*********************  Dr. Roberts "Dry Eyes" *******************

Date: Mon, 13 Nov 1995 18:16:38 -0500
From: aeulenbe <aeulenbe@ezinfo.ucs.indiana.edu>
To: bettym19@mindspring.com
Subject: dry_aspar.html

   Note: the following text was provided by Elaine Fitchpatrick and Betty
   Martini of MISSION POSSIBLE, an organization dedicated to the
   eradication of NutraSweet.

                 "DRY EYES" FROM USE OF ASPARTAME (NUTRASWEET)

Associated Insights Concerning the Sjogren Syndrome

  The Townsend Letter for Doctors, Jan. 1994

   by H. J. Roberts, M.D., FCCP, FACA, 300-27th St., West Palm Beach, FL
   33407-5299 (407) 832-2408

     "It is of use from time to time to take stock, so to speak of our
     knowledge of a particular disease, to see exactly where we stand in
     regard to it, to inquire what conclusions the accumulated facts seem
     to point to, and to ascertain in what direction we may look for
     fruitful investigations in the future." Sir William Osler

Abstract

   "Dry eyes" and associated difficulty in wearing contact lenses were
   prominent complaints offered by 56 (8.3%) of 551 aspartame reactors.
   Xerostomia (dry mouth) was a frequent concomitant. The symptoms
   promptly improved after they stopped aspartame-containing products,
   and predictably recurred on aspartame rechallenge. The concomitant
   joint pains, severe confusion, memory loss and depression also have
   clinical significance, with special reference to the Sjogren syndrome.

   The cause and management of "dry eyes" challenge ophthalmologists and
   primary care physicians. This symptom was unexpectedly and repeatedly
   encountered among patients manifesting other reactions to products
   containing aspartame, a sweetener currently being consumed by 54% of
   adults in the United States. This complaint was encountered in both
   the routine questioning of apparent aspartame reactors and a
   computerized, 9-page survey of such individuals. Many also volunteered
   difficulty in wearing contact lenses due to decreased tears, dry mouth
   (xerostomia), joint pains, confusion and memory loss - all
   specifically attributed to the use of aspartame products.

Methods

   Data were obtained from 551 persons who appeared to have systemic
   reactions to aspartame. They consisted of 160 private patients or
   aspartame reactors who were personally interviewed, and 391
   individuals who described their adverse side effects in the survey
   questionnaire...including observations after rechallenge. The names of
   the latter group were supplied by Aspartame Victims and Their Friends
   (courtesy of Mrs. Shannon Wroth), the Community Nutrition Institute
   (courtesy of Mr. Rod Leonard), and Dr. Woodrow Monte of Arizona State
   University.

   The completed questionnaires were analyzed with the assistance of the
   Management Information System staff at the Good Samaritan Hospital,
   West Palm Beach, Florida.

Results

   Dry eyes, ocular irritation from contact lens, or both, occurred in 46
   (8.3%) aspartame reactors, In addition to the sensation of local
   discomfort and "sand" in the eyes, the eyelids of such patients tend
   to become swollen and infected, at times with loss of eyelashes.

   The causative or contributory role of aspartame was indicated by these
   clear-cut clinical correlates: (1) prompt and gratifying improvement
   of ocular and other symptoms following the cessation of aspartame,
   generally within several days; and (2) their recurrence shortly after
   resuming such products. This sequence predictably recurred after
   rechallenge with aspartame, known or inadvertent.

   These observations have been duplicated by more than a score of
   patients complaining of dry eyes in subsequent aspartame reactors.
   There were related problems. For example, a physician who consumed
   considerable diet sodas developed a type of corneal dystrophy
   generally associated with the chronic use of certain drugs (e.g.,
   indomethacin).

   Computerized correlations between aspartame-associated dry eyes, and
   "marked memory loss," "severe depression" and "severe mental
   confusion" were done on the first 362 aspartame reactors who completed
   the questionnaire. (There was a 30.8% response to the initial mailing
   of 1,177 forms.) The correlates were as follows:

     * Recent aspartame-associated dry eyes and severe depression - 18
       (4.9%)
     * Recent aspartame-associated dry eyes and marked memory loss - 20
       (5.5%)
     * Recent aspartame-associated dry eyes and severe mental confusion -
       9 (2.4%)

   Other complaints offered by the larger cohort had considerable
   significance, with particular reference to the Sjogren syndrome. They
   included excessive thirst due to dry mouth (xerostomia) in 65 (12%),
   and severe joint pains in 58 (11%). It is noteworthy that
   three-fourths of patients in this and the large series of aspartame
   reactors were women averaging 50 years, a phenomenon also encountered
   in the Sjogren syndrome.

