Gulf cleanup workers as well as Gulf residents are already reporting chronic health problems associated with TILT, including multi-system symptoms (fatigue, sleep problems, headaches, digestive difficulties, and problems with memory and concentration) as well as new intolerances for everyday exposures that never bothered them before.
For example, they may feel dizzy or nauseated around engine exhaust, cleaning chemicals, fragrances, or ill after meals, eating certain foods or even drinking one can of beer or a glass of wine. These new intolerances are the hallmark symptom of a disease process called “TILT” or “Toxicant Induced Loss of Tolerance.”
We know that even so-called “safe” levels of exposure to toxic chemicals like those in the Gulf can initiate TILT. Once TILT develops, it is very difficult to treat, but TILT can be prevented. To find out whether you may be susceptible to TILT or to track your symptoms, take the QEESI — a validated and published questionnaire developed by Dr. Claudia Miller.
You can download a free and printable QEESI test for you to take yourself:
http://worldvisionportal.org/files/qeesi.pdf [Only if their server is overloaded or offline]
Toxicant Induced Loss of Tolerance is a two-stage disease process:
(1) Initiation. An initial chemical exposure, either chronic low-level, such as a sick building, or an acute exposure such as to pesticides, causes a fundamental breakdown in natural tolerance, leading to newly-acquired intolerances.
(2) Triggering. Subsequently, previously tolerated substances including everyday chemical exposures, foods, medications, alcoholic beverages, and caffeine trigger multi-system symptoms.
Masking greatly complicates identification and treatment of TILT. Everyday we are exposed to many different foods, chemicals, drugs, etc…. Patients with TILT typically develop intolerances to dozens of different exposures (called “incitants” – chemicals that trigger a response). Masking is the hiding of a response to a particular exposure by a patient’s responses to the many other exposures (chemicals, foods, drugs) that now trigger symptoms as a result of TILT. This overlapping of exposures and responses in time requires a structured effort to minimize exposures to potential incitants so as to reduce the background “noise” that makes it hard link causes and effects between exposures and symptoms. Getting the patient to a clean baseline is a key step in effectively investigating TILT.
Claudia Miller, M.D., M.S. is a tenured Professor in Environmental and Occupational Medicine and Vice Chair of the Department of Family and Community Medicine of the University of Texas Health Science Center at San Antonio (UTHSCSA). She is also founder and director of the South Texas Environmental Education and Research (STEER) Program, the only medical school curriculum to offer hands-on, experiential training in environmental health, public health, and international health at the US-Mexico border. STEER has been the recipient of national and state awards for excellence in environmental and medical training.