# 4650
T.I.L.T. or Toxicant Induced Loss of Tolerance is a disease theory that may help explain a wide spectrum of illnesses that are characterized by environmental and chemical sensitivities.
TILT reportedly occurs after a susceptible person is exposed to a toxicant (chemical, pesiticide, etc) and develops an intolerance of certain chemicals, odors, and even some foods.
Victims may also experience `flu-like’ symptoms at the time of exposure, including headaches, joint pains, cough, respiratory problems, and cognitive difficulties.
The idea has been long championed by Dr. Claudia S. Miller, an allergist and immunologist who is a tenured Professor of Occupational and Environmental Medicine at the University of Texas Medical School in San Antonio.
Toxicant-induced Loss of Tolerance-An emerging theory of disease? Miller CS. Environ Health Perspect 1997 Mar;105 S:445-453.
Empirical approaches for the investigation of toxicant-induced loss of tolerance Miller CS, Ashford NA, Doty R, Lamielle M, Otto D, Rahill A, Wallace L. Environmental Health Perspectives 1997 Mar;105(2):515-519.
TILT, or variants such as MCS (Multiple Chemical Sensitivities) or EI (Environmental Illness), are poorly understood syndromes and remain controversial among many doctors.
The EPA (Environmental Protection Agency) defines MCS this way:
MULTIPLE CHEMICAL SENSITIVITY (MCS): A condition in which a person reports sensitivity or intolerance (as distinct from "allergic") to a number of chemicals and other irritants at very low concentrations. There are different views among medical professionals about the existence, causes, diagnosis, and treatment of this condition.
In other words, we are entering a gray area of medical science where a consensus on the validity and cause of these acquired sensitivities has not been established.
That, of course, does not invalidate the legitimacy of the issue. But it does interject an element of uncertainty.
Which brings us to several reports in the media over the last few days of oil spill workers suffering from what is being described as TILT.
Mysterious illness plagues Gulf oil disaster workers
SAN ANTONIO -- For weeks now, local hospitals have tracked patients with suspicious symptoms coming in from the gulf coast. Doctors are having trouble distinguishing it from the flu.
"What makes it challenging is that patients show up with non-specific symptoms. Headaches, fatigue, problems with memory and concentration, upset stomach," lists Dr. Claudia Miller at UT Health Science Center.
The illness is called "TILT," or Toxicant-Induced Loss of Tolerance. Patients lose tolerance to household products, medication, or even food after being exposed to chemicals, like burning oil, toxic fumes, or dispersants from the spill.
A similar article, along with a WOAI news interview with Dr. Miller, appeared in yesterday’s Huffington Post:
Gulf Coast Oil Spill Workers Falling Ill With TILT (VIDEO)
And last night Keith Olbermann on MSNBC spent 5 minutes discussing TILT and the oil spill, the video is on Youtube and may be viewed here.
While the real risks of exposure to the oil, tar, and dispersants being released in the Gulf of Mexico remain unknown, concerns over the safety of cleanup workers and impacted coastal residents are understandably high.
After all, it was just last week that a Federal Judge approved a $712 million dollar settlement to compensate the first responders and cleanup workers at ground zero after 9/11, who suffered serious illness and injury due to toxic exposures.
Exposures that, at the time, many officials dismissed as not being a serious health concern.
Historically, wars and pandemics have been credited with spurring advances in our medical knowledge.
Our modern EMS system (of which I was a part many years ago) and the creation of regional trauma centers came out of the Vietnam and Korean war combat medic experience.
We are seeing unprecedented research into influenza and other infectious diseases today, largely because the pandemic threat was made real and palpable by the emergence of H5N1 a dozen years ago.
It may be that environmental medicine will make similar leaps over the next few years due to what we learn from this oil spill in the Gulf.
Theories on TILT, MCS, and other toxic exposure concerns - as well as treatments - may well be validated or eventually disproven.
A small silver lining, perhaps.
But one that - like from wars and pandemics - comes at a terrible cost.
