Multiple chemical sensitivity (MCS) remains mostly in the wilderness when it comes to recognition by the medical profession with no official diagnostic criteria for the condition in many countries, although this is slowly changing as some countries recently revised their versions of the International Classification of Diseases (ICD) to include MCS. The best diagnostic criteria currently available were originally developed in 1989 after a survey of multidisciplinary survey of 89 researchers and medical doctors, and revised in 1999. (read more)
As a result of the ongoing uncertainty among clinicians about MCS there is a corresponding lack of treatment available for patients affected. Fortunately, a growing number of clinicians and researchers have become interested in elucidating the causes of MCS and offering various forms of treatment.
The following are currently the most common treatments recommended to MCS patients by knowledgeable healthcare providers and also those most widely implemented by those made ill by chemical exposure of their own accord. Due to the MCS healthcare gap it is often down to individual sufferers to determine the management techniques and interventions that bring them most relief from symptoms.
The cornerstone of of MCS treatment is chemical avoidance; the elimination of exposure to chemicals that trigger symptoms. Not only does the avoidance of problem chemicals bring immediate relief since acute symptoms are not triggered, or at least to a lesser degree, but it also helps to reduce the body's total toxic burden and allows the hepatic detoxification pathways to more efficiently inactivate toxic substances and eliminate them from the body. A number of doctors and researchers believe the total toxic burden to be the key between health and illness e.g. MCS. Probably the best example of such a theory is toxicant-induced loss of tolerance (TILT) proposed by Claudia Miller, a medical doctor and academic in the area of environmental health. (read more)
MCS is primarily thought to be a neurological condition but may also involve other bodily systems, the immune system in particular. In any case, according to theories like TILT and the anecdotal experiences of millions of MCS sufferers, failure to avoid exposure to chemical that trigger a reaction may result in sensitisation to other chemicals that were previously tolerable.
Chemical avoidance is not easy. It must include avoidance of exposures from many sources including:
- Household cleaning and personal care products
- Building materials, household furnishings and electronics (e.g. computer printers)
- Environmental exposures including vehicle exhaust, tobacco smoke, pesticides, neighbours' chimneys and dryer/boiler exhaust - and of course other peoples' perfume/deodourants.
For detailed information on chemical avoidance please see our Avoiding Offending Chemical page.
Nutritional medicine is commonly used in the treatment of MCS with various rationales proposed for including specific nutrients or classes of nutrients.
It has been demonstrated that people with self-reported sensitivity to chemicals (read: "undiagnosed MCS sufferers") are more susceptible to the effects of chemical exposures than healthy individuals due to variations in genes of great importance in the detoxification of xenobiotic substances1. One study found that individuals known as 'slow acetylators' are more likely to be chemically sensitive - acetylation is one of several important chemical reactions by which toxic compounds are inactivated and excreted by the body1. The same study found gene variants that reduced the activity of glutathione, considered one of the most important detoxification and antioxidant molecules in the body, were also at increased risk of chemical sensitivity. With this in mind nutritional interventions often aim to support these detoxification pathways by supplying the required nutrients; N-Acetyl-Cysteine2 and alpha lipoic acid3 have been shown to effectively raise glutathione levels for example, as has the herb milk thistle (silymarin marianum)4.
Another approach to detoxification using nutritional medicine takes things further and is designed to restore health to the cellular membranes so that every cell in the body becomes more efficient at detoxifying itself of toxic substances, both those from the environment such as drugs and pollutants and those generated in larger than normal amounts by the body itself due to the state of illness. This approach has been developed by Patricia Kane PhD and colleagues. The crux of the proposed protocol is the use of a fatty substance known as phosphatidylcholine (PC) in large dosages (both orally and intravenously). PC makes up a large proportion of a healthy cell membrane so the idea is that introducing large amounts of pure PC will replace the PC damaged by toxins and currently comprising the cell membranes, thus restoring cellular health and detoxification efficiency. The hoped for end result then is that total body toxic load is reduced which should aid in recovery from MCS. There are no published studies to support this theory but plenty of anecdotal reports from MCS patients on this website and around the internet. Learn more in The Detoxx Book and on our dedicated page here.
