Aaron Goodman:
[00:00:00] Before we begin, a brief note for listeners. This episode includes discussion of suicide. Listener discretion is advised. You're listening to the Chemical Sensitivity Podcast and the host and podcast creator Aaron Goodman. Many listeners of this podcast trace the beginning of their experiences with multiple chemical sensitivity MCS to a series of specific exposures.

Or a one-time exposure often to pesticides, fragrance products, mold, smoke, or fumes, and more, and many others report something different. They say their symptoms began after taking a prescription medication, especially antibiotics. One group of antibiotics in particular, fluoroquinolones, has been linked to a condition known as fluoroquinolone associated disability or FQAD.

Patients report long lasting neurological, cognitive, and physical symptoms that can persist for months or [00:01:00] years after taking the drug. Some of these people also develop intolerance to chemicals, developing reactions to fragrances, many cleaning products, medications, paint, air, fresheners, cigarette smoke, and a lot of everyday environmental exposures and symptoms that closely resemble multiple chemical sensitivity.

My guest today is Dr. Stefan Peeper, a physician with a 25 year career in integrative medicine focused on mitochondrial medicine. He's treated thousands of patients with fluoroquinolone associated disability and written extensively about its biological mechanisms. Dr. Pee's work raises important questions.

Can medications trigger long-term multiple chemical sensitivity? What happens in the body when this occurs? What can be done to resolve it? And what might this teach us about the broader condition known as [00:02:00] MCS? This conversation is part of a larger effort to understand on this podcast how chemical exposures, including prescription drugs, can lead to chronic multi-system illness.

Thank you for listening to the Chemical Sensitivity Podcast. Please check out and share a link for the podcast new webpage, listen dot chemical sensitivity podcast.org. It's easy to share with anyone in your life who may be interested in learning more, but MCS. Your doctor, employer, even family and friends, listen dot chemical sensitivity podcast.org.

Please subscribe to the podcast wherever you get your podcasts. And to learn more, follow the podcast on YouTube, Facebook X, Instagram, blue Sky, and TikTok. And you can reach me at aaron@chemicalsensitivitypodcast.org. Thanks for listening, Dr. Peeper, thank you for joining me. Thank you for having me. For listeners, would you like to introduce yourself briefly please?

Dr. Stefan Pieper:
[00:03:00] 
 Well, I'm a, uh, a German doctor practicing in, uh, the little but very beautiful city of Constance, uh, in the south of Germany, uh, um, near a big lake called Lake Constance as well. I'm having a practice, uh, a general practice with, together with my wife. She's a doctor as well. We are doing, um, what we call in integrative medicine.

So we do a lot of conventional medicine, but this is, um, recently only maybe a quarter of our time and the rest is alternative and holistic medicine, functional medicine, as you say, in in America. Um, trying to, to, to do. For every patient to do a, a composition of different approaches, uh, which, [00:04:00] which is, um, which we think is best, uh, to treat the patient right.

And we, we do that, uh, since, you know, um, 20, 30 years now, um, and over the last seven to 10 years, um, I'm very much in this. Special, um, area of, um, fluocinolone toxicity. Um, so, um, at the moment most of my patients I'm seeing are fluocinolone, uh, toxicity patients, more or less. Yeah. Yeah. And we can use the acronym F-Q-A-D-F-Q-A-D.

Aaron Goodman:
Do you want to, um, help us understand and. Basic terminology. What is FQAD? 

Dr. Stefan Pieper:
Well, um, we should start with the antibiotic, um, [00:05:00] with always a group of antibiotics. Um, they are called fluocinolone. Um, the most known, uh, one is, uh, cyprofloxacin. Um, but there are. Plenty of others. Um, and, um, you see at, at the end of the words, there's always the floxin as laflin, no floxin, uh, cyprofloxacin.

