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