Treatments

The following are tips that helped me alleviate 50 symptoms and reduce my sensitivities a lot.
I am a medical doctor or health practitioner - so these tips are NOT meant to treat or replace proper medical attention

Treatment in my opinion should primarily focus on managing Central Sensitivity and reducing the neurotransmitter glutamine and NMDA activity - hyper excitability, these can significantly contribute to heightened pain, prolonged pain, wide spread pain (allodynia, hyperalgesia, hyperpathia) and hypersensitivity to chemicals, stimuli and stress.

Heightened NMDA activity and glutamine (glutamate) are involved in the self maintaining NO/OONO inflammatory disease cycle postulated by biochemist Dr Martin Pall, it is worsened by what I call Toxicity, inflammation and stress (TIS). It has also been connected to "sensitisation" and "kindling" which may be worsened by continued exposures to triggering substances and stimuli.

Managing environment and reducing exposure to stimuli and chemicals is very important

it can disrupt the kindling process and reduce sensitivities. (I call this the V5 treatment approach- explained at www.50symptoms gone -also found at my blog 50 symptoms gone are product recommendations and other resources you may find helpful)

For some people anticonvulsant medications such as Gabapentin can be helpful

Tricyclics is another option, however as people with MCS generally have quite severe medicine sensitivity these need to be started on low doses and increased slowly under medical supervision to test for tolerance. This is also recommended to people with chronic fatigue syndrome by the Centers for Disease Control and Prevention (CDC)

Supplement protocols like the Neural Protocol promoted by both Dr Grace Ziem and Dr Martin Pall, have proven beneficial for some people with MCS however harmful for others.

For people with more severe phenol-salicylate intolerance they can worsen symptoms and sensitivities. People with more severe phenol-salicylate intolerance and other pharmacological food intolerance (e.g. MSG, aspartame, glutamine, amines) may experience "drug resistant" depression according to Psychiatrist Dr Gordon Parker and may experience very heightened side effects to "psychogenic" drug therapies.

Phenol-Salicylate intolerance and pharmacological food intolerance affects at least 1 in 3 people with CFS and chemical sensitivities quite severely according to Dr Robert Loblaly Director of the RPAH Allergy Unit.

Until phenol-salicylate intolerance is ruled out I personally think it is important to a take a precautionary approach and assume it is a problem as continuing to take agents and eat foods high in phenols-salicylates has been shown to further deplete enzymes (particularly those that affect Phase 2 liver detoxification-sulfation) and increase toxicity . Some supplements more suitable for people with phenol-salicylate intolerance are listed in the RPAH Allergy Unit personal care and hygiene guide for people with scent and chemical sensitivity. Non phenolic supplements such as B12 methylcobalamin, tri-salts and non plant based toxin binders such as charcoal tabs and zeolites (taken at least 1 hr either side of food so as not to interfere with nutrient absorption) have been reported beneficial by many.

For some people detoxification methods such as FIR Sauna Therapy can be useful if engaged in very safely

however, other detoxification methods can be problematic due to enzyme depletion and liver detoxification impairment and are generally not recommended. Detoxification methods that provoke rapid detoxification such as fasting and high quantities of juices are not generally recommended. Very restricted calorie diets, that promote rapid weight loss should also be avoided according to Dr Grace Ziem.

When it comes to Sauna Therapy Dr Sarah Myhill says that short periods of time in the sauna is all that is necessary as most chemicals come out within a few minutes of sweating. After being in the sauna it is also really important to shower and rehydrate with a mineral mix. http://drmyhill.co.uk/wiki/Detoxing_-_Far_Infrared_Sauna_(FIRS)

Stress Management is also very important

starting with doing what is necessary to get a better nights sleep and learning and practising stress reduction and management techniques such as MINDFULNESS

Your diet can't heal you but it can worsen your symptoms or it can reduce your symptoms

An unhealthy diet can increase inflammation and pain and a healthy diet if not adjusted for food intolerance if applicable (usually is quite a problem for people with MCS) can increase inflammation and pain. The most common type of food intolerance experienced are linked to carbohydrates, sugar and believe it or not fruits and vegetables. MSG and Aspartame should be eliminated from the diet and it is best to also avoid food additives, preservatives and colourings as well. Find out more about Eating Right when you have MCS at www.50symptoms.gone

Managing MCS without support and help (particularly if very severe and disabling) can be quite difficult

if you do not have help and support at home, find support through your local MCS support organisation and on line.

Dr Bradford Recommends that prior to engaging in any form of treatment a number of resources by Dr Grace Ziem should be read

The following is the recommended reading found at his site: http://www.dr-bradford.com/Ziem-Protocol.htmlrecommends patients read the following

ENVIRONMENTAL CONTROLS ARE THE MOST IMPORTANT FIRST STEP target="blank"

LETTER TO PATIENTS: Detailed explanation of Dr. Ziem’s treatment.

