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Toxicant-induced loss of tolerance (TILT)
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'''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|Multiple Chemical Sensitivity]] (MCS) or Idiopathic Environmental Intolerance (IEI).<ref name="Masri2021" /> The TILT hypothesis describes how chemical intolerances to synthetic or natural chemicals, foods, or drugs develops.<ref name="tilt-origins">{{Cite web|url=https://tiltresearch.org/about-tilt/tilt-origins/ | title = Origins of TILT|website=Tilt Research|language=en-US|access-date=2022-01-08}}</ref><ref name="Masri2021" /> People with TILT are said to be have been '''TILTed'''.<ref name="tilt-origins" /> ==Theory== The TILT hypothesis is that there are two stages to developing chemical intolerances: *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<ref>{{Cite web|url=https://tiltresearch.org/2021/09/15/how-chemically-sensitive-are-you/ | title = How Chemically Sensitive Are You? | last = | first = | author-link =| date = 2021-09-15 | website = Tilt Research|language=en-US|archive-url=|archive-date=|url-status=|access-date=2022-01-08}}</ref> Common symptoms are: * neurological symptoms: [[memory problems]], [[brain fog]] (difficulty thinking), and [[Mental health|mood changes]] * [[:Category:Digestive signs and symptoms|gastrointestinal symptoms]] * [[Headache|headaches]] or [[Migraine|migraines]] * [[Fatigue: Biomedicine, Health & Behavior|fatigue]] * [[Myalgia|muscle pain]] The [[Quick Environmental Exposure and Sensitivity Inventory]] (QEESI) is a self-report questionnaire to identify who may have MCS/IEI.<ref name="qeesi">{{Cite web|url=https://tiltresearch.org/qeesi-2/ | title = Chemical Intolerance Self Assessment (QEESI)|website=Tilt Research|language=en-US|access-date=2022-01-08}}</ref> ==Evidence== ==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.<ref name="faq">{{Cite web|url=https://tiltresearch.org/about-tilt/frequently-asked-questions/ | title = TILT FAQs {{!}} Hoffman TILT Program|website=Tilt Research|language=en-US|access-date=2022-01-08}}</ref> {{See also|Multiple chemical sensitivity#Treatment|Multiple chemical sensitivity - treatment}} ==Notable studies == *1996, Chemical sensitivity: symptom, syndrome or mechanism for disease?<ref name="Miller1996">{{Cite journal | title = Chemical sensitivity: symptom, syndrome or mechanism for disease? | date = 1996-07-17|url=https://www.sciencedirect.com/science/article/pii/0300483X96033938|journal=Toxicology|volume=111|issue=1 | pages = 69–86 | last =Miller | first = Claudia S. | author-link = Claudia Miller|language=en|doi=10.1016/0300-483X(96)03393-8|issn=0300-483X}}</ref> [https://www.sciencedirect.com/science/article/abs/pii/0300483X96033938 (Abstract)] *1997, Toxicant-induced loss of tolerance--an emerging theory of disease?<ref name="Miller1997">{{Cite journal | title = Toxicant-induced loss of tolerance--an emerging theory of disease? | date = Mar 1997|url=https://ehp.niehs.nih.gov/doi/10.1289/ehp.97105s2445|journal=Environmental Health Perspectives|volume=105|issue=suppl 2|pages=445–453 | last =Miller | first = C S | authorlink = Claudia Miller|language=en|doi=10.1289/ehp.97105s2445|pmc=PMC1469811|pmid=9167978|access-date=|issn=0091-6765|quote=|via=}}</ref> [https://ehp.niehs.nih.gov/doi/pdf/10.1289/ehp.97105s2445 (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<ref name="Miller1999">{{Cite journal | title = Are we on the threshold of a new theory of disease? Toxicant-induced loss of tolerance and its relationship to addiction and abdiction | date = Apr 1999|url=https://journals.sagepub.com/doi/abs/10.1177/074823379901500302|journal=Toxicology and Industrial Health|volume=15|issue=3-4|pages=284–294 | last =Miller | first = Claudia S. | author-link = Claudia Miller|doi=10.1177/074823379901500302|pmc=|pmid=|access-date=|issn=0748-2337|quote=|via=}}</ref> [https://journals.sagepub.com/doi/abs/10.1177/074823379901500302 (Full text)] *2006, The Compelling Anomaly of Chemical Intolerance<ref name="Miller2006-compelling">{{Cite journal | title = The Compelling Anomaly of Chemical Intolerance | date = 2006 |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.2001.tb05810.x|journal=Annals of the New York Academy of Sciences|volume=933|issue=1|pages=1–23 | last =Miller | first = Claudia S. | author-link = Claudia Miller|language=en|doi=10.1111/j.1749-6632.2001.tb05810.x|issn=1749-6632}}</ref> [https://www.academia.edu/52776539/The_Compelling_Anomaly_of_Chemical_Intolerance (Full text)] *2013, Chemical sensitivity: pathophysiology or pathopsychology?