Multiple Chemical Sensitivity
Multiple chemical sensitivity (MCS) is a chronic polysymptomatic syndrome whose core symptom is the subjective experience of illness from low level exposures to environmental chemicals that most people find neutral or nontoxic. MCS overlaps with fibromyalgia and chronic fatigue syndrome, as well as Gulf War I Syndrome, in clinical presentation. Women in mid life constitute the majority of affected individuals. Comorbidities include rhinitis, sinusitis, bronchitis, migraine headache, irritable bowel, multiple food intolerances, arthritis, and anxiety and affective disorders. Leading proposed mechanisms for which human and animal data exist include time dependent sensitization and neurogenic inflammation. Skeptics of MCS focus on a dualistic model in which symptoms are presumed psychogenic, imagined, or misattributed. Current treatments are limited, but recent studies suggest that a pragmatic, multidisciplinary, clinical package of care including chemical avoidance, elimination diets, tolerated nutritional supplementation, and mind body interventions such as mindfulness meditation can be helpful and cost effective. Additional systematic research on MCS will facilitate better understanding of this likely heterogeneous condition with different initiating etiologies and overlapping endpoint phenomenologies.