The Martin Pall Protocol
Martin Pall is Professor Emeritus of Biochemistry and Basic Medical Sciences at Washington State University and Research Director of The Tenth Paradigm Research Group. He has focused his research efforts on multiple chemical sensitivity, chronic fatigue syndrome, fibromyalgia and other interconnected multi-system illnesses for a number of years and developed arguably the most complete theory for their pathophysiology. His basic hypothesis states that an initial stressor of some kind (e.g. acute pesticide exposure, viral infection, physical trauma etc) initiate a response in the body that while protective and helpful in the short-term, becomes pathological in the long-term and leads to symptoms and illness. This he proposes is what happens in MCS, the reaction to the stressor never gets switched off and the resulting biochemical dysfunction causes and perpetuates the illness. The dysfunction centres around altered nitric oxide (NO) metabolism which has many consequences involving the production of very damaging reactive molecules (oxidative and nitrosative stress) like peroxynitrite, which in turn trigger production of inflammatory immune chemicals called cytokines; some of these being interleukin-1b (IL-1b), IL-6, tumor necrosis factor-alpha (TNF-a) and interferon gamma (IFN-g). The vicious cycle is perpetuated since these inflammatory cytokines induce the production of yet more NO. Professor Pall refers to his theory as NO ONOO (NO for nitric oxide and ONOO- being the chemical formula for peroxynitrite).
Professor Pall proposes that since the NO ONOO cycle is perpetuated by reactive oxygen species (ROS), also known as free radicals, along with inflammatory immune chemicals, it might be interrupted using nutritional supplements that are potent antioxidants and anti-inflammatory agents. The hope being that this would also lead to symptom resolution and recovery from MCS. These nutrients include vitamin C, vitamin B12, folic acid, coenzyme Q10, vitamin E (as natural tocopherols) and various antioxidant plant compounds such as bioflavonoids. More on the specific nutrients recommend by Pall here.
Dr. Grace Ziem
Grace Ziem MD has worked extensively with patients suffering from MCS and chemical injury in her medical practice and has worked closely with Prof. Pall to develop a nutrient-based treatment protocol that is very close to Pall's own recommendations. Please visit Dr. Ziem's website for further details of her MCS treatment protocol - http://www.chemicalinjury.net/html/chemical_injury_treatment_ingr.html
This adrenal hormone is included here in the nutrient therapy section as it is available (in the US at least) as an over-the-counter nutritional supplement. DHEA is the most abundant hormone produced by the adrenal glands but its role remains unclear - it appears to have many functions. What is known is that is a neurosteroid i.e. a steroid hormone that acts on the brain and CNS. Importantly, it modulates the effects of the neurotransmitters N-methyl-D-aspartate (NMDA) and gamma-aminobutyric acid (GABA) in the limbic system (emotional and stress centre of the brain5. This could be important in the treatment of MCS since studies have shown hypersensitivity of certain brain regions like the limbic system with corresponding excessive neural activity when sufferers are exposed to a chemical to which they have become sensitised6. This also fits with Prof. Palls NO ONOO theory as the cycle of dysfunction proposed includes chronic dysfunction of NMDA activity. In a survey of 917 MCS patients Pamela Reed Gibson PhD asked them to rate the effectiveness of various treatments they had tried, DHEA faired well with roughly 30% of those who had tried it finding it to be either 'somewhat' or 'very' helpful7. Other nutrients that faired as well or better in this survey are included in Prof. Pall's and Dr. Ziem's recommendations.
Sauna Therapy with Far-Infrared Saunas
As well as promoting detoxification through nutrient therapy, other means to rid the body of accumulated toxins are also frequently recommended, one such method being use of a far-infrared (FIR) Sauna. Renowned environmental medicine pioneer Dr. William Rea MD uses FIR saunas for treating MCS patients from around the world at his clinic, The Environmental Health Center, in Dallas, USA. The basic principle behind the use of sauna therapy is to mobilise toxic chemicals stored in adipose tissue (fat) throughout the body and promote their excretion via sweat. Expert in environmental medicine and author of Detoxify or Die, Dr. Sherry Rogers MD, believes that FIR saunas are superior to more traditional saunas for detoxification purposes8. She suggests that FIR saunas use wavelengths of heat energy that more efficiently penetrate tissues, releasing subcutaneous stores of chemicals in fat cells directly into the sweat and out of the body. This is in contrast to traditional saunas which she says, lead to release of stored toxins into the bloodstream which exacerbate existing symptoms or even create new ones. Additionally the FIR sauna uses lower temperatures so MCS patients need not endure the 160 degrees (Farenheit) or more of a traditional sauna that may leave them feeling at best uncomfortable and at worst nauseous, weak, dizzy, faint, and headachey.