And, and so you can, uh, determine where if this antibiotic is one of these groups, uh, of this group of fluocinolone. Uh, it's a very interesting group before because in the 1980s it was the first antibiotic, um, developed, um, as a synthetic antibiotic. All the other antibiotics before like penicillin and others, um, were.

Actually [00:06:00] a blueprint from nature, but the fluocinolone, um, they came up as a, as a mistake during developing a malaria drug. Um, and then they saw with a, this is, um, it's, it's a very potent drug to treat bacterias. Uh, and then they developed this group of fluocinolone, which is really a very, very effective antibiotic group for bacterial infections.

One has to say that, um, however, uh, saying that, um, the, the last 40 years since these, this, this an antibiotic group exists, um. Millions of people have been treated with very minor infections, uh, um, in [00:07:00] with, with this, uh, you know, potent and heavy drug. Um, and, uh. Because the, the huge scale of, uh, of treatments, uh, the huge, um, number of, of patients, uh, uh, um, produces, um, a lot of side effects.

The side effects are actually rare. One in a thousand, one in of 10,000. But if you prescribe, um, in a society like the American or here in Europe as well, um, millions of these drugs, um, then the, um, the number of patients getting ill are very high as well. So, um, we, the estimation for. A small country like Germany is 40,000 patients.

Uh, a year produced by, uh, by [00:08:00] fluocinolone, uh, patients with this, uh, special disability in America is four times higher. And, uh, it's about, um, um, it's about. 320,000 is a, is a, is a, um, a scientist called Bennett, who, who did the, who did the, the count, who did the, the math, um, about this, um, so, and. The thing is that, uh, the, the picture, the clinical picture of this, uh, intoxication of Fluor Canones is, is so severe, um, that there is a, a, an, an, uh, special expression for this.

And this is called fluocinolone associated disability. Um, so that's what we are talking about tonight. Thank you.

Aaron Goodman:
Doctor, Do some [00:09:00] people who develop FQAD develop new sensitivities to chemicals? Could be fragrance medications, or other environmental exposures. 

Dr. Stefan Pieper:
Yeah, I see that a lot actually. Um, I'm not sure if some, some, sometimes there is a disposition beforehand and there is a, a manifestation of these, of, of these, uh, mild symptoms maybe, uh, after intoxication, after having, uh, developing FQAD.

But I see that a lot. Um, there are actually two. Big groups of patients. Um, I can see one group is very, very healthy beforehand. Um, there are athletic sport teeth patients, young in their forties, maybe doing lots of sports, very active, and then all of a sudden, uh, they get this, uh, [00:10:00] side pro or whatever.

Um, drug and from one day to the other, they are bed bound and very, very ill. And, and another group, which is maybe a third of my patients, um, they are actually. You can see that the, the system was fragile even before taking fluocinolone. And some of them were sensitive beforehand. Some of them had, um, a mild co mild, uh, muscle activation syndrome or fatigue because, uh, of, uh, of a virus disease or something else.

Um, and these patients, this group, this, this group, um, is very much at risk develop, develop, developing MCS after, uh, the, the fluocinolone intoxication. I can, I see that very often and [00:11:00] I see, um, as well that there are. Side symptoms side, which, which both groups can develop. Yeah. For example, uh, which is very often the case is that the, my patient, the FQID patients develop mast cell activation. Right. And I believe that MCS patients also have, uh, a very high risk of, of mass cell activation, um, in, in, in, in the, the course of the, of the, um, disease. 

This is one, another one, which I see very often, um, is, uh, the leaky gut. Um, if you, if you have a look at the microbiome and the gut, uh, and do some gut tests, then uh, there's a huge group of leaky gut patients within FQAD as well asMCS patients. And, and this is something which, um, which [00:12:00] makes the picture a little bit rounder because I think is, is my belief. There is no, I don't know if there is any scientific evidence for that yet, but that, um, the leaky gut is probably one of the. Very early, um, um, um, illnesses are very early symptoms, um, which leads to other serious, more serious, uh, um, illnesses afterwards.

