“In chemical sensitivity multi-organ complaints should be expected and their presence is not evidence of psychological origin, even though brain functions are often involved.”
It may not be surprising that chemical exposure seems to make some people ill, as we are now exposed to many more man-made chemicals than ever before.
• Most have not been fully tested even for individual toxicity.
• Even fewer have been checked for the possibility that combinations could give problems not seen with exposure to a single substance.
Chemicals enter the body by being ingested (in food, as additives, in water, from the hands, or as drugs), inhaled, injected, or by being absorbed through the skin. Any chemical that enters the body has to be 'detoxified' (broken down) and eliminated. This process is carried out by a range of enzymes and pathways in the body, notably in the liver, kidneys and blood.
How May Chemical Sensitivity Develop?
One theory is that chemical sensitivity develops when these pathways don't work effectively enough to keep up with demand.
Chemical sensitivity often (but not always) develops in people who are prone to other types of allergy. They may have a history of asthma, eczema or hay fever [pollen allergy] in the past, or in close family members. Some will have been prone to headaches from perfumes, or nausea from paint smells, for many years and this gradually develops into more serious chemical sensitivity.
In other patients illness follows an acute exposure to a high level of a particular chemical such as a pesticide, or fumes from an office photocopier. In this latter group a higher than normal chemical exposure triggers illness and after this the patient reacts to the much lower levels found in everyday life, which previously were not a problem.
• Initially they react to the same chemical that set off their sensitivity (although at much lower doses);
• Then they begin to react to related chemicals;
• Then (often) the sensitivity spreads to almost any chemical.
Patients with these problems can also be triggered into reactions to foods (food intolerance) and/or classic inhalant allergens like house dust mites, moulds, pets or pollens. They tend easily to acquire new allergies.
This pattern has been termed Toxicant Induced Loss of Tolerance (TILT) and is an important feature of the condition.
What Sort of Illness Does It Cause?
Even 'classic' allergy is usually a multi-organ disease; for example, hay fever can affect the eyes, nose, chest and skin. Thus in chemical sensitivity multi-organ complaints should be expected and their presence is not evidence of psychological origin, even though brain functions are often involved.
Most chemically sensitive people are grossly fatigued and have trouble with coordinating (brain fog) and lengthy concentration (brain fag).
Headaches are common. Many tend to have skin rashes (urticaria and/or eczema), irritable bowel, musculoskeletal pains, asthma and rhinitis. Burning sensations are common.
Whilst many become depressed, in some this may be a consequence of having the cause of their problems rejected by unsympathetic doctors, although primary depression also occurs.
Some patients manage to create a safe island within their own homes where they can keep fairly well and find leaving this environment makes them worse and they become frightened about doing so.
How Does It Make You Ill?
The mechanism of chemical sensitivity is not known. As mentioned, it appears to be due to an alteration in the ability of the body to detoxify and get rid of chemicals, combined with some sort of increased sensitivity to the effects of these chemicals on the body.
Detoxification pathways rely heavily on vitamins, minerals and some amino acids to work effectively, and in some people there may be a link with low levels or inadequate absorption and use of these substances.
The body has a limited number of detoxification pathways, down which all chemicals and other substances must pass to be detoxified. There seems, therefore, to be a 'total load' effect - if a pathway is busy detoxifying one chemical, there is less availability for other chemicals to be 'cleared'.
What Can Be Done About It?
It is important that patients be given a correct diagnosis. Currently so few people are trained to recognize and treat multiple chemical sensitivity (MCS) that there is a real danger that patients are misdiagnosed, usually as suffering from a psychiatric condition.
General practitioners should be enabled to identify the possibility that individual patients may be affected and to ensure that they receive appropriate management.
A doctor or specialist skilled in the management of chemical sensitivity should be able to take a full medical and environmental exposure history (usually a lengthy procedure) and would be familiar with the various methods which might be used to aid diagnosis using specialist laboratory testing. Biochemical tests of nutritional status may be required.
There are four main strands to the self-management of chemical sensitivity.
1. Reduction of exposure to chemicals.
As chemical sensitivity tends to spread from one substance to others over time, it is important to reduce exposure to all chemicals, not just those to which you are reacting at the moment. This also frees up the detoxification pathways to work more effectively.
See below for 'Chemical Avoidance' information. Note that some of the enzymes that detoxify chemicals are 'inducible' - that is to say, they are only produced in response to the chemical being present. Therefore over-zealous avoidance of chemicals may lead to a reduction in the ability to detoxify that chemical (and perhaps related chemicals).
While it is important to create a 'safe-haven' at home, it is also important to maintain contact with the outside world for this reason, and for psychological benefit.
2. Reduction of exposure to other allergens.
Chemically-sensitive people seem to have an increased tendency to become affected by other allergens such as housedust mites, moulds and animals. It is therefore important to follow general allergen reduction advice (see the 'Avoiding Indoor Allergens' fact sheet).
Good nutrition is vitally important in managing chemical sensitivity. A wide range of vitamins, minerals, essential fatty acids and proteins are needed for detoxification pathways to work.
Chemically sensitive people seem to have an increased tendency to develop food intolerances.
The risk of this is increased if the diet is limited, as repeated eating of the same few foods makes it much more likely that sensitivity to those foods will follow. The key to dietary management is to eat a wide-ranging, varied diet.
4. Specialist help.
Increasing the level of certain vitamins, minerals and amino acids will benefit many chemically-sensitive people.
However there are risks in using high-dose supplements of some substances if they are not 'balanced' correctly. This should therefore not be done without specialist advice.
For some people other special supplements, or high-dose intravenous vitamins and minerals may be beneficial, both in boosting detoxification pathways and in 'chelating' (getting rid of) harmful chemicals.
Some other supplements such as digestive enzymes or prescription drugs may also be helpful in some people.
Further information on Chemical Sensitivity with avoidance information and general hints and tips on cleaning without chemicals can be found in our fact sheets.
The Allergy UK helpline can also offer support and advice on chemical sensitivity, and can help you locate the nearest appropriately qualified NHS allergy specialist. Call us on 01322 619898 if you would like to discuss (9-5, M-F).
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Locating Environmental Medicine Physicians
According to the (Chemical Sensitivity Foundation), the physicians in these two associations are interested in evaluating or treating patients who are chemically sensitive. The Chemical Sensitivity Foundation is providing this list only for your information and does not endorse any individual physician on either list.
• American Academy of Environmental Medicine
6505 E. Central Avenue #296
Wichita, KS 67206
Listing covers US, Canada, UK, Mexico, Australia, Brazil, Japan, Israel, and six EU countries
• Association of Occupational and Environmental Clinics
1010 Vermont Ave., NW, Suite 513
Washington, D.C. 20005
Listing covers US, Canada, and Germany
The American College of Occupational and Environmental Medicine also offers a Doctor Finder Service for those seeking an occupational medicine physician.
* This information has been reproduced here with the kind permission of www.AllergyUK.org. Allergy UK is the operational name of the British Allergy Foundation, a charitable company limited by guarantee and registered in England and Wales. Company No: 4509293. Charity No: 1094231. Registered in Scotland - Charity No: SC039257.