Is the World Making You Sick? | Hacker News Reader

Is the World Making You Sick?

nautil.us

39 pointsdnetesn53 comments

I run a hospital lab, and I see requests for testing for all sorts of bizarre things, largely by naturopaths, deriving from the "philosophy" expressed here. We refer to people who believe this stuff as being on the "Quest for Purity", a quixotic drive to remove all "toxins" from their bodies. Regardless of whether or not there are substantiated examples of low doses of chemicals causing effects, the worry about this problem being widespread is a very common delusion that consumes an enormous amount of attention and money, is preyed upon by charlatan doctors (or naturopaths, who call themselves doctors), and is incredibly confounding. The rub in these potential illnesses is that you can never actually remove any of these exposures completely, and thus you are required to continue to purchase diagnostics, cures, and consultations forever. If there is a true toxicobiologic effect in here, it will be essentially impossible to discern from the obvious and overriding psychiatric issues and financial conflicts at play.

> and I see requests for testing for all sorts of bizarre things

It would be interesting: Can you list a bunch?

Micronutrients, even in hair. Trace metals, especially after chelation therapy, when the results are definitely misleading. Labs that associate Candida with everything. "Stealth" virus testing. Quack Lyme disease serology labs that always give positive results. Anti-malignin antibodies. Multi variate index assays predicting irritable bowel disease. IgG food allergies. Outrageously large (>50-100 component) IgE allergy tests.

A bit of a wild guess, but many of those look like self-diagnosing or "fringe" from folks dealing with autoimmunity issues. Is that right?

Comes from all walks, but some from those folks. Mostly folks with real problems, like those in these threads, but who have unwittingly entered into a predatory industry that relies on providing overly specific data to people with nonspecific problems.

I'm sorry to hear that it extends to many fields.

> but who have unwittingly entered into a predatory industry

How exactly is it predatory? Rheumatology, which rarely engages in "cures" and whose "treatments" are often an exchange of one set of problems for another (if at all), and yet never fails to collect on its patients, might well fall under that umbrella.

Yep, this was pretty much my opinion.

But then my wife got sick. Spent 5 years with myriads of specialists, who all did their testings, and threw their hands up in the air.

So guess where we eventually land, when traditional medicine gets us no where? Within months of removing these effect-less "toxins" from her diet, I have a wife back.

So believe what you want -- I'd do the same if it hadn't radically effected my own life.

I don't think you actually read enziobodoni's post. (S)he certainly didn't say there were no toxins or they were effect-less.

Can you back up your anecdote with more facts?

What kind of sick was your wife? What was her recovery like? What were the toxins you removed?

Sure, I could write a book.

She presented with the most useless of symptoms: fatigue, caused by nearly every disease ever according to her specialists. She also had GI symptoms, but she's had those most of her life, though they got worse when the fatigue hit after child #4. GI specialist (and every other specialist) gave her a clean bill of health, not celiac disease or a known autoimmune disease, though she had a positive ANA.

Years into this, she went gluten free. That helped a bit. Then she went dairy and egg free. She saw a nutritionalist, and took out several other foods. More improvement, but still so fatigued that 3+ days a week she was out of commission.

She saw a naturopathic doctor who ran quantitative tests (stool and blood sample) and advised my wife to do what the tests indicated (food sensitivities and candida, another quack diagnosis according to traditional medicine). My wife continually got better over the next two months. Today, she's active in the family again with only the rare flare-up -- less than one day a week.

What were the toxins?

I see gluten listed, and I know it's commonly believed by some to be a toxin (I don't hold an opinion fwiw), and otherwise it looks like diet changes.

Glad to hear she's feeling better, though.

A lot of gluten in foods comes from GMO wheat which is grown using chemicals. Maybe it isn't the gluten so much as the chemicals from the wheat that the gluten is from that are causing the problems.

What? If you're not trolling, what wheat is grown without chemicals? Sincere question.

Certified organic foods.

https://en.wikipedia.org/wiki/Organic_food

"Synthetic pesticides and chemical fertilizers are not allowed, although certain organically approved pesticides may be used under limited conditions. In general, organic foods are also not processed using irradiation, industrial solvents, or synthetic food additives."

> GMO wheat which is grown using chemicals

I think this comment in particular is getting downvoted because it doesn't say anything. Every food we eat is genetically modified; we've bred it to produce more over the past thousands of years. And "chemicals" is literally everything you, food, and most of the universe is made of.

There's a pretty big difference between selective breeding within an existing species and injecting foreign DNA from a different species.

