The concept of multiple food or chemical sensitivities manifested by numerous symptoms in the absence of objective physical findings lacks a scientific foundation. There is no evidence that such patients suffer from an immunologic abnormality. The existence of such an illness is based on anecdotal reports with no verification using properly controlled blinded challenges. The diagnosis is made on the basis of the subjective history alone or in combination with provocation-neutralization testing, which has been shown to be unreliable. The treatment and theories underlying this presumed illness are not consistent with current immunologic knowledge and theory. Medical and psychiatric evaluations of these patients indicate instead that most may suffer from psychiatric illness that they cannot accept, preferring instead to interpret their symptoms as environmental sensitivities. Treatment by environmental chemical and food avoidance in combination with administration of neutralizing injections or sublingual drops is ineffective and likely to lead to harmful social isolation. In many cases, the diagnosis of IEI obscures a treatable psychiatric or physical disease.
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The American Academy of Allergy and Immunology issued a position statement as follows: “An objective evaluation of the diagnostic and therapeutic principles used to support the concept of clinical ecology indicates that it is an unproven and experimental methodology. It is time-consuming and places severe restrictions on the individual’s lifestyle. Individuals who are being treated in this manner should be fully informed of its experimental nature.”
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The American College of Physicians position statement concludes: “Review of the clinical ecology literature provides inadequate support for the beliefs and practices of clinical ecology. The existence of an environmental illness as presented in clinical ecology theory must be questioned because of the lack of a clinical definition. Diagnoses and treatments involve procedures of no proven efficacy.” The American College of Occupational Medicine has adopted the position on clinical ecology of the American College of Physicians.