Gulf War Syndrome: A Comprehensive GuideUpdated March 7, 2023 Veterans Disability
For over 30 years, medical researchers could not explain Gulf War syndrome despite thousands of United States veterans experiencing similar symptoms. As a result, experts in the field categorized it as an undiagnosed illness for a long time.
Fortunately, researchers from UT Southwestern Medical School tested the genes of those affected. The study's lead author, Dr. Haley explained the team's findings. Sarin — a human-made chemical — caused countless health problems for the Gulf War-era veterans, including headaches, joint pain, and chronic fatigue.
This article will discuss this condition in more detail. Read on to learn more about the illness itself and the healthcare benefits the Veterans Affairs (VA) office grants GW veterans.
What Is Gulf War Syndrome?
Also called Gulf War illness or GWI, Gulf War syndrome is a chronic multi-symptom illness discovered in Gulf War service veterans. It affects people who were in military service during the Persian Gulf War of 1991. While it's not fatal, patients suffering from the condition complain about its impact on their physical and mental health.
The Persian Gulf War veterans fought with Iraqi troops when the former bombed chemical weapons production and storage facilities. Unknown to the soldiers then, they were exposed to the chemical weapon sarin. Experts classify this human-made chemical as a nerve agent — the most toxic and rapidly acting warfare substance.
While the gulf veterans were in the battle for only 43 days, sarin's harmful effects lasted decades for some of them. They experienced many symptoms, including insomnia, dizziness, and memory lapses.
Dr. Haley and his team discovered that the gulf veterans with the least protective genotype and closest to the explosion were almost nine times more likely to develop symptoms.
In 2003, when the U.S.-led coalition ran Operation Iraqi Freedom, the veterans didn't realize they were again exposed to the toxic substance. Saddam Hussein and his troops targeted citizens with sarin to further spread its harmful effects.
To date, experts still do not have immediate answers to why some veterans develop particular symptoms, and others do not. However, they agree that gulf veterans and other specialists exposed to sarin should have access to quality care.
What Are the Symptoms of Gulf War Syndrome?
Patients suffering from Gulf War illness often complain of a cluster of various "undiagnosed illnesses." Below are some of the most common Gulf War syndrome symptoms:
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): People suffering from this complex and potentially disabling illness sometimes cannot perform their usual daily activities. In extreme cases, they experience overwhelming chronic fatigue that confines them to bed, the kind that doesn't get better with rest.
- Musculoskeletal pain: This symptom includes chronic pain that impacts bones, muscles, and at times, nerves. It's one of the cardinal signs that someone has experienced toxic exposure to sarin.
- Fibromyalgia: Gulf War deployment is associated with this condition. It's a chronic disorder that causes pain, body tenderness, fatigue, and insomnia. Individuals suffering from this disorder typically have a heightened pain sensitivity, although scientists cannot explain why.
- Cognitive issues: GWI veterans may experience problems like memory lapses, mood and sleep disturbances, and difficulty understanding their surroundings. They may even be at risk of brain cancer, Parkinson's disease, or multiple sclerosis.
- Respiratory disorders: Allergic rhinitis, chronic obstructive pulmonary disease (COPD), and asthma are other negative health effects associated with GWI. A study also shows its potential link to chronic bronchitis, chronic airway obstruction, and emphysema.
- Skin rashes: When specialists examined the Gulf War vets, some complained about come-and-go itching. Some of them even experienced occasional scaling, burning, or stinging.
- Intestinal hypermobility: This symptom surprised many specialists. They could not determine the cause behind the veterans' gastrointestinal symptoms, which included chronic abdominal pain, diarrhea, and indigestion.
- Sexual dysfunction: After their sarin exposure, servicemen and servicewomen alike reported experiencing this symptom. Some studies show that it's more prevalent in veterans with chronic fatigue.
- Fever and night sweats: Some veterans reported feeling too hot or too cold because of their illness. In some cases, their chills reached such extreme levels that they soaked their bed sheets in sweat.
- Lou Gehrig's disease: Also known as amyotrophic lateral sclerosis (ALS), this illness is a neurological disease that affects motor neurons. New research shows that Gulf War veterans are twice as likely to get this disease than people in the general population.
What Causes Gulf War Syndrome?
For medical practitioners, the cause of Gulf War syndrome is unclear. They cannot pinpoint one source of this condition. However, below are some possible factors that may have induced it.
