Toxicant-Induced Loss of Tolerance: A Theory to Account for Multiple Chemical Sensitivity

HorowitzSala,

doi:10.1089/act.2014.20201

Cited by 1 publication

(1 citation statement)

References 27 publications

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“…TILT provides a unifying explanation for the myriad symptoms clinicians see today. 4,6,7,22,23 Historically, new theories of disease arose when physicians observed patterns of illness that did not fit accepted explanations for disease at that time, for example, the germ or immune theory of disease.…”

Section: Discussionmentioning

confidence: 99%

Three Questions to Screen your Patients for Chemical, Food, and Drug Intolerances the Brief Environmental Exposure and Sensitivity Inventory (BREESI)

Palmer

Jaén

Perales

et al. 2020

Preprint

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Background: The 50-item Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a validated questionnaire used worldwide to assess intolerances to chemicals, foods, and/or drugs and has become the gold standard for assessing chemical intolerance (CI). Despite a reported prevalence of 8-33%, CI often goes undiagnosed in epidemiological studies and routine primary care. To enhance the QEESI’s utility, we developed the Brief Environmental Exposure and Sensitivity Inventory (BREESI) as a 3-item CI screening instrument. We tested the BREESI’s potential to predict whether an individual is likely to respond adversely to structurally unrelated chemicals, foods, and drugs. Methods: We recruited 286 adult participants from a university-based primary care clinic and through online participation. The positive and negative predictive values of the BREESI items were calculated against the full QEESI scores. Results: 90% of participants answering “yes” to all three items on the BREESI were classified as very suggestive of CI based upon the QEESI chemical intolerance and symptom scores both ≥ 40 (positive predictive value = 90%). For participants endorsing two items, 92% were classified as either very suggestive (39%) or Suggestive (53%) of CI (positive predictive value = 87%). Of those endorsing only one item, only 13% were found to be very suggestive of CI. However, 70% were classified as Suggestive. Of those answering “No” to all of the BREESI items, 99% were classified as not suggestive of CI (i.e., negative predictive value = 99%). Conclusions: The BREESI is a versatile screening tool for rapidly determining potential CI, with clinical and epidemiological applications. Together, the validated BREESI and QEESI provide much needed diagnostic tools that will help inform treatment protocols and teach health care professionals about Toxicant Induced Loss of Tolerance – the mechanism driving CI.

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Section: Discussionmentioning

confidence: 99%