Gulf War Illness: Still Fighting for Recognition

4-24-2025

By Dr. Howard Friedman, MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

Gulf War Illness: Still Fighting for Recognition—Decades later, veterans continue the battle for answers, acknowledgment, and care.

There have always been injuries after armed conflicts. Some are visible—wounds, scars, amputations—but others are hidden, surfacing years later and often dismissed or misunderstood. One such condition is Gulf War Illness (GWI), formerly referred to as Gulf War Syndrome.

Let’s begin with a historical comparison. During the Vietnam War, service members were repeatedly exposed to Agent Orange, a powerful herbicide. Soldiers were told it was safe. It wasn’t. Nearly a decade after the war, abnormal health conditions began surfacing in that population. It took relentless advocacy by veterans and scientists to establish the connection. Even today, the list of conditions linked to Agent Orange continues to grow.

The story of Gulf War Illness is strikingly similar. Veterans who served in the 1990–1991 Persian Gulf War began reporting a cluster of symptoms—debilitating fatigue, muscle and joint pain, cognitive difficulties (memory and concentration issues), and persistent gastrointestinal problems. The pattern was hard to ignore. As outlined by the National Library of Medicine in this comprehensive review, Gulf War and Health, these symptoms have been recognized in higher frequency among Gulf War veterans than in the general population.

Yet, some still question whether GWI is a distinct medical condition. A separate article, also hosted by the National Library of Medicine, openly explores this skepticism: Is Gulf War Syndrome a Real Condition?. This tension between veterans' lived experience and institutional doubt has only complicated access to care and benefits.

In the world of VA disability, however, the standard isn’t certainty—it’s “as likely as not.” That 50% threshold recognizes the limits of science and the reality of military exposure. And as any physician or veteran knows, no two people respond to toxic stressors in the same way. Our bodies are not uniform. Genetics, resilience, prior health—all of these shape how service-connected conditions manifest.

The precise cause of GWI remains elusive. Theories include exposure to nerve agents, pesticides, experimental vaccinations, oil well fires, and environmental contaminants—perhaps even something as fundamental as the sand itself. Burn pits, which were once overlooked, are now understood to have long-term health impacts. It’s likely GWI stems from a combination of these factors, not a single source.

This isn’t theoretical for me. I served in the Army during the Gulf War. I deployed. I was given 72 hours to prepare a will, and then I received 19 vaccinations in a single sitting—compressed air guns to both arms. No one explained what I was being given. We didn’t question it. That’s what duty demanded.

Now, nearly 24 years since the end of that war, I believe—as a physician and as a veteran—that Gulf War Illness is real. It meets the threshold. The symptoms are consistent. The experiences are documented. And the burden of proof shouldn’t rest solely on the shoulders of those who already bore the weight of war.

At HHOM LLC, we honor those experiences. We provide the medical clarity veterans need to support their claims and restore their dignity. Gulf War Illness deserves the same recognition we eventually gave Agent Orange exposure. It’s time to listen—before another generation is forced to fight the same battle twice.

—Dr. Howard Friedman, MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

---

Question: What is Gulf War Illness (GWI)?

Answer: Gulf War Illness refers to a cluster of chronic symptoms affecting veterans of the 1990–1991 Gulf War. These include fatigue, joint pain, memory problems, and gastrointestinal issues. The condition is believed to be linked to toxic exposures during deployment, though the exact cause remains uncertain.

Question: Is Gulf War Illness officially recognized by the VA?

Question: How can HHOM LLC support Gulf War veterans with claims?