Shining a Light on Diagnosing and Treating Multiple Chemical Sensitivity

By Dr. Susan Tanner, MD

Multiple Chemical Sensitivity, or MCS, is a controversial medical condition characterized by an adverse physical reaction to low levels of many common chemicals that has been reported and acknowledged, although not formally classified as an illness, for some years. MCS has been placed under the umbrella of many different symptom categories, including environmental toxicity and most unfortunately, been deemed a “psychological problem” by medical professionals and laypeople alike. Part of the difficulty in gaining a formal medical diagnosis for MCS is the fact that sufferers present with myriad symptoms, from sinusitis/rhinitis, huge fluctuations in blood pressure and heart rate, to breathing difficulties, skin sensory abnormalities, and sudden changes in cognition. Some MCS sufferers even report losing consciousness or the ability to walk when in the presence of certain scents or chemicals.

A Pioneer for Environmentally-Triggered Illness

Originally thought to be an allergic reaction, patients were then perplexed and dismayed to find that they did not “test positive” in the traditional sense when given in-office allergy testing. Back in the 1940s, the syndrome began to be described by Dr. Theron Randolph, MD, who had a select group of patients who demonstrated some unique and difficult-to-treat symptoms. Randolph’s first published research on the topic was entitled, Environmental Ecology, and it provided the basis and start for what would become the American Academy of Environmental Medicine.

At the time, hospitalization of patients was not so difficult, controlled, or expensive as it is today. Dr. Randolph created an entire ward of a hospital into which he admitted these patients. The ward was regulated as to air quality, the patients’ diets, and surroundings. Basically, he created a “bubble” into which these patients were treated. And, guess what? The patients got better! Why did this happen? In essence, by strictly controlling their air, food, and surroundings, he was reducing the total body load or overall toxicity that had built up over time or with one large exposure to make them sick in the first place. It sounds like such a simple intervention, but with complete avoidance of the toxins causing the symptoms, not much more was needed to help the patients improve.

The Physiology of Multiple Chemical Sensitivity

The pathophysiology of MCS is basically an imbalance of the autonomic nervous system. This is the part of our body responsible for regulating everything, from heart rate, to breathing, to urinary frequency to hormonal release. It is thought that the reason the odors and chemicals set this off so rapidly is that they hit the olfactory bulb, which is associated with sense of smell but located at the base of the brain. It has more far-reaching regulatory mechanisms that simply smell. Proving that a patient does, indeed, have MCS and not a psychiatric problem is possible and can be done, but requires some very specialized testing. This may include, but is not limited to, heart rate variability, pupillography, balance regulation, and sweat monitoring. In some cases, neuropsychiatric testing done by a knowledgeable professional can help distinguish the source of the disorder.

Multiple Chemical Sensitivity Diagnosis

Patients who have MCS have become extremely sensitive to even minute amounts of odors, fragrances, toxins, and foods. As the load on the system increases, it takes less and less of a “hit” to bring on symptoms. Another confounding fact is that the symptoms can change, for instance, on one occasion the patient may have dizziness and a headache, on another, with even the same type of exposure, it may present as rapid heart rate, and shortness of breath. Because many of these symptoms are similar to anxiety, it is easy to see why and how they may be misdiagnosed, or thought to be just “in the patient’s head.”

The first order of business has to be an extremely thorough history. When a doctor maps out symptoms, previous illnesses, times of stress, jobs, and living environments with the patient in the form of a timeline, often it becomes apparent that MCS symptoms began to appear after a significant or long-term exposure to a toxin or chemical, or after a significant illness. In other words, there was always a “priming” exposure, illness, or event that caused the present sensitivities.

Mold and Multiple Chemical Sensitivity

Of particular mention is the correlation between the development of MCS and living or working in a moldy environment. The mycotoxins (MVOCs) produced by the molds load down the system, and the dysregulation begins. For many patients, the mycotoxins are not being properly excreted in the body’s natural detoxification processes, so the longer the exposure goes on, the more mold toxins that are being stored in the patient’s body and tissues. Thus, MCS occurs as part of the natural progression of the body being overwhelmed by the mold. In order to recover, the patient must get to a safe environment where they can finally detox properly and heal. Once out of the moldy environment, MCS symptoms often become less severe and eventually subside as well.

Treatment Options for MCS

Once MCS has been diagnosed, then the treatment follows the guidelines set forth years ago by Dr. Randolph, which begins with simply, “clean up the air, food and water.” This is the reason that environmentally-trained doctors insist on looking at these steps first before jumping into more specialized treatment. Patients will not get better if they do not take these fundamental steps.

Other modalities that help the condition are sauna bathing, which encourages the body to excrete stored toxins from the fat tissues, targeting nutrients, such as glutathione, to help the liver process byproducts out of the system, and oxygen therapy to help deliver adequate amounts of oxygen to deprived tissues due to capillary spasm. None of these should be instituted without a proper workup and evaluation by an environmental physician. Each case is different and must be addressed slowly and carefully. Tolerance to treatment varies and must be adjusted step by step.