“There is also good evidence that toxicants like solvents, pesticides, or volatile molecules from oil spills can travel straight into the brain via the olfactory receptors studding the inner lining of our nose. “
In 1962, physicist and historian Thomas Kuhn proposed that science makes progress not just through the gradual accumulation and analysis of knowledge, but also through periodic revolutions in perspective.
Anomalies and incongruities that may have been initially ignored drive a field into crisis, he argued, and eventually force a new scientific framework. Copernicus, Darwin, Newton, Galileo, Pasteur—all have spearheaded what Kuhn has called a “paradigm shift.”
Thomas Kuhn is Claudia Miller’s hero. An immunologist and environmental health expert at the University of Texas School of Medicine in San Antonio, and a visiting senior scientist at Harvard University, Miller lives by Kuhn’s maxim that “the scientist who embraces a new paradigm is like the man wearing inverting lenses…[he] has undergone a revolutionary transformation of vision.”
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 shows how a person can have a toxic exposure and never recover.
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 the Massachusetts Institute of Technology policy and technology professor emeritus Nicholas Ashford, 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.
Even if your theory makes sense, what proof is there? Germs can be seen and studied and treated, and the immune system’s different products can be measured and tweaked as well.
There are several types of proof. Nick Ashford and I observed the same patterns of inexplicable new-onset intolerances across very different toxic exposures in over a dozen countries. Sheep dippers using organophosphate pesticides in rural areas of Europe, radiology workers inhaling chemicals while developing films in New Zealand, Gulf War veterans, EPA workers in a remodeled and poorly ventilated office building in 1987, cleanup crews breathing fumes after oil spills. Many would get ill, and a small percentage never recovered. They became exquisitely sensitized, as well as disabled. The second type of proof is what happens when TILT-ed individuals avoid exposures. They begin to get better, even if they don’t completely recover.
How do we know chemicals wreak havoc with our immune systems, especially at low doses?
There are studies in rats bred to be uniquely sensitive to organophosphates, which are extremely potent pesticides. After exposure they exhibit abnormal sleep and increased sensitivity to many other chemicals. There might be humans who are like those rats—genetically susceptible to organophosphate poisoning.
There is also good evidence that toxicants like solvents, pesticides, or volatile molecules from oil spills can travel straight into the brain via the olfactory receptors studding the inner lining of our nose. Animal studies show that intermittent lower-dose exposures can be as toxic as a single higher-dose exposure. If an individual has had too much exposure, sensitization could possibly lead to permanently increased reactivity to chemicals via the limbic system in the brain.
It literally blew my mind. There would be depression, vomiting, and cognitive dysfunction.
There might well be changes in gene expression and cell receptor sensitivity due to ongoing chemical exposure, but while those are very plausible, we don’t really know for sure yet. It remains an open question for research. In terms of discovering the underlying mechanism of TILT, we are at a very early stage of understanding.
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