Antidepressants advice to be taken with a pinch of salt (Sunday Telegraph)
PL | 23.11.2003 03:54 | Analysis | Ecology | Health
"Seriously hazardous chemicals can be found in the tissue of nearly every person alive. It is a frightening thought, but exposure to such toxic substances has been linked to a higher incidence in several cancers, reproductive complications, a continuing decline in fertility rates and birth defects." - The Scotsman 2003.
Ref: "In sickness and in health: Chronic Fatigue" Could antidepressants help those with ME after all, asks Dr James Le Fanu. Sunday Telegraph 16/11/2003
Sent to:
dtletters@telegraph.co.uk
Dr Le Fanu writes: "Chronic Fatigue, it has been alleged, is either a psychological disorder such as hypochondriasis, or even a "malingerer's charter", an unprovable pseudo-scientific diagnosis much favoured by the indolent and work-shy." (1)
Firstly it should be pointed out that "Chronic Fatigue" and "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" are classified as different illnesses in the World Health Organisations International Classification of Diseases. "Chronic Fatigue" is classified under mental illness, whilst Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is classified under neurological disease (2), hence the apparent confusion created by the terms "Chronic Fatigue" and "Chronic Fatigue Syndrome" especially when used interchangeably ! It could therefore be argued that Dr Le Fanus' article heavily relies on semantics to avoid deliberately misinforming his readers.
The heart of the problem lies in the fact that ME/CFS is not an unprovable pseudo-scientific diagnosis much favoured by the indolent and work-shy, and treatable with SSRI antidepresants. Nor are we dealing with mere tiredness, as experienced by low paid immigrant workers, or young single mothers living in high rise council flats, as Le Fanu also suggests. (3) The association of which will surely breed contempt from those readers with right wing ideologies towards such subjects. More likely is the fact that "seriously hazardous chemicals can be found in the tissue of nearly every person alive. It is a frightening thought, but exposure to such toxic substances has been linked to a higher incidence in several cancers, reproductive complications, a continuing decline in fertility rates and birth defects." (4)
In a Testimony to the Flemish Parliament (Belgium), the well respected international ME/CFS researcher, Professor Kenny De Meirleir explains:
"..During an attempt to describe what exactly is going on in the patients, we discovered a subgroup. We discovered in about ten families with at least two patients that someone had been exposed to pentachlorophenol (PCP). Fifteen to twenty years later, all these people suffered from the Chronic Fatigue Syndrome. Following PCP poisoning, we notice changes in the immune system that increase the risk of infection. Therefore, there is a relationship between toxins and the Chronic Fatigue Syndrome. Several publications have already shown that zinc, cadmium, chromium, lead, mercury and nickel affect the immune system, so that infections are no longer eliminated. In a family who have built their home on a site where arsenic has been dumped in the past, we notice that the immune system is similarly affected. This has already been shown in animal experiments as well.
Then the connection between the Chronic Fatigue Syndrome and opportunistic infections needs to be shown. We examined the incidence of chronic mycoplasma infections in a group of 272 patients and found this to be 68.7 percent. In two control groups the incidence was less than 10 percent. We find all kinds of infections. In some people, two or even three infections occur and in 17 percent of cases we find multiple infections. There are 7 trigger factors that may lead to the Chronic Fatigue Syndrome, specifically pregnancy, a number of isotropic viruses, long-term stress, excessive physical activity, various infections, transfusions, allergic reactions and heavy metals, phosphates and PCBs. These factors also lead to a deterioration of immune system function. Once a cellular dysfunction has appeared, infections occur that perpetuate a defect in the immune system and make a return to the normal situation impossible. A number of abnormalities develop which lead to the symptoms of the Chronic Fatigue Syndrome, so that additional infections occur and cancer risk increases.
