EMFs and Chemical Hypersensitivity Part 3: TILT, MCS, and Immune Dysfunction

Welcome to part 3 of ODX's "Electromagnetic and Chemical Hypersensitivity" Series. In the third post, we'll explore the intricate connection between Toxicant-Induced Loss of Tolerance (TILT), Multiple Chemical Sensitivity (MCS), and Immune Dysfunction in individuals experiencing hypersensitivity to electromagnetic and chemical triggers.

The ODX EMF Series

Dicken Weatherby, N.D. and Beth Ellen DiLuglio, MS, RDN, LDN

1. Electromagnetic and Chemical Hypersensitivity Part 1: Electromagnetic Fields
2. Electromagnetic and Chemical Hypersensitivity Part 2: Health Effects of EMFs
3. Electromagnetic and Chemical Hypersensitivity Part 3: TILT, MCS, and Immune Dysfunction
4. Electromagnetic and Chemical Hypersensitivity Part 4: Mitigating SRIs

Exposure to toxic chemicals, pesticides, heavy metals, surgical implants, dental material, infections, radioactive compounds, etc., can “bioaccumulate” the body and contribute to electromagnetic hypersensitivity. Eventually, this overwhelming load can lead to a toxicant-induced loss of tolerance (TILT), a phenomenon associated with multiple chemical sensitivity (MCS) impaired immune tolerance, hypersensitivity, altered catecholamine and neurotransmitter metabolism, compromised detoxification, and a dysregulated immune response. Once a certain threshold has been reached, a relatively small amount of exposure can trigger systemic signs and symptoms (Genuis 2012).

The Phenomenon of TILT

Source: Masri, Shahir, et al. "Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon." Environmental Sciences Europe 33.1 (2021): 1-19. This article is licensed under a Creative Commons Attribution 4.0 International License

The concept of TILT was considered in 1997 when researchers proposed that susceptible individuals may become extremely sensitive to chemicals, drugs, foods, alcohol, or caffeine, even though they had tolerated these compounds in the past. Once they have lost tolerance, extremely low doses may trigger a reaction in these individuals (Miller 1997).

The TILT phenomenon appears to correspond to the dramatic expansion of petrochemical use following World War II, including agricultural organophosphate pesticides, solvents, dyes, and fragrances. A review of eight major exposure events, including Gulf War veterans, pesticide workers, and the World Trade Center collapse, found that the toxins most commonly associated with TILT were mixed volatile and semi-volatile organic compounds followed by pesticides and combustion products. Specific chemicals included pesticides, peroxides, nerve agents, anti-nerve agent drugs, lubricants and additives, xylene, benzene, and acetone. Once TILT has occurred, individuals can become increasingly sensitive and intolerant to the smell of gasoline, perfume, cleaning compounds, pesticides, and even newsprint (Masri 2021).

Multiple Chemical Sensitivity

Multiple chemical sensitivity (MCS) Definition (Damiani 2021)

• A multisystem, recurrent, environmental disorder
• MCS flares in response to different exposures (i.e., pesticides, solvents, toxic metals, and molds) under the threshold limit value (TLV) calculated for age and gender in the general population.
• MCS is a syndrome characterized by cutaneous, allergic, gastrointestinal, rheumatological, endocrinological, cardiological, and neurological signs and symptoms.

MCS is an emerging disorder characterized by a sensitivity and physiological reaction to a dose of chemicals that would not trigger a response in most individuals. Although a clear dose-response association has not been identified, individuals with MCS often react to petroleum-based chemicals, including plastics, pesticides, epoxy, cleaning products, detergents, diesel exhaust, formaldehyde, and synthetic fragrances, as well as carpeting and related chemicals. Over time, the range of symptoms and triggers increases. The phenomenon of MCS may be associated with heightened odor sensitivity, fibromyalgia, Gulf War Syndrome, chronic fatigue syndrome, sick building syndrome, and electromagnetic radiation exposure. Multiple chemical sensitivity may be closely associated with electromagnetic hypersensitivity (EHS). Common symptoms of MCS that resolve when the offending compound is removed include (Zucco 2021):

• Anxiety
• Chest pain
• Concentration deficits
• Depression
• Dizziness
• Fatigue
• Headache
• Indigestion
• Joint pain
• Memory deficits
• Mood disruption
• Nausea
• Runny nose
• Throat pain
• Upper respiratory discomfort