Representative Case Reports

   Case 1 - A 47 year-old woman complained of severe dryness of the eyes
   that required one bottle of artificial tears a week. Her consumption
   of aspartame included 10-12 glasses or cups of aspartame-sweetened
   beverages, the addition of a tabletop sweetener to 3 cups of coffee in
   the morning, and considerable aspartame pudding. She also suffered
   confusion, significant memory loss, intense headaches (never
   previously a problem), impaired hearing, lightheadedness, severe
   "nervousness," muscle cramps, and depressions with suicidal thoughts.
   These symptoms markedly improved after stopping aspartame, and
   disappeared within several weeks. She no longer required artificial
   tears. Such dramatic improvement enabled her to travel abroad several
   weeks later with her church group for relief work.

   Case 2 - A 36 year-old businesswoman complained of recent difficulty
   wearing contact lenses. She had been consuming considerable amounts of
   soft drinks and gum containing aspartame. These and other symptoms -
   including lightheadedness, headache and leg cramps - abated within two
   weeks after all aspartame products were avoided.

   Case 3 - a 61 year-old female court reporter developed dry eyes and
   bilateral blurring of vision. Other recent complaints included marked
   memory loss, severe headache, dizziness, extreme irritability, and
   atypical facial and joint pains. As a result, she had been making many
   errors at work. The patient improved "immediately" when she ran out of
   aspartame-containing beverages, and resumed regular sodas. She
   therefore deduced that aspartame products had been causing her
   problems. Her previous daily consumption included 4 cans of aspartame
   soft drinks, 2 glasses of aspartame hot chocolate, and 6 packets of an
   aspartame tabletop sweetener.

Comment

   The unexpected associated of aspartame use and dry eyes offers clues
   concerning this symptom and the Sjogren syndrome. Other problems
   encountered in aspartame reactors, especially dry mouth and joint
   pains provide related insights.

   Two reactors who complained of "thick saliva" developed enlargement
   and tenderness of the parotid glands. The secretory structures of the
   salivary glands presumably had been affected by aspartame, as well as
   the lacrimal glands. The affinity of aspartame for salivary glands
   were demonstrated experimentally by the prompt uptake of
   isotopically-labelled aspartame.

   The Sjogren or sicca syndrome affects an estimated 2% of the adult
   population. The reduction or absence of lacrimal and salivary
   secretions results in dry eyes and dryness of the mouth. (The
   diagnostic lipstick-on-teeth sign consists of lipstick adhering to the
   upper front teeth). This disorder is presently regarding as a chronic
   autoimmune disorder resulting from lymphocyte-mediated destruction of
   these glands and changes in the points.

   A vicious cycle is likely to ensue if considerable
   aspartame-containing beverages are consumed because of the intense
   thirst created by severe dryness of the mouth. Weiffenbach et al.
   demonstrated that taste impairment is not a necessary consequence of
   salivary gland dysfunction among patients with "dry mouth" caused b
   the chronic absence of saliva. Accordingly, such individuals may come
   to prefer the taste of aspartame in satisfying their chronic thirst,
   with perpetuation of the sicca syndrome.

   The systemic and central nervous system sequelae of the Sjogren
   syndrome underscore the potential importance of these findings.
   Cognitive impairment and lamenting features have been reported by
   one-fourth of Sjogren patients. Severe confusion and memory loss also
   were noted in 157 (28.5%) aspartame reactors in the present series.
   Indeed, many reactors in their third and fourth decades asked, "Could
   I be developing early Alzheimer's disease?" The prompt and impressive
   regression of their confusion and memory impairment after abstinence
   from aspartame proved reassuring.

   Several phenomenon may explain cerebral dysfunction associated with
   aspartame use. They include flooding of the brain with large amounts
   of phenylalanine (50% of the aspartame molecule), disturbances of
   neurotransmitters (especially dopamine), other effects of its three
   chemical components (phenylalanine, aspartic acid, methanol),
   methanol-induced cerebral edema, and glucopenia due to increased
   insulin release and concomitant decreased food intake in an attempt
   to lose weight.