Gulf War Illness: Difference between revisions

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[[File:Operation Desert Storm.png|400px|thumb|right|Map of ground operations of Operation Desert Storm starting invasion February 24-28th 1991. Shows allied and Iraqi forces. Special arrows indicate the American 101st Airborne division moved by air and where the French 6th light division and American 3rd Armored Cavalry Regiment provided security]]
[[File:Operation Desert Storm.png|400px|thumb|right|Map of ground operations of Operation Desert Storm starting invasion February 24-28th 1991. Shows allied and Iraqi forces. Special arrows indicate the American 101st Airborne division moved by air and where the French 6th light division and American 3rd Armored Cavalry Regiment provided security]]
'''Gulf War Illness''' (GWI), also known as '''Gulf War Syndrome''' (GWS), is a term used for unexplained illnesses occurring in veterans of the 1991 [[wikipedia:Gulf_War|Gulf War]] in Southwest Asia. According to the [[Institute of Medicine]] in 2013, about one-third of US Gulf War veterans (250,000 of 700,000 personnel) suffer from “chronic multi-symptom illness (CMI): a series of symptoms that cannot be medically explained.”<ref>{{Cite web|url=http://www.hopkinsmedicine.org/healthlibrary/conditions/environmental_medicine/gulf_war_syndrome_85,P00487/|title=Gulf War Syndrome - Johns Hopkins Medicine Health Library|website=www.hopkinsmedicine.org|language=en|access-date=2018-08-24}}</ref><ref name=":7">{{Cite web|url=http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12835|title=Gulf War Service Linked to Post-Traumatic Stress Disorder, Multisymptom Illness, Other Health Problems, But Causes Are Unclear|last=Stencel|first=Christine|date=Apr 9, 2010|website=|publisher=The National Academies of Science Engineering Medicine|language=en|archive-url=|archive-date=Apr 9, 2010|dead-url=|access-date=2018-08-26}}</ref> ''Science News'' summary of June 29, 2016, states: "Veterans of the Gulf War are more than twice as likely to have medically unexplained symptoms known as "multisymptom illness" (MSI), compared to Iraq/Afghanistan War veterans, according to an updated research."<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2016/06/160629130628.htm|title=Gulf War veterans still have high rate of multisymptom illness|last=|first=|date=Jun 29, 2016|work=ScienceDaily|access-date=2018-08-24|archive-url=|archive-date=|dead-url=|publisher=Journal of Occupational and Environmental Medicine|language=en}}</ref>   
'''Gulf War Illness''' (GWI), also known as '''Gulf War Syndrome''' (GWS), is a term used for unexplained illnesses occurring in veterans of the 1991 Gulf War in Southwest Asia. According to the [[Institute of Medicine]] in 2013, about one-third of US Gulf War veterans (250,000 of 700,000 personnel) suffer from “chronic multi-symptom illness (CMI): a series of symptoms that cannot be medically explained.”<ref>{{Cite web | url=http://www.hopkinsmedicine.org/healthlibrary/conditions/environmental_medicine/gulf_war_syndrome_85,P00487/ | title = Gulf War Syndrome | website = Johns Hopkins Medicine Health Library|language=en|access-date=2018-08-24}}</ref><ref name=":7">{{Cite web | url=http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12835 | title = Gulf War Service Linked to Post-Traumatic Stress Disorder, Multisymptom Illness, Other Health Problems, But Causes Are Unclear | last = Stencel | first = Christine | date = Apr 9, 2010 | website = | publisher = The National Academies of Science Engineering Medicine|language=en|archive-url=|archive-date=Apr 9, 2010|access-date=2018-08-26}}</ref> ''Science News'' summary of June 29, 2016, states: "Veterans of the Gulf War are more than twice as likely to have medically unexplained symptoms known as "multisymptom illness" (MSI), compared to Iraq/Afghanistan War veterans, according to an updated research."<ref name="Porter2016">https://journals.lww.com/joem/Abstract/2016/07000/Multisymptom_Illness_in_Gulf_War_Veterans__A.3.aspx</ref>
 
A May 2022 study by Robert W Haley et al.<ref name="Haley2022"/> have concluded that "exposure to sarin gas that occurred after coalition airplanes blew up chemical storage tanks" was the cause, and that genetic differences in the [[Paraoxonase 1|PON1]] gene resulted in different risk levels to GWI.<ref>{{Cite web | url=https://www.healthrising.org/blog/2022/05/21/gulf-war-illness-breakthrough-chronic-fatigue-fibromyalgia-long-covid/ | title = The Gulf War Illness Breakthrough and why it Matters to ME/CFS/FM and long COVID | last = Johnson | first =Cort | date = 2022-05-21 | website = Health Rising|language=en-US|access-date=2022-06-09}}</ref><ref name="Haley2022"/> The PON1 gene determines the genetic risk of susceptibility to [[organophosphate]] cholinesterase-inhibiting chemicals including nerve agents such as sarin.<ref name="Haley2022"/>   


== Symptoms ==
== Symptoms ==
The [https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs US Department of Veterans Affairs] has a list on [http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp Gulf War Veterans’ Medically Unexplained Illnesses].<ref name=":1" />
The U.S. Department of Veterans Affairs has a list on Gulf War Veterans' Medically Unexplained Illnesses.<ref name="VA-MUS" />
*[[ME/CFS|Myalgic Encephalomyelitis/Chronic fatigue syndrome]] ([[ME/CFS]]) with long-term severe [[fatigue]].
*[[ME/CFS|Myalgic Encephalomyelitis/Chronic fatigue syndrome]] ([[ME/CFS]]) with long-term severe [[fatigue]].
*[[Fibromyalgia]] characterized by widespread [[muscle pain]] and may include [[insomnia]], morning stiffness, [[headache]], and [[memory problems]].<ref name=":1">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp|title=Gulf War Veterans’ Medically Unexplained Illnesses - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>
*[[Fibromyalgia]] characterized by chronic widespread [[myalgia|muscle pain]] and may include [[insomnia]], morning stiffness, [[headache]], and [[memory problems]].<ref name="VA-MUS">{{Cite web | url=https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp | title = Gulf War Veterans' Medically Unexplained Illnesses - Public Health | last = | first = |website=U.S. Department of Veterans Affairs, Veterans Health Administration|language=en|access-date=2018-08-24}}</ref>


=== Functional gastrointestinal disorders ===
=== Functional gastrointestinal disorders ===
A group of conditions marked by chronic or recurrent symptoms related to any part of the [[Gastrointestinal system|gastrointestinal tract]]. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.
A group of conditions marked by chronic or recurrent symptoms related to any part of the [[Gastrointestinal system|gastrointestinal tract]]. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.
*functional [[abdominal pain]] syndrome
*functional [[abdominal pain]] syndrome
*functional dyspepsia (indigestion)
*functional [[dyspepsia]] (indigestion)
*[[irritable bowel syndrome]]<ref name=":1" />
*[[irritable bowel syndrome]]<ref name="VA-MUS" /><ref name="VA-MUS"/>


=== Undiagnosed illnesses ===
=== Undiagnosed illnesses ===
These symptoms may be connected to undiagnosed illnesses.
These symptoms may be connected to undiagnosed illnesses.
*abnormal [[Weight loss|weight loss]]
*abnormal [[weight loss]]
*[[cardiovascular]] disease
*[[cardiovascular]] disease
*fatigue
*[[fatigue]]
*headache
*[[headache]]
*[[joint pain]]
*[[joint pain]]
*[[menstrual]] disorders
*[[menstrual disorder]]s
*muscle and [[joint pain]]
*[[Myalgia|muscle pain]]
*[[Nervous system|neurological]] and psychological problems
*[[Nervous system|neurological]] and [[mental health|psychological problems]]
*respiratory disorders
*respiratory disorders
*skin conditions
*skin conditions
*[[sleep dysfunction]]<ref name=":1" />
*[[sleep dysfunction]]<ref name="VA-MUS" />


=== Other symptoms ===
=== Other symptoms ===
* [[dizziness]]
* [[dizziness]]
 
