According to recent estimates, an estimated 125 million Americans have at least one chronic condition, with that number expected to rise to 157 million by 2020. Another 60 million Americans suffer from multiple chronic conditions. Sickness Syndrome depression is prevalent in individuals suffering from chronic conditions, particularly those that have an inflammatory component.

Unfortunately, while advances in medical science have yielded significant responses in treating or controlling acute conditions, there has not been a similar trend in managing chronic conditions. Nearly three-quarters of all Americans experiencing a chronic condition report difficulty in obtaining the needed care from a medical specialist — not surprising, given the complexity and multifaceted nature of these conditions.

Further complicating the issue is the role that environmental toxins play in initiating or exacerbating chronic conditions and inflammation in the brain. Research has demonstrated that toxins increase the extent of the severity of the symptoms by stimulating the inflammatory response-leading to Sickness Syndrome depression. Furthermore, these toxins (many of which are manmade) have at least an additive, and frequently a synergistic, effect on the magnitude and duration of the inflammatory response — the extent of which certainly warrants further research.

However, this does not imply that there is little that a patient can do. In many cases, the inflammatory response that aggravates chronic conditions and causes Sickness Syndrome depression can be minimized or controlled by first understanding how toxins affect the immune system and then initiating improvements to the internal and external environments to reduce the impact.

The extent of environmental toxins has increased exponentially since the 1930s, with the number of manmade chemicals estimated to now exceed over 160 billion kilograms per year. These chemicals then find their way from the ecosystem into our systems, as documented by two surveys: the National Human Adipose Tissue Survey (NHATS) conducted by the Environmental Protection Agency (EPA) and the FDA’s Total Diet Survey.

The goal of NHATS was to investigate the presence of xenoestrogens — synthetic substances whose unintended side-effect is an imitation or enhancement of the estrogen effect - in the environment and its direct effect on our bodies. During an eleven-year period (1976 to 1987), pathologists and medical examiners from 47 metropolitan statistical areas collected and chemically analyze a nationwide sample of adipose tissue specimens for the presence of these xenoestrogens.. The results were alarming — one hundred percent of the tissues analyzed had levels of organochlorine pesticides, PCBs, dioxins and furans, volatile organics, semivolatile organics, and trace elements, OCDD (a dioxin which is commonly present in dairy and meat products), styrene (a solvent), 1,4-dichlorobenzene, xylene, and ethylphenol. This clearly demonstrated that no one is immune from these toxins and their associated detrimental effects.

The FDA’s Total Diet Survey (an ongoing program also known as the Market Basket Study) revealed some equally disturbing statistics. The survey analyzed the levels of DDE inadvertently ingested and subsequently stored in adipose (fat) tissue for years following exposure. An analysis of DDE presence in foods commonly found in grocery stores ranged from 81% (in cheddar cheese, pork sausage, quarter-pounders, white sauce, and creamed spinach) and 87% (in lamb chops, salami, canned spinach, meatloaf and butter) to 93% (in American processed cheese, hamburger, hot-dogs, bologna, collards, chicken, turkey and ice cream sandwiches) and 100 % (in raisins, fresh and frozen spinach , beef and bean chili con carne, and beef).

Both studies illustrated the thin and obviously highly permeable “wall” that separates the human body from those specific toxins. And according to the National Research Council, there are other external contaminants as well that have documented immunotoxic (immune system malfunction) effects on the body. These include chemical classes (metals such as lead, methyl mercury, arsenic), polyhalogenated aromatic hydrocarbons, (e.g., PCBs, TCDD), pesticides (e.g., chlordane, carbofuran), aromatic hydrocarbons (e.g., benzene, toluene), drugs of abuse (cannabinoids, cocaine, opioids) and even therapeutic drugs (e.g., diphenylhydantoin, lithium) and natural products (e.g., antibiotics, plant alkaloids).

Exogenous (existing outside the body) toxins can also induce autoimmunity, whereby one’s own immune system attacks tissues or organs, leading to functional impairment and inflammation throughout the body. Examples of these toxin-induced autoimmune conditions include systemic lupus erythematosus, autoimmune hemolytic anemia, myasthenia gravis, pemphigus, glomerulonephritis, autoimmune thyroid disease, autoimmune hepatitis and scleroderma. Once these toxins enter the body, they prompt the release of proinflammatory cytokines which, for localized immune challenges brought about by toxins, leads to activation of peripheral nerves that signal the brain and ultimately an exaggerated pain response.

Other neurological responses to toxins, and specifically to environmental toxicants, are well documented. Neurotoxicity (an alteration of the normal activity of the nervous system) caused by environmental toxicants in this case refers to all external factors, beyond known chemicals that are present in contaminated air, water and soil. These include foods, radiation, pharmaceutical agents, occupational exposures, and lifestyle factors. Some of these toxicants include compounds such as cadmium, dyes, excitatory amino acids, formaldehyde, glycerol, organophosphates, pyrethroids, ricin, toluene, trichloroethylene and more.

An immune response can also be generated by an impaired intestinal tract. Responsible for 60% of the body’s immunity, a healthy intestinal system with an appropriate level of intestinal permeability is able to balance its absorptive ability with its exclusionary function. However, should this balance be disrupted, due to infections, ethanol, NSAIDS, low dietary fiber, cytotoxic drugs, and nutritional deficiencies of zinc, vitamin A and folate, proportionally more antigens enter the body. This can result in an immune response that has been correlated with numerous chronic disease conditions, among them malabsorption, enteritis, arthropathies, food allergies, migraine and autoimmune diseases.