The most common nerve agents are sarin, soman, tabun, and VX. These man-made compounds do not occur naturally. Instead, military stockpiles across several nations store them for warfare.
Exposure to nerve agent vapor may induce pain, eye burning, and difficulty breathing. In extreme cases, the symptoms can progress to sudden collapse, convulsions, and even death.
Despite the threats nerve agents pose to public health, many Gulf war veteran brigades inhaled sarin for prolonged periods. For this reason, some specialists believe the nerve agent is the root cause of the GWI outbreak in Persian Gulf war veterans.
During the Gulf War, specialists used pyridostigmine bromide as a pretreatment to protect veterans from the dangers of chemical warfare. Ultimately, the goal was to protect military personnel from death by nerve agents like sarin.
The Gulf War troops took one 30-mg tablet every eight hours during their mission. As the process was self-administered, research organizations could not support the association between pyridostigmine bromide and Gulf War syndrome.
However, these institutions are not disregarding the drug's potential role in causing Gulf War illness.
Burn Pit Exposure
Burn pits are massive land areas where military contractors incinerate waste items, including medical waste, human waste, plastics, and other materials. Troops use them much less now, but they were a standard part of waste disposal protocol during the Gulf War.
While the practice did help servicemembers dispose of large quantities of waste, it exposed them to plumes of toxic smoke. The fumes affected military camps and nearby communities because the wind carried the gas for miles.
Many veterans suffered health concerns because of these burn pits. Most of them complained of temporary ailments, but some studies link the exposure to GWI.
Infectious Diseases From Doubtful Water Sources
The scope of the deployment of U.S. troops during the Gulf War was massive. While the logisticians performed their tasks well, the desert environment made some problems inevitable. For instance, some teams had to use unauthorized water storage and distribution methods.
As the troops became more dependent on the host nation's supplies and equipment, their water sources became more vulnerable to potential sabotage tactics. However, there is no definitive evidence linking water sources to GWI.
GWI has affected many veterans of the Persian Gulf War, and most report co-occurring mental health disorders. For this reason, some experts think psychological factors play a crucial role in developing Gulf War syndrome, including post-traumatic stress disorder (PTSD), anxiety, and depression.
Despite years of research, specialists still have much to learn about GWI. However, recent data can back the idea that one of these factors or a combination causes the disorder.
How Common Is Gulf War Syndrome?
In the early 1990s, almost 700,000 men and women served in the Gulf War during Operation Desert Storm. From 2010 to 2011, over 50,000 servicemembers fought in Operation New Dawn. Unfortunately, these troops were exposed to sarin, one of the potential culprits behind GWI.
According to studies, GWI now affects 175,000 to 250,000 troops. However, the figures also show that the disorder affects veteran subgroups differently. For instance, U.S. Army and Marine Corps troops have a higher infection rate than their Navy and Air Force counterparts. Also, the servicemembers nearest to the combat zones have the highest positivity rates for the disease.
Is Gulf War Syndrome Recognized as a Medical Condition?
Technically speaking, Gulf War syndrome is not a medical condition. After all, specialists cannot identify its presence through any diagnostic test. However, the veterans who suffer from it experience real illnesses that the medical field could not previously explain. Therefore, think of it as a collection of conditions visible in Gulf War vets.
Initially, experts labeled it a similar disorder to other functional somatic syndromes, like chronic fatigue syndrome and fibromyalgia. The symptoms, which represent responses to particular stressors, were almost identical. However, many veterans likely with Gulf War syndrome also suffered from other definable conditions, including gastrointestinal disorders and undiagnosed illnesses like weight loss, joint pain, and sleep disturbances.
Who Is Most Likely To Develop Gulf War Syndrome?
As the name suggests, Gulf War syndrome affects vets from the Gulf War of 1990 to 1991. While the name remains, specialists later discovered that veteran groups from other operations exposed to nerve agents also showed similar symptoms.
Experts were at a loss about the syndrome for decades, but recent findings suggest there's a genetic factor to it. After years of research, a team of UT Southwestern specialists found that veterans with a weak PON1 gene were nine times more likely to show GWI signs.
PON1 or Paraoxonase 1 is a protein gene associated with conditions like ALS, diabetes, and fatty acid metabolism. Typically, it should protect people from low-level nerve gas, but the weak type is less effective than the strong one.