* [[memory problems]]<ref name="VA-MUS" />
* memory problems<ref name=":1" />
 
== Cause of illness ==
Causation include [[Vaccine|vaccination]]s; oil well fires; chemical and biological weapons; depleted uranium; noise; [https://www.publichealth.va.gov/exposures/carc-paint/index.asp CARC paint] used on military vehicles; occupational hazards; [[Mestinon|pyridostigmine]] bromide; pesticides or other [[Organophosphate|organophosphates]]; sand, dust, and particulates; toxic embedded fragments; infectious diseases; heat injuries; fuel; decontamination solutions; and the antibiotic ciprofloxacin.<ref name=":8" /><ref>{{Cite web|url=http://www.ei-resource.org/illness-information/environmental-illnesses/gulf-war-syndrome/|title=Gulf War Syndrome - Overview, Symptoms & Possible Causes|last=Hogg|first=Matthew|date=Jun 8, 2017|website=www.ei-resource.org|language=en-gb|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref><ref name=":2" />


=== Multisystem condition ===
=== Multisystem condition ===
In 2003, ''New Scientist''<nowiki/>'s March 29th print edition reported on Dr. [https://profiles.utsouthwestern.edu/profile/12888/robert-haley.html Robert Haley] and his team identifying three distinct syndromes in Gulf war veterans that involved [[brain]] damage.  
In March 2003, New Scientist magazine's print edition reported on Dr. Robert Haley and his team identifying three distinct syndromes in Gulf war veterans that involved [[brain]] damage.  
* ''Syndrome 1'': Symptoms are [[Cognitive impairment|impaired cognition]], distractions, and [[insomnia]] from the exposure of pesticide with [[basal ganglia]] damage.  
* ''Syndrome 1'': Symptoms are [[Cognitive impairment|impaired cognition]], distractions, and [[insomnia]] from the exposure of pesticide with [[basal ganglia]] damage.  


* ''Syndrome 2'': The symptoms are [[confusion]], disorientation, [[ataxia]], and [[vertigo]] due to exposure to sarin and pyridostigmine with damage to the [[brainstem]] and basal ganglia.  
* ''Syndrome 2'': The symptoms are [[confusion]], disorientation, [[ataxia]], and [[vertigo]] due to exposure to sarin and pyridostigmine with damage to the [[brainstem]] and basal ganglia.  


* ''Syndrome 3'': Symptoms are [[pain]], tingling, and [[numbness]] from exposure to [[wikipedia:DEET|DEET]] and pyridostigmine with damage to the brainstem.<ref name=":2">{{Cite news|url=https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/|title=US in U-turn over Gulf war syndrome|last=MacKenzie|first=Deborah|date=Nov 3, 2004|work=New Scientist|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
* ''Syndrome 3'': Symptoms are [[pain]], [[paresthesia|tingling]], and [[numbness]] from exposure to DEET and [[Mestinon|pyridostigmine]] with damage to the brainstem.<ref name="NS2018">{{Cite news | url=https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ | title = US in U-turn over Gulf war syndrome | last = MacKenzie | first = Deborah | date = Nov 3, 2004|work=New Scientist|access-date=2018-08-26|archive-url=|archive-date=|language=en-US}}</ref>
175,000 of 700,000 US Gulf War personnel are affected by the brain damage syndromes categorized by Dr. Haley and 75,000 are ill due to other exposures; in total 250,000 are chronically ill with GWI. <ref name=":9">{{Cite web|url=https://youtu.be/OYKMMbPp_Do?t=546|title=Dr. Robert Haley, What Caused Gulf War Illness|last=Haley|first=Robert|date=May 6, 2013|website=YouTube|publisher=David Spencer|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2" /><ref name=":8">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/sources/index.asp|title=Gulf War Exposures - Public Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-26}}</ref>
175,000 of 700,000 US Gulf War personnel are affected by the brain damage syndromes categorized by Dr. Haley and 75,000 are ill due to other exposures; in total 250,000 are chronically ill with GWI.<ref name=":9">{{Cite web | url=https://youtu.be/OYKMMbPp_Do?t=546 | title = Dr. Robert Haley, What Caused Gulf War Illness | last = Haley | first = Robert | date = May 6, 2013 | website = YouTube| publisher = David Spencer|archive-url=|archive-date=|access-date=}}</ref><ref name="NS2018" /><ref name="VA-GWI">{{Cite web | url=https://www.publichealth.va.gov/exposures/gulfwar/sources/index.asp | title = Gulf War Exposures|website=U.S. Department of Veterans Affairs, Veterans Health Administration|language=en|access-date=2018-08-26}}</ref>
=== Research conclusions ===
 
The ''Conclusions and Recommendations'' of the [https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013]<ref name=":0">{{Cite web|url=https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf|title=Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013: Updated Scientific Findings and Recommendations|last=|first=|date=May 2014|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|page=60|archive-url=|archive-date=|dead-url=|access-date=}}</ref> conclude "exposure to pesticides and pyridostigmine bromide are causally associated with Gulf War illness" as well as other hazardous exposures including gas agents sarin/cyclosarin. "Mixed exposures include not only mixtures of chemicals but also chemicals combined with heat, dehydration, infection and other environmental stressors."<ref name=":0" />
== Cause of illness ==
Causation include [[Vaccine|vaccination]]s; oil well fires; chemical and biological weapons; depleted uranium; noise; CARC [https://www.hillandponton.com/toxic-exposure/ paint used on military vehicles]; occupational hazards; [[Mestinon|pyridostigmine bromide]]; [[pesticide]]s or other [[organophosphate]]s; sand, dust, and particulates; toxic embedded fragments; infectious diseases; heat injuries; fuel; decontamination solutions; and the fluoroquinolone antibiotic [[ciprofloxacin]].<ref name="MilitaryTimes2013">{{Cite web | url=https://www.militarytimes.com/2013/11/01/new-fda-warnings-on-cipro-may-tie-into-gulf-war-illness/ | title = New FDA warnings on Cipro may tie into Gulf War illness | date = 2017-08-08 | website = Military Times|language=en-US|access-date=2020-09-13}}</ref><ref name="VA-GWI" /><ref name="Hogg2017">{{Cite web | url=http://www.ei-resource.org/illness-information/environmental-illnesses/gulf-war-syndrome/ | title = Gulf War Syndrome - Overview, Symptoms & Possible Causes | last = Hogg | first = Matthew | date = Jun 8, 2017 | website = EI Resource|language=en-gb|archive-url=|archive-date=|access-date=2018-08-26}}</ref><ref name="NS2018" />
 
=== Toxins ===
The conclusions and recommendations of the ''Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013'' report<ref name="RACReport2014">{{Cite web | url=https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf | title=Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013: Updated Scientific Findings and Recommendations | last = ((Research Advisory Committee on Gulf War Veterans' Illnesses)) | first = | date = May 2014|location=Washington,D.C.| publisher = U.S. Government Printing Office | page = 60|archive-url=|archive-date=|access-date=}}</ref> conclude "exposure to pesticides and pyridostigmine bromide are causally associated with Gulf War illness" as well as other hazardous exposures including gas agents sarin/cyclosarin. "Mixed exposures include not only mixtures of chemicals but also chemicals combined with heat, dehydration, infection and other environmental stressors."<ref name="RACReport2014" />
 
A May 2022 study by Robert W Haley et al.<ref name="Haley2022" /> - "have concluded that "exposure to [[sarin]] gas that occurred after coalition airplanes blew up chemical storage tanks" was the cause of Gulf War Illness.<ref>{{Cite web | url=https://www.healthrising.org/blog/2022/05/21/gulf-war-illness-breakthrough-chronic-fatigue-fibromyalgia-long-covid/ | title = The Gulf War Illness Breakthrough and why it Matters to ME/CFS/FM and long COVID | last = Johnson | first =Cort | date = 2022-05-21 | website = Health Rising|language=en-US|access-date=2022-06-09}}</ref>