In long-term cases of the Chronic Fatigue Syndrome, the incidence of cancer is five times higher than normal. It is, therefore, possible to indirectly implicate chemicals in cancer, especially in immune system disorders where P53 (the protective factor against cancer) disappears. If one has one or more factors and gets an infection one cannot get rid of, one enters a vicious circle that is very hard to break. In the 1984 Lake Tahoe epidemic, where 9 percent of the population develops the Chronic Fatigue Syndrome after infections, the incidence of cancer is higher than normal. Certain lymphotropic and brain cancers occur up to a million times more often in the American population. There is a large statistical increase. This means that specific cancers can develop, which in turn will be related to changes in the immune system. Therefore, the Chronic Fatigue Syndrome can be explained. One of its inducing factors can be found in the environment..." (5)
Here are just a few examples of the many articles about the link between ME/CFS and Chemicals:
'A preliminary investigation of chlorinated hydrocarbons and chronic fatigue syndrome' - (R H Dunstan et al - Med J Aust 1995; 163: 294-297)
'Chronic fatigue syndrome following a toxic exposure' Racciatti D. et al. - The Science of The Total Environment Volume 270, Issues 1-3, Pages 27-31 April 10, 2001
'Four Cases of Pesticide Poisoning, Presenting as ME, Treated with a Choline and Ascorbic Acid Mixture' John Richardson - J of CFS, Vol. 6 No. 2, 2000, pp. 11-21
'Three Babuska Clusters of Enteroviral Associated Myalgic Encephalomyelitis' - Paper Presented by Byron Marshall Hyde M.D.: New South Wales, February 1998 - The Nightingale Research Foundation: (quote:)
"..It should be remembered, that the period when polio virus claimed most victims, and most increase in incidence in the United States, was the same period when large scale introduction of the pesticide DDT came into circulation. Obviously, this is just one of many stressors. Many environmental stressors can decrease the circulating interferon and thus increase the risk of individuals falling ill with a chronic viral infection. In neurotropic viruses such as the enterovirus, there is evidence that the site of injury in some cases may be the blood brain barrier of the small arterioles and capillaries of the brain..."
Indeed Professor Malcolm Hooper of Sunderland University writes: "There is convincing evidence that when combined with physical trauma, chemical or biological insult, stress potentiates the condition and that the disorder may be due in part to multiple chemical and / or biological exposures which have been shown to increase the permeability of the blood brain barrier (BBB), leading to a significant brain injury. Evidence of BBB breakdown in ME / ICD-CFS was presented at the international conference held in London in April 1999: scientists in Israel have shown that severe stress (physical or mental) can produce breakdown of the BBB; if that barrier is broken, small amounts of substances which are normally outside the brain could produce brain injury. It is postulated that in the case of ME / ICD-CFS, a person already under physical or mental stress is exposed to an agent (viral or chemical) which crosses the BBB, enters the brain, and produces long-term dysfunction." (6)
One of the world's leading exponents on ME/CFS, Dr Paul Cheney, Professor of Medicine at Capital University; Medical Director of the Cheney Clinic, North Carolina, warns us that drugs such as SSRIs "fry the brain" of ME/CFS patients. SSRIs and stimulants work by increasing the firing of neurons. The body views any neuron that fires excessively over time as damaged, and destroys it (7). Therefore the suggestion patients be given SSRIs is highly inappropriate.
Does this mean that Le Fanu is actively promoting potentially harmful pharmaceuticals regardless of the consequences to individuals health ? Who knows for sure ? But alas I personally don't think so given his highly commendable and outspoken beliefs over the effects of the MMR jab in relation to autism. (8)
I suggest the reason for Le Fanus' ignorance of ME/CFS can be found in his book 'The Rise and Fall of Modern Medicine' in which Le Fanu says: "The environmentalist theory is invalidated by the biological necessity that the human organism be resilient and not readily injured by minuscule levels of pollutants in air and water." This argument may be true when applied to naturally-occurring toxins, such as tannins. But today's humans are exposed to a whole soup of artificial toxins that people were rarely or never exposed to before in their evolutionary history. There is no reason to believe our biology should be so resilient that it can even handle radically new toxins never before encountered ! (9)
Thus, with the denial that environmental toxin cause so much damage to public health, the gap in Le Fanus' knowledge is not merely unbridged, but in principle unbridgable and subsequently his ignorance will remain ineluctable. Antidepressant-type drugs such as SSRIs may well work for some forms of chronic fatigue, but the detrimental effects of SSRIs on ME/CFS sufferers (myself included) and attested to by so many patients as harmful, surely renders Le Fanu as intellectually disconnected from the facts.