What Treatments Are Available for Gulf War Syndrome?
Because of the wide range of symptoms associated with Gulf War syndrome, there's no one-size-fits-all plan for treating affected individuals. However, below are some of the solutions specialists recommend.
Cognitive-behavioral therapy (CBT) is a psycho-social treatment that works wonders for several health problems, including severe mental illness, anxiety, and bipolar disorder. In addition, various studies suggest its effectiveness in improving an individual's quality of life.
Sleep disturbance is one of the most common symptoms of GWI. This condition impacts pain, fatigue, and cognition factors.
There's a treatment for sleeplessness called CBT-I or cognitive behavioral therapy for insomnia. As it's an effective solution for sleep disturbance, specialists recommend it for veterans with GWI.
Regular exercise is one of the most important things individuals can do for their health. However, it's not only beneficial for a person's physical wellness. It's also essential in boosting one's mental health.
Physical activity releases endorphins — feel-good brain chemicals that act as natural pain and stress relievers. For this reason, it can help veterans suffering from PTSD, anxiety, and depression.
Antidepressants can address several Gulf War syndrome symptoms, including depression, fibromyalgia, irritable bowel syndrome (IBS), panic disorder, and PTSD. Depending on the case, specialists may recommend tricyclic antidepressants like amitriptyline, amoxapine, and desipramine for GWI patients.
Commonly known as steroids, corticosteroids are anti-inflammatory drugs that suppress the immune system. Some experts believe chronic inflammation is the culprit behind GWI and its many underlying indicators. So if the symptoms fit, they may recommend corticosteroids to affected veterans.
Oral Nicotinamide Adenine Dinucleotide
Oral nicotinamide adenine dinucleotide (NADH), the body's active vitamin B3 coenzyme, plays a crucial role in producing energy. In addition, it helps improve mental clarity, memory, and concentration. It's also effective against chronic fatigue syndrome.
As these symptoms are often present in GWI, medical practitioners can prescribe the drug for veterans who need it.
What Role Does the U.S. Department of Veterans Affairs Play in Gulf War Syndrome?
The U.S. Department of Veterans Affairs (VA) is an executive-level government branch that provides life-long health, education, disability, funerary, and financial services to eligible military veterans. Its mission is "to care for him who shall have borne the battle, and for his widow, and his orphan" by honoring the men and women who have fought and continue fighting for the country's freedom.
Today, the VA acknowledges that there are potentially hundreds of thousands of veterans affected by Gulf War syndrome. These vets may be eligible for various services, including healthcare, rehabilitation, and disability benefits. Plus, they can request a Gulf War Registry health exam and the Airborne Hazards and Open Burn Pit Registry.
Also, their dependents and survivors may be entitled to specific benefits.
The VA "presumes" some illnesses to be related to a veteran's military service across Southwest Asia, including:
- Medically unexplained illnesses (also called Gulf War syndrome)
- Select infectious diseases
- ALS for vets with at least 90 days of continuous military service
Note that veterans can still speak with representatives regarding their VA benefits for "non-presumptive" diseases related to their Gulf War operations.
There are several ways to apply for VA survivor benefits for Gulf War vets, including eBenefits or visiting a regional office. However, if you have questions or concerns about these processes, you can visit Benefits.com — a free service designed to help vets get the benefits they deserve.
What Is the Impact of Gulf War Syndrome on Gulf War Veterans?
Iraq's invasion of Kuwait on August 2, 1990, triggered the beginning of the Gulf War of 1990 - 1991. During that time, Iraq's leader Saddam Hussein ordered the occupation of Kuwait to acquire the nation's oil reserves, cancel Iraq's debt, and expand the country's power. It was the first major international crisis after conflicts like World War I or World War II.
When the news of the invasion broke out, 39 nations came to Kuwait's aid, including the U.S., Britain, France, Saudi Arabia, and Egypt. In total, these nations sent 1,000,000 soldiers, 700,000 of whom were American troops.
The U.S. lost 148 troops in combat deaths during the operations and 145 more to disease or injury. While this number seems low, the survivors were exposed to several stressors, including the following:
- State-issues pyridostigmine bromide
- Nerve agents
- Oil fire smoke
- Petrochemicals and solvents
- Missile attacks
- Depleted uranium
- Extreme heat
Following the war, the troops resumed their daily activities. However, some of them started experiencing a wide range of symptoms, including cognitive problems, fatigue, muscle and joint pain, shortness of breath, and rashes.