=== Vaccinations ===
=== Vaccinations ===
Mass vaccinations "against infectious diseases including medical counter-measures against biological weapons" were given prior to military deployment.<ref name="Peakman, 2006">{{Citation|last1=Peakman|first1=Mark|authorlink1=|last2=Skowera|first2=Ania| authorlink2=|last3= Hotopf|first3=Matthew|authorlink3=Matthew Hotopf|title= Immunological dysfunction, vaccination and Gulf War illness|journal=Philosophical Transactions of the Royal Society B: Biological Sciences|volume=361|issue=1468|page= 681–687|date=2006|doi=10.1098/rstb.2006.1826}}</ref> Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal|last=Bernton|first=E.|last2=Hoover|first2=D.|last3=Galloway|first3=R.|last4=Popp|first4=K.|date=1995-12-29|title=Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal|last=Ramírez|first=F.|last2=Fowell|first2=D.J.|last3=Puklavec|first3=M.|last4=Simmonds|first4=S.|last5=Mason|first5=D.|date=1996-04-01|title=Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref>
Mass vaccinations "against infectious diseases including medical counter-measures against biological weapons" were given prior to military deployment.<ref name="Peakman, 2006">{{Citation | last1 = Peakman | first1 = Mark | authorlink = | last2 = Skowera | first2 = Ania| authorlink2= | last3 = Hotopf | first3 = Matthew | authorlink3 = Matthew Hotopf | title = Immunological dysfunction, vaccination and Gulf War illness|journal=Philosophical Transactions of the Royal Society B: Biological Sciences|volume=361|issue=1468 | page = 681–687 | date = 2006 | doi=10.1098/rstb.2006.1826}}</ref> Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref name="Bernton1995">{{Cite journal | last = Bernton | first = E. | last2 = Hoover | first2 =D. | last3 = Galloway | first3 = R. | last4 = Popp | first4 = K. | date = 1995-12-29 | title = Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function | url =http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774 | pages = 217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal | last = Ramírez | first = F. | last2 = Fowell | first2 =D.J. | last3 = Puklavec | first3 = M. | last4 = Simmonds | first4 = S. | last5 = Mason | first5 =D. | date = 1996-04-01 | title = Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro| url = http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology|volume=156|issue=7 | pages = 2406–2412|issn=0022-1767|pmid=8786298}}</ref>


== Notable studies ==
== Comorbidities ==
* Sep, 2017, Role of [[mitochondrial DNA]] damage and dysfunction in veterans with Gulf War Illness<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf|title=Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness|last=Falvo|first=Michael|last2=Meyer|first2=Joel|date=Sep 2017|website=ncbi.nlm.nih.gov|type=PDF|archive-url=|archive-date=|dead-url=|access-date=|last3=Hill|first3=Helene Z.|last4=Lange|first4=Gudrun|last5=Condon|first5=Michael|last6=Klein|first6=Jacquelyn C.|last7=Ndirangu|first7=Duncan|last8=Falvo|first8=Michael J.}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf (Full Text)]
Gulf War Illness increases the risk of developing other medical conditions. The U.S. Department of Veteran's Affairs found that "1990-1991 Gulf War deployment is associated with an increased risk for [[ME/CFS]], [[fibromyalgia]], skin conditions, and dyspepsia."<ref name="VA-website">{{Cite web | url=https://www.publichealth.va.gov/exposures/gulfwar/chronic-fatigue-syndrome.asp | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Gulf War Veterans - Public Health | last = | first = |website=U.S. Department of Veterans Affairs, Veterans Health Administration|language=en|access-date=2018-08-24}}</ref>
** [https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite Researchers find evidence of DNA damage in Vets with Gulf War illness]<ref>{{Cite web|url=https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite|title=Researchers find evidence of DNA damage in Vets with Gulf War illness|last=Richman|first=Mike|date=Oct 19, 2017|website=www.research.va.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Nov, 2018, The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild [[Traumatic Brain Injury]]<ref>{{Cite journal|last=Janulewicz|first=Patricia|last2=Krengel|first2=Maxine|last3=Quinn|first3=Emily|last4=Heeren|first4=Timothy|last5=Toomey|first5=Rosemary|last6=Killiany|first6=Ronald|last7=Zundel|first7=Clara|last8=Ajama|first8=Joy|last9=O’Callaghan|first9=James|date=Nov 2018|title=The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury|url=https://www.mdpi.com/2076-3425/8/11/198|journal=Brain Sciences|language=en|volume=8|issue=11|pages=198|doi=10.3390/brainsci8110198|pmc=|pmid=|quote=|author-link=|author-link2=|access-date=|author-link3=|author-link4=|author-link5=|author-link6=|via=}}</ref> - [https://www.mdpi.com/2076-3425/8/11/198/htm (Full Text)]
* Dec, 2018, Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network<ref>{{Cite journal|last=|first=|author-link=Glenn Wylie|author-link2=Helen Genova|author-link3=Ekaterina Dobryakova|author-link4=John DeLuca|author-link5=Nancy Chiaravalloti|author-link6=Michael Falvo|author-link7=Dane Cook|date=2018-12-11|title=Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network|url=https://www.sciencedirect.com/science/article/pii/S2213158218303899|journal=NeuroImage: Clinical|language=en|volume=|issue=|pages=101641|doi=10.1016/j.nicl.2018.101641|issn=2213-1582|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S2213158218303899#%21 (Full Text)]
* Feb 21, 2019, [[Gastrointestinal system|Gastrointestinal]] [[Neuroimmune disease|neuroimmune]] disruption in a mouse model of Gulf War illness<ref>{{Cite journal|last=Hernandez|first=Siomara|last2=Fried|first2=David E.|last3=Grubišić|first3=Vladimir|last4=McClain|first4=Jonathon L.|last5=Gulbransen|first5=Brian D.|date=2019-02-21|title=Gastrointestinal neuroimmune disruption in a mouse model of Gulf War illness|url=https://www.fasebj.org/doi/10.1096/fj.201802572R|journal=The FASEB Journal|pages=fj.201802572R|doi=10.1096/fj.201802572R|issn=0892-6638}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463928/ (Full text)]
** [https://www.sciencedaily.com/releases/2019/02/190221141506.htm GI neuroimmune disruption contributes to Gulf War Illness]<ref name=":11">{{Cite web|url=https://www.sciencedaily.com/releases/2019/02/190221141506.htm|title=GI neuroimmune disruption contributes to Gulf War Illness: Mouse model points to gastrointestinal neuroimmune disruption as contributing mechanism of Gulf War Illness|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=ScienceDaily.com|publisher=|language=en|via=Science Daily for Federation of American Societies for Experimental Biology|archive-url=|archive-date=|dead-url=|access-date=2019-02-22}}</ref> <blockquote>Many Persian Gulf War veterans experience Gulf War Illness (GWI), a chronic condition with symptoms ranging from gastrointestinal to neurological. While exposure to the anti-nerve gas pyridostigmine bromide (PB) is linked to the development of GWI, the exact cause and mechanisms of the illness remain unclear. Recently, an animal study tested the hypothesis that exposure to PB contributes to the development of GWI by disrupting the neural and immune systems of the intestine.<ref name=":11" /></blockquote>
*May 2, 2020, In-vivo imaging of neuroinflammation in veterans with Gulf War illness<ref name="Loggia2020">{{Cite journal|last=Alshelh|first=Zeynab|author-link=|last2=Albrecht|first2=Daniel S.|author-link2=|last3=Bergan|first3=Courtney|author-link3=|last4=Akeju|first4=Oluwaseun|author-link4=|last5=Clauw|first5=Daniel J.|author-link5=Daniel Clauw|last6=Conboy|first6=Lisa|author-link6=|last7=Edwards|first7=Robert R.|last8=Kim|first8=Minhae|last9=Lee|first9=Yvonne C.|displayauthors=8|date=2020-02-04|title=In-vivo imaging of neuroinflammation in veterans with Gulf War illness|url=http://www.sciencedirect.com/science/article/pii/S0889159119313340|journal=Brain, Behavior, and Immunity|language=en|volume=|issue=|pages=|doi=10.1016/j.bbi.2020.01.020|issn=0889-1591|pmc=|pmid=|access-date=|quote=|via=|last10=Protsenko|first10=Ekaterina|last11=Napadow|first11=Vitaly|last12=Sullivan|first12=Kimberly|author-link12=Kimberly Sullivan|author-link13=Marco Loggia|last13=Loggia|first13=Marco F.}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0889159119313340 (Full text)]
*August 10, 2020, Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Washington2020">{{Cite journal|last=Washington|first=Stuart D.|author-link=|last2=Rayhan|first2=Rakib U.|author-link2=Rakib Rayhan|last3=Garner|first3=Richard|author-link3=|last4=Provenzano|first4=Destie|author-link4=|last5=Zajur|first5=Kristina|author-link5=|last6=Addiego|first6=Florencia Martinez|author-link6=|last7=VanMeter|first7=John W.|last8=Baraniuk|first8=James N.|author-link8=James Baraniuk|date=2020-07-01|title=Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074|journal=Brain Communications|language=en|volume=2|issue=2|pages=|doi=10.1093/braincomms/fcaa070|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074 (Full text)]


