EMS Not Caused by L-Tryptophan
Can
other supplements, drugs, or substances cause EMS or EMS-like disorders?
Yes......
A Brief Explanation
Eosinophilia-Myalgia
Syndrome (EMS) or EMS-like disorders have also occurred as the result of ingestion
of other dietary substances (vitamins or supplements): Niacin, L-Lysine, and 5-hydroxy-L-tryptophan
(5-HTP); and, possibly, Melatonin and others. I should point out that
the number of cases known for a fact to have been caused by Niacin, Lysine and 5-HTP
are few. However, I think the real numbers, especially for 5-HTP, may be much higher
indeed than we know for certain. It's also possible to have EMS-like disorders from
reactions to prescription drugs which can cause eosinophilia and myalgia; quite often,
in these situations, the symptoms gradually go away once the offending drug is withdrawn.
This can also happen after withdrawal of 5-HTP and other supplements, according to
anecdotal reports I received from persons sickened by these over-the-counter preparations.
However, I also have heard from people who have developed chronic illnesses after
ingestion of 5-HTP, Melatonin, and a few other dietary supplements. Their symptoms
are very similar to EMS although eosinophilia is not always found. Furthermore, several
persons with LT/EMS have reported worsening of EMS symptoms after using Melatonin.
The best advice is probably to 1) Be sure to tell your physician what you're
taking and 2) Report at once unusual symptoms.
It's important, also,
to point out that EMS is similar to other diseases associated with toxins: Toxic
Oil Syndrome (TOS) that occurred in Spain in 1981 and which injured about 20,000
persons and killed outright about 500 and Gulf War Illness. Even some survivors
of Anthrax infection in 2001 are reporting ongoing symptoms which are similar
to chronic EMS, and I wonder, also, if some people affected by the toxins around
the World Trade Center in NYC have developed an EMS-like illness. In addition, EMS
is similar to Scleroderma (which can be associated with toxins), Fibromyalgia,
Chronic Fatigue Syndrome, and others. It will take research to find all the ways
in which these diseases are related, and research into one might benefit others,
as well as research projects that involve more than one of these related diseases.
It would be a great step forward to see more cooperative research projects at NIH
and elsewhere.
References:
Non-LT
Related EMS - PubMed (published winter 2003) NO ABSTRACT on PubMed; just
basic info
Abstract
of Above on Current Journal of Rheumatology Web Site
Structural
characterization of a case-implicated contaminant, "Peak X," in commercial
preparations of 5-hydroxytryptophan. (abstract, January 2003)
Eosinophilia-Myalgia Syndrome by
Shrilekha Sairam, MD, MBBS, Fellow, Dept. of Internal Medicine, Div. of Rheumatology,
University of Texas at Galveston; co-author: Jeffrey R. Lisse, MD, FACP, University
of Arizona School of Medicine; numerous editors; 14-page article on EMS; last updated
August 2002; mentions L-Lysine, Niacin and 5-HTP as possible other causes, though
rare, of EMS.
FDA TALK PAPER: Impurities Confirmed
in Dietary Supplement (5-HTP findings)
FDA/CFSAN Congressional Testimony
(July 18, 1991) (mentions L-tryptophan and L-Lysine as not being recommended
to be given to patients by doctors)
1999 Letter on Melatonin (from
Mayo) Added 4-23-03 (discusses EMS-like impurities found in samples of Melatonin
that is sold over the counter)
Entrez-PubMed
Abstract on Melatonin containing Contaminants (abstract)
Mayo has reported the case of a woman in Canada who got EMS or an EMS-like disorder
from mixing 5-HTP powder for her children. I talked to her and am convinced she has
EMS. There are articles on this on the Internet. When I find them, I will post them.
Update: June 2006 - I have added a link which mention the Canadian woman.
See "Safety of 5-HTP..." below.
I believe that Dr. Sternberg of NIH reported as early as 1980 that experiments with
a certain type of rat showed scarring similar to scleroderma after ingestion of 5-HTP.
This happens in some with EMS, also. In the spring of 1989, Dr. Silver of MUSC called
Dr. Sternberg about two patients who'd developed a similar syndrome of scarring from
using L-tryptophan. Tryptophan and 5-HTP are chemically related, of course. When
I find the sources for these, I will post them here
Update: June 2006
- I have added a link that gets into some of the above matters about Drs. Sternberg,
Silver, scleroderma-like disease in spring of 1989 in several patients using L-Tryptophan
(patients of Dr.Silver). See "Biomedical Researcher" below.