There have been published stories about these symptoms, like those from Frontline.
For instance, in 1991, Brian Martin returned home to Michigan from Iraq. He reported experiencing debilitating fatigue, memory lapses, and mood swings. Doctors couldn't find an organic cause for his condition, so he couldn't work or get disability pay from the VA.
Similarly, another veteran in Illinois named Troy Albuck suffered from unexplained symptoms, including headaches, swollen joints, and bleeding gums.
The symptoms didn't only impact Americans. In Yorkshire, England, an English vet named Robert Lake went home plagued by extreme symptoms. He served as a radar technician in the war and experienced PTSD, violent mood swings, and nightmares. He spent two months in psychiatric hospitals and made two suicide attempts.
The Gulf War vets were only in combat for 43 days, but the harmful physical, emotional, and mental effects on some of them stretched for decades.
Specialists and the VA didn't recognize the extent of the vets' symptoms, but after a while, it became apparent that several exposures negatively impacted the troops' health.
Fortunately, today, the VA recognizes that some health complications the vets face today stem from their service in the Gulf War. Veterans benefits assistance is available to learn more about the services available to them, including disability compensation, healthcare access, and rehabilitation programs.
What Is the Impact of Gulf War Syndrome on the Families of Gulf War Veterans?
Military life does not only affect active soldiers and veterans. The uncertainty and breaks in their routines also impact their family members, who may also experience PTSD, high anxiety, depression, and other similar conditions.
The scenario was not any different for the families of Gulf War vets. In the earlier example, we discussed the woes of vets Brian Martin, Troy Albuck, and Robert Lake. When they got home, they likely exposed their families to toxic substances.
For instance, Brian's then twenty-five-year-old wife, Kim, suffered from headaches and rashes — some of the most common symptoms in GWI vets. However, she also had ovarian cysts, breast lumps, and unexplained cervical infections. Plus, she complained of cramps and a burning sensation after intercourse.
The worst part is that their son Deven was not so lucky. He had a five-foot-long umbilical cord at birth and tested positive for acute respiratory problems.
Similarly, Troy's wife, Kelli, displayed unrelated symptoms. She had migraines, hearing problems, and bouts of pelvic inflammatory disease. Also, like Kim, she reported that intercourse hurt her because her husband's semen caused sores.
Like the Martins, the Albucks gave birth prematurely to their son, Alex, who was later diagnosed with cerebral palsy and a rare blood infection. He was born with a rash similar to that of his parents.
On the other hand, Robert Lake's German wife did not show any physical health concerns. However, she could not handle how the Gulf War syndrome impacted her husband. Robert believes that the anthrax inoculations and anti-nerve gas tablets were to blame for his violent and suicidal tendencies, and his wife eventually left him.
Like the Martins, Albucks, and Lakes, many families of Gulf War vets suffered with their military relatives. Some of them may not have experienced symptoms like Kim and Kelli. However, those who did not get physically sick likely had to deal with the damage that comes from seeing a loved one suffer.
For this reason, VA also offers benefits for vet spouses, dependents, survivors, and even family caregivers. You can get in touch with Benefit.com representatives for free assistance or advice. Check your eligibility now to start accessing government-issued benefits.
The Gulf War syndrome puzzled experts for many years. When the Persian Gulf War vets headed home from the operation, they experienced a wide range of symptoms, from memory lapses to cardiovascular disease to chronic fatigue syndrome. However, specialists could not classify GWI as a medical condition because they could not identify its presence through diagnostic tests.
For this reason, the government could not give some vets and their families the benefits they deserved.
However, now that specialists have corroborated that exposure to sarin and other toxic substances played a crucial role in developing GWI, the VA acknowledges that vets deserve full benefits. These services include disabled veterans benefit, pension, healthcare, insurance, loans, and many others.
To simplify the claims process, the office released a list of "non-presumptive" conditions, including ME/CFS, fibromyalgia, functional gastrointestinal disorders, and other undiagnosed illnesses. Gulf War vets with these symptoms do not need to prove a connection between their service and symptoms to receive disability compensation.
Do you or anyone you know qualify for these benefits? At Benefits.com, we provide clients with a better way to understand such services through free assistance and advice. Visit our website to learn more about benefits ideal for you or your loved ones.
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