I once had a conversation with a doctor about Gulf War Syndrome (GWS). They said,”Its frustrating to treat something that you can’t describe and that has no definite cause.” However, the numbers of affected soldiers, coming back to the US after the first Gulf War with a bevy of mysterious chronic ailments, speak to the reality of *some* cause.
Officially, symptoms attributed to this syndrome encompass chronic fatigue, loss of muscle control, headaches, dizziness and loss of balance, memory problems, muscle and joint pain, indigestion, skin problems, shortness of breath, and even insulin resistance. Brain cancer , amyotrophic lateral sclerosis and fibromyalgia are now recognized by the Defense and Veterans Affairs departments as potentially connected to service in the Gulf War.
Seeing as how we are currently engaged in another war in the same region (and under potentially more damaging and toxic conditions), it’s important to try to pinpoint the root of the syndrome. Speculation has roamed from blaming the anthrax vaccine that troops received, to depleted-uranium weapons, to intense exposure to pollution from burning oil wells. Now, a provocative article in the Economist suggests that the symptoms may be the result of neurochemical warfare. Specifically, that troops were exposed to acetylcholinesterase inhibitors (AChEis) found in pesticides used to protect the troops from sand flies, in the nerve gas Sarin, and in pyridostigmine bromide pills given to troops as pre-treatment against nerve gas. AChEis prevent the breakdown of the neurotransmitter acetylcholine, causing it to remain in the synpase for longer than it should. This causes those neurons to fire excessively, causing abnormal brain and muscle activity as well as possible loss of white matter (myelin).
Dr. Beatrice Golomb, whose theory is currently published in PNAS, points out that severe exposure to AChEis mimics the range of chronic symptoms that many veterans suffering from Gulf War Syndrom report.
One study modeled the amount of exposure to organophosphates (another kind of AChEi) received by veterans and found that higher estimates of exposure are associated with greater losses of the brain’s white matter. Another study found that among veterans, those who were sick were more likely to have a genetic variation that means their bodies are less able to detoxify AChEis. Finally, there is a study of veterans given pyridostigmine bromide pills. Separate studies of American and Australian Gulf-war veterans show that the more pills veterans took, the worse their health is today.
Dr Golomb adds that patients with a low level of occupational exposure to acetylcholinesterase inhibitors in agriculture–for example through sheep-dipping or work in greenhouses–report symptoms that mirror those of sick veterans. Taken together, she argues, the evidence suggests that AChEis do have a role in the chronic illnesses experienced by many veterans.
Whether this hypothesis is exactly true or not, I do think that Golomb’s argument is worth investivating. Unfortunately, we will have a slew of new test subjects returning to the US over the next few years who may be able to shed more light on the causes, since (other than the Sarin) exposure to AChEis continues.