The Eosinophilia-Myalgia Syndrome

In 1994, the eosinophilia-myalgia syndrome (EMS) was recognized as a disease caused by the consumption of L-tryptophan supplements contaminated with trace chemicals. Symptoms included severe muscle pain, elevated eosinophil counts, and skin hardening, with some cases resulting in death. By August 1, 1992, there were 1,511 reported cases and 38 fatalities. The median daily dose of L-tryptophan consumed by patients was 1.5 grams. The exact pathogenesis was unclear, but contaminants were suspected to induce inflammatory and fibrotic responses. Treatments like glucocorticoids provided some relief, but many patients experienced persistent symptoms. A follow-up of 210 patients offered insight into the long-term effects of EMS. The document highlighted the need for more research and stricter regulatory measures for supplement safety.