For Soldiers With Gulf War Illness, a Clue to the Mystery in Their Cells

As a kid, Adam Such knew he wanted to join the military when he grew up. And after graduating from West Point in 1989, he went on to have a career that included 17 years in special operations, which he discovered he "had a passion" for, he says. Such served in the first Gulf War, the 2003 Iraq War, and other places, too. In Fallujah, Iraq, in 2004, his helicopter was shot down, resulting in a broken back.

But in the years after his time in the first Gulf War, he began to realize that something didn't feel right about his health. "By the mid-90s," he recalled, "I absolutely recognized a significant degradation in my stamina, my focus, my concentration; the worst part was what's now termed fibromyalgia… because it's everywhere." His symptoms also included joint pain. But, he says, he was a typical soldier: you tough through things, and you don't look for "externals" to explain your problems. He had thought of the tiredness as what he calls "the post-deployment fatigue"—just a result of pushing his body—but now he knows better: eventually he was diagnosed with Gulf War Illness.

Once known as Gulf War Syndrome, Gulf War Illness is now a diagnosis recognized by the Veterans Administration. But it remains a perplexing sickness. It can display as an array of seemingly unrelated symptoms, including headache, gastrointestinal problems, pain, and fatigue — and its onset can be many years after exposure. Roberta White, a professor at Boston University's School of Public Health, calls the disease a "complex illness" as the underlying biological processes are not precisely clear.

More than 700,000 troops were deployed in the Gulf War, and the Department of Defense estimates that "as many as 200,000 veterans" of that conflict might be affected. Treatment is difficult, and not all veterans show the same symptoms, with the same severity, nor respond to treatments in the same way.

And assigning blame is difficult. It's nearly impossible to figure out whether exposure to a specific substance can cause any given case of Gulf War Illness. However, many vets remember things from their tours that didn't—and still don't—sit right. One Gulf War veteran, Melissa Forsythe (a retired colonel who now is the program manager for the Department of Defense Gulf War Illness Research Program) recalls the burning oil wells: "you could taste it, in your mouth," she tells Newsweek. "If you blew your nose, it came out black." Forsythe knows of another veteran who was in a recently-vacated Iraqi bunker when he noticed a distinct scent: "geraniums and onions." That was probably from mustard gas and another nerve agent, she says. Another veteran, Andy Berdy, a now-retired colonel who commanded a battalion in the war, spoke of feeling "tired all the time" after he retired, and would experience "momentary blackouts." As for the causes of his illness, "Something happened in our deployment in Desert Storm," he says. Berdy brought up a specific anti-nerve-agent pill he took (which in the middle of their deployment they were urgently told to stop taking) or as well as agricultural chemicals he was exposed to after spending weeks in fox holes dug into soil near the Euphrates River.

One physician thinks she's found an important clue inside the cells of stricken vets. Dr. Beatrice Golomb, a medical doctor and researcher at the University of California, San Diego School of Medicine, suspected that the problem might be in the mitochondria that are found in the body's cells.

You may remember mitochondria from high school biology: they are the way the body produces energy. Some of the "classic symptoms" of Gulf War Illness, like fatigue, match perfectly with the symptoms of a person with mitochondrial disorder, Golomb says. A person with mitochondrial dysfunction could feel tired, have trouble exercising, have gastrointestinal problems or even cognitive problems—just like with Gulf War Illness. Other factors make it a likely fit, too.

Golomb matched seven veterans who had Gulf War Illness with seven healthy controls of a similar profile. To measure mitochondrial function, she focused on a substance called phosphocreatine, which she describes as an "energy backup." Both the veterans and the healthy controls exercised, and Golomb's team measured the phosphocreatine recovery afterwards. She found that in six of the seven pairs, the recovery for the veterans was significantly delayed compared to the controls—pointing a finger at mitochondrial dysfunction.

That alone doesn't mean their health problems were caused by the events of Gulf War, since mitochondrial dysfunction can be caused by any number of things. However, according to Golomb, "We know that mitochondrial dysfunction is triggered by some of the classes of chemicals that show the strongest epidemiological link to Gulf War Illness." In other words, the problems she found are linked to things those vets probably breathed in, swallowed, or otherwise put in their bodies back in the 90s. The results of her study were just published in the journal PLOS One.

Experts suspect a variety of toxins could be linked to Gulf War Illness—from pesticides to the anthrax vaccine—but one likely culprit, Golomb says, is something that wasn't an enemy weapon, or even an accidentally released chemical: the PB pill. The PB pill was given to troops by the U.S. Armed Forces in case of possible exposure to nerve agents—it was a preventative. The cure may have made them sick.

The study is too small to draw big conclusions from, says Lea Steele, the director of the Veterans' Health Research Program at Baylor University. "It's potentially very important, especially if larger studies validate what Dr. Golomb's team found. Bottom line on this illness is that people have been sick so long. And we are beginning to understand the mechanisms of the illness, but we really haven't identified effective treatments that we know can apply to a lot of people."

Adam Such retired in 2009 with the rank of lieutenant colonel. His health was part of the reason—he needed surgeries after being shot down in 2004—and he was a single dad, too. Even given his health issues, he says he wouldn't change his career. "For the service, I volunteered to do it. I'd do it again in a heartbeat," he says. But he feels for other veterans who might not have the resources or support he does. "That's where you see the emotions come out with me, where I become very adamant about our obligation to treat and take care a lot of these young men and women who willingly went and served."

As for helping veterans who are suffering from Gulf War Illness, Golomb says that "there are potential treatment implications" based on the results of this small study. She's still working on it. "I think there will be treatment strategies that will clearly" benefit sick vets, she says. Still, she added: "It will still be a challenge to generate a complete cure."