Sincerely,
Paul Lynch
References:
(1) 'In sickness and in health: Chronic Fatigue' by Dr James Le Fanu, Sunday Telegraph. 16 November 2003.
http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2003/11/17/hdoc16.xml&sSheet=/health/2003/11/17/ixhfeatures.html
(2) The Countess of Mar, House of Lords Debate 16 April 2002
http://www.meactionuk.org.uk/House_of_Lords_Debates_160402.htm
(3) Dr James Le Fanu, Telegraph. Saturday 18 July 1998.
http://www.in.nl/sites/me-cvs/E1998/CFS_ENGE.635
(4) 'Enough to make the blood boil' by James Reynolds, Environment Correspondent, The Scotsman Fri 14 Nov 2003
http://www.news.scotsman.com/index.cfm?id=1257142003
(5) Testimony of Prof. Kenny De Meirleir in the Flemish Parliament. 6 June 2001.
http://listserv.nodak.edu/scripts/wa.exe?A2=ind0203d&L=co-cure&F=&S=&P=3931
(6) 'What is ME? What is CFS? - INFORMATION FOR CLINICIANS AND LAWYERS, by E.P. Marshall, M. Williams, M. Hooper. December 2001
http://www.meactionuk.org.uk/What_Is_ME_What_Is_CFS.htm
(7) Cheney - Antidepressants & stimulants can fry your brain: eye twitching. By Carol Sieverling. 30 December 2000
http://www.cfsresearch.org/cfs/cheney/24nf.htm
(8) 'When friends ask should children be immunised, my answer is no' Dr James Le Fanu, Telegraph. 21 January 2001.
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2001/01/21/nmmr221.xml
(9) Book Review: James Le Fanu, 'The Rise and Fall of Modern Medicine', Carroll & Graf, New York, 2000. Review by Jeffrey Shallit Department of Computer Science University of Waterloo, Waterloo, Ontario, Canada, N2L 3G1.
http://www.math.uwaterloo.ca/~shallit/lefanu.html
------------------------------------------------------------------------------------------
Related article - http://www.indymedia.org.uk/en/2003/11/280430.html
Sent to:
dtletters@telegraph.co.uk Dr Le Fanu writes: "Chronic Fatigue, it has been alleged, is either a psychological disorder such as hypochondriasis, or even a "malingerer's charter", an unprovable pseudo-scientific diagnosis much favoured by the indolent and work-shy." (1)
Firstly it should be pointed out that "Chronic Fatigue" and "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" are classified as different illnesses in the World Health Organisations International Classification of Diseases. "Chronic Fatigue" is classified under mental illness, whilst Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is classified under neurological disease (2), hence the apparent confusion created by the terms "Chronic Fatigue" and "Chronic Fatigue Syndrome" especially when used interchangeably ! It could therefore be argued that Dr Le Fanus' article heavily relies on semantics to avoid deliberately misinforming his readers.
The heart of the problem lies in the fact that ME/CFS is not an unprovable pseudo-scientific diagnosis much favoured by the indolent and work-shy, and treatable with SSRI antidepresants. Nor are we dealing with mere tiredness, as experienced by low paid immigrant workers, or young single mothers living in high rise council flats, as Le Fanu also suggests. (3) The association of which will surely breed contempt from those readers with right wing ideologies towards such subjects. More likely is the fact that "seriously hazardous chemicals can be found in the tissue of nearly every person alive. It is a frightening thought, but exposure to such toxic substances has been linked to a higher incidence in several cancers, reproductive complications, a continuing decline in fertility rates and birth defects." (4)
In a Testimony to the Flemish Parliament (Belgium), the well respected international ME/CFS researcher, Professor Kenny De Meirleir explains:
"..During an attempt to describe what exactly is going on in the patients, we discovered a subgroup. We discovered in about ten families with at least two patients that someone had been exposed to pentachlorophenol (PCP). Fifteen to twenty years later, all these people suffered from the Chronic Fatigue Syndrome. Following PCP poisoning, we notice changes in the immune system that increase the risk of infection. Therefore, there is a relationship between toxins and the Chronic Fatigue Syndrome. Several publications have already shown that zinc, cadmium, chromium, lead, mercury and nickel affect the immune system, so that infections are no longer eliminated. In a family who have built their home on a site where arsenic has been dumped in the past, we notice that the immune system is similarly affected. This has already been shown in animal experiments as well.
