Treatment of Organophosphate Exposure

Editor:

In my experience, organophosphate exposure causes more than just the neurological problems associated with anticholinesterase activity. However, the medical literature, most of the time, concentrates on that aspect of the poisoning. Particularly in chronic poisoning, the chemical dissociates within the body, resulting in metabolites of the organic component (which appear to have slightly different properties from the original at first exposure), phosphorus (which is highly toxic and corrosive in its own right) and whatever the associated radical/chemical add-on which the manufacturers add (in the Gulf War, this appears to have been fluorine which is also toxic in its own right).* With each of these component parts, there are separate sets of sypmtoms, separate storage sites, separate means of elimination. When the chemicals are stored in the body, they can be mobilized back into the bloodstream (in greater concentrations than at the time of absorption) as a result of exercise, heat, emotional excitement/distress, infection, massage, exposure to nutrients via dermal route near the storage sites, or due to displacement by other chemicals/drugs to which the person is exposed. Any detox must therefore be carried out with considerable care and caution, to avoid overwhelming the body’s coping mechanisms because of overload by chemicals re-emerging into the bloodstream.

There is precious little about chronic phosphate poisoning in modern literature; however, older books do deal with phosphorus poisoning because it was common in people manufacturing matches at that time. Body fluids containing phosphorous (particularly feces, urine, and possibly semen) will burn. Phosphorus bind strongly to mucous membranes (the cause of diarrhea and watery eyes in GWI cases). The toxic effects of chemicals can be somewhat ameliorated by ingestion of liquid bentonite several times a day (not close to meals) – it binds to phosphorous and the organics, preventing some of the caustic effects, and helping prevent re-absorption back into the system through the intestinal wall. Both phosphorus and fluorine can be bound by calcium and magnesium. A combination of calcium citrate and magnesium oxide, in approximate physiological balance, plus potassium amino acid chelate, can be taken as needed throughout the day as symptoms are noted in the muscles, head, extremities.

Materials and dosages:

Calcium Citrate and Magnesium (Nature's Life, Garden Grove, CA 92841) containing Calcium (Citrate) 1000 mg, Magnesium (Oxide) 667 mg) 2 tablets with 1 capsule of Potassium 99 mg (Nature's Way Products, 10 Mountain Springs Parkway, Springville, Utah 84663) - 99 mg Potassium amino acid chelate

In addition, nutrients may be supplemented with a good multivitamin preparation (which must contain choline and inositol, and very low – or no – iron). The best one I have turned up is "Green Multi” from Nature’s Life, Garden Grove, California 92841. Because the organophosphates diminish absorption of nutrients while increasing the requirement for them, both this preparation, plus the calcium/magnesium and potassium mentioned above, can be dissolved in the mouth – absorbing through the mucous membranes of the mouth. Individual supplements can be taken as desired – such as vitamin E (an antioxidant), vitamin A (to help protect vision), copper (which phosphorus binds to), zinc (balances copper), and B complex (balanced – the only balanced formula I know of is "Balanced B-Complex Formula" from General Nutrition Corporation, Pittsburgh, Pennsylvania 15222). Vitamin C is also useful, although I don't recommend dissolving that in the mouth. The teeth (and bones) are under sufficient stress as it is – both from the corrosive effect of the phosphorus, and from the storage of fluoride which makes teeth and bones brittle. Dissolved Green Multi dissolves through the skin, too.

All fluorine exposure should be avoided – which may be difficult considering water supplies are being increasingly fluoridated. Fluoride absorbs through the skin as well as via mouth, making hot tubs and swimming pools places to add to the body's already excessive fluoride.

The old standby for restoring damaged myelin sheaths around nerves – lecithin – contains a whopping amount of phosphorus. However, some of it may have to be taken in order to restore neurological integrity or prevent further damage. Taking choline and inositol separately via supplement appears to dislodge stored chemicals from brain and other neurological tissue all at once, creating some rather bizarre and unsettling effects. (This info is based on a supplement containing 250 mg crystalline choline (from bitartrate) and 250 mg crystalline inositol (TwinLabs, Ronkonkoma, New York 11779). However, without choline and inositol in some form, dimness of vision cannot be prevented or reversed, nor can damaged brain cell coverings be mended.

