC says “a
variety of studies by CDC and others have shown that between 1 and 4 million Americans
suffer from Chronic Fatigue Syndrome (CFS). They are seriously impaired, at
least a quarter are unemployed or on disability because of CFS.”
People who
suffer from CFS have unrelenting fatigue severe enough to limit the most basic
daily living tasks of bathing, cleaning, and dressing. The CDC cites the following symptoms
presentation for CFS:
- cognitive dysfunction,
including impaired memory or concentration
- postexertional
malaise lasting more than 24 hours (exhaustion and increased symptoms) following
physical or mental exercise
- unrefreshing
sleep
- joint
pain (without redness or swelling)
- persistent
muscle pain
- headaches
of a new type or severity
- tender
cervical or axillary lymph nodes
- sore
throat
The CDC lists several possible causes of CFS, including infectious
agents, immunology, hypothalamic-pituitary adrenal (HPA) axis deregulation, neurally mediated hypotension, and nutritional
deficiencies.
Due to the fact that post-exertional malaise is common in CFS, most practitioners recommend
avoidance of exercise and strenuous activity to preserve energy.
However, the Cochrane
Collaboration advises practitioners to implement graded exercise therapy,
saying that it can be undertaken safely with no detrimental effects on the
immune system provided that it is catered for individual physical capabilities
and takes into account the fluctuating nature of symptoms.
They do,
however, acknowledge that exercise can exacerbate symptoms and may promote
immune dysfunction. Patients with CFS
frequently report debilitating exhaustion after a mere few minutes of gentle
exercise despite any former athletic abilities.
An individual
with CFS undertaking an exercise program should remember to pace their
activities and respect their physical and mental limitations with the ultimate
aim of improving their everyday functioning, according the researchers.
Reference
Nijs J, Paul L, Wallman K. Chronic
fatigue syndrome: an approach combining self-management with graded exercise to
avoid exacerbations. J Rehabil Med. 2008 Apr;40(4):241-7.
Reconstructive Screws Cause Unexplained Allergy
Unexplained allergies
can be annoying, sometimes debilitating, and often frustrating for both doctors
and patients alike. When medical
providers cannot find a cause for what they refer to as “vague” and
“subjective” symptoms, patients are frequently assumed to be depressed or
anxious and referred for derisory psychiatric therapy.
However, the
failure to find a source for symptoms regardless of how vague and subjective
does not in itself repudiate the validity of a true biochemical etiology.
Researchers at the
University of Athens Hospital provide supportive testimony with a scientific
review of a 30 year old patient who complained of inability to focus mentally,
rash, chronic fatigue, decreased sex drive, and hair loss.
Detailed allergy testing
showed a positive value for biodegradable poly-L-lactic acid (PLLA). As it turns out, the patient had two PLLA
screws placed after anterior cruciate ligament (ACL)
reconstructive surgery on his knee. His
symptoms began a few months after the surgery and produced a systemic allergic
reaction.
Surgeons removed one of the two screws which resulted in marked symptom
reduction. When the remaining screw and
screw rests were later removed, all symptoms disappeared and the PLLA antigen
level in follow-up allergy testing had diminished.
This case has
a respectable ending. But for many who
do not receive care at university research hospitals, an obscure allergy to
PLLA would not likely lend itself to discovery.
Patients may be left to manage symptoms with pharmaceutical drugs and
coping skills instead.
Physicians can
help by listening carefully to patients, believing what they report, and
exhausting all reasonable possibilities before assuming a status of malingering
of psychiatric imbalance. Patients can
help by keeping track of new surroundings, changes in diet, new products, and
other possible allergic triggers and reporting suspicions to their
physician. It is crucial that patients
and physicians work as a health care
team.
Reference
Mastrokalos DS, Paessler
HH. Allergic reaction to biodegradable interference poly-L-lactic
acid screws after anterior cruciate ligament
reconstruction with bone-patellar tendon-bone graft. Arthroscopy. 2008
Jun;24(6):732-3.