Then the connection between the Chronic Fatigue Syndrome and opportunistic infections needs to be shown. We examined the incidence of chronic mycoplasma infections in a group of 272 patients and found this to be 68.7 percent. In two control groups the incidence was less than 10 percent. We find all kinds of infections. In some people, two or even three infections occur and in 17 percent of cases we find multiple infections. There are 7 trigger factors that may lead to the Chronic Fatigue Syndrome, specifically pregnancy, a number of isotropic viruses, long-term stress, excessive physical activity, various infections, transfusions, allergic reactions and heavy metals, phosphates and PCBs. These factors also lead to a deterioration of immune system function. Once a cellular dysfunction has appeared, infections occur that perpetuate a defect in the immune system and make a return to the normal situation impossible. A number of abnormalities develop which lead to the symptoms of the Chronic Fatigue Syndrome, so that additional infections occur and cancer risk increases.
In long-term cases of the Chronic Fatigue Syndrome, the incidence of cancer is five times higher than normal. It is, therefore, possible to indirectly implicate chemicals in cancer, especially in immune system disorders where P53 (the protective factor against cancer) disappears. If one has one or more factors and gets an infection one cannot get rid of, one enters a vicious circle that is very hard to break. In the 1984 Lake Tahoe epidemic, where 9 percent of the population develops the Chronic Fatigue Syndrome after infections, the incidence of cancer is higher than normal. Certain lymphotropic and brain cancers occur up to a million times more often in the American population. There is a large statistical increase. This means that specific cancers can develop, which in turn will be related to changes in the immune system. Therefore, the Chronic Fatigue Syndrome can be explained. One of its inducing factors can be found in the environment..." (5)
Here are just a few examples of the many articles about the link between ME/CFS and Chemicals:
'A preliminary investigation of chlorinated hydrocarbons and chronic fatigue syndrome' - (R H Dunstan et al - Med J Aust 1995; 163: 294-297)
'Chronic fatigue syndrome following a toxic exposure' Racciatti D. et al. - The Science of The Total Environment Volume 270, Issues 1-3, Pages 27-31 April 10, 2001
'Four Cases of Pesticide Poisoning, Presenting as ME, Treated with a Choline and Ascorbic Acid Mixture' John Richardson - J of CFS, Vol. 6 No. 2, 2000, pp. 11-21
'Three Babuska Clusters of Enteroviral Associated Myalgic Encephalomyelitis' - Paper Presented by Byron Marshall Hyde M.D.: New South Wales, February 1998 - The Nightingale Research Foundation: (quote:)
"..It should be remembered, that the period when polio virus claimed most victims, and most increase in incidence in the United States, was the same period when large scale introduction of the pesticide DDT came into circulation. Obviously, this is just one of many stressors. Many environmental stressors can decrease the circulating interferon and thus increase the risk of individuals falling ill with a chronic viral infection. In neurotropic viruses such as the enterovirus, there is evidence that the site of injury in some cases may be the blood brain barrier of the small arterioles and capillaries of the brain..."
