Gulf War Syndrome

Gulf War Syndrome (GWS), or Gulf War Illness (GWI), refers to an array of physical and emotional symptoms reported by thousands of United States veteransfollowing their participation in the Persian Gulf War in 1990 and 1991. Considerable confusion and controversy surround GWS because symptoms are not onlyvaried but often vary among individuals and may mimic symptoms of other diseases. Also, many vets remain symptom-free, and some researchers claim symptomsare no more prevalent among Gulf War vets than in the general population. Some are of the opinion GWS is related to Post-Traumatic Stress Syndrome. Regardless of the controversy, many vets who left for the war in perfect health now experience illnesses ranging from mild to incapacitating and which,in some cases, has resulted in death.

During the Gulf War, many service people were exposed to dense smoke from oilwell fires, infectious diseases, pesticides, depleted uranium, chemical andbiological weapons, pyridostigmine bromide--a pretreatment against potentialexposure to poisonous gas, anthrax and botulinum toxin vaccines, and psychological and physiological stress. GWS symptoms include aches and pains and fatigue closely resembling fibromyalgia (FM) and Chronic FatigueSyndrome (CFS), migraine headaches, depression, weight gain, rashes unresponsive to treatment, asthma, difficulty with concentration and memory, gastrointestinal upset, sore throat and swollen glands, fevers, and lowered immune system. Studies reported in the Journal of the American Medical Association (JAMA) in 1997 by Haley, et al determined 70 percent of 249 members of a battalion which served in the gulf had"serious health concerns." Researchers concluded neuropsychologic difficulties may have been caused by exposure to pesticides, chemical weapons, and/or pyridostigmine bromide. Also reported in JAMA in 1997 by Schwarts, et al was a study of service personnel from all branches of the armed services representing more than 800 military units. When compared to service personnel not sent to the Gulf, Gulf vets were much more likely to experience GWS and, of those, symptoms were significantly greater when contact with solvents, smoke, pesticides, pyridostigmine, and agents of chemical warfare were reported.

It was not until 1996 that the U.S. Department of Defense acknowledged the escape of neurotoxic chemicals following post-war destruction of Iraqi ammunition bunkers. The Gulf War Illness office established by the Pentagon is now conducting investigations, including studies done on Czechoslovakian and Frenchtroops, analysis of a theory of an Iraqi terrorist attack with chemical weapons at Al Jubayl, claims of biological weapon use, hazards from exposure to depleted uranium dust, and insecticide/pesticide use and exposure. These investigations and epidemiological studies have thus far failed to identify the cause of GWS, and medical research has failed to find clinical parameters by which it can be defined. A January 1997 article in JAMA concluded that these illnesses are real, not simply psychosomatic, and that treatment of symptoms, counselling, and emotional support are critical.

In an open trial conducted by Drs. Pietr Hitzig and Dan Malone, complete remission of GWS was reported in up to 90 percent of patients on the FEN/PHEN protocol, which is a combination of phentermine and fenfluramine. Fatigue and body aches experienced in GWS, FM, and CFS appear to be linked to low or unbalanced levels of serotonin and dopamine. The FEN/PHEN combination--which must be highly individualized and monitored because of potential adverse side affects--appears to balance the levels of these neurotransmitters. Results must now be tested in rigorous controlled trials.

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