Have You TILTed (Toxicant-Induced Loss of Tolerance)?


When we talk about a disease or condition, the conversation often includes the cause of the problem (or at least it should). If we’re discussing diabetes, the “cause” is an underproduction of insulin or cells that are resistant to insulin’s action. If we consider GERD or acid reflux, the “cause” is sometimes wrongly assumed to be an overproduction of stomach acid.

But what about those conditions like depression or “seasonal” allergies that may not have a clear etiology (i.e., a cause or set of causes that lead to a disease or condition)? What about all those symptoms like headaches or stiff joints that we live with on a daily basis and can’t figure out what’s causing them?

Theories of Disease

In the 1800s, the germ theory of disease began to take hold and was based on the notion that many conditions were a direct result of infection by bacteria, viruses, yeasts and/or parasites. Prevention required avoiding the microbes through sanitary practices. Cures required eradicating the microscopic troublemaker. It was a straight forward theory: one germ causes one disease and the one cure is to kill the invader.

In the 1930s, the immune theory of disease was developed and described how the immune response may be the cause of symptoms. The process requires four steps: 1) exposure to an antigen (a foreign substance that elicits a response from the immune system), 2) development of antibodies to the antigen, 3) re-exposure to the antigen, followed by 4) an antibody triggered response resulting in the associated symptoms. This theory states that something biological (food, pollen, poison ivy) triggers the immune system and leads to associated symptoms. It helps explain all kinds of allergies and gives a possible mechanism for autoimmunity.

Now, there is a new theory for disease called TILT, or toxicant-induced loss of tolerance. Dr. Claudia Miller formulated this theory due to the mounting evidence that overexposure to chemicals, either all at once or in small doses over time, causes many of the chronic symptoms and conditions with which we suffer. The theory asserts that exposure to one or more chemicals uses up some (or a lot) of the body’s resources, which makes us more susceptible to reacting to non-harmful substances (for example, casein) and/or low-ish levels of harmful substances (for example, car exhaust or heavy metals). The real problem here is that it’s very difficult to figure out what substances are triggering which reactions because the body simply can’t cope with everything being thrown at it and the symptoms can show up anywhere in the body. (I mean, let’s face it, we are exposed to chemicals all. the. time.)

Toxin-Disease Associations

Just as Dr. Miller theorizes, there is evidence that exposure to toxins may lead to all sorts of problems. Of course, it’s very difficult to prove these relationships because it is unethical to, for example, expose a child to a bunch of mercury to see if she or he develops autism. As such, the following are examples of potential toxin-disease associations that have been identified through correlational or observational studies:

  • ADHD: bisphenol A (BPA), phthalates, PCBs, lead and mercury
  • Allergies: BPA, formaldehyde, phthalates, mold, cadmium and nickel
  • Autoimmune disease: mold, arsenic, lead and mercury
  • Cancer: there are way too many to list here since cancer is really a family of diseases, so here’s just a few… benzene and leukemia; phthalates and prostate, uterine and breast cancer; POPs and breast cancer; lead and lung, stomach and bladder cancer.
  • Chronic Fatigue Syndrome and fibromyalgia: arsenic, benzene, formaldehyde, pesticides, PCBs, solvents, PVC, POPs, lead, arsenic, cadmium, mercury, nickel and mold
  • Diabetes and insulin resistance: BPA, PCBs, PVC, dioxin, pesticides and arsenic
  • Fertility issues, endometriosis and menstrual disorders: BPA, formaldehyde, phthalates, PCBs, PAHs, solvents, PVC, dioxins, arsenic, cadmium, lead and mercury
  • High blood pressure: arsenic, lead and mercury
  • Neurobehavioral issues: phthalates, PCBs, solvents, aluminum, arsenic, lead, mercury, and mold
  • Osteoporosis: cadmium and lead
  • Parkinson’s disease: pesticides
  • Peripheral neuropathy: PCBs, arsenic, lead and mercury

Note: These are the relationships which have been shown to be correlated via research. There are undoubtedly numerous other correlations for which we haven’t even begun to be aware.