Health and Environment
What you don’t know has power
over you;
Knowing it
brings it under your control, and makes it subject to your choice.
Ignorance
makes real choice impossible.
-
Abraham Maslow
“If
individuals and the public are properly educated about chemical toxicants, they
will be empowered with the choice to make decisions to protect themselves and
their offspring; without knowledge, the choice is precluded,” says Stephen J. Genuis, a researcher in the Department of Obstetrics and
Gynecology at the
Genuis says recent research
demonstrates a definitive link between chemical toxicants and potential health
problems, including congenital defects and gynecological disorders. Nevertheless, Genuis
stated, “There has been limited exploration of the relationship between
contemporary chemical exposure and reproductive medical issues in mainstream
obstetrics and gynecology literature.
Credible scientific study is emerging, however, which raises disquieting
evidence about the potential for environmental toxicants to profoundly affect
the health and well-being of individuals at all stages of life.”
In his peer reviewed
article, Health issues and the environment—an emerging
paradigm for providers of obstetrical and gynecological health care, Genuis survey’s research exploring the impact of adverse
exposure on reproductive health. He then
makes various points that are essential for us to consider in the pursuit of
new legislation and better medical care here in
- Over the last
half-century, more than 75,000 new synthetic chemicals have been
introduced.
- An ‘innocent until proven
guilty’ approach remains in effect for chemical agents; proof of safety is
generally not required before products go to market.
- Adverse chemical agents
may be inhaled in many homes, schools, and workplaces. Various personal care products inflict
dermal exposure to chemical toxicants.
- Although small exposures
may seem insignificant, many chemicals bioaccumulate
(collect into larger amounts) within the human body.
- Exposure to some toxic
chemical appears to have an impact at seemingly minuscule levels, very
much like the reactions reported by individuals with
multiple chemical sensitivity (MCS).
- Xenobiotics (foreign
chemicals) can alter communication between cells and disrupt cellular and
tissue regulation, often disrupting hormones.
- Individuals
have differing genetic vulnerabilities and may exhibit differing responses
to the same exposure
- Doses of environmental
chemicals asserted to be ‘safe’ are based on many assumptions and are
typically derived from animal experiments.
It is not ethical to intentionally expose a human to a potentially
toxic substance in clinical trials, therefore the actual impact of
chemicals on humans has not been evaluated and no claims to safety are
warranted.
- “Vociferous claims that
insufficient proof exists to establish a link between common chemical
exposure and harm as well as protestations by some industry that the
benefits and expediency of chemical use outweigh the risks have contributed to confusion regarding chemical
toxicity.” Vested interests
frequently have input into determining threshold levels for toxicants.
Symptoms of toxic
chemical exposure may range from trembling, seizures, respiratory problems,
headaches, and other neurological ailments to behavioral problems and
psychiatric illnesses. The phrase “mad
as a hatter” was coined after workers occupationally exposed to mercury
exhibited symptoms of mercury poisoning, including trembling and various
psychiatric anomalies later termed “Mad Hatter Syndrome”.
Detoxification is
utilized by many alternative practitioners as a method of reducing body burden
of chemicals and therefore improving health.
Chemicals are broken down by the liver, and excreted in stool, urine,
perspiration, and breath. Genuis cites that preliminary data suggests clinical
improvement after detoxification.
However, mainstream medicine has been slow to accept detoxification as a
means to health and healing as the profession has repeatedly missed the
correlation xenobiotics have to health aliments. Despite this, detoxification is something
that can be employed without medical supervision, though medical supervision is
advised. Many environmental medicine
medical doctors employ various methods of detoxification, including sauna, hot
baths, colonics, organic diet, fasting, juicing, and other gentle ways of
encouraging the body to mobilize and release stored toxicants.
Ultimately, political
involvement is needed to legislate tighter regulations and ensure that
chemicals are adequately tested before being sold or used in consumer
products. Legislation like the Kid Safe
Chemical Act, recently proposed by Senator Lautenberg, is just the beginning. We all need to become more involved in
approaching our legislators to regulate toxic chemicals. For a sample letter to
your legislators, see “Inside MCS America:
Activist’s Corner” in the July issue of MCSA News or contact admin@mcs-america.org.