== Risk of developing other conditions ==
==Potential treatments ==
The US Department of Veteran's Affairs found that "1990-1991 Gulf War deployment is associated with an increased risk for ME/CFS, fibromyalgia, skin conditions, and dyspepsia."<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/chronic-fatigue-syndrome.asp|title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>  
[[Vagus nerve stimulation]] has been identified as a possible treatment for GWI.<ref name="Natelson2021"/>


== Controversy ==
== Controversy ==


=== US Department of Veterans Affairs' cover-up of GWI ===
=== U.S. Department of Veterans Affairs' cover-up of GWI ===
* Aug 28, 1997, [http://gulfwarvets.com/arison/gws.htm The Cover-up of Gulf War Syndrome -- A Question of Natinal Integrity]<ref>{{Cite web|url=http://gulfwarvets.com/arison/gws.htm|title=The Cover-Up of Gulf War Syndrome -- A Question of National Integrity|last=Harrison III|first=H. Lindsey|date=Aug 28, 1997|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Aug 28, 1997, [http://gulfwarvets.com/arison/gws.htm The Cover-up of Gulf War Syndrome -- A Question of Natinal Integrity]<ref>{{Cite web | url=http://gulfwarvets.com/arison/gws.htm | title = The Cover-Up of Gulf War Syndrome -- A Question of National Integrity | last = Harrison III | first = H. Lindsey | date = Aug 28, 1997 | website = gulfwarvets.com|archive-url=|archive-date=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [http://gulfwarvets.com/va_cover_up_data.htm Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome]<ref>{{Cite web|url=http://gulfwarvets.com/va_cover_up_data.htm|title=Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome|last=Reno|first=Jamie|date=Mar 13, 2013|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [http://gulfwarvets.com/va_cover_up_data.htm Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome]<ref>{{Cite web | url=http://gulfwarvets.com/va_cover_up_data.htm | title = Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome | last = Reno | first = Jamie | date = Mar 13, 2013 | website = gulfwarvets.com|archive-url=|archive-date=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ Researcher says officials covered up vets' health data]<ref name=":6">{{Cite news|url=https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/|title=Researcher says officials covered up vets' health data|last=Kennedy|first=Kelly|date=Mar 13, 2013|work=USA TODAY|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
* Mar 13, 2013, [https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ Researcher says officials covered up vets' health data]<ref name="USAT-2013">{{Cite news | url=https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ | title = Researcher says officials covered up vets' health data | last = Kennedy | first = Kelly | date = Mar 13, 2013|work=USA TODAY|access-date=2018-08-26|archive-url=|archive-date=|language=en}}</ref> - USA Today
<blockquote>WASHINGTON — [[wikipedia:United_States_Department_of_Veterans_Affairs|Department of Veterans Affairs]] officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.</blockquote><blockquote>"If the studies produce results that do not support the office of public health's unwritten policy, they do not release them," said [[wikipedia:Steven_S._Coughlin|Steven Coughlin]], a former epidemiologist in the VA's public health department.</blockquote><blockquote>"This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War," Coughlin said. "On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible."<ref name=":6" /></blockquote>
<blockquote>WASHINGTON — [[U.S. Department of Veterans Affairs]] officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.</blockquote><blockquote>"If the studies produce results that do not support the office of public health's unwritten policy, they do not release them," said [[Steven Coughlin]], a former epidemiologist in the VA's public health department.</blockquote><blockquote>"This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War," Coughlin said. "On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible."<ref name="USAT-2013" /></blockquote>
* Apr 12, 2013, [https://www.youtube.com/watch?v=OYKMMbPp_Do&feature=youtu.be&t=546 Dr. Robert Haley, What Caused Gulf War Illness]<ref name=":9" /> (Video) Dr.  Haley speaks about the United States Department of Veterans Affairs' cover-up of US Gulf War troop illness being due to environmental exposure.  
* Apr 12, 2013, [https://www.youtube.com/watch?v=OYKMMbPp_Do&feature=youtu.be&t=546 Dr. Robert Haley, What Caused Gulf War Illness]<ref name=":9" /> (Video) Dr.  Haley speaks about the United States Department of Veterans Affairs' cover-up of US Gulf War troop illness being due to environmental exposure.  


* Mar 14, 2014, [https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb Congress Confronts VA Over Gulf War Illness Research]<ref>{{Cite news|url=https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb|title=Congress Confronts VA Over Gulf War Illness Research|last=Ruiz|first=Rebecca|date=Mar 24, 2014|work=Forbes|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
* Mar 14, 2014, [https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb Congress Confronts VA Over Gulf War Illness Research]<ref>{{Cite news | url=https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb | title = Congress Confronts VA Over Gulf War Illness Research | last = Ruiz | first = Rebecca | date = Mar 24, 2014|work=Forbes|access-date=2018-08-26|archive-url=|archive-date=|language=en}}</ref>
* Mar 30, 2015, [https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/ Former VA Chief Of Staff Linked To Gulf War Scandal]<ref>{{Cite news|url=https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/|title=Former VA Chief Of Staff Linked To Gulf War Scandal|last=Krause|first=Benjamin|date=2015-03-30|work=DisabledVeterans.Org|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
* Mar 30, 2015, [https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/ Former VA Chief Of Staff Linked To Gulf War Scandal]<ref>{{Cite news | url=https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/ | title = Former VA Chief Of Staff Linked To Gulf War Scandal | last = Krause | first = Benjamin | date = 2015-03-30|work=DisabledVeterans.Org|access-date=2018-08-26|archive-url=|archive-date=|language=en-US}}</ref>