Symptoms Questionnaires

The Brief Environmental Exposure and Sensitivity Inventory (BREESI) is a screening tool that can predict the likelihood of chemical intolerance. If identified, chemical intolerance can be further evaluated using the Quick Environmental Exposure and Sensitivity Inventory (QEESI©) (Palmer 2020):

• The BREESI is not a substitute for the QEESI but a time-saving tool to identify individuals likely to have chemical intolerance.
• The BREESI may be helpful for researchers, clinicians, health plans, and workplace or community investigations.
• Individuals answering “yes” to any of the three BREESI questions should complete a full QEESI questionnaire.
• BREESI questions include:
  • Do you feel sick when you are exposed to tobacco smoke, certain fragrances, nail polish/remover, engine exhaust, gasoline, air fresheners, pesticides, paint/thinner, fresh tar/asphalt, cleaning supplies, new carpeting, or furniture?
    • By sick, we mean headaches, difficulty thinking, difficulty breathing, weakness, dizziness, upset stomach, etc.
  • Are you unable to tolerate or do you have adverse or allergic reactions to any drugs or medications (such as antibiotics, anesthetics, pain relievers, x-ray contrast dye, vaccines, or birth control pills) or an implant, prosthesis, contraceptive chemical, or device, or other medical/surgical/dental material or procedure?
  • Are you unable to tolerate or do you have adverse reactions to any foods such as dairy products, wheat, corn, eggs, caffeine, alcoholic beverages, or food additives (such as MSG or food dye)?
• Individuals who endorse 2 or 3 BREESI items may be at greater risk of developing additional intolerances or adverse reactions to exposures or medications.

The Quick Environmental Exposure and Sensitivity Inventory (QEESI©) questionnaire can help identify sensitivity to common chemical triggers (Miller 2021):

• The QEESI is a validated 50-item questionnaire
• QEESI is considered the international reference standard for assessing CI
• It is based on data from over 32,000 respondents from 16 countries
• The QEESI has four scales:
• Symptom Severity
• Chemical Intolerances
• Other Intolerances
• Life Impact
• Each scale item is scored from 0 to 10 (0 = “not a problem” to 10 = “severe or disabling problem”).
• Total scale scores range from 0 to 100.
• There is also a 10-item Masking Index, which gauges ongoing exposures (such as to caffeine, tobacco, or drugs) that can reduce or mask individuals’ awareness of their intolerances
• QEESI© https://aseq-ehaq.ca/wp-content/uploads/2020/07/QEESI-EN.pdf

Immune Dysfunction

Exposure to man-made EMFs is associated with immunological changes in humans and animals, including low-level exposure to wireless technologies. These changes indicate immune activation, including inflammation, allergic reactions, mast cell proliferation, altered lymphocyte viability, and decreased natural killer and T-lymphocyte counts. Individuals with electromagnetic hypersensitivity often report immune-related symptoms, including itching, redness, pain, heat sensation, papules, pustules, coughing, etc., after exposure to visual display terminals, cellphones, DECT phones, and WiFi equipment. Some individuals can see a profound increase in mast cells, degranulated mast cells, histamine, chymase, and tryptase. A small study of 23 EHS subjects found symptoms including skin redness, eczema, nasal congestion, sweating, cognitive issues, and muscle and joint pain even without an elevation in IgE antibodies (Johansson 2009).

Once an individual has become hypersensitive to toxins and entered the TILT phase, minimal exposure to antigens such as pollen, foods, chemicals, EMFs, etc., can trigger an immune reaction involving pro-inflammatory cytokines and antibodies, including IgA, IgE, and IgM. Associated multimorbidity symptoms include allergic-type reactions, compromised respiratory status, gastrointestinal damage, malabsorption, musculoskeletal impairment, neurological dysfunction, psychological disorders, and fatigue. Chronic inflammation and suboptimal blood chemistry can be a hallmark of TILT-associated dysfunction (Genuis 2014).

