Multiple Chemical Sensitivity

Imagine a world where walking down the street and passing someone wearing perfume causes shortness of breath and cough.  Doctors need to treat you for a medical condition but every medication you try causes intolerable side effects.  Working at a computer for any length of time causes blurry vision, headaches and dizziness.  Eating out at a restaurant is impossible because you have so many food intolerances you’re guaranteed to react to anything you eat.

This is what life can be like when you suffer from Idiopathic Environmental Intolerance (IEI).  I have a mild form of IEI, having a number of moderate to severe food intolerances.  However my symptoms are manageable and don’t impact my life significantly as long as I avoid my trigger foods.

What if the entire WORLD triggered your symptoms?  This is what happens when you have Multiple Chemical Sensitivity (MCS).  Patients with MCS report symptoms in just about every system with exposure to substances that are generally considered safe and don’t cause problems in others.  For instance, they may get muscle and joint pain, confusion and mental fogginess, abdominal pain, diarrhea or constipation, cough, shortness of breath, nasal congestion, anxiety and panic attacks, sleep problems, skin rashes and many other symptoms.

I confess I don’t know much about MCS.  When a patient recently came to me for an opinion about her previously-diagnosed and longstanding MCS, I had to go to the research database.  Since I was doing the research anyway I thought I’d share what I found with you!

Multiple Chemical Sensitivity has been recognized for decades but a search for one cause has not been successful.  It seems to be a combination of neurological sensitivity and environmental exposures that interact to create illness.  Exposures that have been thought to bring on MCS include heavy metals including mercury (particularly in dental fillings), chlorine and fluoride in tap water, pesticides in food, and volatile organic chemicals in everything from fabric softener to carpet.

It has been shown that people with MCS have brains that react to environmental exposures just like people having a panic attack.  This has led to the theory that MCS is a disorder similar to fibromyalgia.  In fibromyalgia the brain and nervous system interprets sensations as painful that an ordinary person would not find painful.  It seems that in MCS part of the illness sees to be the brain interpreting sensations as painful/dangerous/unpleasant that an ordinary person would find innocent or even pleasant (like perfume).

How do we know if someone has Multiple Chemical Sensitivity?  There is a questionnaire called the Quick Environmental Exposure and Sensitivity Inventory (QEESI) that can screen for the problem.  If you or someone you know is curious about it, you can find the questionnaire here.  If you have a positive questionnaire, you should take the results to your doctor to discuss.

What do we do if you have Multiple Chemical Sensitivity?  First of all, the patient needs to understand clearly that there is no known cause and no known cure.  We can do simple things like filtering drinking water to remove chlorine, buying organic food, and using nontoxic cleaning products that don’t release volatile organic chemicals.  Smart supplementation with a high-quality multivitamin and products that support the liver’s detoxification processes is helpful.

Fairly simple testing can help identify triggers.  Provocative testing for whole-body heavy metal burden can identify whether mercury or other metals may be contributing to symptoms.  Testing for food intolerances can help adjust diet and begin healing the gut and immune system.  Gamma glutamyl transferase (GGT) is a quick screening blood test to see whether the liver’s detoxification processes are overworked and can identify fatty liver disease.

It is important to choose a medical doctor, functional medicine provider or naturopath that has experience in treating environmental sensitivities or is at least open to learning about them.  Minimizing unnecessary drugs is helpful.  A holistic, integrative approach is key.

One last thing to remember is that part of the problem is in the brain.  The brain of a patient with MCS misinterprets or is highly sensitized to stimulus that doesn’t bother others.  There have been studies that show scans of brains of MCS patients lighting up on exposure to odors the same way brains light up during a full-blown panic attack.  Why does perfume cause the equivalent of a panic attack in a patient with MCS?  We don’t know, but we do know that treatments that help panic disorder (like cognitive behavior therapy and antidepressant medication) have been shown to improve the quality of life of patients with MCS.  As a more extreme example, there was a patient with MCS who had significant and sustained benefit from electroconvulsive therapy.

In extreme cases, patients with Multiple Chemical Sensitivity can feel forced to completely withdraw from the world and become modern-day hermits.  They avoid social situations because they are afraid their symptoms will be triggered.

In conclusion, Multiple Chemical Sensitivity is an uncommon (although probably more common than we realize) illness that has no known cause and no known cure.  It IS real though, and more research is needed to identify risk factors, find patients early in their illness, and offer meaningful treatments to restore their quality of life.

If you feel you have Multiple Chemical Sensitivity and your physician isn’t able to help you, the Academy of Integrative Health and Medicine website can offer some options.

QUESTION: Do you or does someone you know seem overly sensitive to chemicals, perfumes and medications?


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