===Simon Wessely's past stress related beliefs in GWI ===
===Simon Wessely's past stress related beliefs in GWI ===
Professor [[Simon Wessely]], psychiatric paradigm researcher of [[chronic fatigue syndrome]], believed that [[stress]] was the common denominator of GWI.
Professor [[Simon Wessely]], psychiatric paradigm researcher of [[chronic fatigue syndrome]], believed that [[stress]] was the common denominator of GWI.
* 2004, Interview with ''New Scientist'', [https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ US in U-turn over Gulf war syndrome]<ref name=":2" />
* 2004, Interview with ''New Scientist'', [https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ US in U-turn over Gulf war syndrome]<ref name="NS2018" />
<blockquote>Wessely told ''New Scientist'': “There is not one single cause for the ill health,” adding that he believes we may never fully know what happened to the people who became ill.</blockquote><blockquote>Wessely asked both Gulf and non-Gulf veterans about 50 standard symptoms. “Gulf veterans reported every symptom twice as often,” he told the Lloyd inquiry. If there were a unique Gulf syndrome, some would be relatively more frequent in the Gulf group. “But they are just experiencing more ill health. There is no unique syndrome here.”</blockquote><blockquote>Wessely favours psychological explanations for Gulf war illnesses. The only thing that could have affected so many different people, he says, was stress, especially anxiety about chemical weapons, misinformation about Gulf war syndrome afterwards, and the many vaccinations Gulf troops received. His team found the more vaccine Gulf, but not non-Gulf veterans, received the more likely they are to be ill.</blockquote><blockquote>Haley says the questions in Wessely’s study were too vague to distinguish between a real syndrome and people who have, say, occasional dizziness or joint pain. He says this will confound efforts to uncover a meaningful pattern behind the veterans’ symptoms.<ref name=":2" /></blockquote>
<blockquote>Wessely told ''New Scientist'': “There is not one single cause for the ill health,” adding that he believes we may never fully know what happened to the people who became ill.</blockquote><blockquote>Wessely asked both Gulf and non-Gulf veterans about 50 standard symptoms. “Gulf veterans reported every symptom twice as often,” he told the Lloyd inquiry. If there were a unique Gulf syndrome, some would be relatively more frequent in the Gulf group. “But they are just experiencing more ill health. There is no unique syndrome here.”</blockquote><blockquote>Wessely favours psychological explanations for Gulf war illnesses. The only thing that could have affected so many different people, he says, was stress, especially anxiety about chemical weapons, misinformation about Gulf war syndrome afterwards, and the many vaccinations Gulf troops received. His team found the more vaccine Gulf, but not non-Gulf veterans, received the more likely they are to be ill.</blockquote><blockquote>Haley says the questions in Wessely’s study were too vague to distinguish between a real syndrome and people who have, say, occasional dizziness or joint pain. He says this will confound efforts to uncover a meaningful pattern behind the veterans’ symptoms.<ref name="NS2018" /></blockquote>
* 2006, A study published in [[The Lancet|''The Lancet'']] that Wessely was involved with, [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study]<ref name=":3">{{Cite journal|last=Hotopf|first=Matthew|last2=Hull|first2=Lisa|last3=Fear|first3=NicolaT|last4=Browne|first4=Tess|last5=Horn|first5=Oded|last6=Iversen|first6=Amy|last7=Jones|first7=Margaret|last8=Murphy|first8=Dominic|last9=Bland|first9=Duncan|date=2006|others=Earnshaw, Mark; Greenberg, Neil; Hacker Hughes, Jamie; Tate, Rosemary; Dandeker, Christopher; Rona, Robert; Wessely, Simon|title=The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext|journal=The Lancet|language=English|volume=367|issue=9524|pages=1731–1741|doi=10.1016/S0140-6736(06)68662-5|issn=0140-6736|via=}}</ref> interpretation:  
* 2006, A study published in [[The Lancet|''The Lancet'']] that Wessely was involved with, ''The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study''<ref name="Hotopf2006">{{Cite journal | last = Hotopf | first = Matthew | authorlink = Matthew Hotopf | last2 = Hull | first2 = Lisa | last3 = Fear | first3 = Nicola T | last4 = Browne | first4 = Tess | last5 = Horn | first5 = Oded | last6 = Iversen | first6 = Amy | last7 = Jones | first7 = Margaret | last8 = Murphy | first8 = Dominic | last9 = Bland | first9 = Duncan | date = 2006 | others=Earnshaw, Mark; Greenberg, Neil; Hacker Hughes, Jamie; Tate, Rosemary; Dandeker, Christopher; Rona, Robert; Wessely, Simon | title = The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study| url = https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext|journal=The Lancet|language=English|volume=367|issue=9524 | pages = 1731–1741|doi=10.1016/S0140-6736(06)68662-5|issn=0140-6736|via=}}</ref> interpretation:  
<blockquote>For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.<ref name=":3" /></blockquote>
<blockquote>For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.<ref name="Hotopf2006" /></blockquote>
* 2006, [http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome]<ref name=":10">{{Cite web|url=http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of|title=Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome|website=www.gresham.ac.uk|access-date=2018-08-29}}</ref>
* 2006, [http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome]<ref name=":10">{{Cite web | url=http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of | title = Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome|website=Gresham College|access-date=2018-08-29}}</ref>
<blockquote>So my story then: something old, we have seen some of these before; something new, there was a definite hazard with some of the precautions that were taken to protect Gulf veterans; something borrowed, soldiers can also be civilians and the things that concern us also can concern them; something blue, the psychiatry of Gulf War is the psychiatry more of [[depression]] than it is of [[Post-traumatic stress disorder|PTSD]].<ref name=":10" /></blockquote>
<blockquote>So my story then: something old, we have seen some of these before; something new, there was a definite hazard with some of the precautions that were taken to protect Gulf veterans; something borrowed, soldiers can also be civilians and the things that concern us also can concern them; something blue, the psychiatry of Gulf War is the psychiatry more of [[depression]] than it is of [[Post-traumatic stress disorder|PTSD]].<ref name=":10" /></blockquote>
* 2010, A second study [https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study]<ref name=":4">{{Cite web|url=https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf|title=What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces?: A cohort study|last=Fear|first=Nicola T|last2=Jones|first2=Margaret|date=2010|website=kcl.ac.uk|others=Jones, Norman; Greenberg, Neil; Landau, Sabine; Dandeker, Christopher; Rona, Roberta J; Hotopf, Mathew; Wessely, Simon|archive-url=|archive-date=|dead-url=|access-date=|last3=Murphy|first3=Dominic|last4=Hull|first4=Lisa|last5=Civerson|first5=Amy|last6=Coker|first6=Bolaji|last7=Machell|first7=Louise|last8=Sundin|first8=Josefin|last9=Woodhead|first9=Charlotte|type=PDF}}</ref> interpretation:  
* 2010, A second study [https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study]<ref name="Fear2010">{{Cite web | url=https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf | title=What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces?: A cohort study | last = Fear | first = Nicola T | last2 = Jones | first2 = Margaret | date = 2010 | website = kcl.ac.uk|others=Jones, Norman; Greenberg, Neil; Landau, Sabine; Dandeker, Christopher; Rona, Roberta J; Hotopf, Mathew; Wessely, Simon|archive-url=|archive-date=|access-date= | last3 = Murphy | first3 = Dominic | last4 = Hull | first4 = Lisa | last5 = Civerson | first5 = Amy | last6 = Coker | first6 = Bolaji | last7 = Machell | first7 = Louise | last8 = Sundin | first8 = Josefin | last9 = Woodhead | first9 = Charlotte|type=PDF}}</ref> interpretation:  
<blockquote>Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable [[post-traumatic stress disorder]] was low. These findings show the importance of continued health surveillance of UK military personnel.<ref name=":4" /></blockquote>
<blockquote>Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable [[post-traumatic stress disorder]] was low. These findings show the importance of continued health surveillance of UK military personnel.<ref name="Fear2010" /></blockquote>
* 2011, A ''BBC'' report [https://www.bbc.com/news/uk-12195884 Two decades on, battle goes on over 'Gulf War Syndrome']<ref name=":5">{{Cite news|url=https://www.bbc.com/news/uk-12195884|title=Battle continues over Gulf War Syndrome|last=Hughes|first=Caroline Hawley and Stuart|date=2011|work=BBC News|access-date=2018-08-26|language=en-GB}}</ref>
* 2011, [https://www.bbc.com/news/uk-12195884 Two decades on, battle goes on over 'Gulf War Syndrome']<ref name="BBC-1">{{Cite news | url=https://www.bbc.com/news/uk-12195884 | title = Battle continues over Gulf War Syndrome | last = Hughes | first = Caroline Hawley and Stuart | date = 2011|work=BBC News|access-date=2018-08-26|language=en-GB}}</ref> - BBC News
<blockquote>Professor [[Simon Wessely]] is director of the King's Centre for Military Health Research in London and an adviser to the Ministry of Defence. He does not believe Gulf War Syndrome exists as a distinct illness.</blockquote><blockquote>Even so, he has no doubt that a significant number of Gulf veterans became ill as a direct result of their military service.</blockquote><blockquote>"The evidence is incontrovertible that there is a Gulf War health effect," he says.</blockquote><blockquote>"Something to do with the Gulf has affected health and no-one serious has ever disputed that.</blockquote><blockquote>"Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest."</blockquote><blockquote>The Ministry of Defence echoes Professor Wessely's view.<ref name=":5" /></blockquote>
<blockquote>Professor [[Simon Wessely]] is director of the King's Centre for Military Health Research in London and an adviser to the Ministry of Defence. He does not believe Gulf War Syndrome exists as a distinct illness.</blockquote><blockquote>Even so, he has no doubt that a significant number of Gulf veterans became ill as a direct result of their military service.</blockquote><blockquote>"The evidence is incontrovertible that there is a Gulf War health effect," he says.</blockquote><blockquote>"Something to do with the Gulf has affected health and no-one serious has ever disputed that.</blockquote><blockquote>"Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest."</blockquote><blockquote>The Ministry of Defence echoes Professor Wessely's view.<ref name="BBC-1" /></blockquote>
 
==News articles and interviews ==
*2022, [https://www.military.com/daily-news/2022/05/17/researchers-think-theyve-found-cause-of-gulf-war-illness.html Researchers Think They've Found the Cause of Gulf War Illness] - Military.com
* 2013, [https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ Researcher says officials covered up vets' health data] - USA Today
*2011, [https://www.bbc.com/news/uk-12195884 Two decades on, battle goes on over 'Gulf War Syndrome'] - BBC News
* 2004, [https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ US in U-turn over Gulf war syndrome] - New Scientist
 
