Facts About Toxicant-induced Loss of Tolerance

TILT IcebergSome people develop persistent, disabling symptoms following an accidental chemical spill or release, exposure to a sick building or school, mold exposure, pesticides, chemicals in the military, or even certain drugs or implants. The question is, why doesn’t everyone who is exposed get sick and why don’t those get sick get better once the exposure stops? The answer lies in a new disease mechanism that most doctors have never heard of — a pathological process they didn’t learn about from their medical school professors or textbooks.

This new mechanism is called “TILT,” short for “Toxicant-Induced Loss of Tolerance.” Only some exposed individuals are vulnerable to developing TILT. Those who do, experience long-lasting symptoms that are amazingly diverse. Common complaints include difficulties with memory and concentration, fatigue, headaches, weakness and mood changes such as extreme irritability and depression. They often report gastrointestinal, respiratory and skin problems too. TILT has all the earmarks of a new general disease mechanism, or theory of disease. Physicians and scientists have documented this phenomenon in over a dozen nations — in countries with different languages, exposures and media.

It was the germ theory of disease that brought medicine into science in the late 1800s, just after the Civil War. The germ theory is relatively straightforward (which may be why it was the first theory of disease to be discovered): it involves only a single step: a microscopic germ (virus, bacteria, etc.) enters the body and multiplies, causing symptoms. The next major mechanism for disease to be discovered was the immune theory in the 1930s. The immune theory of disease provided the scientific scaffolding that allowed us to begin to understand how allergies and autoimmune diseases develop. Because it involves two separate steps, the immune theory escaped notice at first: Its first step involves exposure to a sensitizing biological antigen like dust mite droppings, pollen, poison ivy or penicillin, resulting in antibody formation against that specific substance. Subsequent re-exposure to the same antigen produces symptoms in the previously sensitized person.

TILT, our most recent medical model for disease, might be thought of as the 21st Century theory of disease. Instead of germs or biological proteins, TILT implicates synthetic chemicals or chemical mixtures as causal agents. Why has medicine been so late to recognize TILT? There are two reasons.  First, the exposures that initiate TILT are very new in human history—within the past 50 years or so, since World War II. Further, TILT involves three stages, which has made it all but impossible for patients or their doctors to track what is going on. The three steps are:

  1. initiation by a  chemical exposure that causes breakdown in tolerance; followed by
  2. triggering of symptoms by common foods, everyday low level exposures, and drugs; and, finally
  3. masking, which hides the relationship between exposures and triggers.

Masking results from the multiple overlapping reactions that occur to many different chemicals, foods and drugs (including alcoholic and caffeinated beverages that were formerly tolerated) and normal habituation associated with chronic exposures. Once an individual’s reactions have spread to many diverse exposures and that person is masked, it is difficult to identify specific food or environmental triggers without the use of special, environmentally controlled hospital units (environmental medical units or EMUs). Although the need for such specialized hospital units has been recognized for decades, none currently exist in this country. Consequently, research using EMUs is lacking, so that when illness outbreaks occur or questions about the role of environmental exposures in an individual’s health problems arise, we have few tools to help us. Trying to identify causal exposures without an EMU would be like trying to identify germs without a microscope. The EMU is an essential tool for diagnosis, research and treatment of complex, TILT-related illnesses, which may include autism, ADHD, chronic fatigue, food and chemical intolerances, and persistent illnesses following exposures to pesticides, industrial chemicals, 9-11, and wartime exposures.

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Contact Information

Dr. Claudia Miller
Department of Family & Community Medicine
University of Texas Health Science Center at San Antonio
7703 Floyd Curl Drive (222 MCS)
San Antonio, TX 78229-3900

emailButton mail@drclaudiamiller.com


For information on how you can support Dr. Claudia Miller’s research, please contact Ms. Kim Warshauer in the Office of Development at warshauer@uthscsa.edu.