Removal of Mercury Amalgam Dental Fillings
Numerous anecdotal reports suggest that if an MCS sufferer has dental amalgam fillings and has them removed by an environmental illness-aware dentist, their condition often improves. It is known that the mercury contained in amalgam fillings makes its way into the body and can then accumulate in tissues, including the brain9. Mercury of course is well known to be neurotoxic10. Evidence for an association between dental amalgam fillings, body mercury burden and MCS is so far lacking, however. It should be emphasised that research into this area, as with MCS as a whole, has been limited and of poor quality to this point.
Brain Retraining Techniques (Ashok Gupta, Annie Hopper etc)
It has traditionally been thought that the neural pathways in the brain once developed through childhood and adolescence, remain relatively static. Research over the past decade or so has changed this however. It is now known that the brain has the ability to essentially "rewire" itself based on stimuli including our thoughts themselves. It is possible for the brain to make new connections between neurons and in doing so alter the way in which it functions - this property is referred to as neural plasticity. Meditation makes use of this property and a number of techniques have been developed that take advantage of neural plasticity aimed specifically at treating MCS and related conditions. These techniques typically involve regular practice of mental exercises designed to eradicate the neural connections that are causing the brain to overreact to chemical stimuli and replace them with more appropriate responses, thus eradicating the symptoms of MCS. Whether these techniques are able to achieve this is far from certain since no clinical studies have been performed, again however, anecdotal reports suggest that at least in some cases a complete cure is possible. The most well known of these techniques are Ashok Gupta's Amygdala Retraining Program and Annie Hopper's Dynamic Neural Retraining (DNRS) System.
Treatment Effectiveness According to MCS Sufferers
As mentioned previously, Pamela Reed Gibson PhD asked 917 MCS patients to complete surveys in which they rated the effectiveness of treatments they had tried. The list of treatments the participants had tried was extensive and included interventions that would be classed as conventional and those that would be referred to as alternative.
Some of the most effective treatments based on the results of this survey were:
- Chemical avoidance/chemical-free living space
- Charcoal/carbon filter facemask
- Air purifier
- Personal oxygen for use after exposures
- Sauna Therapy
- Intravenous magnesium
- Vitamin C
- DHEA & thyroid hormone replacement
- Herbal medicines
- Colonics & liver flushes
- Psychotherapy to help cope with MCS
As a group, prescription medications faired worst in the survey although some of the alternative therapies were also deemed of little help.
The complete results of the survey are available as an appendix in Pamela Reed Gibson's excellent book Multiple Chemical Sensitivity: A Survival Guide.
The Allergy Connection
As we currently understand it, MCS is not an allergy. An allergy is an immune reaction involving the production of IgE antibodies that attack harmless substances such as pollen and animal dander, triggering symptoms that typically include itchy, watery eyes, sneezing and nasal congestion. MCS is not primarily the result of such an immune reaction but involves neurological hypersensitivity and potentially complex systemic pathophysiological changes as outlined by Prof. Pall and others. That said, inflammatory cytokines are implicated in Pall's NO ONOO hypothesis and there is some evidence that mast cell activation (the cells that release histamine in an IgE-mediated allergic reaction) is involved in MCS11.
It is also common for an individual to suffer from both MCS and classical allergies and each is likely to compound the symptoms of the other so it only makes sense to treat the allergies as well if relief from MCS is to be achieved. Some common treatments for allergies, both conventional and laternative, include:
- Enzyme Potentiated Desensitisation (EPD)
- Low Dose Antigen Therapy (LDA)
- Nambudripad's Allergy Elimination Technique (NAET)