If you're playing pinball and bang it about, the word 'TILT' will show up on the screen. This four-letter word also stands for 'toxicant-induced loss of tolerance', an apt name for the violent impact of a noxious exposure that knocks you completely out of kilter.
Multiple chemical sensitivity (MCS) is now a fully accepted medi-cal condition (Bascom R. Chemical Hyper-sensitivity Syndrome Study: Options for Action, a Literature Review, and a Needs Assessment. State of Maryland Department of Health, 1989; Ashford N, Miller C. Chemical Exposures: Low Levels and High Stakes, 1st edn. New York, NY: van Nostrand Reinhold, 1991: 232 ff). In fact, N. Ashford and C. Miller's 1989 report-Chemical Sensitivity-to the New Jersey State Department of Health won the prestigious Macedo Award for the most outstanding contribution to public health funded by a state health department.
Previously, MCS was viewed as 'all in the head'. After 1991, MCS was recognized as due to toxic overload from the patient's environment. The US National Research Council developed recommendations for MCS directed at, among others, orthodox clinicians, naturopaths, toxicolo-gists, immunologists, epidemiolo-gists, psychiatrists and psychologists.
Research since then has shown that the TILT spectrum of disorders leads to a loss of tolerance to specific chemicals, foods, herbals, and/or complex homeopathic remedies and conventional drugs. It's clear that:
- many different kinds of chemicals cause TILT responses (see box)
- responses can involve any and every organ system
- specific mechanisms vary greatly
- there's no single biomarker of a response, and identifying the cor-rect biomarkers may be a very slow process
- prevention (avoidance of triggers) may precede knowledge of the specific mechanisms.
TILT can lead to a diverse spectrum of diseases, including attention-deficit/hyperactivity disorder (ADHD), depression, nose and ear infections, chronic fatigue syndrome, eczema, fibromyalgia, arthritis, irritable bowel syndrome, gastric reflux, asthma, cardiac arrhythmias and hypertension.
The more thorough naturopathic physicians will review every bodily system and symptom in the search for environmental contributors to the patient's illness, with emphasis placed on patients' dietary and exposure histories. Environmental exposure can provoke symptoms in several systems at the same time, and exposure to even tiny amounts of a chemical can induce TILT in those who have a heightened reactivity. Unlike what happens in orthodox medicine, the diagnosis is usually made before end-organ damage occurs.
Hypersensitivity to solvents, pes-ticides, combustion products, off-gassing from particleboard (chip-board, Prestwood, masonite board), metals and plasticizers-to name but a few-is generally tested for using the lymphocyte chemical-sensitivity test, although a number of other appropriate tests are also available.
Some practitioners carry out inhalation challenges in specially constructed exposure chambers (usually for cases involving disability).
Isopathic drainage, enzyme-potentiated desensitization (EPD), nutritional supplementation, expo-sure avoidance (whenever possible), homeopathic immunotherapy and chelation therapy are some of the treatment approaches of choice.
In my clinical practice, each of these treatments works, albeit to varying degrees and according to the given patient. I have often used two or more of these therapeutic approaches in combination, follow-ing the appropriate testing.
At present, it's safe to say that TILT is the effect of pollution 'in spades'. It's also likely that the so-called 'Gulf War syndrome' belongs to the TILT spectrum of disorders. Toxicant-induced loss of tolerance is not a widespread condition, which may be why it is still not properly understood or studied.
Harald Gaier, a registered naturopath, osteopath, homeopath and herbalist, practises at The Allergy and Nutrition Clinic, 22 Harley Street, London, and the Irish Centre of Integrated Medicine, Co. Kildare (www.drgaier.com).
What causes TILT?
In my practice over the past six years, the 26 most common causative agents of TILT were (in decreasing order of frequency):
- Paint and/or thinner
- Detergents (particularly laundry powders)
- Lauryl sulphate (in shampoo and toothpaste)
- Ammonium compounds
- Solder flux and welding fumes
- Petrol (gasoline)
- Paraffin (kerosene)
- Nail polish
- Carbon tetrachloride
- Dental and/or other metals
- Polyvinyl chloride
- Sulphur dioxide and/or sulphur-based preservatives
- Wood dust and/or resin.