Gulf War, Chronic Fatigue, and the Miotic Syndromes

Townsend Letter for Doctors and Patients,  Oct, 2002  by Herbert A. Solomon

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Abstract

The mystery of the cause of Gulf War and Chronic Fatigue Syndromes/ Fibromylagia is explored. The remarkably similar relationship to systemic symptoms of Miotics. Speculation on the relationship between visual stress and the 'Miotic Syndrome' as inducing Chronic Fatigue Symdrome. A recent discovery of a possible relationship of Gulf War Syndrome and Fluoride/Fluoroacetate to inhibition of N-Acetyl-Aspartate.

Key Words:

Gulf War Syndrome, Chronic Fatigue Syndrome, Miotics, physostigmine, prostigmine, neostigmine, pyridostigmine, near point of convergence, visual stress, fluoride, N-Acetyl aspartate.

Introduction

Several years ago the Townsend Letter had a series of articles on Gulf War Syndrome (GWS), Chronic Fatigue Syndrome (CFS), and Fibromyalgia (FM). (7) I wrote a letter at that time concerning the possibility that visual stress, particularly imbalances of the extraocular muscle systems could have a cause relationship to CFS. (25) I received numerous inquiries regarding my research in this regard with prisms.

Recently, my interest in GWS was expanded by a nurse who had reviewed 20 GWS patients and shared with me that prostigmine or physostigmine, an antiglaucoma drug, was given to all her clients as a nerve gas antidote during the war action. The actual drug used was pyridostigmine (PS), a longer acting drug which was considered reversible with atropine. (10,11)

Unfortunately, most of the military were not appropriately informed of the hazards and how it should be administered. Current studies seem to indicate that stress will increase PS entry through the Blood/Brain barrier into the central nervous system.

GWS is "mired in controversy about its existence, its symptoms and above all, its causes." (22) Haley/Kurt (15) reported on suspected causes of GWS.

Suspected Causes of Gulf War Syndrome

Chemical warfare agents *, Environmental pesticides *, Pesticides in uniform *, Pesticides in flea collars *, DEET-containing insect repellants *, Pyridostigmine Bromide *, Ciprofloxacin, Chloroquine, Multiple immunizations, Smoke from oil well fires, Fumes from jet fuel in the environment, Fumes from burning jet fuel in tents, Petroleum in drinking water, Depleted uranium in munitions, CARC paint on vehicles #, Combat stress, Smoking, alcohol or cocaine use. (* - These include Choline esterase-inhibiting chemicals. DEET - indicates N,N,-diethyl-m-toluamide. # - CARC indicates Chemical Agent-Resistant Coating.)

I looked up physostigmine, and pyridostigmine which is a miotic, in Clinical Ocular Pharmacology by Bartlett and Jaanus (B&J). (3) I was surprised to find a table of 'systemic effects of miotics' which described most of the symptoms of CFS and GWS. Continued usage of miotics will sensitize toward permanent miosis according to B&J unless a mydriatic drug like atropine is used periodically. Attached are tables comparing the symptoms of CFS, GWS, and Miotic Systemic Effects (MSE). (3,20)

Systemic Effects of Miotics

Headache, Browache, Marked Salivation, Profuse perspiration, Nausea, Vomiting, Bronco-spasm, Pulmonary edema, Systemic hypotension, Bradycardia, Generalized muscular weakness, Increased tone and motility of gastrointestinal tract (abdominal pain, diarrhea), Respiratory paralysis.

Gulf War Syndrome/Chronic Fatigue Symptoms (20)

Aching joints, Chronic fatigue, Memory loss, Night sweats, Headaches, Skin rashes, Concentration loss, Depression, Muscle spasms, Nervousness, Diarrhea, Blurred vision, Anxiety, Breathing problems, Chest pain, Dizziness, Nausea, Stomach pain, Other vision problems including convergence insufficiency, Light sensitivity, Loss of balance, Hives, Sex problems, Urination problems, Hair loss, Chemical sensitivities, Frequent coughing, Bleeding gums.

Discussion and Speculations

The largest study of GWS was established by the Department of Defense in 1994, called a Comprehensive Clinical Evaluation Program (CCEP); (17) 18,495 veterans participated in the CCEP of the 700,000 deployed in the Gulf, or approximately 2.6%. More than 2/3 indicated exposure to: fuels, fumes, cigarette smoke, oil fires, pyridostigmine, pesticides, and non-US foods. Less than 20% indicated exposure to depleted uranium, nerve gas, and blistering agents.

Combination of agents was further considered. A special significant investigation was made between pyridostigmine (PS) and pesticides. There was only a few percentage points lower individually as compared to both exposure agents. No conclusion as to synergistic toxicity could be drawn. Over 2/3 of the vets reported developing symptoms after the war, with 40% after a year. (15)

It is obvious from the study that one single environmental exposure cannot be blamed for GWS; (18) that a multitude of conditions or combination can induce or lower resistance to various stress mechanisms in our society. That visual stress and/or the Miotic Systemic Syndrome as described by B&J should not be overlooked as among the precipitating factors.

Research supports Dr. Sapolsky's consideration of Kaufer et al.'s hypothesis as to how short-term experience becomes long-term neurochemistry via a negative feedback loop that increases acetylcholinesterase (AChE) and thereby breaks down the acetyl choline (ACh). (1,22) They found that both AChE inhibitors and stress, after causing an initial increase in excitatory ACh tone, leads to a long-lasting 'disease.' The 'disease' is an extended increase in AChE while reducing ACh formation.