Book Review

Chemical Sensitivity: The Truth About Environmental Illness

Stephen Barrett, MD, and Ronald E. Gots, MD, PhD
Prometheus Books

This is an excellent book that sheds some light on the issues surrounding the diagnosis or, in the authors’ opinions, lack of diagnoses for chemical sensitivity syndromes. Both authors are nationally renowned leaders in the fight against quackery.

Steven Barrett, MD, is a retired psychiatrist, board chairman of Quackwatch, Inc., and the coauthor/editor of 44 books, including The Health Robbers: A Close Look at Quackery in America. He is a consumer advocate and board member of the National Council Against Health Fraud and chairs its Task Force on Victim Redress.

Ronald E. Gots, MD, PhD, is a physician and toxicologist at the International Center for Toxicology and Medicine in Rockville, MD, has authored or coauthored six books and published numerous scientific articles, some of which have appeared in Family Circle and Good Housekeeping, among others. During the past 20 years, he has consulted in thousands of situations involving established or perceived toxic exposures. He is an adjunct associate professor of toxicology at the Georgetown University School of Medicine, and in 1996 he participated in a panel convened by the World Health Organization to develop a consensus on this topic.

This concise, 212-page book is an easy read. It provides illustrations, key documents and references to legal cases involving chemical sensitivity. Each chapter is well referenced. The authors explore the scientific, ethical, legal and political issues surrounding chemical sensitivity. Chapters cover topics such as multiple chemical sensitivity (MCS), sick building syndrome (when exposure to a building causes a myriad of symptoms), diet and hyperactivity, mercury-amalgam toxicity, candidiasis hypersensitivity (yeast syndrome) and Gulf War syndrome.

The appendices include the position statements of the American Medical Association; American Academy of Allergy, Asthma and Immunology; and the California Medical Association on Clinical Ecology (the medical discipline that supports the diagnosis of MCS). None of the three associations recognize MCS as a valid diagnosis. All are of the opinion that there is a lack of scientific and clinical evidence to support the diagnosis. Currently, MCS is not listed as a diagnosis in standard medical textbooks or the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM), which is the standard manual used for classifying medical conditions.

Complaints associated with MCS include . . . depression, irritability, mood swings, inability to concentrate or think clearly, poor memory, fatigue, drowsiness, diarrhea, constipation, dizziness, mental exhaustion (“brain fog” or “brain fag”), lightheadedness, sneezing, runny or stuffy nose, wheezing, itching eyes and nose, skin rashes, headaches, chest pain, muscle and joint pain, urinary frequency, pounding heart, muscle and joint pain, muscle incoordination, swelling of various parts of the body, upset stomach, tingling of the fingers and toes, and psychotic experiences associated with schizophrenia.

Proponents claim that virtually any part of the body can have elusive symptoms for which no physical cause can be found. The authors and skeptics want to see validated, randomized, double-blind, placebo-controlled studies, of which there are none, to determine the validity of the diagnoses. The authors suggest that MCS is primarily psychologically mediated rather than chemically induced.

According to Barrett and Gots, “MCS patients typically portray themselves as immunologic cripples in a hostile world of dangerous foods and chemicals and an uncaring medical community. In many cases, their life becomes centered around their illness.” As pharmacists and compounders, we have a unique opportunity to touch these people’s lives. Whether we support or reject their problems as an illness, we can offer our support and compounding services in order to make their lives a bit easier. Compounding pharmacists can omit preservatives, dyes, flavors, fillers and other possible allergens in their compounds. These patients are in search of providers who will fill their psychological as well as physical needs, and compounding pharmacists are in an excellent position to do so.

Regardless of one’s opinion on MCS, this book is a “must read” for pharmacists who have patients affected by these problems. It opens the readers’ eyes to the issue and allows a better understanding of patients and what they are going through.