How Chemically Sensitive Are You?

Do you have chemical intolerance? Are you TILTed?

Toxicant‐Induced Loss of Tolerance (TILT) is a two-stage disease started by a one-time major exposure or a series of low-level chemical exposures, followed by symptoms triggered by everyday chemicals, foods, and drugs that never bothered before. Read about TILT origins and triggers.

TILT-related symptoms may involve any and every organ system, from neurological symptoms (memory problems, brain fog, and mood changes), to gastrointestinal problems, migraines and headaches, and fatigue and muscle pain.

The good news is you can find out how chemically sensitive you are.

Our team at the Hoffman TILT Program at UT Health San Antonio has created these self-assessments:

1. The Chemical Intolerance Self-Evaluation is a complete evaluation form for assessing chemical intolerance and includes the BREESI (see below), the QEESI (see below), and a 7-item exposure history. This is designed for patients to bring to their doctors, or for doctors to give to their patients.

2. The Brief Environmental Exposure and Sensitivity Inventory (BREESI) is a 3-item screener for chemical intolerance with excellent predictive validity. It’s a useful tool for a quick assessment for TILT. Ideal for personal or doctor office assessments and epidemiological studies.

The three questions are:

  • Do you feel sick when you are exposed to tobacco smoke, certain fragrances, nail polish/remover, engine exhaust, gasoline, air fresheners, pesticides, paint/thinner, fresh tar/asphalt, cleaning supplies, new carpet or furnishings? By sick, we mean: headache, difficulty thinking, difficulty breathing, weakness, dizziness, upset stomach, etc.
  • Are you unable to tolerate or do you have adverse or allergic reactions to any drugs or medications (such as antibiotics, anesthetics, pain relievers, X-ray contrast dye, vaccines or birth control pills), or to an implant, prosthesis, contraceptive chemical or device, or other medical/surgical/dental material or procedure?
  • Are you unable to tolerate or do you have adverse reactions to any foods such as dairy products, wheat, corn, eggs, caffeine, alcoholic beverages, or food additives (e.g., MSG, food dye)

3. The Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a validated questionnaire for chemical intolerance and the most widely used screening instrument available for personal use. Researchers and clinicians around the world use the QEESI to document symptoms and intolerances. People who use the QEESI find it helpful for self-assessment. It’s also a useful tool for you to take to your doctor to explain your exposures and symptoms.

“Triggers and symptoms will differ from person to person,” according to the Hoffman TILT team, led by Dr. Claudia Miller, allergist/immunologist and professor emeritus at UT Health San Antonio. “We encourage everyone to take the QEESI survey. Whether you are TILTed or not, the avoidance of triggers and toxic exposures are a good idea. This is especially true to protect the most vulnerable individuals – children, pregnant women, or the chemically susceptible.”

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