Like, for example, MCS. Yeah. Mm-hmm. 

Aaron Goodman:
What I heard you say is that, um, many people who take these antibiotics develop MCS. Mm-hmm. So. Is FQAD and MCS the same illness, or do they share. Similar. Are they similar in some ways? Can you help me untangle this? Yes. I think they're similar in some ways. There are two different entities, [00:13:00] two different illnesses.
 
 Dr. Stefan Pieper:
Of course. There there is, there's a lot of similarities. Uh, like for example, um, I could start with the energetic, um. Um, problem both groups have like fatigue, uh, syndromes. Mm-hmm. Which is very, very severe often in FQAD. Um, um, lots of patients with FQAD have, uh, develop, uh, an uh, CFS chronic fatigue syndrome after being L four.

A longer time than, uh, and MCS patients. I, I see that they have fatigue problems, uh, as well, energetic problems. Now, probably both of both groups. The reason for both in both groups, uh, is the mitochondrial damage. I would think, uh, at least in in the FQAD group, the mitochondrial, the mitochondrial damage is very, very severe because.

The [00:14:00] fluocinolone, the antibiotic aims mm-hmm. To destroy, uh, bacterias with the, um, aim to, to destroy the genetic part. The genetic part of the bacteria. The DNA. Right. And the mitochondria. They have got the same DNA, uh, like a bacteria. Um, and, um, the, the, um. The, uh, the activity of the antibiotic drug goes as well in the mitochondrial area.

Mm-hmm. Then to the, uh, as, as, as in the, uh, bacterial one. This is very, very dangerous as well for the human. Cell, um, uh, as well as the bacterial cell. So, and that's because, uh, that's the reason for the, for the, for the mitochondrial damage with a lot of free radicals going around in the, in the mitochondrial.

And so they are destroyed. [00:15:00] And then. But, but they're not, you know, it's, it's not a clean cell death. They don't go into, into apoptosis, um, within, I don't know, a day or so, no. Mm-hmm. They survive this damaged mitochondrial and they survive as, uh, as, uh, as cell particles, which produces lots. Of free radicals.

Uh, which worse is which, which worse is the situation within in the cell. This, that's a problem. I think this research is, is really critical. I'm sorry to step on your toes. Yeah. Another guest talked about the mitochondrial and actually talked about mcss and a mitochondrial illness, and to me that's just revolutionary thinking and so important because so often we're told as, as you know, that it's in our heads, it's a psychological disorder, but if we think of it in concrete terms, that's [00:16:00] actually.

For some people caused by, uh, cellular damage. Exactly. Yeah. That's, that's the problem always with these, uh, more or less unknown diseases that, um, that the risk to, uh, to give it a psychological name or psychiatric name, uh, is very high. Yeah. In the, in the, in our medical society, in our. In my, in, in the medical group, I'm in the, the doctors, for example.

I see that every day. You see that every day among your. Fellow physicians, I see that, I see that every day. More than 90% of my patients come from, uh, from an environment where they were stamped as, uh, as psychiatric patients, or at least with a psychological damage. They were diagnosed with psychological disorder.

That's, and in [00:17:00] fact they had, um, mitochondrial or cellular damage caused by, as a result, often of taking antibiotics. Yeah. Yeah. It's an, it's an organic, uh, biochemical disease actually. Yeah. And the patients who come to you must be so relieved to find you. Yeah, I mean, the publicity for FQAD, uh, is, uh, at least in Germany, higher than it was, and it, it used to be, than it was 10 years ago or 15 years ago.

Nobody knew. This term, you know, and nobody really cared about, uh, drug related diseases at all. So, um, but now it's a little bit more common to think about this problem under doctor, within the doctor groups. Well, and the patients are a little bit more sensitized, uh, to think about this. Um, I think it's, in America it's, [00:18:00] it's, it's the same.