== Notable studies ==
*2015, [[Cytokine]] expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis<ref name="GWME2015">{{Cite journal | title = Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis | date = 2015-03-01| url = https://www.sciencedirect.com/science/article/pii/S1043466614006024|journal=Cytokine|volume=72|issue=1 | pages = 1–8 | last = Khaiboullina | first = Svetlana F. | authorlink = | last2 = DeMeirleir | first2 = Kenny L. | authorlink2 = Kenny De Meirleir | last3 = Rawat | first3 = Shanti | authorlink3 = | last4 = Berk | first4 = Grady S. | authorlink4 = | last5 = Gaynor-Berk | first5 = Rory S. | authorlink5 = | last6 = Mijatovic | first6 = Tatjana | authorlink6 = | last7 = Blatt | first7 = Natalia | last8 = Rizvanov | first8 = Albert A. | last9 = Young | first9 = Sheila G. | last10 = Lombardi | first10 = Vincent C. | authorlink10 = Vincent Lombardi|language=en|doi=10.1016/j.cyto.2014.11.019|pmc=PMC4410698|pmid=|access-date=|issn=1043-4666|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410698/ (Full text)]
* 2017, Role of [[mitochondrial DNA]] damage and dysfunction in veterans with Gulf War Illness<ref name="Falvo2017">{{Cite journal | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026 | title = Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness | last = Falvo | first = Michael | last2 = Meyer | first2 = Joel | date = 2017 | journal=PLoS One. |volume=12|issue=9| pages = e0184832|doi=10.1371/journal.pone.0184832|pmid=
28910366|pmc=PMC5599026 | last3 = Hill | first3 = Helene Z. | last4 = Lange | first4 = Gudrun | authorlink4 = Gudrun Lange | last5 = Condon | first5 = Michael | last6 = Klein | first6 = Jacquelyn C. | last7 = Ndirangu | first7 = Duncan | last8 = Falvo | first8 = Michael J.}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf (Full Text)]
** [https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm Researchers find evidence of DNA damage in Vets with Gulf War illness]<ref name="DNA2017">{{Cite web | url=https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm | title = Researchers find evidence of DNA damage in Vets with Gulf War illness | last = Richman | first = Mike | date = Oct 19, 2017 | website = U.S. Department of Veterans Affairs|language=en|archive-url=|archive-date=|access-date=2018-08-26}}</ref>
* 2018, The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury<ref>{{Cite journal | last = Janulewicz | first = Patricia | last2 = Krengel | first2 = Maxine | last3 = Quinn | first3 = Emily | last4 = Heeren | first4 = Timothy | last5 = Toomey | first5 = Rosemary | last6 = Killiany | first6 = Ronald | last7 = Zundel | first7 = Clara | last8 = Ajama | first8 = Joy | last9 = O'Callaghan | first9 = James | date = Nov 2018 | title = The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury| url = https://www.mdpi.com/2076-3425/8/11/198|journal=Brain Sciences|language=en|volume=8|issue=11 | pages = 198|doi=10.3390/brainsci8110198|pmc=|pmid=|quote=|access-date=|via=}}</ref> - [https://www.mdpi.com/2076-3425/8/11/198/htm (Full Text)]
* 2018, Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network<ref name="Wylie2018">{{Cite journal | last = Wylie | first = Glenn | authorlink = | last2 = Genova | first2 = Helen | authorlink2 = | last3 = Dobryakova | first3 = Ekaterina | authorlink3 = | last4 = DeLuca | first4 = John | authorlink4 = | last5 = Chiaravalloti | first5 = Nancy | authorlink5 = | last6 = Falvo | first6 = Michael | authorlink6 = | last7 = Cook | first7 = Dane | authorlink7 = Dane Cook | date = 2018-12-11 | title = Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network | url =https://www.sciencedirect.com/science/article/pii/S2213158218303899|journal=NeuroImage: Clinical|language=en|volume=|issue= | pages = 101641|doi=10.1016/j.nicl.2018.101641|issn=2213-1582|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S2213158218303899#%21 (Full Text)]
*2018, Gulf War agents [[Mestinon|pyridostigmine bromide]] and [[permethrin]] cause hypersensitive nociception that is restored after [[vagus nerve stimulation]]<ref name="Nizamutdinov2018">{{Cite book | title = Pyridostigmine Bromide|trans-title=|chapter= | date = 2000| publisher = National Academies Press (US)|location=|isbn=|edition=|volume=|language=en | url =https://www.ncbi.nlm.nih.gov/books/NBK222848/|chapter-url= | pages = |editor-last = |editor-first = |editor1-link=|editor-last2 = |editor-first2 = |editor2-link= | last = Institute of Medicine (US) Committee on Health Effects Associated with Exposures During the Gulf War | first = | authorlink = | last2 = Fulco | first2 = Carolyn E. | authorlink2 = | last3 = Liverman | first3 = Catharyn T. | authorlink3 = | last4 = Sox | first4 = Harold C. | authorlink4 = |others=|quote=}}</ref> - [https://pubmed.ncbi.nlm.nih.gov/30273628/ (Full text)]
* 2019, [[Gastrointestinal system|Gastrointestinal]] [[Neuroimmune disease|neuroimmune]] disruption in a mouse model of Gulf War illness<ref name="Hernandez2019">{{Cite journal | last = Hernandez | first = Siomara | last2 = Fried | first2 = David E. | last3 = Grubišić | first3 = Vladimir | last4 = McClain | first4 = Jonathon L. | last5 = Gulbransen | first5 = BrianD. | date = 2019-02-21 | title = Gastrointestinal neuroimmune disruption in a mouse model of Gulf War illness| url = https://www.fasebj.org/doi/10.1096/fj.201802572R|journal=The FASEB Journal|volume=33|issue=5 | pages = 6168-6184|doi=10.1096/fj.201802572R|issn=0892-6638}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463928/ (Full text)]
** [https://www.sciencedaily.com/releases/2019/02/190221141506.htm GI neuroimmune disruption contributes to Gulf War Illness] <blockquote>Many Persian Gulf War veterans experience Gulf War Illness (GWI), a chronic condition with symptoms ranging from gastrointestinal to neurological. While exposure to the anti-nerve gas pyridostigmine bromide (PB) is linked to the development of GWI, the exact cause and mechanisms of the illness remain unclear. Recently, an animal study tested the hypothesis that exposure to PB contributes to the development of GWI by disrupting the neural and immune systems of the intestine.<ref name=":11">{{Cite web | url=https://www.sciencedaily.com/releases/2019/02/190221141506.htm | title = GI neuroimmune disruption contributes to Gulf War Illness: Mouse model points to gastrointestinal neuroimmune disruption as contributing mechanism of Gulf War Illness | last = | first = | authorlink = |language=en|via=Science Daily for Federation of American Societies for Experimental Biology|archive-url=|archive-date=|access-date=2019-02-22}}</ref></blockquote>
*2020, In-vivo imaging of neuroinflammation in veterans with Gulf War illness<ref name="Loggia2020">{{Cite journal | last = Alshelh | first = Zeynab | authorlink = | last2 = Albrecht | first2 = Daniel S. | authorlink2 = | last3 = Bergan | first3 = Courtney | authorlink3 = | last4 = Akeju | first4 = Oluwaseun | authorlink4 = | last5 = Clauw | first5 = Daniel J. | authorlink5 = Daniel Clauw | last6 = Conboy | first6 = Lisa | authorlink6 = | last7 = Edwards | first7 = Robert R. | last8 = Kim | first8 = Minhae | last9 = Lee | first9 = Yvonne C. | date = 2020-02-04 | title = In-vivo imaging of neuroinflammation in veterans with Gulf War illness| url = http://www.sciencedirect.com/science/article/pii/S0889159119313340|journal=Brain, Behavior, and Immunity|language=en|volume=|issue= | pages = |doi=10.1016/j.bbi.2020.01.020|issn=0889-1591|pmc=|pmid=|access-date=|quote=|via= | last10 = Protsenko | first10 = Ekaterina | last11 = Napadow | first11 = Vitaly | last12 = Sullivan | first12 = Kimberly | authorlink12 = Kimberly Sullivan | author-link13 = Marco Loggia | last13 = Loggia | first13 = Marco F.}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0889159119313340 (Full text)]
 
