Treatment MethodsTreatment of environmental illness is accomplished according to primarily three modalities: a program of avoidance of environmental chemical exposure, special elimination diets, and neutralization therapy. Drugs are regarded as harmful synthetic chemicals that cause environmental illness. Nevertheless, patients are often instructed to take vitamin and mineral supplements, and some are treated with certain salts, such as sodium bicarbonate, to “neutralize” allergic reactions and with amino acids, intravenously administered gamma-globulin, or oxygen inhalation to relieve symptoms. Patients with a diagnosis of Candida hypersensitivity are usually treated with several drugs to eliminate Candida albicans.

Clinical Studies

In recent years, results of several critical evaluations of patients claiming IEI have been published. Collectively these studies do not support a role for food and chemical sensitivities as a cause of the patient’s symptoms nor do they indicate immunologic dysfunction. Instead, they do provide evidence for a significant role for underlying psychiatric illness.

Immunologic Evaluation

Two studies up to now have reviewed the clinical and laboratory evidence for immunologic illness in patients with multiple food and chemical sensitivities. In 50 cases studied by Terr, levels of circulating immunoglobulins, complement components, and lymphocyte subsets fell mostly within the normal expected range and did not correlate with severity of reported illness or length of reported exposure to the foods or chemicals believed to cause the illness. None of the patients had clinical evidence of immunodeficiency or autoimmune disease, and the prevalence of allergic disease was similar to that found in the general population.

Conclusion. Multiple Food and Chemical Sensitivities

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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