Ciguatera Toxin and Chronic Fatigue Syndrome: Should You Be Tested?

The ciguatera toxin may be found in large reef fish, most commonly barracuda, grouper, red snapper, eel, amberjack, sea bass, and Spanish mackerel. These fish live in coral reef waters between 35 degrees south to 35 degrees north latitude. This area lies basically between the Tropic of Cancer and the Tropic of Capricorn that ring the Earth north and south of the equator and make up what we commonly call the tropics. Areas include the Caribbean, Hawaii, and coastal Central America.

The toxin tends to concentrate in predator fish, such as the barracuda and other carnivorous reef fish, because they eat other fish that consume toxin-producing algae (dinoflagellates) living in coral reef waters.

The toxin is harmless to fish but poisonous to humans. The toxin is odorless and tasteless and is NOT destroyed by cooking. People are poisoned by the toxin after eating tropical or subtropical contaminated fish.

To answer (and restate, in some cases) often asked questions about the

new research on ciguatera toxin, [an association for CFS] has prepared the following questions and answers.

1. Is this a fish toxin?

Ciguatera is a fish toxin but until all research is complete, we don’t

know if this is the exact same entity as ciguatera toxin. We do know that all tests for ciguatera toxin come up positive in those with CFS that we’ve heard from thus far and are far higher than those seen in acute ciguatera poisoning.

2. Is testing available?

Yes. Testing has been ongoing as announced and the protocol may be

read. Those on the east coast are now advised to include a cold pack in the shipment. No kit is given by the laboratory so first check to see what the laboratory you are using requires of you (i.e.: packing material).

3. How much does testing cost?

The test now costs $100.00 and patients

will be sent an invoice. The prescribing physician will receive the


4. What treatment is recommended?

There is currently no known, proven treatment for this. Cholestyramine, mentioned by many, will not help. A proven treatment may be available sometime this year but in order to do no harm to the patient, more proven science is necessary first.

6. When can we expect publication of the science?

There will be two publications of two slightly different studies in

two peer-reviewed medical journals. The date of each is currently

unknown but should be expected within a few months.

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