Is the World Making You Sick?

Miller has spent 30 years hammering out a theory to explain the contemporary surge in perplexing, multi-symptom illnesses — from autism to Gulf War Syndrome — which represent a Kuhnian shift in medicine. She calls her theory “TILT,” short for Toxicant Induced Loss of Tolerance.

TILT posits that a surprising range of today’s most common chronic conditions are linked to daily exposure to very low doses of synthetic chemicals that have been in mass production since World War II. These include organophosphate pesticides, flame-retardants, formaldehyde, benzene, and tens of thousands of other chemicals.

TILT, says Miller, is a two-step process. Genetically susceptible individuals get sick after a toxic exposure or series of exposures. Instead of recovering, their neurological and immune systems become “tilted.” Then, they lose tolerance to a wide range of chemicals commonly found at low doses in everyday life and develop ongoing illnesses.

Along with Nicholas Ashford, professor of policy and technology at the Massachusetts Institute of Technology, Miller co-authored Chemical Exposures: Low Levels and High Stakes. In 2012, Miller and her colleagues published a study in the family practice journal Annals of Family Medicine. They reported that 20.3 percent of individuals with chronic health issues suffer from some degree of chemical intolerance. That’s one in five — and, says Miller, they become vulnerable to TILT if they endure too much toxic exposure.

Miller is currently working with scientists at Harvard to inform a new generation of studies to document TILT. Her theory has been controversial, particularly for its idea that low-dose exposures, below the accepted toxic threshold, can be disabling. Yet in conversation with Nautilus, Miller was open and friendly, never defensive, even when presented with her critics.

You state TILT is the third major theory of human illness, after the germ and immune theories. That’s a bold conjecture. What exactly do you mean by that?

The germ theory is an example of a “Kuhnian” revolution in science. Because of germ theory, we changed the way we conduct surgery, prepare and preserve foods, treat wounds, or even cover our mouths when we cough. We have a unifying explanation for a stunning variety of symptoms, all caused by different germs with different propensities.

But many illnesses remained that couldn’t be explained by germs alone. The next revolution was immune theory. We discovered antibodies, antigens, and immunoglobulin. Antigens are molecules, such as microbes or pollens, which provoke an immune response. Antibodies are the molecules your body crafts to bind to and inactivate those antigens. Once we discovered them, we gained new insight into conditions like rheumatoid arthritis or asthma.

Today, a novel class of illnesses is on the rise, and neither theory sufficiently explains it. TILT shows how a person can have a toxic exposure and never recover. Exposures trigger a bewildering array of symptoms that many people never trace back to synthetic chemicals in their daily life. They may experience cardiac and neurological abnormalities, headaches, flu-like symptoms, bladder dysfunction, asthma, depression, anxiety, pain, cognitive dysfunction, and sleep disorders.

If we are sensitive to such low doses of common chemicals, how can we ever manage to avoid them all?

Let me tell you the story of the EMU, and how it changed my life and set me on this path. EMU is short for Environmental Medical Unit, a term coined by a heretical genius, allergist Theron Randolph. He would put patients on an allergy elimination diet and have them stay in an EMU he’d constructed, a non-toxic room with highly filtered air. He invited me to sit in and observe patients with him. Over the course of days, the patients’ symptoms would melt away, and once they felt better, he’d start introducing foods or chemicals, blinded, one at a time. The responses completely shocked me. He would put copy paper in a jar and the exposure level would be so low, and it literally blew my mind that low exposures like that could cause symptoms. There would be depression, vomiting, and cognitive dysfunction. It was as if the whole picture of the disease returned. Once the patients knew what they were sensitive to, they could avoid those foods and chemicals.

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