> What were the toxins?

Fantastic question, actually. Besides removing the test-indicated food sensitivities from her diet, she also went to eating "real food" -- as much as possible, pure fruits, vegetables and meats. Without additives -- preservatives, anti-caking agents, food colorings, and processing.

Of course, with this many variables changed in her diet, it's impossible to know whether she's feeling better due to removing foods she's sensitive to, the various additives (toxins?), the medicine for the candida, or psychological changes. Humans are complex things.

But is what you observed an actual ... chemical process, or is it the placebo effect? Can we even tell?

The placebo effect is just as real as any other medical phenomenon. It's just very hard to measure.

It is devilishly difficult to separate correlation and causation. This difficulty has to be the reason why some forms of "medicine" persist, ie naturopathy will have to work sometime, just as a stopped watch is right twice a day. I would never be so foolish as to discount your story, however, without knowing the actual facts, and without acknowledging that some people do, in fact, have food allergies, celiac sprue, etc... The problem is that not nearly as many people actually have these things as they might believe. And, combined with the STRONG financial motivation for folks to exploit the sufferings of others like yourself, my point is just hat its devilishly hard to make sense of anything.

I think I might have missed what I meant to say. Can we be sure that is wasn't a self-limited condition that resolved at he same time as the dietary changes, but not because of them? That kind of thing happens a lot. People get over strep throat without penicillin, after all.

Double-blind experiments are a great way to separate correlation and causation. See my (@zenkat's) wife's story above. Every so often, she accidentally and unknowingly eats foods she is sensitive to, and exhibits symptoms shortly afterwards. We go back and check the label and ... yep, there's the dairy/soy/yeast extract.

Oh, and there's no financially motivated third-parties here. We've done all this testing, elimination, and observation on our own.

That's not a double blind experiment. I don't even know how to qualify it unless you at least have some data on how often those things the unknowingly eats that contains whatever she is sensitive against does not exhibit any reactions in her.

That's not a double blind experiment, but I'd agree it points to an intolerance. Actual experiments, I will reiterate, are hard to do. Have you tried feeding your wife food devoid of known triggers but told her they were in the food? I would hope not, because it's not an ethical thing to do, but you need that sort of thing to nail it down. Also, since she seems to accidentally eat food of unknown provenance, can you be sure the times she's gotten away with it without symptoms that the food in question was truly devoid of triggers? In others words, it is very very easy to confirm that things are bad for you, correctly or not.

My wife has nearly the same story. Complaints of fatigue, nausea, cognitive difficulties (feeling spacey, fuzzy-headed). Tried a radical elimination diet, and then reintroduced different dietary components one-by-one to see which we're causing the symptoms. Dairy and soy products were the worst, along with products containing yeast extract. Gluten also had an effect, but not as strong. She's cut these from her diet, and feels much better.

Both of us have a background in the biological sciences (she has a PhD in Biochemistry from Washington University), and we both have a skeptical mindset. Neither of us are particularly susceptible to "woo". But the evidence is clear -- these foods make her very ill, and avoiding them makes her feel much better.

The clincher for me were the inadvertent double-blind experiments that we occasionally run when she eats something without checking the label first. All sorts of foods contain dairy, soy, or yeast extract, so it's very easy to make a mistake. Nothing drives the point home like watching your wife hurl by the side of the road after a snack -- and then checking the label on the salami she just ate, only to find it contains "nonfat dry milk solids". It's hard to remain skeptical after that has happened a dozen times.

We are still puzzled by the etiology of the disease. It seems like there is an immunological component (she also has asthma and hives, both of which flare up when she eats these foods), but she doesn't test as "allergic" in standard tests. I'm a bit skeptical of the low-level exposure hypothesis in this article (hard to test, hard to treat). However, the connections to the limbic system hinted at in this article are an interesting lead. The immune system can be affected by the nervous system, and I could see the olfactory system becoming sensitized after "learning" a correlation between a chemical and nausea, etc ... but these are just musings at this point.

Anyone know of good research along these lines?

I flipped through an interesting book many years ago - I can't recall the title, but it was written by a medical doctor who spent many years poking around the phenomenon on a case-by-case basis. He was more concerned with treatment than science, so no large scale studies, but there was a wealth of anecdotes. It may possibly have been "The Food Allergy Book"[0] (the Amazon description makes it sound at bit nutrition-woo ish, and there was a certain element of that, but his approaches were actually scientific with blind tests and controlling out variables and so on).

