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Illness from low levels of environmental chemicals: relevance to chronic fatigue syndrome and fibromyalgia
Bell, I. R.
Baldwin, C. M.
Schwartz, G. E.
American Journal of Medicine Vol. 105, issue 3A, 74S-82S, 1998
Abstract
This article summarizes (1) epidemiologic and clinical data on the symptoms
of maladies in association with low-level chemicals in the environment,
i.e., environmental chemical intolerance (CI), as it may relate to chronic
fatigue syndrome (CFS) and fibromyalgia; and (2) the olfactory-limbic neural
sensitization model for CI, a neurobehavioral synthesis of basic and
clinical research.
Severe CI is a characteristic of 20-47% of individuals with apparent CFS
and/or fibromyalgia, all patients with multiple chemical sensitivity (MCS),
and approximately 4- 6% of the general population. In the general
population, 15-30% report at least minor problems with CI. The levels of
chemicals reported to trigger CI would normally be considered nontoxic or
subtoxic.
However, host factors--e.g., individual differences in susceptibility to
neurohormonal sensitization (amplification) of endogenous responses-- may
contribute to generating a disabling intensity to the resultant multisystem
dysfunctions in CI. One site for this amplification may be the limbic system
of the brain, which receives input from the olfactory pathways and sends
efferents to the hypothalamus and the mesolimbic dopaminergic [reward]
pathway. Chemical, biologic, and psychological stimuli can initiate and
elicit sensitization. In turn, subsequent activation of the sensitized
limbic and mesolimbic pathways can then facilitate dysregulation of
behavioral, autonomic, endocrine, and immune system functions. Research to
date has demonstrated the initiation of neurobehavioral sensitization by
volatile organic compounds and pesticides in animals, as well as
sensitizability of cardiovascular parameters, beta-endorphin levels, resting
EEG alpha- wave activity, and divided-attention task performance in persons
with CI. The ability of multiple types of widely divergent stimuli to
initiate and elicit sensitization offers a new perspective on the search for
mechanisms of illness in CFS and fibromyalgia with CI.
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