Toxicant-induced loss of tolerance (TILT)

Toxicant-induced loss of tolerance or TILT is a proposed term for a new class of diseases involving chemical intolerance, previously called Multiple Chemical Sensitivity (MCS) or Idiopathic Environmental Intolerance (IEI). The TILT hypothesis describes how chemical intolerances to synthetic or natural chemicals, foods, or drugs develops. People with TILT are said to be have been TILTed.

Theory
The TILT hypothesis is that there are two stages to developing chemical intolerances: Common symptoms are: The Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a self-report questionnaire to identify who may have MCS/IEI.
 * the person experiences either a single major chemical exposure, or a series of low-level chemical exposures, causing chemical intolerances to develop
 * symptoms are then triggered by everyday chemicals, foods, and drugs that never bothered the person before
 * neurological symptoms: memory problems, brain fog (difficulty thinking), and mood changes
 * gastrointestinal symptoms
 * headaches or migraines
 * fatigue
 * muscle pain

Treatment
The main approach is to manage symptoms of chemical intolerance by identifying the chemicals, food or drugs that the person is intolerant to, and then avoiding then.

Notable studies

 * 1996, Chemical sensitivity: symptom, syndrome or mechanism for disease? (Abstract)
 * 1997, Toxicant-induced loss of tolerance--an emerging theory of disease? (Full text)
 * 1999, Are we on the threshold of a new theory of disease? Toxicant-induced loss of tolerance and its relationship to addiction and abdiction (Full text)
 * 2006, The Compelling Anomaly of Chemical Intolerance (Full text)
 * 2013, Chemical sensitivity: pathophysiology or pathopsychology? (Full text)
 * 2014, Toxicant-Induced Loss of Tolerance: A Theory to Account for Multiple Chemical Sensitivity (Full text)
 * 2020, Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI) (Full text)
 * 2021, Mast cell activation may explain many cases of chemical intolerance (Full text)
 * "MCAS mirrors the two-stage disease mechanism that Miller first described as toxicant-induced loss of tolerance (TILT) in 1996"


 * 2021, Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon (Full text)
 * 2021, Multiple Chemical Sensitivity (Full text)

Learn more

 * TILT research - UT Health San Antonio
 * Common chemical triggers and alternatives - UT Health San Antonio
 * TILT Brochure