There wasn't really much focus on "root" cause, but there were some interesting patterns. Two stand out in my memory: excessive consumption of a particular thing seemed to instil the "allergy", and once present would be triggered even if the "allergen" were administered intravenously without the patient's knowledge. In one case a man who had access to cheap eggs had them daily in large quantities for years - when finally seeking treatment for some very general symptom (migraines?), the hospital took him off his egg-diet. Thereafter, even the tiniest amount of intravenously administered egg would cause drastic symptoms (what symptoms I can't recall either, but may even have been as strange as violent episodes).

I realize this isn't the rigorous science you were looking for, and I apologise for the vagueness of my memory, but if it is indeed the same thing your wife experienced you can probably rule out "learned" correlations.

[0] http://www.amazon.com/The-Food-Allergy-Book-Walsh/dp/0963154...

As a scientist, wouldn't you want to perform extensive formal experimentation before reaching your definitive conclusions? Your dismissive attitude on this topic seems a bit closed minded.

Believing that everything yet undisproven is somehow valid or worth study does not indicate open-mindedness, necessarily. The question you ask also presupposes that there has been no formal experimentation on his sort of thing before, which is not true. We know much that supports the old saw that, "the dose makes the poison," gleaned from years and years of study of environmental toxicology. One of my favorite musicians, Tim Minchin, once said that if you open your mind too much, your brain will fall out.

> There are several types of proof. Nick Ashford and I observed the same patterns of inexplicable new-onset intolerances across very different toxic exposures in over a dozen countries. Sheep dippers using organophosphate pesticides in rural areas of Europe, radiology workers inhaling chemicals while developing films in New Zealand, Gulf War veterans, EPA workers in a remodeled and poorly ventilated office building in 1987, cleanup crews breathing fumes after oil spills. Many would get ill, and a small percentage never recovered. They became exquisitely sensitized, as well as disabled.

This doesn't really sound that crazy to me. People working with industrial chemicals need protection. This is a widely known and accepted fact. It doesn't point to the entire population getting sick from small doses of chemicals in their day to day lives, like the flame-retardants in their mattresses, as the article opens up claiming.

I see similar complaints about risk to health and personal safety from emergency services personnel, but their life expectancies suggest otherwise.

What I would really like to see is an estimation of the life-expectancy of the workers in these industries. Is it actually lower than average, or does it appear that the exposure has a minimal effect on health?

Do the benefits of working in the industry out-weigh the risks (e.g. good health insurance benefits for treating other diseases out-weigh harms from exposure)?

Are life insurance companies requiring higher premiums?

Farmers dipping sheep in organophosphates may have many years of reduced quality life before dying at about the same age as other people.

Farm workers are traditionally poor so that might be a confounding factor.

I worked in lawn/pest control and my boss said that after a time, some guys take a hit from the chemicals, and become 'exquisitely sensitized' as is referenced here.

Chemicals that had no noticeable effect previously, suddenly have immediate consequences, like rashes or illness.

It's at least conceivable that chronic exposure to a chemical that isn't being properly removed could cause eventual sensitization. With the "bath salts" phenomenon, there were stories posted to HN of certain compounds acting similarly to known stimulants, but that certain people never came down from due to the molecules getting stuck in whatever receptor they targeted.

Not even industrial chemicals - colgate plax mouthwash causes my tongue to develop weird flat patches within a day of a single use. Takes two weeks to clear up. There was a Bloomberg article not too long ago about them using, iirc, triclosan in their Total toothpaste, which is considered dodgy by many. This chemical soup experimentation is way too close to home for me.

I predict many of the additives in our food and other products will be dimly viewed in retrospective, similar to how we view asbestos & lead paint today.

The preservatives, anti-caking agents, food colorings and other profit-enhancing additives are basically used with an "innocent until proven guilty" mindset.

As usual, you need only follow the money; who profits from adding these things to our food? Pretty much everyone.

There's much less profit motivation for pure food, so it simply won't happen until there's conclusive proof that the additives are bad.

And who's going to pay for that proof -- enough that those profiting from them can't squash it?

Because of market forces and some of the documentation regimes, the end cost to the consumer is higher without these things. One might think it's because the-products-without are less mainstream and less subject to economy of scale, or just because shopping at Whole Foods signals caring. That does not make Whole Foods a scam; it's complicated. Not picking on Whole Foods ( I've never even been there ) - they're just a visible metaphor for this phenomenon.

There's something in our Values Map that seems to put profit at cross purposes to "human values" or "caring". It may also be that food "made by hand" is actually of higher quality since the producers have more control and are interested in it more as an... art statement(?).