There, there is more knowledge around. Um, you can, you can ask, uh, the, uh, the ae or you can ask Google and you find your way to the, to the doctor, uh, who knows a little bit about that, which wasn't. Possible 10 years ago, and many of the people who come to see you, um, are experiencing chronic reactions to chemicals and environmental triggers, including fragrance.

Uh, how do they get on, how, how do they cope? Uh, what are their day-to-day challenges like? Well, it's, it's very different. Um, I have lots of patient with suicidal thoughts, um, um, uh, to start with when they come to me. Um, one reason is that, uh, unfortunately the Fluocinolone Disturb the neurological system called gaba.[00:19:00] 

The GABA system in the brain is a system which calms you down. Which, which, which always. Tells you take it easy and, and sleep well, and it's, it's nothing to worry about. And if the GABA system. Is, um, is blocked from this fluocinolone molecules. Then the patients become anxious and over agitated and nervous and, uh, sometimes really psychotic.

Um, uh, or. Um, uh, overwhelmed and, and, um, with, with a suicidal tendency, um, that means that, uh, most of my patients, and most of the patients with FQAD, I know they die of suicide. Nothing. I, I mean, sometimes there are other reasons, but they're very rare. The most [00:20:00] common reason for, uh, for for flu lon to die on is suicide.

Aaron Goodman:
It’s devastating to hear that, and we know that it happens a lot with people with MCS for many reasons, and part of it is the lack of medical recognition. 
 Yeah. And the gaslighting rejection misdiagnosing we face in the encounter. Mm-hmm. Also, the, so social isolation. 

Dr. Stefan Pieper: Yeah. The stigmatization. This is the ignorance of the system, which is, uh, sometimes the worst part of the earnest.

For many patients. Mm-hmm. It's very difficult and, and it can lead to despair. And I wonder, doctor, are there things that people can do who have FQAD or chemical intolerance to, [00:21:00] other than avoid and survive?

Aaron Goodman:
Are there things that people can do to restore their health? 

Dr. Stefan Pieper:
Sure there are many. I mean, when I, when I first started with these, uh, problems, um, the, uh, the treatment was very limited.

I have to agree. But, um, but now, after many years, um, of, of treatment and many years of help from, from a huge, um, group of patients, um, they, they all, all of them. Drive different approaches. And so I learned a lot from my patients as well. There are very different ways to treat FQAD patients now, right? You can do it with nutritions, you can do it with, uh, with different diets.

You can do it. Um, was, um, was, um. Uh, with different [00:22:00] minerals or vitamins like auto molecular, um, approach, uh, you can sometimes even use Medic mes. Um, is this. More the, um, as the rare side of treatment. But even that you can use, you can use prescription medication in rare instances medication, or you can use, um, which I use a lot at the moment, is, uh, the low dose naltrexone approach.

Yes. Um, which is very, very interesting. Come it, uh, an an approach which comes from America and, and is now a, a, a very. Um, a, a good part of my, of my treatment protocol. LDN, low dose naltrexone. Lone, yeah. LDN. Yeah. And yeah. And there can be some side effects with LDN as well. Yeah. If I'm not mistaken, right?

Yeah. So is it a medication that [00:23:00] needs to be taken with. With caution. With caution, of course, but I have to say every, every, even, even a vitamin or mineral has to be taken with caution because, uh, the fact is that the patients are sometimes so sensitive to everything that you have to think really about what you.

Should give and what you should avoid. I always say every patient is to, to avoid all this actionism. Even so, um, a doctor or somebody who wants to help, um, gives an advice, which is well meant, but, um, um, for example, detoxification. F in an FQID patient. Mm-hmm. Uh, could, uh, could be a disaster for him Right.

To start detoxification because the system is so [00:24:00] fragile that, um, that everything, um, um, would the, the rest of the, of the, of the building would collapse, you know. Uh, Dr. Peeper, what does FQAD tell you about the harms of chemicals in the environment? Uh, fragrance. Um, does it teach us anything about, about the nature of these products that are often under-regulated?