*2020, Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Washington2020">{{Cite journal | last = Washington | first = StuartD. | authorlink = | last2 = Rayhan | first2 = Rakib U. | authorlink2 = Rakib Rayhan | last3 = Garner | first3 = Richard | authorlink3 = | last4 = Provenzano | first4 = Destie | authorlink4 = | last5 = Zajur | first5 = Kristina | authorlink5 = | last6 = Addiego | first6 = Florencia Martinez | authorlink6 = | last7 = VanMeter | first7 = John W. | last8 = Baraniuk | first8 = James N. | author-link8 = James Baraniuk | date = 2020-07-01 | title = Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome| url = https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074|journal=Brain Communications|language=en|volume=2|issue=2 | pages = |doi=10.1093/braincomms/fcaa070|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074 (Full text)]
*2021, Exposure to Gulf War Illness-related agents leads to the development of chronic pain and fatigue<ref name="Nguyen2021">{{Cite journal | title = Exposure to Gulf War Illness-related agents leads to the development of chronic pain and fatigue | date = 2021-10-15| url = https://www.sciencedirect.com/science/article/pii/S0024320521008547|journal=Life Sciences|volume=283 | pages = 119867 | last = Nguyen | first = Huy | last2 = Sahbaie | first2 = Peyman | last3 = Goba | first3 = Lihle | last4 = Sul | first4 = Julian | last5 = Suzaki | first5 = Aoi | last6 = Clark | first6 = J. David | last7 = Huang | first7 = Ting-Ting|language=en|doi=10.1016/j.lfs.2021.119867|issn=0024-3205}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0024320521008547 (Full text)]
*2021, Vagal nerve stimulation as a possible non-invasive treatment for chronic widespread pain in Gulf Veterans with Gulf War Illness<ref name="Natelson2021">{{Cite journal | title = Vagal nerve stimulation as a possible non-invasive treatment for chronic widespread pain in Gulf Veterans with Gulf War Illness | date = 2021-10-01| url = https://www.sciencedirect.com/science/article/pii/S0024320521007918|journal=Life Sciences|volume=282|issue= | pages = 119805 | last = Natelson | first = Benjamin H. | authorlink = Benjamin Natelson | last2 = Stegner | first2 = Aaron J. | authorlink2 = | last3 = Lange | first3 = Gudrun | authorlink3 = Gudrun Lange | last4 = Khan | first4 = Sarah | authorlink4 = | last5 = Blate | first5 = Michelle | authorlink5 = | last6 = Sotolongo | first6 = Anays | authorlink6 = | last7 = DeLuca | first7 = Michelle | last8 = Van Doren | first8 = William W. | last9 = Helmer | first9 = Drew A.|language=en|doi=10.1016/j.lfs.2021.119805|pmc=|pmid=|access-date=|issn=0024-3205|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0024320521007918 (Full text)]
*2021, [[Mestinon|Pyridostigmine bromide]], chlorpyrifos, and DEET combined Gulf War exposure insult depresses mitochondrial function in neuroblastoma cells<ref name="Delic2021">{{Cite journal | title = Pyridostigmine bromide, chlorpyrifos, and DEET combined Gulf War exposure insult depresses mitochondrial function in neuroblastoma cells | date = Dec 2021| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678325/|journal=Journal of Biochemical and Molecular Toxicology|volume=35|issue=12 | pages = | last = Delic | first = Vedad | authorlink = | last2 = Karp | first2 = Joshua | authorlink2 = | last3 = Klein | first3 = Julian | authorlink3 = | last4 = Stalnaker | first4 = Katherine J. | authorlink4 = | last5 = Murray | first5 = Kathleen E. | authorlink5 = | last6 = Ratliff | first6 = Whitney A. | authorlink6 = | last7 = Myers | first7 = Catherine E. | last8 = Beck | first8 = KevinD. | last9 = Citron | first9 = Bruce A.|language=en|doi=10.1002/jbt.22913|pmc=PMC8678325|pmid=34528356|access-date=|issn=1095-6670|quote=|via=}}</ref> - [https://pubmed.ncbi.nlm.nih.gov/34358550/ (Full text)]
*2022, Evaluation of a Gene-Environment Interaction of PON1 and Low-Level Nerve Agent Exposure with Gulf War Illness: A Prevalence Case-Control Study Drawn from the U.S. Military Health Survey's National Population Sample<ref name="Haley2022">{{Cite journal | title = Evaluation of a Gene-Environment Interaction of PON1 and Low-Level Nerve Agent Exposure with Gulf War Illness: A Prevalence Case-Control Study Drawn from the U.S. Military Health Survey's National Population Sample | date = May 2022| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9093163/|journal=Environmental Health Perspectives|volume=130|issue=5 | pages = 57001 | last = Haley | first = Robert W. | last2 = Kramer | first2 = Gerald | last3 = Xiao | first3 = Junhui | last4 = Dever | first4 = Jill A. | last5 = Teiber | first5 = John F.|doi=10.1289/EHP9009|pmc=PMC9093163|pmid=35543525|issn=1552-9924|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9093163/ (Full Text)]
 
==See also==
==See also==
* [[Vagal nerve stimulation]]
* [[Organophosphate]]
* [[Mestinon]] (pyridostigmine bromide)
* [[Vaccine]]
* [[Vaccine]]


==Learn more==
==Learn more==
* 2004, ''Independent Public Inquiry on Gulf War Illnesses'' (The Lloyd Inquiry)  ([https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc Report Resume])<ref>{{Cite web|url=https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc|title=Independent Public Inquiry on Gulf War Illnesses REPORT RÉSUMÉ|date=2004-11-20|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|via=Wayback Machine|last2=Jones|first2=Norman|last3=Davies|first3=Michael|type=WORD}}</ref> - ([https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf Full Testimony])<ref>{{Cite web|url=https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf|title=Independent Public Inquiry on Gulf War Illnesses|date=2005-01-19|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|last2=Jones|first2=Norman|last3=Davies|first3=Michael|publisher=Way Back Machine|type=PDF}}</ref>
*2019, [https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/# Veterans Study Suggests Two Subtypes of Gulf War Illness] - Georgetown University Medical Center
 
*2019, [https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions]
* 2008, [https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations]<ref>{{Cite web|url=https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf|title=Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations|last=|first=|date=Nov 2008|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|type=Microsoft WORD|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*2016, [https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be Testing nine potential treatments for Gulf War Illness pain and fatigue] - [[Jarred Younger]]
* 2014, [http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/ Advisory Group: Exposures, Not Stress Caused Gulf War Illness]<ref>{{Cite news|url=http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/|title=Advisory Group: Exposures, Not Stress Caused Gulf War Illness - U.S. Medicine|last=usmedicine.com|date=2014-06-06|work=U.S. Medicine|access-date=2018-08-26|language=en-US}}</ref>
* 2015, [http://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf GULF WAR RESEARCH STRATEGIC PLAN 2013-2017]<ref>{{Cite web | url=https://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf | title=GULF WAR RESEARCH STRATEGIC PLAN 2013-2017 - 2015 Update | last = | first = | date = 2015 | website = U.S. Department of Veterans Affairs|archive-url=|archive-date=|url-status=|access-date=}}</ref>
* 2015, [http://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf GULF WAR RESEARCH STRATEGIC PLAN 2013-2017]<ref>{{Cite web|url=https://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf|title=GULF WAR RESEARCH STRATEGIC PLAN 2013-2017 - 2015 Update|last=|first=|date=2015|website=va.gov|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*2014, [https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013]
 
*2014, [http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/ Advisory Group: Exposures, Not Stress Caused Gulf War Illness] - U.S. Medicine
*2016, [https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be Testing nine potential treatments for Gulf War Illness pain and fatigue]<ref>{{Cite web|url=https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be|title=Testing nine potential treatments for Gulf War Illness pain and fatigue|last=Younger|first=Jared|date=Apr 13, 2016|website=YouTube|publisher=Younger Lab|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
* 2008, [https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations] - Research Advisory Committee on Gulf War Veterans' llnesses
*2019, [https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/# Veterans Study Suggests Two Subtypes of Gulf War Illness]<ref>{{Cite web|url=https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/|title=Veterans Study Suggests Two Subtypes of Gulf War Illness|date=2019-12-12|website=Georgetown University Medical Center|language=en-US|access-date=2019-12-13}}</ref>
* 2004, [https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc Independent Public Inquiry on Gulf War Illnesses] - The Lloyd Inquiry (Report Resume)
*2019, [https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions]<ref>{{Cite web|url=https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html|title=Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions|website=medicalxpress.com|language=en-us|access-date=2019-12-13}}</ref>
*[[wikipedia:Gulf_War_syndrome#CITEREFRAC-GWVI_Minutes2005|Wikipedia article on GWI]]


