What initiates chemical intolerance (CI)? In a newly released survey of hundreds of U.S. adults, respondents most regularly cited exposures to biological sources, corresponding to mold and algae “blooms,” and/or fossil fuels, their combustion products and artificial chemical derivatives corresponding to pesticides, plastics and chronic organic pollutants.

It’s a difficulty within the news, as toxic mold spawned by the moisture left behind by flood waters from Hurricane Idalia may lead to severe health problems for people that suffer from chemical intolerance. This mold also could initiate the condition in some individuals.

Everyone should avoid prolonged exposure to mold at any time when possible. Research has increasingly shown that toxic mold is way more dangerous than was previously recognized.”

Claudia Miller, MD, MS, physician-researcher, The University of Texas Health Science Center at San Antonio

Within the survey, published within the journal Environmental Sciences Europe, 17.5% of participants who attributed their illness to an initiating event cited mold exposure because the perceived reason for their chemical intolerance. CI is estimated to afflict as much as 20% to 30% of Americans, Miller, senior creator of the study, said.

Participants were queried about antibiotic use, as well. In keeping with the outcomes, prolonged courses of antibiotics were related to an increased risk of CI.

The survey data also indicate that with each additional initiating exposure respondents can recall, the percentages of their reporting CI nearly triple.

“With climate change contributing to more severe storms and more intense flooding worldwide, the danger posed by toxic mold is prone to increase dramatically within the near future,” Miller said. “As mold exposure is understood to be a significant initiator, the likelihood of increasingly individuals with chemical intolerance can be unfortunately on the rise.”

TILT

The study furthers understanding about how a two-stage disease process called TILT (toxicant-induced lack of tolerance) begins. The survey asked 10,981 people to state their self-perceptions concerning the events that began the downward spiral through TILT and into chemical intolerance.

“TILT can develop rapidly, as an example after a pesticide exposure, or steadily if someone is working or living in a setting corresponding to a moldy constructing,” Miller said. She first proposed TILT in 1996 and is professor emerita of family and community medicine at UT Health San Antonio.

Unknown origins

“Initiating events commonly go unrecognized and due to this fact unreported, leaving triggers and symptoms because the only documented components,” Miller said. “This has thwarted our understanding of the particular causes of TILT.”

Participants accomplished an 80-question online survey called the Personal Exposure Inventory. It included items concerning individuals’ medical diagnoses and private exposures including antibiotic use.

Chemical intolerance was assessed using the Quick Environmental Exposure and Sensitivity Inventory (QEESI©) developed by Miller 25 years ago. It’s a validated, self-administered questionnaire now used worldwide to distinguish individuals with CI from the overall population. One-fifth of survey respondents met the QEESI criteria for chemical intolerance.

Toxic mold

Exposure to mold was essentially the most regularly mentioned initiating event on the Personal Exposure Inventory. “Lately, global warming has led to more rainfall, floods, hurricanes, roof leaks and water intrusion, leading to increased mold growth indoors,” said paper co-author Raymond F. Palmer, PhD, a biostatistician and professor of family and community medicine at UT Health San Antonio.

Mold was followed in rank order by exposures to pesticides (cited by 13.8% of respondents), medical/surgical procedures (12.6%), remodeling/latest construction (12.0%), fires/combustion products (7.2%) and breast implants (1.8%).

Antibiotics

Respondents answered questions pertaining to what number of courses of antibiotics that they had accomplished for specific kinds of infections. Antibiotics prescribed for infections categorized as skin, tonsil, gastrointestinal, prostate, sinus, wound and pneumonia were most strongly related to chemical intolerance.

“Our seek for the underlying causes of CI represents a much-needed addition to the CI/TILT literature, whose principal focus has been on triggers that elicit CI symptoms from day after day with no try to determine what initiated TILT,” Miller said.

‘A cohesive narrative’

“Taken together, our data support the concept the one who reports multiple symptoms, multiple intolerances and recurrent infections in addition to a history of exposure events is sharing a cohesive narrative, one which points to physiological (versus psychosomatic) explanations of their oft-confusing complaints,” she said.

Although certain exposures corresponding to medical/surgical procedures could also be difficult to avoid, reducing exposures to contaminants related to pesticide use, latest construction/remodeling and mold is feasible and ought to be the main target of efforts to forestall future CI/TILT, the authors wrote.

Digging in

Finally, they encourage practitioners who see patients with medically unexplained symptoms -; currently one in 4 primary care patients -; to think about administering the QEESI. “‘TILTed’ individuals who report brain fog, memory, mood and concentration difficulties often receive referrals to psychiatrists, psychologists or social staff who explore their psychosocial environments but don’t ask about changes of their actual -; physical and chemical -; environments,” Miller said. “If initiating exposures corresponding to pesticides, toxic mold, implants and combustion products usually are not stopped, sensitivities can spiral uncontrolled.”

Teaching in schools of drugs, public health, architecture and engineering has not kept pace with these toxicants, a lot of that are latest to the planet since World War ll, Miller noted. That is exacerbated by energy conservation efforts which have increased exposures to indoor air toxicants, she said.

Marilyn Brachman Hoffman

Of their acknowledgments, the authors “thank the Marilyn Brachman Hoffman Foundation for generously funding this study and Marilyn Hoffman for her prescient bequest prioritizing research on toxicant-induced lack of tolerance. We’re deeply grateful to the patients who participated on this groundbreaking study.”

Hoffman’s bequest specified research on TILT. “She suffered terribly from chemical, food and drug intolerances herself, but especially from not being believed by members of the family and her doctors,” Miller said. “She was a citizen-scientist who read all my papers and book, “Chemical Exposures: Low Levels and High Stakes,” co-authored with Nicholas Ashford, PhD, JD, of the Massachusetts Institute of Technology.

“Greater than anything, Mrs. Hoffman desired to discover the biomechanism for TILT,” Miller said. “She knew that it was essential for helping patients like herself. Her bequest has led to publication of the biomechanism for TILT in a series of papers over the past two years in Environmental Sciences Europe, a journal read by regulatory toxicologists all over the world.”

In case you suspect that you simply or a loved one has developed chemical intolerance or TILT, answer this temporary, three yes-or-no query screening test, called BREESI. A positive response to any of the questions should result in taking the more extensive, validated diagnostic questionnaire, the QEESI, or Quick Environmental Exposure and Sensitivity Inventory. Individuals who have high scores on the QEESI are seen as prone to be chemically intolerant and are encouraged to share the knowledge with their health care providers.

Source:

University of Texas Health Science Center at San Antonio

Journal reference:

Miller, C. S., et al. (2023) What initiates chemical intolerance? Findings from a big population-based survey of U.S. adults. Environmental Sciences Europe. doi.org/10.1186/s12302-023-00772-x.