Mast Cell Activation Syndrome (MCAS)

The activation of mast cells appears to underlie TILT and multiple chemical sensitivity, and their association is explained in many cases. A study of 147 subjects with MCAS, 345 subjects with chemical intolerance/TILT, and 76 healthy controls found that 59% of MCAS subjects met the criteria for chemical intolerance using the validated Quick Environmental Exposure and Sensitivity Inventory (QEESI). The likelihood of having chemical intolerance/TILT increased as the likelihood of MCAS increased, with symptom and intolerance patterns becoming nearly identical between the chemical intolerant and MCAS groups. Researchers surmise that chemicals and xenobiotics activate mast cells and promote the release of mediators, including histamine, which can cause hives, hypotension, syncope, respiratory distress, and even death. Mast cells can respond immediately or over time and signal other immune cells to participate in the reaction. The concentration of chemicals and other triggers inside sealed buildings may increase mast cell activation, though hypersensitivity can eventually lead to a reaction following low-dose exposures. The following subjects met the criteria for TILT/chemical intolerance (Miller 2021):

Source: Miller, Claudia S., et al. "Mast cell activation may explain many cases of chemical intolerance." Environmental Sciences Europe 33 (2021): 1-15. This article is licensed under a Creative Commons Attribution 4.0 International License

Optimal Takeaways TILT, Multiple Sensitivities, and Immune Dysfunction

• Exposure to toxic substances such as pesticides, heavy metals, and other pollutants can lead to a condition known as toxicant-induced loss of tolerance (TILT).
• TILT causes individuals to become extremely sensitive to everyday chemicals, EMFs, and environmental triggers that were previously tolerable, leading to multiple chemical sensitivity (MCS) and a range of severe health symptoms.
• The concept of TILT highlights the increasing sensitivity to chemicals following significant historical increases in chemical use, particularly petrochemicals.
  • This sensitivity manifests in severe reactions to common substances like gasoline, perfumes, and cleaning products, which can profoundly affect the quality of life for those affected.
• Researchers have identified that minimal exposure to certain chemicals or EMFs can cause immune reactions and inflammation once TILT is triggered.
  • These reactions are characterized by various symptoms, including allergic responses, respiratory issues, and neurological symptoms, indicating a severe disruption in immune system function.
• The management of TILT involves careful avoidance of known triggers. It may require interventions to reduce exposure to both chemical and electromagnetic pollutants to prevent the immune system's overwhelming and help mitigate the chronic health issues associated with TILT and MCS.

References

Damiani, Giovanni et al. “Italian Expert Consensus on Clinical and Therapeutic Management of Multiple Chemical Sensitivity (MCS).” International journal of environmental research and public health vol. 18,21 11294. 27 Oct. 2021, doi:10.3390/ijerph182111294 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Genuis, Stephen J. “Sensitivity-related illness: the escalating pandemic of allergy, food intolerance and chemical sensitivity.” The Science of the total environment vol. 408,24 (2010): 6047-61. doi:10.1016/j.scitotenv.2010.08.047

Genuis, Stephen J, and Christopher T Lipp. “Electromagnetic hypersensitivity: fact or fiction?.” The Science of the total environment vol. 414 (2012): 103-12. doi:10.1016/j.scitotenv.2011.11.008

Genuis, Stephen J, and Marko G Tymchak. “Approach to patients with unexplained multimorbidity with sensitivities.” Canadian family physician Medecin de famille canadien vol. 60,6 (2014): 533-8.

Johansson, Olle. “Disturbance of the immune system by electromagnetic fields-A potentially underlying cause for cellular damage and tissue repair reduction which could lead to disease and impairment.” Pathophysiology : the official journal of the International Society for Pathophysiology vol. 16,2-3 (2009): 157-77. doi:10.1016/j.pathophys.2009.03.004  

Masri, Shahir, et al. "Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon." Environmental Sciences Europe 33.1 (2021): 1-19

Miller, C S. “Toxicant-induced loss of tolerance--an emerging theory of disease?.” Environmental health perspectives vol. 105 Suppl 2,Suppl 2 (1997): 445-53. doi:10.1289/ehp.97105s2445

Miller, Claudia S., et al. "Mast cell activation may explain many cases of chemical intolerance." Environmental Sciences Europe 33 (2021): 1-15. This article is licensed under a Creative Commons Attribution 4.0 International License

Palmer, Raymond F et al. “Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI).” PloS one vol. 15,9 e0238296. 16 Sep. 2020, doi:10.1371/journal.pone.0238296 This is an open access article distributed under the terms of the Creative Commons Attribution License

The Quick Environmental Exposure and Sensitivity Inventory (QEESI©) https://aseq-ehaq.ca/wp-content/uploads/2020/07/QEESI-EN.pdf

Zucco, Gesualdo M, and Richard L Doty. “Multiple Chemical Sensitivity.” Brain sciences vol. 12,1 46. 29 Dec. 2021, doi:10.3390/brainsci12010046 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).