== References ==
== References ==

Latest revision as of 11:22, January 11, 2024

Map of ground operations of Operation Desert Storm starting invasion February 24-28th 1991. Shows allied and Iraqi forces. Special arrows indicate the American 101st Airborne division moved by air and where the French 6th light division and American 3rd Armored Cavalry Regiment provided security

Gulf War Illness (GWI), also known as Gulf War Syndrome (GWS), is a term used for unexplained illnesses occurring in veterans of the 1991 Gulf War in Southwest Asia. According to the Institute of Medicine in 2013, about one-third of US Gulf War veterans (250,000 of 700,000 personnel) suffer from “chronic multi-symptom illness (CMI): a series of symptoms that cannot be medically explained.”[1][2] Science News summary of June 29, 2016, states: "Veterans of the Gulf War are more than twice as likely to have medically unexplained symptoms known as "multisymptom illness" (MSI), compared to Iraq/Afghanistan War veterans, according to an updated research."[3]

A May 2022 study by Robert W Haley et al.[4] have concluded that "exposure to sarin gas that occurred after coalition airplanes blew up chemical storage tanks" was the cause, and that genetic differences in the PON1 gene resulted in different risk levels to GWI.[5][4] The PON1 gene determines the genetic risk of susceptibility to organophosphate cholinesterase-inhibiting chemicals including nerve agents such as sarin.[4]

Symptoms[edit | edit source]

The U.S. Department of Veterans Affairs has a list on Gulf War Veterans' Medically Unexplained Illnesses.[6]

Functional gastrointestinal disorders[edit | edit source]

A group of conditions marked by chronic or recurrent symptoms related to any part of the gastrointestinal tract. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.

Undiagnosed illnesses[edit | edit source]

These symptoms may be connected to undiagnosed illnesses.

Other symptoms[edit | edit source]

Multisystem condition[edit | edit source]

In March 2003, New Scientist magazine's print edition reported on Dr. Robert Haley and his team identifying three distinct syndromes in Gulf war veterans that involved brain damage.

  • Syndrome 2: The symptoms are confusion, disorientation, ataxia, and vertigo due to exposure to sarin and pyridostigmine with damage to the brainstem and basal ganglia.

175,000 of 700,000 US Gulf War personnel are affected by the brain damage syndromes categorized by Dr. Haley and 75,000 are ill due to other exposures; in total 250,000 are chronically ill with GWI.[8][7][9]

Cause of illness[edit | edit source]

Causation include vaccinations; oil well fires; chemical and biological weapons; depleted uranium; noise; CARC paint used on military vehicles; occupational hazards; pyridostigmine bromide; pesticides or other organophosphates; sand, dust, and particulates; toxic embedded fragments; infectious diseases; heat injuries; fuel; decontamination solutions; and the fluoroquinolone antibiotic ciprofloxacin.[10][9][11][7]

Toxins[edit | edit source]

The conclusions and recommendations of the Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013 report[12] conclude "exposure to pesticides and pyridostigmine bromide are causally associated with Gulf War illness" as well as other hazardous exposures including gas agents sarin/cyclosarin. "Mixed exposures include not only mixtures of chemicals but also chemicals combined with heat, dehydration, infection and other environmental stressors."[12]

A May 2022 study by Robert W Haley et al.[4] - "have concluded that "exposure to sarin gas that occurred after coalition airplanes blew up chemical storage tanks" was the cause of Gulf War Illness.[13]

Vaccinations[edit | edit source]

Mass vaccinations "against infectious diseases including medical counter-measures against biological weapons" were given prior to military deployment.[14] Vaccination in the presence of elevated cortisol levels can drive cytokine expression toward Th2 dominance.[15][16]

Comorbidities[edit | edit source]

Gulf War Illness increases the risk of developing other medical conditions. The U.S. Department of Veteran's Affairs found that "1990-1991 Gulf War deployment is associated with an increased risk for ME/CFS, fibromyalgia, skin conditions, and dyspepsia."[17]

Potential treatments[edit | edit source]

Vagus nerve stimulation has been identified as a possible treatment for GWI.[18]

Controversy[edit | edit source]

U.S. Department of Veterans Affairs' cover-up of GWI[edit | edit source]

WASHINGTON — U.S. Department of Veterans Affairs officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.

"If the studies produce results that do not support the office of public health's unwritten policy, they do not release them," said Steven Coughlin, a former epidemiologist in the VA's public health department.

"This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War," Coughlin said. "On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible."[21]

Simon Wessely's past stress related beliefs in GWI[edit | edit source]

Professor Simon Wessely, psychiatric paradigm researcher of chronic fatigue syndrome, believed that stress was the common denominator of GWI.

Wessely told New Scientist: “There is not one single cause for the ill health,” adding that he believes we may never fully know what happened to the people who became ill.

Wessely asked both Gulf and non-Gulf veterans about 50 standard symptoms. “Gulf veterans reported every symptom twice as often,” he told the Lloyd inquiry. If there were a unique Gulf syndrome, some would be relatively more frequent in the Gulf group. “But they are just experiencing more ill health. There is no unique syndrome here.”

Wessely favours psychological explanations for Gulf war illnesses. The only thing that could have affected so many different people, he says, was stress, especially anxiety about chemical weapons, misinformation about Gulf war syndrome afterwards, and the many vaccinations Gulf troops received. His team found the more vaccine Gulf, but not non-Gulf veterans, received the more likely they are to be ill.

Haley says the questions in Wessely’s study were too vague to distinguish between a real syndrome and people who have, say, occasional dizziness or joint pain. He says this will confound efforts to uncover a meaningful pattern behind the veterans’ symptoms.[7]

  • 2006, A study published in The Lancet that Wessely was involved with, The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study[24] interpretation:

For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.[24]

So my story then: something old, we have seen some of these before; something new, there was a definite hazard with some of the precautions that were taken to protect Gulf veterans; something borrowed, soldiers can also be civilians and the things that concern us also can concern them; something blue, the psychiatry of Gulf War is the psychiatry more of depression than it is of PTSD.[25]

Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable post-traumatic stress disorder was low. These findings show the importance of continued health surveillance of UK military personnel.[26]

Professor Simon Wessely is director of the King's Centre for Military Health Research in London and an adviser to the Ministry of Defence. He does not believe Gulf War Syndrome exists as a distinct illness.

Even so, he has no doubt that a significant number of Gulf veterans became ill as a direct result of their military service.

"The evidence is incontrovertible that there is a Gulf War health effect," he says.

"Something to do with the Gulf has affected health and no-one serious has ever disputed that.

"Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest."

The Ministry of Defence echoes Professor Wessely's view.[27]

News articles and interviews[edit | edit source]

Notable studies[edit | edit source]

  • 2020, Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome[37] - (Full text)
  • 2021, Exposure to Gulf War Illness-related agents leads to the development of chronic pain and fatigue[38] - (Full text)
  • 2021, Vagal nerve stimulation as a possible non-invasive treatment for chronic widespread pain in Gulf Veterans with Gulf War Illness[18] - (Full text)
  • 2021, Pyridostigmine bromide, chlorpyrifos, and DEET combined Gulf War exposure insult depresses mitochondrial function in neuroblastoma cells[39] - (Full text)
  • 2022, Evaluation of a Gene-Environment Interaction of PON1 and Low-Level Nerve Agent Exposure with Gulf War Illness: A Prevalence Case-Control Study Drawn from the U.S. Military Health Survey's National Population Sample[4] - (Full Text)

See also[edit | edit source]

Learn more[edit | edit source]

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  20. Reno, Jamie (March 13, 2013). "Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome". gulfwarvets.com. Retrieved August 26, 2018.
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  22. Ruiz, Rebecca (March 24, 2014). "Congress Confronts VA Over Gulf War Illness Research". Forbes. Retrieved August 26, 2018.
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  29. Falvo, Michael; Meyer, Joel; Hill, Helene Z.; Lange, Gudrun; Condon, Michael; Klein, Jacquelyn C.; Ndirangu, Duncan; Falvo, Michael J. (2017). "Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness". PLoS One. 12 (9): e0184832. doi:10.1371/journal.pone.0184832. PMC 5599026. PMID 28910366.
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