<ref name="Genuis2013">{{Cite journal | title = Chemical sensitivity: pathophysiology or pathopsychology? | date = May 2013|url=https://pubmed.ncbi.nlm.nih.gov/23642291/|journal=Clinical Therapeutics|volume=35|issue=5|pages=572–577 | last =Genuis | first = Stephen J. | author-link = |doi=10.1016/j.clinthera.2013.04.003|pmc=|pmid=23642291|access-date=|issn=1879-114X|quote=|via=}}</ref> [https://www.national-toxic-encephalopathy-foundation.org/wp-content/uploads/2012/01/Clin_Ther_-_Chemical_Sensitivity.pdf (Full text)] *2014, Toxicant-Induced Loss of Tolerance: A Theory to Account for Multiple Chemical Sensitivity<ref name="Horowitz2014">{{Cite journal | title = Toxicant-Induced Loss of Tolerance: A Theory to Account for Multiple Chemical Sensitivity | date = Apr 2014|url=https://www.liebertpub.com/doi/pdf/10.1089/act.2014.20201|journal=Alternative and Complementary Therapies|volume=20|issue=2 | pages = 96–100 | last =Horowitz | first = Sala | authorlink = |doi=10.1089/act.2014.20201|pmc=|pmid=|access-date=|issn=1076-2809|quote=|via=}}</ref> [https://www.niehs.nih.gov/news/assets/docs_a_e/download_background_material_toxicantinduced_loss_of_tolerance_by_claudia_miller_508.pdf (Full text)] *2020, Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI)<ref name="Palmer2020">{{Cite journal | title = Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI) | date = 2020-09-16|url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238296|journal=PLOS ONE|volume=15|issue=9| pages = e0238296 | last =Palmer | first = Raymond F. | last2 = Jaén | first2=Carlos R. | last3 = Perales | first3=Roger B. | last4 = Rincon | first4 = Rodolfo| last5 = Forster | first5 = Jacqueline N. | last6 = Miller | first6 = Claudia S. | authorlink6 = Claudia Miller|language=en|doi=10.1371/journal.pone.0238296|pmc=PMC7494077|pmid=32936802|issn=1932-6203}}</ref> [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238296 (Full text)] *2021, Mast cell activation may explain many cases of chemical intolerance<ref name="Miller2021">{{Cite journal | title = Mast cell activation may explain many cases of chemical intolerance | date = 2021-11-17|url=https://doi.org/10.1186/s12302-021-00570-3|journal=Environmental Sciences Europe|volume=33|issue=1|pages=129 | last =Miller | first = Claudia S. | authorlink = Claudia Miller | last2=Palmer | first2 = Raymond F. | last3 = Dempsey | first3 = Tania T. | last4 = Ashford | first4 = Nicholas A. | last5 = Afrin | first5 = Lawrence B.|language=en|doi=10.1186/s12302-021-00570-3|issn=2190-4715}}</ref> [https://link.springer.com/article/10.1186/s12302-021-00570-3 (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<ref name="Masri2021">{{Cite journal | title = Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon | date = 2021-05-27|url=https://doi.org/10.1186/s12302-021-00504-z|journal=Environmental Sciences Europe|volume=33|issue=1 | pages = 65 | last =Masri | first = Shahir | last2=Miller | first2=Claudia S. | authorlink2 = Claudia Miller | last3=Palmer | first3=Raymond F. | last4 = Ashford | first4 = Nicholas|language=en|doi=10.1186/s12302-021-00504-z|issn=2190-4715}}</ref> [https://link.springer.com/article/10.1186/s12302-021-00504-z?wt_mc=Internal.Event.1.SEM.ArticleAuthorIncrementalIssue (Full text)] *2021, Multiple Chemical Sensitivity<ref name="Zucco2021">{{Cite journal | title = Multiple Chemical Sensitivity | date = 2021-12-29|url=https://www.mdpi.com/2076-3425/12/1/46/htm|journal=Brain Sciences|volume=12|issue=1|pages=46 | last =Zucco | first = Gesualdo M. | last2 = Doty | first2 = Richard L.|doi=10.3390/brainsci12010046|issn=2076-3425}}</ref> [https://www.mdpi.com/2076-3425/12/1/46/htm (Full text)] ==See also== *[[Quick Environmental Exposure and Sensitivity Inventory]] (QEESI) *[[Multiple chemical sensitivity]] ==Learn more== *[https://tiltresearch.org/qeesi-2/ TILT research] - UT Health San Antonio *[https://tiltresearch.org/about-tilt/triggers-prevention/ Common chemical triggers and alternatives] - UT Health San Antonio *[https://issuu.com/elisco/docs/tilt_ebook TILT Brochure] ==References== {{reflist}} [[Category:Medical hypotheses]]
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