Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes

Katerndahl, David A.; Bell, Iris R.; Palmer, Raymond F.; Miller, Claudia S.

doi:10.1370/afm.1346

Cited by 55 publications

(51 citation statements)

References 74 publications

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“…36 In a recent study of primary care clinic patients, 20% met the criteria for chemical intolerance but only one quarter of these individuals had been diagnosed with the condition. 35 Researchers from this study assert that intolerances to chemicals and/or foods are potential underlying causes for illness that are rarely identified by busy practitioners but instead must be actively sought. The underlying pathophysiology of CI/toxicantinduced loss of tolerance seems to involve genetic susceptibility as well as exposure.…”

Section: Chemical Intolerancementioning

confidence: 99%

Maternal Chemical and Drug Intolerances: Potential Risk Factors for Autism and Attention Deficit Hyperactivity Disorder (ADHD)

Heilbrun

Palmer

Jaén

et al. 2015

The Journal of the American Board of Family Medicine

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Purpose: The aim of this study was to assess whether chemically intolerant women are at greater risk for having a child with autism spectrum disorders (ASD) or attention deficit hyperactivity disorder (ADHD).Methods: We conducted a case-control study of chemical intolerance among mothers of children with ASD (n ‫؍‬ 282) or ADHD (n ‫؍‬ 258) and children without these disorders (n ‫؍‬ 154). Mothers participated in an online survey consisting of a validated chemical intolerance screening instrument, the Quick Environmental Exposure and Sensitivity Inventory (QEESI). Cases and controls were characterized by parental report of a professional diagnosis. We used a one-way, unbalanced analysis of variance to compare means across the 3 groups.Results: Both mothers of children with ASD or ADHD had significantly higher mean chemical intolerance scores than did mothers of controls, and they were more likely to report adverse reactions to drugs. Chemically intolerant mothers were 3 times more likely (odds ratio, 3.01; 95% confidence interval, 1.50 -6.02) to report having a child with autism or 2.3 times more likely (odds ratio, 2.3; 95% confidence interval, 1.12-5.04) to report a child with ADHD. Relative to controls, these mothers report their children are more prone to allergies (P < .02), have strong food preferences or cravings (P < .003), and have greater sensitivity to noxious odors (P < .04). Conclusion

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Section: Chemical Intolerancementioning

confidence: 99%

Maternal Chemical and Drug Intolerances: Potential Risk Factors for Autism and Attention Deficit Hyperactivity Disorder (ADHD)

Heilbrun

Palmer

Jaén

et al. 2015

The Journal of the American Board of Family Medicine

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“…The study authors noted that such patients would improve with avoidance of provoking foods, chemicals and medications [13]. Add to such statistics EHS, with prevalence studies ranging from 2.7% of the population in Switzerland to 8.0% in Germany, and the ramifications for the wider community are indeed profound.…”

Section: Resultsmentioning

confidence: 97%

Multiple Chemical Sensitivity (MCS) and Electromagnetic Hypersensitivity (EHS): An Introduction to Environmental Illness

Diana¹

2018

COJNH

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Multiple chemical sensitivity (MCS) and electromagnetic hypersensitivity are disabling conditions hallmarked by adverse reactions to chemicals and electromagnetic frequencies at levels generally considered safe. MCS is underpinned by a vicious cycle of escalating sensitivity initiated by exposure to seven classes of neurotoxicants. Our case study concerns a family sensitized to foods, chemicals and electromagnetic radiation after heavy exposure to phenoxy herbicides and organophosphate pesticides. Also addressed are a number of conditions frequently co-morbid with MCS, which also frequently involve an environmental sensitivity component-which include migraine, rheumatoid arthritis, irritable bowel syndrome, ADHD, hypertension and certain cardiac problems.

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“…Comorbid self-reported allergic disease was significantly higher in MCS patients (84.0%) than those of the general population (30%) in Japan [3]. More recently, Katerndahl et al [4] compared a subset of clinical patients, who met criteria for chemical sensitivity, with the nonchemical sensitivity patients, revealing a significant difference for the self-reported allergies (53 vs. 40%, respectively). The prevalence of chemical sensitivity between allergic and nonallergic groups was also different (19.7 and 11.3%, respectively) in a Korean population [5].…”

Section: Discussionmentioning

confidence: 99%

Assessment of CYP2C9, CYP2C19, and CYP2D6 Polymorphisms in Allergic Patients with Chemical Sensitivity

D'Attis

Massari

Mazzei

et al. 2019

Int Arch Allergy Immunol

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Background: Self-reported chemical sensitivity (SCS) is characterized by adverse effects due to exposure to low levels of chemical substances. The clinical manifestations of SCS are similar to the allergy, and a high percentage of individuals with both diseases have been found. Various genes, especially genes of importance to the metabolism of xenobiotic compounds, have been associated with SCS. Objectives: The purpose of this study was to investigate whether allergic individuals with chemical sensitivity differed from allergic patients without chemical sensitivity with regard to the distribution of genotype and phenotype of CYP2C9, CYP2C19, and CYP2D6 polymorphisms. Methods: A total of 180 patients were enrolled for this study. A questionnaire was employed to collect information on individual chemical sensitivity, while the Skin prick test and the PATCH test were used to verify the presence of an allergic condition against inhalants or contact allergens, respectively. For the evaluation of the CYP2C9, CYP2C19, and CYP2D6 polymorphisms, we used a strategy based on the amplification of the entire gene coupled to direct genomic DNA sequencing analysis. Results: Overall, a total of 15 different CYP2C9, CYP2C19, and CYP2D6 haplotypes were identified in our population. If the 5 CYP2C9 and the 2 CYP2C19 identified alleles correspond to the previously described ones, 4 of the 8 CYP2D6 haplotypes, detected in the study group, present new SNPs combinations. These new suballeles were categorized as CYP2D6*2M Salento Variant 1, CYP2D6*35B Salento Variant 2, CYP2D6*41 Salento Variant 3, and CYP2D6*4P Salento Variant 4 due to the presence of the key SNPs 2,850 C>T, 31G>A, 2,988 G>A, and 1,846 G>A, respectively. When the allergic individuals are divided into 2 groups according to their SCS score, we observed that the distribution of the CYP2D6 phenotypes was significantly different between the 2 groups. Conclusions: Our idea is that the application of the questionnaire that we have adopted has enabled us to diagnose a degree of chemical sensitivity, which results as comorbid of the allergic disease and in which a condition of poor or intermediate metabolizes for the detrimental CYP2D6 alleles, could represent a discriminant between the chemical sensitivity and the health state.

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Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes

Abstract: PURPOSE This study extends previous community-based studies on the prevalence and clinical characteristics of chemical intolerance in a sample of primary care clinic patients. We evaluated comorbid medical and psychiatric disorders, functional status, and rates of health care use.

Cited by 55 publications

References 74 publications

Maternal Chemical and Drug Intolerances: Potential Risk Factors for Autism and Attention Deficit Hyperactivity Disorder (ADHD)

Maternal Chemical and Drug Intolerances: Potential Risk Factors for Autism and Attention Deficit Hyperactivity Disorder (ADHD)

Multiple Chemical Sensitivity (MCS) and Electromagnetic Hypersensitivity (EHS): An Introduction to Environmental Illness

Assessment of CYP2C9, CYP2C19, and CYP2D6 Polymorphisms in Allergic Patients with Chemical Sensitivity

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