Time to Address Emerging Infections and Environmental Toxins: Let the CDC and EPA Do Their Job!
By Dr. Richard Horowitz
Unpopular elements of Obamacare have Republicans calling for a repeal and replacement of health care law. Does our health care system need fixing? Yes. National Census Bureau figures reveal that 19% of Americans are disabled, and chronic diseases are responsible for 70% of deaths each year. Treating people with chronic diseases accounts for 86% of our nation’s health care costs, and despite these staggering figures, many chronic diseases are on the rise. The prevalence of autism in the United States has gone from 1/150 cases in 2000 to 1 in 68 in 2012. Every 67 seconds someone is diagnosed with Alzheimer’s disease in the US. Autoimmune diseases like rheumatoid arthritis affect over 50 million Americans. Chronic Fatigue Syndrome (CFS/ME/S.E.I.D.) and Fibromyalgia (FM) together affect 5% of the US population. Per the CDC, infectious diseases like Lyme disease have increased 10-fold since in 2013, with close to 400,000 individuals affected every year, and the number of counties has increased by 320% over the past two decades. Apart from causing suffering and chronic disability, what do these diseases have in common? Our medical system claims it has no answers. It often treats end stage manifestations of these illnesses with drugs, which can be expensive and ineffective, without identifying preventable and treatable causes. This aspect of the health care system is broken, costing taxpayers billions of dollars every year. Is there a solution?
I am a physician for more than three decades, and I have treated over 12,000 Lyme patients who have failed the traditional health care model. Many of these individuals go to 10-20 physicians before getting a diagnosis, and oftentimes are diagnosed with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, Fibromyalgia, an autoimmune illness like rheumatoid arthritis or MS, or early dementia. Lyme is known as the great imitator, and mimics these different illnesses. In searching for answers for these patients, I have identified up to 16 reasons why they remain chronically ill. I call this syndrome “Multiple Systemic Infectious Disease Syndrome” (MSIDS). The first point on the MSIDS map is infections. Ticks are now containing multiple infections which can be transmitted simultaneously with Borrelia burgdorferi, the agent of Lyme disease. Patients infected with Lyme disease and associated co-infections are much sicker and resistant to standard therapies. Patients with Lyme-MSIDS also have evidence of associated immune dysfunction, inflammation, environmental toxins and detoxification problems. These factors can keep the patient chronically ill, yet they are not regularly accounted for in our health care model. Some of these infections are also now in the blood supply, and these infections and toxins can be transmitted from mother to fetus adversely affecting the future generations of America. President Trump recently put a gag order on the Environmental Protection Agency, and is looking to deregulate environmental controls, which would lead to an increase in pollution. What will be the consequences for health care in this country?
The CDC has identified cancer, cardiovascular and respiratory diseases as being some of the top leading causes of death in the US. These diseases as well as many others, have been shown to have a direct link to environmental pollutants. We are constantly being exposed to hundreds of environmental toxins every day. These include PCB's, PBDE's (flame retardants), dioxins, plastics (like BPA), phthalates, pesticides, and heavy metals. Scientific studies have shown that heavy metals like arsenic, found in apple juice and rice, can cause cardiovascular disease and cancer. Cadmium found in common foods (milk, leafy green vegetables) has been linked to breast and prostate cancer, and increased cardiovascular mortality. Aluminum, which is now added to many things we eat, drink, inject or absorb, has been associated with Alzheimer’s disease. Mercury and small particle pollution has been linked to autoimmune diseases like lupus and rheumatoid arthritis. In addition, dozens of studies have linked BPA (which mimics estrogen) with prostate cancer, infertility, asthma, heart disease, autoimmune disease and several neurodevelopmental disorders, and pesticides have been linked to Parkinson’s disease, ALS and Alzheimer’s. As per recent studies done at Harvard, the higher your environmental exposure to multiple chemicals, the greater the risk your child will be born with autism spectrum disorder.
Emerging scientific research has demonstrated that multiple factors on the 16 point MSIDS model, especially chronic infections and environmental toxins, increase inflammation contributing to the rise in many chronic illnesses. In fact, inflammation has been identified as a common denominator underlying most chronic disease. There is a commonly held belief in medicine, called Pasteur’s postulate that there is “one cause for one illness”, yet scientific advances have disproven this ancient medical paradigm. We must include Lyme and emerging infectious diseases, as well as environmental toxins, into the health care equation to ensure a balanced and comprehensive approach. We also need to address medical ethics and medical politics. Universal health care is insufficient if insurers choose among different published clinical guidelines to deny care, as is often the case in those with chronic Lyme disease. Published scientific studies have shown that testing for Lyme is inadequate and that the bacteria can persist, yet medical politics at the CDC have them taking sides in a medical debate, ignoring cutting edge research from medical institutions like Johns Hopkins University and UC California Davis. This has allowed insurance companies to follow their lead, choosing restrictive guidelines and denying care in those with emerging illnesses where two standards of care exist. Although ethically wrong, there is oftentimes no recourse for patients or physicians.
The EPA and CDC must do their jobs. We need to change the current diagnostic paradigm and politics of how health care is practiced in this country and devote more money to research to solve the challenges of Lyme and other chronic diseases in the 21st century. Improved prevention and “personalized medicine” which uses a multifactorial model to address underlying etiologies causing chronic disease must be part of the paradigm shift needed in medicine if we are to effectively address disability from emerging illnesses with rising health care costs. Let’s make America healthy again.
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Copyright © 2017 by Richard I. Horowitz
Richard I. Horowitz is a board-certified MD specializing in Internal Medicine. He and his wife, Lee, founded the Hudson Valley Healing Arts Center in Hyde Park, New York, which has treated over 12,000 patients for tick-borne diseases over the past twenty-six years. Dr. Horowitz is known for his pioneering work with Lyme disease and is recognized to be one of the country’s foremost experts on chronic illness.