Research

We have identified TILT in up to 20 percent of the patients in our clinics. Pregnant women, children, the elderly, those with chronic disease and/or chemical intolerance are among the most susceptible populations.

Few doctors, nurses, or respiratory therapists have received training on recognizing the impact of environmental exposures on health. Consequently, patients are not being questioned about their air quality at home or work.

Through presentations and peer-reviewed publications, we will share what we learn during this study to teach health care professionals who encounter TILTed patients. Our ultimate goal is that people with TILT have access to information and healthcare specific to their needs.

Environmental House Calls

One of the key components of the Hoffman TILT project was our certified indoor air quality team that conducted home assessments for local study participants. The house calls included indoor air quality assessments to measure levels of volatile organic compounds (VOCs), mold, allergens, particulates as well as temperature and humidity.

Participants in the study received a series of home visits, including an initial assessment, a visit to share results and help them develop an action plan. The final visit determined whether indoor air quality had improved, and symptom triggers had been reduced. Those who followed our recommendations to improve indoor air quality experienced improvements in symptoms related to their chemical intolerance.

The top graph shows the pre and post study symptom scores of the EHC participants. The bottom graph are those who did receive the EHC. The participant group shows a large reduction in symptoms while the other group did not. The study is now closed and results of the program were published in the journal of Primary Health Care and Research Development, 2021. It is available here: Does improving indoor air quality lessen symptoms associated with chemical intolerance?

Biological Testing

We have used biological testing to investigate genetic and other TILT-susceptibility markers. We are currently investigating if those with chemical intolerance have vitamin B12 deficiencies. We are using a special assay method that reliably measures B12 in a small sample of urine. This study is no longer open and we are currently writing up our results for publication.

Chemical Intolerance Data Repository

Our program has collected data from five large population-based surveys which we continue to publish manuscripts with. We are making this resource available to other Chemical Intolerance researchers. Sharing this resource enables reuse for further discovery and hypothesis testing, increases transparency, and facilitates reproducibility of research results. Codebooks and data are available from the University of Texas Health Science Center data repository at https://tiltresearch.org/about/research/

Recent Publications

2025

Palmer RF, Kattari D, Verduzco-Gutierrez M. Effects of the COVID-19 pandemic on individuals with chemical intolerance. Fam Med Community Health. 2025 Apr 24;13(2):e003081. doi: 10.1136/fmch-2024-003081. PMID: 40280594; PMCID: PMC12035467.

 

2024

Rincón R, Perales R, Palmer RF, et al. Environmental house calls can reduce symptoms of chemical intolerance: a demonstration of personalized exposure medicine. Prim Health Care Res Dev. 2024;25:e53. Published 2024 Oct 22. doi:10.1017/S146342362400046X

---

Palmer RF, Kattari D, Rincon R, Miller CS. Assessing Chemical Intolerance in Parents Predicts the Risk of Autism and ADHD in Their Children. Journal of Xenobiotics. (2024); 14(1):350-367.

---

Ravi T, Johnson-Esparza Y, Hernandez J, Andry N, Ali F, Del Pilar Montanez Villacampa M, Rincon R, Perales R, & Palmer RF. Clinical assessment and patient education of chemical intolerance. International Journal of Community Medicine and Public Health. (2024).

---

Johnson-Esparza, Y., Wood, R., Cruz, I. et al. Diabetes quality of life, Chemical Intolerance, and generational status in a Latino sample: an RRNeT study. J Diabetes Metab Disord (2024).

 

2023

Palmer RF, Dempsey TT, Afrin, LB. Chemical Intolerance and Mast Cell Activation: A Suspicious Synchronicity. Journal of Xenobiotics (2023), 13(4), 704–718.

---

Palmer RF, Almeida M, Perales RB, Rincon R. A genome-wide SNP investigation of chemical intolerance, Environmental Advances, 12,(2023), 2666-7657

---

Miller CS, Palmer RF, Kattari D, Masri S, Ashford NA, Rincon R, Perales RB, Grimes C. and Sundblad DR, What Initiates Chemical Intolerance? Findings from a Large Population-Based Survey of US Adults. Environmental Sciences Europe (2023), 35:65.

 

2022

Palmer RF, Rincon R., Perales RB, Walker TT, Jaén CR, Miller CS. The Brief Environmental Exposure and Sensitivity Inventory (BREESI): an international validation study. Environ Sci Eur 34, 32 (2022).

---

Perales RB, Palmer RF, Rincon R, Viramontes JN, Walker TT, Jaén CR, Miller CS. Does improving indoor air quality lessen symptoms associated with chemical intolerance? Prim Health Care Res Dev. (2022) Jan 12;23:e3.

 

2021

Palmer RF, Walker T, Kattari D, Rincon R, Perales RB, Jaén CR, Grimes C, Sundblad DR, Miller CS. Validation of a Brief Screening Instrument for Chemical Intolerance in a Large U.S. National Sample. Int J Environ Res Public Health. (2021) Aug 18;18(16):8714.

---

Miller CS, Palmer RF, Dempsey TT, Ashford N, Afrin LB. Mast cell activation may explain many cases of chemical intolerance. Environ Sci Eur. 33,129 (2021).

---

Palmer RF, Walker T, Perales RB, Rincon R, Jaén CR, Miller CS. Disease comorbidities associated with chemical intolerance. Environmental Disease. (2021) Oct 1;6(4):134.

---

Masri S, Miller CS, Palmer RF, Ashford. N. Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon. Environ Sci Eur 33, 65 (2021).

 

2020

Palmer RF, Jaén CR, Perales RB, Rincon R, Forster JN, Miller CS. Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI). PLoS One. (2020) Sep 16;15(9):e0238296.