Brain damage? That’s the latest theory from researchers trying to explain Gulf War illness. I’m skeptical of the new study and disappointed because medical research again is missing the point.

Thousands of Gulf War veterans have been sick and undiagnosed for more than decade as doctors grope for answers. No one can convincingly explain their many symptoms, which include pain, fatigue and cognitive impairment.

Things won’t change until medical science acknowledges that we are dealing with an entirely new mechanism of disease. We recognize how germs and immune-system failures cause disease. Now we need to recognize that chemical exposures cause disease, too.

The Gulf War veterans are suffering the effects of chemical intolerance probably brought on by one or many such exposures in the war zone. I said so in congressional testimony as far back as 1999.

Wartime in the past has opened new thinking on the origin of disease. The germ theory, for example, emerged from the Civil War. Photo: Library of Congress.

My conclusions are based years of study. I also served as the environmental medical consultant to the Department of Veterans Affairs regional referral center in Houston for seven years in the 1990s. I’ve evaluated dozens of ill veterans. They have what is called TILT, or Toxicant-induced Loss of Tolerance.

A single exposure or repeated chemical exposures can cause TILT. People with TILT suffer from chemical intolerances that can impair cognitive abilities and cause multi-symptom illnesses.

With the Gulf War veterans, it doesn’t matter so much which exposure caused their breakdown in tolerance — be it pesticides, smoke from the oil fires or pyridostigmine bromide pills. Those things have long since left these veterans’ bodies. It’s the aftermath of these exposures — the new-onset intolerances to low-level chemical exposures — which appear to be perpetuating their symptoms. In some cases, it may be difficult to sort out individual intolerances, or “triggers,” because of a phenomenon called “masking.” This occurs when individuals are reacting to so many exposures that they have overlapping symptoms.

How can we help these people? The single most important task is to sort out and “unmask” the causes or triggers for their symptoms. This requires an environmental medical unit, or EMU. Congress once endorsed EMU research for the Gulf War veterans but never funded it. Only a few EMUs exist in the world. They are environmentally controlled in-patient hospital units designed to isolate patients from exposures that set them off.

Once we get patients to baseline, we can reintroduce things like caffeine, foods and various substances to identify what causes their flare-ups.

This is not the first time doctors have been baffled by wartime disease. During the Civil War, doctors faced a similarly mysterious “syndrome” characterized by fever. Hundreds of thousands of soldiers died. The doctors did what good epidemiologists do today. They classified the cases. Since the hallmark symptom was fever, they classified the cases by fever type — remittent, intermittent, or relapsing. In doing so, they unknowingly lumped together dozens of unrelated illnesses — everything from typhus and typhoid to malaria and tuberculosis.

Today we face this same situation with Gulf War veterans, only this time the hallmark symptom is not as simple as fever. It’s newly acquired intolerances these veterans have been experiencing since the end of the war.

The shooting tragedy at Sandy Hook Elementary School in Newtown, Conn., underscores the urgency for mental health practitioners to understand the TILT iceberg. The iceberg is a graphical depiction of the risks for people with Toxicant-induced Loss of Tolerance.

Practitioners need to take a proper history of their patients and think about the role of petrochemicals/drug exposures in violence. These hair-trigger anger reactions were not uncommon among chemically-exposed Gulf War veterans I saw as a consultant for the Veterans Administration. The veterans had become chemically intolerant and were so afraid they might harm their own families that they gave their guns to friends for safe-keeping.

Dietary intolerances are one of the main consequences of TILT, based upon our extensive studies of people who became ill following exposure to pesticides, solvents, substances used in remodeling, and Gulf War chemicals.

Prisons are controlled environments in which it’s been shown that reducing exposures, even to such benign chemical substances as sugar, can reduce violence.

Read an in-depth exploration in the book I co-authored,
Chemical Exposures: Low Levels and High Stakes.

The Sandy Hook shootings, like those earlier in Oregon, Colorado and elsewhere, appear random but individuals whose limbic systems have been sensitized by exposures and then are triggered by cleaning agents, foods or medications they no longer can tolerate are more likely to pick up a gun and use it.

Using the QEESI, or Quick Environmental Exposure and Sensitivity Inventory, with patients and reducing exposures (pesticides, solvents, etc.) could help. TILT may be responsible for a small subset or a large number of cases, but almost no mental health professionals are aware of this illness dynamic/new paradigm and they must not miss the diagnosis. Too many lives are at stake.