A French court recently awarded a disability allowance ($912 per month for three years) to Marine Richard based upon her claim that she has EHS (electromagnetic hypersensitivity). This is a concerning development because EHS is likely not a real disease. The situation, however, is a bit more nuanced than it may at first appear.

EHS and Non-Specific Symptoms

First for some background on EHS (or Idiopathic Environmental Intolerance attributed to electromagnetic fields, IEI-EMF, as it is now called in the scientific literature) – sufferers claim that they are sensitive to electromagnetic fields and that these fields cause symptoms such as headaches, dizziness, nausea, fatigue, tingling sensation, or palpitations. In one case series of EHS specifically subjects reported:

The most frequently reported symptoms from exposure to smart meters were (1) insomnia, (2) headaches, (3) tinnitus, (4) fatigue, (5) cognitive disturbances, (6) dysesthesias (abnormal sensation), and (7) dizziness. The effects of these symptoms on people’s lives were significant.

This list of symptoms may seem familiar to anyone with a medical background. They are all considered to be common, subjective, and non-specific symptoms. Sometimes we refer to such symptoms as the “symptoms of life,” because most people will have them at some point, even if they are completely healthy.

Vague and/or nonspecific symptoms such as these are often a challenge for both patients and medical professionals. Because they are non-specific they don’t point to any one disease or even one category of disease. They can be caused by a long list of actual diseases. They can also be lifestyle symptoms, associated with things like poor sleep, being overweight or inactive, or overusing caffeine.

They can also be a manifestation of an underlying mood disorder, such as anxiety or depression. Sometimes a mood disorder might exaggerate baseline symptoms of life, or cause what is called hypervigilance – paying attention to every little daily symptom. These everyday symptoms then provoke further anxiety and depression, resulting in a vicious cycle.

The challenge for the healthcare professional is to ferret out any significant underlying medical condition. Because the symptoms are non-specific this can involve a fairly thorough medical workup. At some point, though, it is reasonable to conclude that any serious underlying condition has been ruled out. Then the challenge becomes shifting focus to addressing the symptoms and improving the quality of life, rather than continuing on an endless hunt for an elusive diagnosis that may not exist.

This is all challenging enough, but in addition there are an increasing number of “alternative” practitioners whose livelihood consists mainly of throwing a monkey wrench into this whole process. They are like sirens luring vulnerable patients who are struggling to deal with non-specific symptoms toward the rocky shores of the fake diagnosis.

Imagine if after a thorough workup your physician is trying to convince you that any serious disease has been ruled out and perhaps we need to focus on your sleep and your anxiety, then a naturopath or fringe doctor tells you that they have magically diagnosed your problem as being something very specific and treatable (what you have been looking for the whole time). The allure of that fake diagnosis would be great.

Often patients in this situation are diagnosed with chronic Lyme disease, something called “Wilson’s syndrome,” low thyroid, candida hypersensitivity, multiple chemical sensitivity, food allergies, non-celiac gluten sensitivity, or electromagnetic hypersensitivity.

Whatever is going on with patients who claim to suffer from EHS we can say with a high degree of scientific confidence that it is not being caused by electromagnetic fields. A 2010 systematic review of provocative studies found:

An extensive literature search identified 15 new experiments. Including studies reported in our earlier review, 46 blind or double-blind provocation studies in all, involving 1175 IEI-EMF volunteers, have tested whether exposure to electromagnetic fields is responsible for triggering symptoms in IEI-EMF. No robust evidence could be found to support this theory. However, the studies included in the review did support the role of the nocebo effect in triggering acute symptoms in IEI-EMF sufferers. Despite the conviction of IEI-EMF sufferers that their symptoms are triggered by exposure to electromagnetic fields, repeated experiments have been unable to replicate this phenomenon under controlled conditions.

This is a consistent and robust result. People who self-identify as having EHS cannot actually tell when they are exposed to an EMF – the electromagnetic field itself is not causing the symptoms.

The French Court Decision

Does all this mean that the judge who ruled to give Marine Richard a disability allowance based upon her EHS diagnosis was wrong? Perhaps, but there is a nuance here I would like to explore.

According to reports, the court “stopped short of recognising EHS as an illness.” What I think this means is that the court recognized that Richard is disabled by her symptoms, and that is sufficient to treat her as disabled, even while it remains agnostic toward the cause of her symptoms.

This is actually not unreasonable and is common practice. Courts are not the place to sort out complex medical science. The challenge that courts face is that they are often tasked to dispense justice in the absence of a clear scientific answer or in the face on an ongoing controversy.

Often courts will err on the side of perceived victims or those in need, while not explicitly endorsing their claims. The vaccine court in the US operates this way. They grant compensation to families of children who may have had a vaccine side effect. They give a wide benefit of the doubt to the families, and essentially grant compensation even with the acknowledged lack of a scientific conclusion that vaccines can cause the alleged injury.

In other words, if you happen to have a seizure following a vaccine, the court is not going to spend its time trying to sort out whether or not the vaccine actually caused the seizure. They will just grant you compensation.

The downside of this policy is that people will often interpret the court’s action as if it is endorsing the causative claim, even when it explicitly is not.

A more troubling situation I won’t get into extensively here is when the issue is not one of public compensation but one of liability. For example, when companies are sued because their product allegedly caused an illness, even before the science is in. Here I do not think that courts are justified in simply erring on the side of the alleged victim, even though they will often do that.

There are many examples of this, including the alleged association of silicone implants and autoimmune disease. While the data was still preliminary courts awarded a multi-billion dollar class action settlement against Dow Corning, forcing them into bankruptcy protection for nine years and the removal of silicone breast implants from the market. However, when the science was finally in, it turns out there is no increased risk of autoimmune disease from silicone implants.

Conclusion

In the end it is important to have the science right so that we can best approach difficult situations such as those who feel their life is being destroyed by EHS. It is extremely helpful to know scientifically that electromagnetic fields are not causing their symptoms.

This, however, does not mean that they are not sick or at least have a disorder. It’s just probably not what they think it is. In some cases it is possible that patients who become convinced they have EHS have another identifiable illness, which is being missed because they are pursuing a false diagnosis.

In many cases, however, the cause(s) may be as vague as the symptoms. There may be a number of lifestyle and mood factors contributing to the symptoms in a self-reinforcing manner. We don’t really have a good non-judgmental name for this situation, which is unfortunate. We need a label that describes the syndrome without implying a cause, especially one that is probably not true.

In any case, it is important to recognize that these non-specific symptoms, when severe, can be debilitating. As physicians we take this approach all the time, and then try to address the debility. I have no problems with courts taking the same approach, if that is how their laws are construed.

It is important to recognize, however, that concluding that “compensation is appropriate” (often the wording used by the vaccine court) is not the same as endorsing an alleged cause.

Unfortunately, however, that is how it is often taken, especially by proponents.