During the process of detox and mending, the body's detox and eliminatory systems need to be supported. Milk thistle will help sustain and cleanse liver function; (Milk thistle's scientific name is Silybum marinarum.) Stellaria spp. (common chickweed) will help prevent kidney damage/stress. Dulcamara (sweet nightshade) is the best source of atropine that I know of – very little (about a dime-size piece) of a fresh leaf can stop anticholinesterase flare-up from re-mobilized chemicals within minutes. (Must be held in the mouth and gently chewed for some minutes before swallowing.) Leaves vary in potency – the more purple on a leaf, the stronger it is. Dulcamara does not keep its potency well when dried – it gradually loses it (with stems losing potency more slowly). Copious amounts of water (non-fluoride containing spring water preferably) should be consumed, and bathing should be done with organic non-phosphate soaps.

Diet should be heavy on green veggies and other veggies (grown free of pesticide if possible). Carbonated beverages which contain phosphoric acid (many of them do) are to be absolutely avoided – they can burn out the kidneys all by themselves – even in people who have no organophosphate exposure. Milk, unfortunately, contains a high amount of phosphorus in proportion to its calcium content. A nutritional table can be consulted to find foods high in potassium, calcium and/or magnesium, but low in phosphates. A healing salve can be applied externally over the kidney and liver area to speed healing – with a base of olive oil and a thickener of beeswax, the herbal ingredients are comfrey, plantain (Plantago lanceolata – lanceleaf plantain – a common garden weed) and ordinary cooking sage (Salvia officinalis).

It needs to be noted that clothing contaminated with organophosphates cannot be washed clean, and trying to wash it with other items of clothing results in the contamination of all of them. Storage in drawers and closets will also result in contamination not only of other clothing items in the same place, but also contaminate walls, floors of closets, and the wood in the chests of drawers. Contaminated walls can be washed down first with organic soap and then immediately with a slurry of lime. This does not eliminate the chemical from the walls entirely, but creates a film which can bind to at least some of the chemicals as they out-gas. It will have to be repeated. While performing such an operation, vigorous fresh-air ventilation is essential. Protective clothing and face covering (disposable) would be helpful. Even with these precautions, there is no guarantee that such cleaning won't expose the person doing the cleaning to enough chemicals to cause discomfort or a few days of symptoms.

After reading the article on the Gulf War vets by Gary Null in the October 1998 issue of Townsend Letter for Doctors and Patients I am wondering if part of the organophosphate exposure could have been via uniforms either sprayed to “de-bug” them or stored in a sprayed storage space. I get the impression that military personnel were not always knowledgeable about the properties and hazards of pesticides, and not routinely careful in their use. Clothing contaminated in such a way could well result in sickness and/or death over a period of time, to those wearing them.

Maria Abdin

P.O. Box 21521

Seattle, Washington 98111 USA

Messages: 206-860-8928

Sources

Phosphorus: Henniger, Gordon R., Chapter 4, Drug and Chemical Injury – Environmental Pathology, pp. 146-245 in Kissane, John M., ed., Anderson’s Pathology – 9th ed. (St. Louis, C.V. Mosby Co. 1990)

Merck Manual – 13th ed., p. 1977

McGuigan, Hugh Alister, Applied Pharmacology, pp. 743-746, (St. Louis, C.V. Mosby Co. 1940)

Fluorine: Smith, Frank A., Fluroide Toxicity, pp. 277-283 in Corn, Morton, editor, Handbook of Hazardous Materials (San Diego, Academic Press 1993)

Hennigar, Gordon R., Chapter 4, Drug and Chemical Injury – Environmental Pathology, pp. 146-245 in Kissane, John M., ed., Anderson’s Pathology – 9th ed. (St. Louis, C.V. Mosby Co. 1990)

Merck Manual – 13th ed., p. 1970

McGuigan, Hugh Alister, Applied Pharamcology (St. Louis, C.V. Mosby 1940), p. 184

Organophosphates: Hennigar, Chapter (same as above), p. 226

Berkow, Robert, ed., The Merck Manual of Diagnosis and Therapy – 13th ed. (Rahway, NJ, Merck, Sharp & Dohme Research Laboratories 1977), p. 1482.

Dreisbach, Robt. H. and Wm. O. Robertson, Handbook of Poisoning: Prevention, Diagnosis and Treatment (Appleton & Lange, Norwalk, CT 1987) pp. 110-118.