Comments on: Environmental Sensitivity

By: Science-Based Medicine » Credulous medical reporting

Science-Based Medicine » Credulous medical reporting — Thu, 11 Dec 2008 00:05:04 +0000

[...] generally considered “fake diseases”—CFS exists, but is horribly over-diagnosed. MCS probably doesn’t exist at all. E.s’ doctor discovered she had a virus called Epstein-Barr, which causes mononucleosis and [...]

By: clgood

clgood — Mon, 17 Nov 2008 05:45:13 +0000

jhs:

...the deceptive practice of using technical jargon to confuse and bewilder, rather than to illuminate and educate. Is there a clear, concise term for this practice?

I think there is a term for it.

By: Claire

Claire — Tue, 04 Nov 2008 11:05:36 +0000

Trying to be charitable, I have no doubt that people who claim to suffer from MCS/IES (idiopathic environmental sensitivities) experience real distress but I really, really wish they wouldn’t refer to themselves as being “allergic” when there is no medical evidence that this is the case. Knowing families – including my own – who have been (sometimes tragically) afflicted by the real thing, my worry is that these unjustified claims to be allergic to modern life can undermine public understanding of what allergy is and when it needs to be taken seriously. With modern medicine, awareness and vigilance, fatal outcomes are thankfully infrequent but avoidable tragedies can happen .

By: jhs

jhs — Tue, 04 Nov 2008 02:59:29 +0000

This essay a great example of your writing being accessible, informative, and persuasive. I have forwarded this to a couple of friends, and I finally broke down and registered an account here to say thanks.

(And speaking of accessibility, I’ve often heard you talk about the deceptive practice of using technical jargon to confuse and bewilder, rather than to illuminate and educate. Is there a clear, concise term for this practice? Not to name names, but…)

By: Fizzizist

Fizzizist — Tue, 04 Nov 2008 00:15:20 +0000

Jeez this is like a priest going against science and performing an exorcism, though this is not as extreme as something like that, it is still of major concern to the science community and to people who actually have this problem and should be getting psychological treatment, not some kook fringe science treatment that they are getting now.

By: daedalus2u

daedalus2u — Mon, 03 Nov 2008 21:55:14 +0000

There is a potential physiological pathway that could be involved. Whether it is or not has not been established.

Most xenobiotic chemicals are metabolized through the cytochrome P450 system. These enzymes are quite “uncoupled”, that is they normally produce considerable superoxide as a normal consequence of their normal activity. This superoxide is vectorally produced to the inside of the microsome the P450 enzyme is located in. Normally the P450 enzymes are inhibited by NO binding to the heme. To achieve high activity this NO must be removed, and this is one of the roles of the superoxide, to act as a positive feedback mechanism to robustly turn on those particular P450 enzymes in a time of need by lowering the NO level local to that microsome. Depending on the physiological state, this state of oxidative stress may be confined to the relevant microsome, or it may propagate to others.

Low NO makes mast cells hypersensitive to degranulation. This is a “feature”, when an infection on the skin generates xenobiotic chemicals, proteases for example, they cleave xanthine oxidoreductase into xanthine oxidase where it then makes superoxide. This pulls down the NO level, mast cells become more sensitive and degranulate releasing (among other things) proteases that produce positive feedback.

These same pathways can also be activated neurogenically. There could be a small reaction to some xenobiotic chemical (even some that are “natural), and then a conditioned psychogenic response amplifies the reaction and extends it even to chemicals that don’t activate the P450 system.

Production of superoxide is one of the universal “stress responses”. That is one of the final common pathways of any type of “stress”, chemical, fear, anxiety, infection, fight or flight. It should be quite easy to condition someone to react by producing superoxide. That is what the politicians are trying to do for this election, condition voters to react with fear toward their opponent.

By: DeltaZ

DeltaZ — Mon, 03 Nov 2008 21:14:36 +0000

I do believe that most patients with “environmental sensitivity”
are on the kookie side. There is one “orphaned” disorder which might have been the writer’s better choice to send
Mike Monroe to an isolated place in Alaska. It characteristically shows aggravation of symptoms from multiple environmental stimuli. The condition is “mastocytosis” usually with dermatologic findings secondary to unrestrained histamine release. (urticaria pigmentosa or one other I can’t recall)

One surgeon in our community suffered from this process, quit his work for months and went to the mountains, or maybe it was Canada, to escape local allergens and warm moist climate (as well as family and friends). This is a rare disorder with at least some pathologically identifiable characteristics, no known cure, and in this series of one was self limiting and remissed without known problems. Every rare and every kookie disorder has it’s website, and this one is no exception.. DZ