Evaluating Potential Toxic Burden

Beyond the above diagnoses, toxins can lead to lots of non-specific symptoms (i.e., symptoms that can have multiple root causes). As a practitioner, I start to think about a person possibly having a high toxic burden when they experience many of the below symptoms on a somewhat regular basis.

  • Headaches
  • Fainting
  • Dizziness
  • Insomnia
  • Acne
  • Hives, rashes or dry skin
  • Hair loss
  • Flushing or hot flashes
  • Excessive sweating
  • Watery or itchy eyes
  • Swollen, reddened or sticky eyelids
  • Bags or dark circles under eyes
  • Blurred or tunnel vision
Joints / Muscles
  • Pain or aches in joints
  • Arthritis
  • Stiffness or limitation of movement
  • Pain or aches in muscles
  • Feeling of weakness or tiredness
  • Itchy ears
  • Earaches or ear infections
  • Drainage from ear
  • Ringing in ears or hearing loss
  • Binge eating / drinking
  • Craving certain foods
  • Excessive weight
  • Difficulty losing weight
  • Compulsive eating
  • Water retention
  • Underweight
  • Stuffy nose
  • Sinus problems
  • Hay fever
  • Sneezing attacks
  • Excessive mucus formation in sinuses / nose
Energy / Activity 
  • Fatigue, sluggishness
  • Apathy, lethargy
  • Hyperactivity
  • Restlessness
 Mouth / Throat
  • Chronic coughing
  • Gagging, frequent need to clear throat
  • Sore throat, hoarseness, loss of voice
  • Swollen / discolored tongue, gums, lips
  • Canker sores
  • Poor memory
  • Confusion, poor comprehension
  • Poor concentration
  • Poor physical coordination
  • Difficulty in making decisions
  • Stuttering or stammering
  • Slurred speech
  • Learning disabilities
  • Chest congestion
  • Asthma, bronchitis
  • Shortness of breath
  • Difficulty breathing
  • Mood swings
  • Anxiety, fear or nervousness
  • Anger, irritability or aggressiveness
  • Depression
  • Irregular or skipped heartbeat
  • Rapid or pounding heartbeat
  • Chest pain
  • Frequent illness
  • Frequent or urgent urination
  • Genital itch or discharge
Digestive Tract
  • Nausea or vomiting
  • Diarrhea
  • Constipation
  • Bloated feeling
  • Belching or passing gas
  • Heartburn
  • Intestinal / stomach pain

Because these symptoms are non-specific, it is important to consider all of the following when thinking about your potential toxic burden:

  • Diagnosis of diseases or conditions that have an association with toxins (see partial list above)
  • Frequency and severity of non-specific symptoms (i.e., If you had a runny nose last week and it turned out you had a cold, that would not necessarily be an indicator.)
  • Exposure to toxins including medications and tobacco products
  • Negative reactions to seemingly innocuous substances such as caffeine, fragrances and sulfite containing foods (ex: wine and dried fruit)

Each of these are pieces to a puzzle that, when put together, help you and your healthcare practitioner identify if an increased toxic burden could be contributing to how you feel.


Although TILT (i.e., the proposal that toxins are reducing our overall tolerance to environmental substances) is not considered an official diagnosis today, per the ICD10 codes, I fully expect it to gain ground among healthcare practitioners as a viable explanation as to why many people just don’t feel as good as they deserve to feel. After all, chronic symptoms, conditions and diseases are becoming more and more common.

If you think you may be suffering from a reduced tolerance due to your toxic burden, check out my recommendations for lowering your toxin exposure and for getting all the nutrients you need for detoxification (especially antioxidants!).

If you aren’t sure where to start or you want help working through the process and lowering your toxic burden while addressing other possible issues, contact me. Solving puzzles, especially those that help people feel better, is one of my favorite activities!

Image by MaxiDesigns via Pixabay.

Next Level Functional Nutrition. Level 2, Module 6: Detox. 2015.
IFN Academy. Track 2, Module 6: Toxicity and Chronic Disease. 2016.
— Miller C. About TILT. Accessed on July 11, 2016.

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