Maybe it is profit; maybe it ain't.

> In 1962, physicist and historian Thomas Kuhn proposed that science makes progress not just through the gradual accumulation and analysis of knowledge, but also through periodic revolutions in perspective.

Kuhn is almost always referred to as a philosopher because he left physics to be a "philosopher of science".

In a nutshell I see an article about a scientist who worships a philosopher, believes she's the leader of the third major revolution in understanding human illness, and has a theory that's plausible yet difficult to test. Doesn't make the idea wrong, but these are not good signs.

In her defense she's published a few times on the subject* still something about the article's rubbing me the wrong way.

* - http://scholar.google.com/scholar?hl=en&q=claudia+miller

There is room for improvement in the modern world. But you know what could be making us sick in our everyday lives? Cholera. Makes bpa a little less scary after all.

Let's not resort to the appeal to worse problems as a reason to give up on solving problems closer to home.

If this topic interests you, you might enjoy the Todd Haynes movie [SAFE] (1995).

Also related is Katie Couric's Fed Up (2014).

What makes me sick is this fear-mongering. Go back to the industrialization in England if you want to see real pollution. We have made astonishing advances when it comes to increasing air quality. Catalysts in cars, all kinds of regulations about emissions. We are constantly trying to remove harmful substances from our lives - but that requires evidence, we can't just randomly blame 'chemicals'. It's far from perfect, I know that. But the average lifespan of humans has steadily gone up.

Dreadful fear-mongering? Plenty to monger! Good gracious -we are even told to watch and limit the amount of fish we eat thanks to its mercury content. And mercury (horribly toxic) is only one of many substances that we should get concerned about.

"The researchers, led by scientists from Harvard University and the U.S. Geological Survey, found that the ocean’s mercury levels have already risen about 30% over the last 20 years. Combined, the findings mean the Pacific Ocean will be twice as contaminated with mercury in 2050 as it was in 1995 if the emission rates continue."

The author isn't really arguing for widespread policy changes, that would be for society to decide and like you said, in total maybe the chemical exposure has a net benefit in avg lifespan anyways. But there is a classification of health issues that is not explained by traditional medical views, other than to say that it's a neurological issue. If there is a physiological component at play, research in that area could really help treat suffering patients, or provide opportunities for them to manage their illness. I don't know whats considered fear mongering about that.

The reflexive lay dislike for "chemicals" is a bit weird to me, because everything in this world is made up of chemicals. If anything, the ostensibly healthy foods like fruits and vegetables probably have more chemical complexity and heterogeneity than processed foods.

In terms of pollution and the presence of bad chemicals, it's nothing new. Burning any organic matter releases thousands of chemicals, and for all the romance around wood fires and stoves, those are much more polluting than most industrial processes today.

This isn't to invalidate the core concept of the article, which I can't really evaluate. It seems likely that some of the irritating illnesses people get are due to hypersensitivity to certain chemical agents that, in low doses, most people can tolerate. I just doubt that this is a new problem, given that we've always lived in somewhat of a chemical stew and our air and water have always harbored things that can kill us.

Honest question: given the incredible variety of chemical compounds in nature, if one wants to describe specifically those that are directly harmful to health, or that trigger an immune response in some persons, what is the optimal umbrella term? ("Toxin" is every bit as overloaded and fuzzy as "chemical" in common parlance.)

That's the problem, isn't it? What is directly harmful to health? Beyond those agents we've universally codified as people poison, "harmful" is a constantly shifting designation that will always be misappropriated by those with a cross to bear over their pet subject. Health is such a complex, nuanced subject that its hard to imagine anything different than the messy passions we're describing.

That doesn't address the question. To most people, peanuts aren't harmful, but a small number of people can die due to exposure. A laundry detergent with no effect on most people may cause some to break out in hives. What do you call these substances, whether natural or man-made?

I understood. My answer is that outside of outright toxicants, the language will always be reduced to a "fuzzy" value, because the proposition of "harmful" is itself fuzzy, and is doubly so inside a contentious and complex environment.

It sort of seems like willful ignorance to not recognize that people living in a modern urban environment are surrounded by a vast array of chemical compounds that did not exist in meaningful quantities before the last century or so.

I have a new law based on Betteridge's law of headlines:

Any scientist who claims to have produced a paradigm shift hasn't.

You're welcome to call it Monochr Law of Paradigms.

Mancini's corollary: the robustness of the scientific foundation of an article is inversely proportional to the frequency of the word "chemicals" in the article

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