Is Your Home or Environment Contributing to Chronic Illness or Chemical Sensitivity?

In her ground-breaking article published in March 1997, Dr. Claudia Miller at the University of Texas at San Antonio coined the term “toxicant-induced loss of tolerance” (TILT). This refers to those suffering from multiple chemical sensitivities who have become sensitive to almost everything in their environment. She discovered that chemical sensitivity is the consequence of a two-step process: 1) loss of tolerance in susceptible persons following exposure to various toxicants, and 2) triggering of symptoms by extremely small quantities of previously tolerated chemicals, drugs, foods, and food and drug combinations including caffeine and alcohol. Through her research, Dr. Miller concluded that although chemical sensitivity may be the consequence of this process, the term toxicant-induced loss of tolerance more clearly describes this process.

In a subsequent paper published by Dr. Miller in 2021, she reported the link between exposure to common chemicals and unexplained chronic illnesses. For the first time, a mechanism was found for how and why TILT occurs in some people.

Toxicant-Induced Loss of Tolerance

The 2021 study that Dr. Miller reported on included the following exposures:

• Employees at U.S. Environmental Protection Agency headquarters after new carpeting was installed
• Gulf War veterans
• Casino workers exposed to pesticides
• Pilots and flight attendants exposed to fume events
• Firefighters responding to the World Trade Center tragedy
• Surgical implant patients
• Those exposed to mold in their home or workplace
• Tunnel workers exposed to solvents

Mixed volatile and semi-volatile organic compounds, including some chemicals found in everyday products used to build and maintain homes, were prevalent in those exposures, as were pesticides and combustion products. The exposures suggest TILT’s role in explaining a new class of environmentally initiated chronic illnesses that share the same underlying bio-mechanism.

The underlying mechanism, says Dr. Miller, involves activating “mast cells,” which are the “first responders” to xenobiotics or foreign substances like chemicals and viruses. Mast cells, originating in the bone marrow, migrate to areas located between tissues and the external environment, where they then reside.

The Increase in Mast Cell Activation Syndrome (MCAS)

Mast Cell Activation Syndrome (MCAS) diagnosis is on the rise. Mast cells can be sensitized by a single high-level exposure to xenobiotics, such as chemicals from a pesticide application, or by repeated lower-level exposures, such as breathing volatile organic compounds (VOCs) from remodeling or new construction. Thereafter, even low levels of these and other unrelated chemicals can cause the mast cells to release hundreds of inflammatory chemicals, resulting in allergic-like reactions.

“Treatment first requires avoiding or eliminating initiating exposures and then reducing triggering exposures,” Dr. Miller said. “Carefully selected medications can be helpful. However, many common or formerly tolerated drugs can trigger symptoms in these individuals.”

MCAS can be treated with histamine blockers (so that cells do not take up released histamine), mast cell stabilizers, leukotriene inhibitors, and a low-histamine diet. However, the key to recovery is to avoid triggers in the place where you spend most of your time—your home.

Indoor Air Quality and Chemical Sensitivity Symptoms

Another study published in January 2022 reported findings in which Chemically Intolerant (CI) patients participated in a series of structured environmental house calls. Those affected typically reported health problems such as headaches, fatigue, brain fog, and gastrointestinal problems, which are the common primary care complaints. To qualify, participants were assessed for chemical intolerance with the Quick Environmental Exposure and Sensitivity Inventory. Those with CI volunteered to allow the EHC team to visit their homes to collect air samples for volatile organic compounds (VOCs). An independent lab analyzed initial and post-intervention air sampling to determine VOC levels. The team discussed indoor air exposures and their health effects and provided guidance for reducing exposures.

The homes where recommendations were followed showed the greatest improvements in air quality. The improvements were based upon decreased airborne VOCs associated with reduced use of cleaning chemicals, personal care products, and fragrances, causing reduction in the index patients’ symptoms.

How to Reduce Chemical Exposure in Your Home and Environment

Clean up dust frequently. Use a slightly wet microfiber cloth—microfiber cloths can electrostatically pull chemicals toward them, and a wet cloth will pick up more dust. Some phthalates, flame retardants, and phenols were consistently found in at least 90% of dust samples across multiple studies, indicating their ubiquitous presence in indoor environments.