Indeed Professor Malcolm Hooper of Sunderland University writes: "There is convincing evidence that when combined with physical trauma, chemical or biological insult, stress potentiates the condition and that the disorder may be due in part to multiple chemical and / or biological exposures which have been shown to increase the permeability of the blood brain barrier (BBB), leading to a significant brain injury. Evidence of BBB breakdown in ME / ICD-CFS was presented at the international conference held in London in April 1999: scientists in Israel have shown that severe stress (physical or mental) can produce breakdown of the BBB; if that barrier is broken, small amounts of substances which are normally outside the brain could produce brain injury. It is postulated that in the case of ME / ICD-CFS, a person already under physical or mental stress is exposed to an agent (viral or chemical) which crosses the BBB, enters the brain, and produces long-term dysfunction." (6)
One of the world's leading exponents on ME/CFS, Dr Paul Cheney, Professor of Medicine at Capital University; Medical Director of the Cheney Clinic, North Carolina, warns us that drugs such as SSRIs "fry the brain" of ME/CFS patients. SSRIs and stimulants work by increasing the firing of neurons. The body views any neuron that fires excessively over time as damaged, and destroys it (7). Therefore the suggestion patients be given SSRIs is highly inappropriate.
Does this mean that Le Fanu is actively promoting potentially harmful pharmaceuticals regardless of the consequences to individuals health ? Who knows for sure ? But alas I personally don't think so given his highly commendable and outspoken beliefs over the effects of the MMR jab in relation to autism. (8)
I suggest the reason for Le Fanus' ignorance of ME/CFS can be found in his book 'The Rise and Fall of Modern Medicine' in which Le Fanu says: "The environmentalist theory is invalidated by the biological necessity that the human organism be resilient and not readily injured by minuscule levels of pollutants in air and water." This argument may be true when applied to naturally-occurring toxins, such as tannins. But today's humans are exposed to a whole soup of artificial toxins that people were rarely or never exposed to before in their evolutionary history. There is no reason to believe our biology should be so resilient that it can even handle radically new toxins never before encountered ! (9)
Thus, with the denial that environmental toxin cause so much damage to public health, the gap in Le Fanus' knowledge is not merely unbridged, but in principle unbridgable and subsequently his ignorance will remain ineluctable. Antidepressant-type drugs such as SSRIs may well work for some forms of chronic fatigue, but the detrimental effects of SSRIs on ME/CFS sufferers (myself included) and attested to by so many patients as harmful, surely renders Le Fanu as intellectually disconnected from the facts.
Sincerely,
Paul Lynch
References:
(1) 'In sickness and in health: Chronic Fatigue' by Dr James Le Fanu, Sunday Telegraph. 16 November 2003.
http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2003/11/17/hdoc16.xml&sSheet=/health/2003/11/17/ixhfeatures.html (2) The Countess of Mar, House of Lords Debate 16 April 2002
http://www.meactionuk.org.uk/House_of_Lords_Debates_160402.htm (3) Dr James Le Fanu, Telegraph. Saturday 18 July 1998.
http://www.in.nl/sites/me-cvs/E1998/CFS_ENGE.635 (4) 'Enough to make the blood boil' by James Reynolds, Environment Correspondent, The Scotsman Fri 14 Nov 2003
http://www.news.scotsman.com/index.cfm?id=1257142003 (5) Testimony of Prof. Kenny De Meirleir in the Flemish Parliament. 6 June 2001.
http://listserv.nodak.edu/scripts/wa.exe?A2=ind0203d&L=co-cure&F=&S=&P=3931 (6) 'What is ME? What is CFS? - INFORMATION FOR CLINICIANS AND LAWYERS, by E.P. Marshall, M. Williams, M. Hooper. December 2001
http://www.meactionuk.org.uk/What_Is_ME_What_Is_CFS.htm (7) Cheney - Antidepressants & stimulants can fry your brain: eye twitching. By Carol Sieverling. 30 December 2000
http://www.cfsresearch.org/cfs/cheney/24nf.htm (8) 'When friends ask should children be immunised, my answer is no' Dr James Le Fanu, Telegraph. 21 January 2001.
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2001/01/21/nmmr221.xml (9) Book Review: James Le Fanu, 'The Rise and Fall of Modern Medicine', Carroll & Graf, New York, 2000. Review by Jeffrey Shallit Department of Computer Science University of Waterloo, Waterloo, Ontario, Canada, N2L 3G1.
http://www.math.uwaterloo.ca/~shallit/lefanu.html ------------------------------------------------------------------------------------------
Related article -
http://www.indymedia.org.uk/en/2003/11/280430.html
PL
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