Glyphosate, heavy metals not a factor for brain patients: report

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A provincial investigation into the so-called “mystery disease” has determined neither herbicides nor heavy metals have contributed to the symptoms of more than 200 patients.

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On Friday, chief medical officer Dr. Yves Léger presented the long-awaited report from a provincial investigation launched last March. The probe was initiated to fulfill a campaign promise by the Susan Holt Liberals to study the possible impact of these substances on residents experiencing atypical and undiagnosed neurological symptoms. Symptoms include memory loss, muscle spasms, hallucinations, weakness, and behavioural changes

This promise was made despite a 2022 expert report commissioned by the former Higgs government that concluded the “mystery disease” did not exist and that the 48 patients under study in fact suffered from established diseases.

The authors of a peer-reviewed scientific journal article last year reached the same conclusion based on a review of 25 cases.

Léger’s report aligns with this finding as well, based on nine autopsies conducted as part of the province’s latest probe.

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The autopsies led to posthumous diagnoses of the late patients’ symptoms, such as Alzheimer’s disease, Lewy body disease, and Creutzfeldt-Jakob disease (CJD).

No unknown or new brain diseases were found, Léger said during a technical briefing Friday morning.

While the provincial study did not attempt to diagnose the living patients included in the investigation, Léger said the evidence shows most patients should be able to find a diagnosis for a known illness. When asked how many living patients had received an alternative diagnosis, Leger said he did not have that information.

Dr. Alier Marrero, the neurologist behind the theory of a novel illness affecting a cluster of patients centred in New Brunswick, has repeatedly raised concerns about elevated levels of heavy metals and pesticides, such as glyphosate, metabolites, and glufosinate in those with unexplained neurological symptoms.

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The findings from the herbicide analysis showed the vast majority of patients’ results were within the normal or expected values when compared to the laboratory’s reference ranges, and similar to the levels of other Atlantic Canadians obtained through surveys.

For the metal testing analysis, the team found some patients had levels that were higher than expected, but most test results were not elevated and were similar or lower when compared to other Canadians, with a few of the patients having elevated amounts for some metals.

Léger said there were several limitations that made it difficult to answer some questions, such as many patients not having repeated tests for herbicides and metals, not all testing using the correct type of sample, and only one of the three labs providing an explanation of how they determined their reference range.

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“We found significant limitations that did affect our ability to provide definitive answers to some questions. However, we were still able to conclude that our investigation did not find evidence of a widespread issue among these patients. Therefore we don’t feel that exposure to these substances is a contributing factor to most patients,” he said.

Roughly 60 per cent of the patients had seen neurologist apart from Marrero, but Léger said it was difficult to tell if their consultations were for the same issue or something else.

“Throughout this work, no other neurologist has raised concerns to my office about these patients,” he said.

Sarah Nesbitt, one of Marrero’s patients and co-liaison for the patient group, said the province’s report still left questions for patients about what was making them sick.

“So if you say it’s not herbicides or heavy metals, what is it then?” she said, adding that patients want the province to look at why there are households with multiple members who have similar symptoms.

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Nesbitt did say a positive note from the report was Leger’s commitment to continue working with patients.

“We knew when we started this work that it would not end here,” Léger said.

Nesbitt hopes the continued work includes treatment and symptom management for patients.

The province’s report had three recommendations including follow-up care for patients, having a process in place to support patients in receiving a diagnosis for their illness, and ensuring that a formal process is in place to have two specialists review and agree on any report of undiagnosed neurological illness in a patient.

When asked how long it would take to implement the recommendations, Léger said he hopes the patient care recommendations will be put in place “very shortly,” but that the second assessments will “likely take a bit more time.”

Léger said his office also recommends clinicians make sure they are re-testing patients who show elevated levels in their results, and that the correct specimens are used for the tests, and cautions physicians to place emphasis on a lab’s reference range when interpreting results.

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“Results that are reported as high do not always means there’s unusual exposure happening.”

When asked about the patients who did have elevated levels of herbicides or metals, Léger said those results had a “significant level of uncertainty” and that few patients with elevated levels had been re-tested.

“At the end of the day, it does make those numbers a lot less useful in terms of interpreting those results,” he said.

About 93 per cent of all samples collected across metals and pesticides were within the laboratory’s reference range, he noted.

Nesbitt pointed out that she has undergone re-testing for metals and herbicides and has heard from other patients who have done the same. In her situation, she moved houses and went through a detox regime and she noted analyzing the individual patients’ situations would have given the investigative team a clearer picture.

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Leger had told reporters he couldn’t speak to individual patient cases because they looked at patients’ results, not their individual patient files.

The scientific paper from last year, published in the Journal of the American Medical Association, alleged Marrero had serially misdiagnosed patients as suffering from an unknown disease.

Brunswick News asked Léger if there would be any repercussions for Marrero based on the findings of the province’s report. He told the newspaper this will be the prerogative of the Horizon and Vitalité health networks and New Brunswick’s College of Physicians and Surgeons.

He did confirm that his office is not intending to file a complaint about Marrero, but does plan to meet with the neurologist to discuss the report’s findings.

The College said in a statement it will review the province’s report and its recommendations carefully to determine whether any further action is needed.

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“At this time, we are not able to provide additional comment, said the college, noting it is unable to confirm or provide details on any specific complaint cases, citing privacy. “The College of Physicians and Surgeons of New Brunswick is committed to investigating complaints it receives with fairness and sensitivity for all involved parties.”

Vitalité Health Network said in a statement it will take the time to carefully review the report before determining next steps.

“We will work with our partners to implement the recommendations,” said the health authority. “Patients will be kept informed once next steps have been established.”

Dr. Susan Brien, Horizon Health Network’s senior vice president of medical, academic and research affairs, said in a statement Horizon will continue to work collaboratively with Leger’s office and other partners to establish next steps related to the recommendations.

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“Our neurology teams offer thorough assessments and collaborative diagnostic services for individuals experiencing complex neurological conditions, and work collaboratively to ensure patients receive accurate diagnoses and the ongoing care they need,” she said.

Health Minister John Dornan was asked for an interview. Instead, the Department of Health provided a statement from the minister.

Dornan said that prior to the release of the report, he and the premier met with patients to discuss the report’s findings, recommendations and next steps.

“Moving forward, we will work with our partners in the health care system to ensure patients are able to access the care they need,” the statement reads. “While the New Brunswick investigation is complete, the Public Health Agency of Canada will be completing a review of all the data provided for this investigation.

“This is a separate exercise, and we will review the additional report once its available.”

In August PHAC agreed at the request of the province to undertake an independent review of the available data, including the data Léger’s office analyzed and other data collected in the course of New Brunswick’s investigation. Leger had said a timeline for the federal agency’s work will be known once the patient consent process is completed for the data.

Brunswick News reached out to Marrero for comment but did not receive a reply by press time.

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