Found in daily life. Well, it teaches me of course, but, uh, and it should teach everyone really that, uh, our environment is, it's, it's much more dangerous as, as it, uh, used to be. Uh. Uh, yeah. Um, in the last century, for example. But, um, so we have to take care for ourselves. We have to, we have to think about every step we take in, in, in, in the [00:25:00] medical sense of, uh, of uh, um.

Step, you know, we have to, as a, as persons, uh, we have to, to, to think about adv. Um, the advice that doctors gives us. Um, and, and if, if he, if he go for it or, or if we leave it, if he ask our gut feeling, it's good to do that. And, and on the other hand, I see so many. Uh, chemicals, which are, um, which are ignored.

Take for example, the, for this, this, uh, issue of forever chemicals. Mm-hmm. Um, which is a huge issue. But, um, nobody really cares about that. And, and there are so many different, um, effects which can, um. Which can, um, harm our, our cells and our mitochondrial function. Um, and then comes [00:26:00] along, uh, a fluocinolone drug, which, which gives you, uh, a really, uh, a complicated clinical picture.

And, and, and then there is. If you are, um, unfortunate then the rest of your life is, is going to be changed and Yeah, it really does. It really does. And I can many listeners, uh, live that and know that very well personally. And as I do myself, I want to ask a couple more questions before we wrap up our conversation, but before I go to that place, um, you know, when I think of mitochondrial.

Function and illness. A for a previous guest talked about the mitochondria being like the battery reserves in the cell. Mm-hmm. How could you help me understand what mitochondria is in simple terms? Yeah. All right. Okay. I understand. Well, I mean, the, the [00:27:00] mitochondrias, uh, the mi is a part of the cell, which is usually called the power plant.

The, uh, that's the part of the cell where the energy is produced for the cell, and, um. It's, uh, it's actually from, from the chemical point of view, um, it's, it's like a fusion plant. Um, it's, um, it's a very smart way to, to produce energy. But on the other hand, um, the mitochondria are very, very fragile because there is, there are lots of chemicals around which can, um, which can also, um, um, damage the function of a mitochondria.

Um, and this is, uh, imminent. This, the, in. In this system, you know, and, uh, we are talking about the free radicals. Um, [00:28:00] and free radicals are on the one on one hand, very, very, uh, important for the function of, uh, mitochondrial. But, um, the cell has to get rid of this, uh, uh, of this free radicals very, um, in a, in a very.

Proper way, um, to not have the damage they can, um, they can produce. Mm-hmm. Um, and so there is a, uh, um, uh, how you call it, um. A vicious circle really. Um, uh, if, if, if the damage to the mitochondria one starts, then um, the body sometimes, um, is not able to repair this damage because for the reparation, for the repairment of this damage.

The cell needs energy, and that's exactly [00:29:00] what the cell doesn't have anymore because the mitochondrial, the power plant is damaged. So, um, so this, this is one of, one of different, our, uh, main reason, uh, for, um, having. A chronic, um, uh, um, disease in the end, right? Understood. Because the cell is not able to heal itself really.

So you have to give lots of help within the system like antioxidative, um, remedies and so forth to help the, the cell to recover from this damage. And I think a lot of people who are listening maybe, you know, don't have access to. A specialist like yourself, um, and you know, maybe even don't have access to any doctor at all.

And when they do, they're often don't get the reception that they want or can even be very [00:30:00] harmful. I know you can't see every person with MCS or FQAD, uh, but are there any practical steps that you might be able to offer to people? Hmm. Well, for once, um, a, a very, very important approach is, uh, is to change the diet and to change the way of living and to, to live, uh, under circumstances which are.