Reference
Genius, SJ. Health issues and the environment—an emerging paradigm for providers of obstetrical and gynecological health care. Human Reproduction. 2006. 21(9);2201–2208
The Seven Challenges of MCS
Multiple chemical
sensitivity (MCS), as defined by Spenser et al (2008), is an acquired disorder
characterized by recurrent symptoms, referable to multiple organ systems,
occurring in response to demonstrable exposure to many chemically unrelated
compounds at doses far below those established in the general population to
cause harmful effects. One proposed causation is a chemically induced injury of
the liver, which may generate injury of the enzymatic detoxification systems,
triggering a myriad of end organ responses.
In the 1950’s, Theron Randolph was the first to recognize the process that
later became known as multiple chemical sensitivity. Victims suffer negative health effects, such
as rapid heart rate, dizziness, difficulty breathing, fatigue, flushing,
nausea, coughing, shortness of breath, and seizure activity when exposed to
pesticides, fragrances, air fresheners, household cleaning products, cigarette
smoke, paint fumes, and many other chemically unrelated compounds found in
nearly every indoor environment, as well as many outdoor environments.
MCS results in
significant morbidity and mortality, and economic, healthcare, and social
burdens. As many as 13.5% of cases
result in job loss and countless costs are incurred seeking out medical
interventions, which also burdens the health care system.
Roughly 15% of the population report negative health
effects upon exposure to chemicals, which presents the scientific, medical, legal,
and political communities with many challenges.
The first challenge of
MCS is the persistent difficulty in defining an underlying disease
process. Industry, ready to protect its
financial interests in the chemicals it produces, has supported a psychological
causation. This has created a debate in
the medical and political communities, which is complicated by the lack of an
accepted diagnosis test, such as a blood test, to confirm the condition.
The second challenge of
MCS is called masking, a process by which ongoing exposures hide the effects of
a specific exposure, making identifying triggers and diagnosis difficult. In severe cases, the patient may be in a
constant state of reaction, requiring a controlled setting devoid of triggers
to unmask routine exposures over a
period and then diagnose the specific effects of individual acute exposures.
The third challenge of
MCS is that it is not consistent with current ideas in toxicology, which rely
heavily on visible and lethal effects to label a substance as toxic. A new
paradigm in toxicology is needed to establish toxic effects at lower,
non-lethal doses. Then, the
precautionary principle can be adopted to regulate potentially harmful
chemicals when scientific evidence is convincing.
The fourth challenge of
MCS is a lack of ongoing federally supported research. The EPA and CDC have been woefully deficient,
and according to Spenser, “government funding and support impacts the
legitimization of the experiences of millions of ill Americans, independent of
whatever the etiology may be.”
The fifth challenge of
MCS is that policy makers currently fail to regulate a chemical until it is
later discovered to be harmful. Newly
proposed regulations, such as the Kid Safe Chemical Act, would place the onus
on industry to prove their products safe before they go to market.
The sixth challenge of
MCS is that it falls within the realm of government regulation, since
environmental triggers from air pollution and toxic waste are at fault. Some have recommended establishing a disease
registry with MCS as a reportable condition, while increasing funds and
programs and minimizing use of toxic chemicals.
The seventh challenge of
MCS is that if it is proven scientifically valid, MCS would significantly
impact public health. Spenser asserts, “MCS could fundamentally alter our
understanding of pathophysiology, affecting disease
research design and disease prevention measures. On a much broader level, the government,
private sector, consumers, and general population would be engaged in a
partnership that would benefit all of public health.”
Spenser concludes, “The
question of whether MCS is a legitimate physiologic disease process is, to some
degree, only incidental. Even if MCS
does not prove to be the disease its proponents claim, this does not negate the
need for appropriate treatment for the illness. The health care system and
public health as a whole should respond appropriately. A public health community that is
unable or unwilling at a minimum to contemplate paradigm-altering possibilities
neglects its duty. With such significant implications, neglect would be
insensitive.”
