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 (MCS) or Idiopathic Environmental Intolerance (IEI).[1] The TILT hypothesis describes how chemical intolerances to synthetic or natural chemicals, foods, or drugs develops.[2][1] People with TILT are said to be have been TILTed.[2]

Theory[edit | edit source]

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[3]

Common symptoms are:

The Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a self-report questionnaire to identify who may have MCS/IEI.[4]

Evidence[edit | edit source]

Treatment[edit | edit source]

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.[5]

Notable studies[edit | edit source]

  • 1996, Chemical sensitivity: symptom, syndrome or mechanism for disease?[6] (Abstract)
  • 1997, Toxicant-induced loss of tolerance--an emerging theory of disease?[7] (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[8] (Full text)
  • 2006, The Compelling Anomaly of Chemical Intolerance[9] (Full text)
  • 2013, Chemical sensitivity: pathophysiology or pathopsychology?[10] (Full text)
  • 2014, Toxicant-Induced Loss of Tolerance: A Theory to Account for Multiple Chemical Sensitivity[11] (Full text)
  • 2020, Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI)[12] (Full text)
  • 2021, Mast cell activation may explain many cases of chemical intolerance[13] (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[1] (Full text)
  • 2021, Multiple Chemical Sensitivity[14] (Full text)

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 Masri, Shahir; Miller, Claudia S.; Palmer, Raymond F.; Ashford, Nicholas (May 27, 2021). "Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon". Environmental Sciences Europe. 33 (1): 65. doi:10.1186/s12302-021-00504-z. ISSN 2190-4715.
  2. 2.0 2.1 "Origins of TILT". Tilt Research. Retrieved January 8, 2022.
  3. "How Chemically Sensitive Are You?". Tilt Research. September 15, 2021. Retrieved January 8, 2022.
  4. "Chemical Intolerance Self Assessment (QEESI)". Tilt Research. Retrieved January 8, 2022.
  5. "TILT FAQs | Hoffman TILT Program". Tilt Research. Retrieved January 8, 2022.
  6. Miller, Claudia S. (July 17, 1996). "Chemical sensitivity: symptom, syndrome or mechanism for disease?". Toxicology. 111 (1): 69–86. doi:10.1016/0300-483X(96)03393-8. ISSN 0300-483X.
  7. Miller, C S (March 1997). "Toxicant-induced loss of tolerance--an emerging theory of disease?". Environmental Health Perspectives. 105 (suppl 2): 445–453. doi:10.1289/ehp.97105s2445. ISSN 0091-6765. PMC 1469811. PMID 9167978.
  8. Miller, Claudia S. (April 1999). "Are we on the threshold of a new theory of disease? Toxicant-induced loss of tolerance and its relationship to addiction and abdiction". Toxicology and Industrial Health. 15 (3–4): 284–294. doi:10.1177/074823379901500302. ISSN 0748-2337.
  9. Miller, Claudia S. (2006). "The Compelling Anomaly of Chemical Intolerance". Annals of the New York Academy of Sciences. 933 (1): 1–23. doi:10.1111/j.1749-6632.2001.tb05810.x. ISSN 1749-6632.
  10. Genuis, Stephen J. (May 2013). "Chemical sensitivity: pathophysiology or pathopsychology?". Clinical Therapeutics. 35 (5): 572–577. doi:10.1016/j.clinthera.2013.04.003. ISSN 1879-114X. PMID 23642291.
  11. Horowitz, Sala (April 2014). "Toxicant-Induced Loss of Tolerance: A Theory to Account for Multiple Chemical Sensitivity". Alternative and Complementary Therapies. 20 (2): 96–100. doi:10.1089/act.2014.20201. ISSN 1076-2809.
  12. Palmer, Raymond F.; Jaén, Carlos R.; Perales, Roger B.; Rincon, Rodolfo; Forster, Jacqueline N.; Miller, Claudia S. (September 16, 2020). "Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI)". PLOS ONE. 15 (9): e0238296. doi:10.1371/journal.pone.0238296. ISSN 1932-6203. PMC 7494077. PMID 32936802.
  13. Miller, Claudia S.; Palmer, Raymond F.; Dempsey, Tania T.; Ashford, Nicholas A.; Afrin, Lawrence B. (November 17, 2021). "Mast cell activation may explain many cases of chemical intolerance". Environmental Sciences Europe. 33 (1): 129. doi:10.1186/s12302-021-00570-3. ISSN 2190-4715.
  14. Zucco, Gesualdo M.; Doty, Richard L. (December 29, 2021). "Multiple Chemical Sensitivity". Brain Sciences. 12 (1): 46. doi:10.3390/brainsci12010046. ISSN 2076-3425.