A little more, a lot more easier and a lot more, uh, lower on a lower level of toxicity. I imagine you mean? Yeah. Yeah. Mm-hmm. Exactly. Less exposures. Eliminate the exposures. Mm-hmm. And you start with making our home as safe as possible. Exactly. And then there is this huge word empowerment, and that you, that, uh, everybody should, should, uh, try and, and, uh, and think and take the opportunity to think for its for [00:31:00] himself.

Uh, rather than listen to others and listen to doctors and listen to, I don't know, Dr. Google or so, um, and to see. What is best for me? What, what does my gut feeling says about that? Mm-hmm. Yeah. And um, yeah, this is very, it comes very important. I think It's very important. And people have a lot of knowledge, self-knowledge, don't we?

Exactly. Yeah, that's what I mean. Yeah, but they, they don't realize that, uh, or they, they, they ignore that, um, rather than, than, than take it, uh, in, and, and, uh, yeah, that's, that's the problem. I hear it every day when, when somebody says, yeah, I had to, I had to take this antibiotic because my doctor told me so.

Mm-hmm. And nobody is, um, should tell you what to do in a, in a, um. In a situation where it's, uh, where it's, it's you taking this drug and not any [00:32:00] other uh, uh, person. Yeah. We're often put our trust in the clinician. It can often happen in times when we may not be able to make. Sound judgment or have mm-hmm.

Clear thinking, for example. Mm-hmm. It could happen in an emergency situation, it could happen in surgery. Uh, it could happen in a case of serious illness. And when we desperately need help, and again, we put our trust in medical care providers. Yeah, exactly. And, um, and so it's, it's always. Easier to do that.

Of course. Yeah. To, to give that in, in the end of others. And you think they, they know more than, than than myself. Hmm. But, um, in the end, it's, it's, it's always for the patient to decide this, this is the most important thing I, uh, um, I have learned. Yeah. Mm-hmm. 

Aaron Goodman:
[00:33:00] And perhaps lastly, um, do you see. That there could be positive change that clinicians and, you know, more physicians like yourself and more researchers will have an understanding of drug induced chemical injury and the dangers of, of many prescription medications.

Well, I'm not so sure. Um, I would like to be optimistic, but, um. To be honest, the whole picture of how to, to, to do medicine became a lot more mechanical. Right. And, um, and a lot more a one way picture. And um, and that's very dangerous, I think, because we have to take. We have to take everything into account.

And, and, and one of the [00:34:00] biggest problem is that, as you said, that this, uh, multi toxic environment, which we are staying in with lots of different, uh, even medications from different doctors and so on, um, can destroy our cell systems. The doctors have to see where we go and where we, um, where this, that.

This system doesn't lead, uh, nowhere. So, but at the moment, I don't see actually that, um, there is an improvement, uh, regarding this problem in the, in the, um, in the doctor's society, in the medical society. I think this, that's a huge problem. Because the risk is rising. The risk for, uh, for these kinds of, uh, of illnesses, uh, is, is, is going up instead of down.

So we have to take that into account as [00:35:00] doctors, as a thera, uh, uh, as therapists. Yeah, this really important. Would you like to add anything else, Dr. Pepper? Well, as far as I'm concerned, um, I, I think it is very, very, as I said before, the empowerment of the, of the patient is the most important thing with the intuition with their own, with their own gut feeling.

Everybody can, um, handle the, it's his own problem in the best way, I think. Is this really a very, very useful tool for everybody.

Aaron Goodman:
You've been listening to the Chemical Sensitivity Podcast. I'm the host of podcast creator Aaron Goodman. The Chemical Sensitivity podcast is buy and for the MCS community.

The podcast is generously supported by the Marilyn Bachman Hoffman Foundation and listeners like you. If you wish to support the podcast, please visit chemical sensitivitypodcast.org. Your support will help us continue making the podcast available and creating greater awareness by MCS. Please check out and share link for the podcast New webpage, listen dot chemical sensitivity podcast.org.

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