Remove cleaners that are not safe for air quality by ensuring your cleaning products meet the following recommendations:

• Label: Avoid products with “Danger,” “Poison,” or “Warning” on the label
• Ingredients: Look for products with disclosed ingredients, and avoid non-specific terms like “surfactant,” “dye,” “enzyme,” “carrier,” “cleaning agent,” and “fragrance”
• Fragrance: Choose unscented or fragrance-free products, as synthetic fragrances can trigger asthma
• Antimicrobial products: Avoid products with antimicrobial ingredients like triclosan, triclocarban, and ammonium quaternary compounds (“quats”)
• Safer Choice label: Look for products with the U.S. Environmental Protection Agency’s Safer Choice label
• Eco-friendly: Look for plant-based, biodegradable, and non-toxic components
• You can also make your own cleaners with everyday items like baking soda, mild dish soap, and lemon juice

Gas stoves are a significant source of nitrogen dioxide. If you have a gas stove it is important to use the vent every time you use it, run it at full blast, and change the filter every three months. In addition, make sure it vents to the outside.

Keep an open container of pure baking soda out. It will absorb particulates from the air.

Avoid room fresheners. They are a source of toxic VOCs, formaldehyde, acetaldehyde, acetone, picric acid, and methyl vinyl ketone.

Avoid scented candles unless they are made from soy, coconut, or beeswax candles, and scents are from essential oils.

Get a HEPA vacuum. These vacuums trap allergens like dust, pollen, pet dander, and mold and filter down to 0.3 microns. Use them on furniture regularly.

Animals can trap dust and particulates in their fur. Make sure animals are cleaned regularly.

Limit the use or get rid of your microwave oven. Microwave exposure affects the olfactory plate close to the hypothalamus and can cause insomnia and a condition of hypersensitivity to smells. It can also decrease the plasticity of NMDA receptors in the brain, impairing memory and learning.

Mold can be a source of VOCs, mycotoxins, bacteria, and well as infectious fungal elements. However, mold can be toxic whether it is dead or alive. Even though it may be from an old damaging event, if not properly cleaned, dead mold can still emit mycotoxins and cause allergic reactions and inflammation. Here are simple things you can do to prevent mold:

• Do a visual inspection of your home. Make sure to check closets and the crawl space for fuzzy-looking or dark spots.
• Check the exhaust ventilation in the bathroom. Remove it and make sure there is no mold inside it from a lack of proper air movement.
• Check the exhaust fan blowing on the ceiling: clean the exhaust fan and duct from the exhaust fan
• Inspect behind wallpaper for mold on exterior walls or bathroom and kitchen
• Look behind wall hangings and artwork. Don’t wait until you move. I had friends living in Seattle, and as they were moving, they found mold on the back of all of their hanging artwork.
• Check under the refrigerator; it can harbor moist dust
• Check the defrost pan under the refrigerator
• Check your ice dispenser for mold
• Look at the dishwater filter for mold or dirt and replace as recommended
• Clean the area under windows that drip
• Check under kitchen cabinets and look for leakage from another room
• Inspect the back of register covers in wood floors
• Look for poorly sealed metal boots
• Check your HVAC: a fiberglass lining will grow mold if it gets wet
• Check the crawl space and duct coming up through the floor

Naphthalene can emit toxic odors, and its sources include some bug sprays, toilet deodorant blocks, certain paints, and older wood preservatives. If you can smell it, it is likely in your blood.

Electromagnetic Fields (EMF). If you suffer from TILT, an important step is to minimize your exposure to EMFs. Turning off the modem at night, keeping your cell phone and smart TV out of your bedroom, and shielding a smart meter are simple first steps. The best way to proceed is to get an RF meter to determine the highest exposure sources in your home.

Use a water filter to remove lead and PFAS from your tap water. There are many water filters to choose from, but the cheapest one that removes lead and PFAS is the Zero water filter.

Avoid using plastics as much as possible. Avoid plastic water bottles. They can leach 150 different chemicals from the bottle into the water. Exchange your Tupperware for glass, don’t use straws, and avoid buying food stored in plastic as much as possible, e.g., only buy nut butter that comes in jars.

If you have an attached garage, consider storing paints, cleaners, pesticides, and other harmful substances in a shed or anywhere not attached to the house. Doors from the garage to the house interior are typically not sealed well, and air can easily leak from the garage to the inside of your home.

Taking Steps to Avoid Chronic Illness from Chemical Sensitivity

If you suffer from any chronic illness and/or chemical sensitivities or TILT you may feel alone or neglected by the medical community. Dr. Miller has shown us that your medical team can be a part of your healing. With time and education, more practitioners are accepting and understanding MCAS, so there are ways to get symptom relief as you address the importance of your environment on your health problems. An important first step is ensuring your home is not contributing to your illness. If you are very ill right now, this list can seem too daunting, but don’t let that stop you. It’s okay to take it slow and make one change at a time. Each step will cumulatively benefit you over time.

If you need help with symptoms of MCAS, CI, or TILT, Dr. Clark can help you with testing and implementing ways to start you on a path of healing.