Indeed, many individuals
with MCS suffer great neglect at the hands of the health care system. Often being denied care altogether, those
that can find adequate care can rest assured most of it will not be covered by
insurance. The stigma and financial
burden of acquiring MCS assures most victims of societal rejection.
One has to consider that
the nature of MCS, being defined by chemically induced injury by chemicals that
are virtually unavoidable, means that you or your loved ones could suddenly
become affected. What then?
We must fight now for
funding for more research, EPA and CDC involvement, and tighter chemical
regulations. We must assist and learn
from our citizens who have been injured by chemicals. Our future depends on it!
Reference
Spencer TR, Schur PM. The
challenge of multiple chemical sensitivity. J Environ Health. 2008
Jun;70(10):24-7.
Environmental Causes of Disease Often Missed By Doctors
Our environment is
becoming increasingly more polluted.
Chemical toxicants are nearly impossible to avoid with daily exposure to
our own fragrances, personal care products, pesticides, plastics, rubber,
glues, office equipment, flame retardants, and a myriad of chemicals that is
increasingly called “toxic soup”. Even
those who choose safer, less toxic products are forcibly exposed to the
fragrances and chemicals of neighbors, coworkers, fellow students, and others
around them.
Unexplained illnesses
seem to be increasing in leaps and bounds and include autism, SIDS,
fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity. Many have been linked to the environment, yet
the connection is largely overlooked.
Genuis, a researcher in the Department of Obstetrics and Gynecology at the
Genuis’s statement was the
result of a patient complaining of depression, emotional instability and
various physical symptoms which revealed no objective and diagnosable
abnormality.
More new health
conditions are emerging that cannot be explained by conventional medical
wisdom. Yet all of these ailments have
been linked to environmental exposures.
This link is repeatedly missed by doctors. All too frequently a “garbage pail” diagnosis
of anxiety or depression is given while patients’ conditions deteriorate.
As it turned out, Genuis’s patient was a hairdresser whose neuropsychiatric symptoms were the result of occupational
exposure to hazardous chemicals such as those commonly found in hair spray,
lotions, shampoo, and conditioner. After
a leave of absence from her position, she was no longer exposed to occupational
chemicals and reported cessation of her symptoms. Armed with the knowledge to practice exposure
avoidance, the patient was able to regain her life.
In most conventional
medical establishments, the patient would have been placed in a managed care
situation in which her symptoms were merely managed with various
pharmacological drugs while she was taught coping skills and cognitive
behavioral therapy and continued to
suffer.
Genuis hit the nail on the
head. It is crucial, if not critical, to
public health that environmental correlates are considered in the face of
otherwise unexplained symptoms.
Reference
Genuis, SJ,
Mercury Migrates from Dental Amalgams to the Human Body
After decades of
controversy and denial, the FDA has finally acknowledged that dental amalgams are
harmful to pregnant woman and children, potentially causing neurological
disorders and other health problems.
According to researchers
in
Researchers examined
evidence that has now shown that mercury also directly migrates through the
amalgam filled tooth and into the body via dentinal tubules.
The FDA is scheduled to
reclassify amalgam filings by the summer of 2009 as part of a settlement in a
lawsuit, Moms Against Mercury v. Eschenbach,
filed Dec. 28, 2007, in the U.S. District Court for the
Interesting to note is
that the manufacturers of amalgam say it should not be used in children age 6
and under, or in pregnant women. Yet,
the FDA is just now getting around to possibly enforcing this
recommendation. The agency is now
considering classifying dental amalgam as a Class II substance, which would
enable imposition of special controls to increase safety.
Mercury is a known
neurotoxin, especially dangerous to young brains during development. Activists have worked long and hard to gain
protection for unsuspecting adults and innocent children.
The legal settlement resulted in
the U.S. Food and Drug Administration has changing its website to include a
disclaimer that amalgams “may have neurotoxic effects on the nervous systems of
developing children and fetus.” However
they advise people not to avoid seeking dental care and to instead discuss
options with their dentist.
The
effects of mercury are not always immediately apparent and may increase over
time. The aging brain may be
increasingly affected. Mercury may cause
a loss of IQ points, fatigue, seizures, tremors, cognitive impairment, fatigue,
behavioral problems, and numerous other debilitating symptoms. It has also been implicated in autism.
Approximately
25% of the
The
good news is that there are alternatives in the form of composite fillings made
of glass, porcelain, and other materials that can be used to replace amalgam
fillings. Cost varies from dentist to
dentist to replace fillings. The best
recommendation is to do extensive research into the safety protocols for
removing amalgams and ensure the selected dentist is familiar with them. The Holistic Dental Association and
International Academy of Oral Medicine and Toxicology offer referral lists to
holistic dentists familiar with amalgam removal, as does MCS America. To view these lists, see:
http://mcs-america.org/dentistlist.pdf.
Reference
Harris HH, Vogt S, Eastgate H, Legnini DG, Hornberger B, Cai Z, Lai B, Lay
PA. Migration
of mercury from dental amalgam through human teeth. J Synchrotron Radiat.
2008 Mar;15(Pt 2):123-8.
Kid Safe Chemical Act
In
a press release from the office of Senator Frank R. Lautenberg,
The
legislation, first introduced by Lautenberg in 2005, and now reintroduced along
with Congresswoman Hilda L. Solis of the 32nd District of California and Representative
Henry Waxman of the 30th District of
California, would amend the Toxic Substances Control Act in various ways.
Manufacturers
of chemical substances “distributed in commerce” would be required to certify
within one year that their products will cause “no harm” to unborn children,
infants, children, workers. or any other sensitive group.
Manufacturers
would also be required to certify that products for infants and children meet a
safety standard that is tenfold higher than the standard established for adults.
The
EPA would have to systematically review whether industry has met its burden of
proof for all industrial chemicals within fifteen years.
Hazardous
chemicals detected in human cord blood would be immediately targeted for
restrictions on their continued use.
The EPA would
be authorized to require additional testing as new science and testing methods
emerge. This would include new evidence
of health effects at lower doses or during fetal or infant development.
The
Centers for Disease Control and Prevention (CDC) would be required to expand
existing analysis of pollutants in people and to help identify chemicals that
threaten the health of children, workers, and other vulnerable populations.
An
Internet-accessible public database on chemical hazards and uses would be
started to inform companies, communities, and consumers. In addition, government funding and
incentives would be provided for development of safer alternatives and green
chemistry.
Many parents have hailed
the Kid Safe Chemical Act as a “real solution” to the current problems of
environmental toxicity and pollution that have been correlated with increases
in autism, asthma, multiple chemical sensitivity, chronic fatigue,
fibromyalgia, and other modern day maladies.
The bill
would provide a much needed fundamental overhaul of the way the
At
the present time, chemicals are not required to be tested for safety before
marketing. Frequently, testing is only
conducted when numerous similar health complaints or deaths are discovered after
a product reaches the market. This sell
now, worry later approach has been too little to late for those injured,
including workers, children, and other susceptible individuals. "It is critical that we modernize our nation's chemical
safety laws,” said Waxman.
The Kid Safe
Chemical Act was introduced on the Senate floor on May 20, and subsequently
referred to the Senate Committee on Environment and Public Works.
"Every
day, consumers rely on household products that contain hundreds of chemicals. The
American public expects the federal government to keep families safe by testing
chemicals, but the government is letting them down," Lautenberg said.
Shocking
Statistics
Over 80,000
chemicals are used in various products in our homes, yet the Environmental
Protection Agency (EPA) has only required testing of 200. This is the lack of
testing that has put Americans, especially children, in danger. This new bill would force the EPA to evaluate
every chemical product to ensure its safety before it is allowed onto the market.
“A real
solution” indeed. The Kid Safe Chemical
Act comes at a crucial time when bisphenol A, found
in many baby products, and phthalates, found in dangerous levels in common air
fresheners used in the home, have been proven harmful to health.