NEW PATIENT HEALTH AND ENVIRONMENT HISTORY: Form filled out by Dr. Ziem’s new patients. (Doctors are permitted to adapt and use this form in their own practices.)
MEDICAL TREATMENT:

Neural Protocol

Glutathione is the body's important antioxidant and detoxifying molecule, needed in higher amounts in chemical injury. Commercial oral forms are not absorbed, but a new oral form, S-acetyl Glutathione, is now available that is absorbed directly into the blood stream (contact me for details).

SpectraCell Comprehensive Nutritional Panel (cultured lymphocytes) testing
Intestinal healing is essential to health
Oral forms of healing substances, and sublingual MethylCobalamine (the active form of B12)

Help your healthcare provider help you better

Note: When it came to Dr Grace Ziem's suggestion her Environmental control plan for the most part was beneficial for me, however, I could not tolerate all her suggestions, and had a lot of trouble with her supplement and dietary guidelines due to having a more severe phenol-salicylate intolerance (problems with herbs and other plant chemicals).

Regardless of what therapies or suggestions you want to try GO LOW AND GO SLOW and test for individual tolerance - No one doctors or persons suggestion will be entirely right for you

People with MCS (like other people with Central Sensitivity Syndromes (CSS)are experiencing many dysregulations of the the autonomic nervous system and enzyme depletions - this significantly reduces tolerances to standard therapies: detoxification, supplements, medicines, psychological and more, particularly if the person is also experiencing more severe cortisol depletion (hypocortisolism) and liver detoxification impairment. The 2 often go together! (Yanick)

This does not mean you cannot be helped or your situation can not be improved, it just means you need to become a good researcher and enter into treatments cautiously and slowly do not just jump in but instead PACE yourself and set SMART goals and create you own individualised Wellness Plan [discussed at 50 symptoms gone] with the help of a trusted Health Professional.

Reference

Bibliography
1. Pall M.L. (2007) Explaining “Unexplained Illnesses”: Disease Paradigm for Chronic Fatigue Syndrome, Multiple Chemical Sensitivity, Fibromylagia, Post-Traumatic Stress Disorder, Gulf War Syndrome and Others. Harrington Park (Haworth) Press, New York.
2. Woolfe, J. Clifford (March 2012) Central sensitization: Implications for the diagnosis and treatment of pain
3. Ziem, G. Letter to Patients
4. Psychoneuroendocrinology. 2005 Nov;30(10):1010-6.A new view on hypocortisolism.Fries E, Hesse J, Hellhammer J, Hellhammer DH
5. Does hypocortisolism predict a poor response to cognitive behavioural therapy in chronic fatigue syndrome?A. D. L. Roberts1,2, M.-L. Charler2, A. Papadopoulos3, S. Wessely1,2,3, T. Chalder1,2 and A. J. Cleare1,2,3*
6. Rowat. S.C Environ Health Perspect. 1998 February; 106(Suppl 1): 85–109.Research Article Integrated defense system overlaps as a disease model: with examples for multiple chemical sensitivity.
7. Gibson, P. R., Elms, A. N. M., & Ruding, L. A. (2003). Perceived treatment efficacy for conventional and alternative therapies reported by persons with multiple chemical sensitivity. Environmental Health Perspectives, 111, 1498-1504.
8. Nussbaumer, Linda, South Dakota State University Multiple Chemical Sensitivity Implications VOL. 03 ISSUE 4
9. Ziem G Environmental Control Plans
10. Loblay, MD, PhD, Swain, PhD. The Role of Food Intolerance in Chronic Fatigue Syndrome. Chapter 57. Robert B. Loblay.
11. Bradford L, Bradford T The VOCLESS Guide www.reshapeforhealth.com
12. Pall M.L Elevated nitric oxide/peroxynitrite theory of multiple chemical sensitivity: central role of N-methyl-D-aspartate receptors in the sensitivity mechanism.
13. Hypoadrenia: A causative factor in MCS, Allergies and Impaired Enzymatic Detoxification Dr. Paul Yanick, Jr. Ph.D., N.D. – Board Certified in Integrative Medicine Source: Published in the March 2005 Townsend Letter for Doctors – Revised on 11-20-11 © 2011
14. Bradford L, Bradford T The RESHAPE PLUS book for people with Chronic Fatigue Syndrome, Fibromyalgia, Chemical Sensitivity and Multiple Chemical Sensitivity www.reshapeforhealth.com
15. Engaging with Multiple Chemical Sensitivity (MCS)- London 2003 Malcolm Hooper PhD, B Pharm, C Chem, MRIC Chief Scientific Advisor to the Gulf War Veterans
16. Carruthers B.M and Van de Sande MI, MyalgicEncephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical practitioners –
17. Management of chronic fatigue syndrome a resource guide for health care professionals http://www.cdc.gov/cfs/pdf/cfs-resource-guide.pdf
18. Novel Disease Paradigm Produces Explanations for a Whole Group of Illnesses A Common Causal (Etiologic) Mechanism for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, Multiple Chemical Sensitivity, Fibromyalgia and Post-Traumatic Stress DisorderMartin L. Pall, Professor Emeritus of Biochemistry and Basic Medical Sciences,Washington State University and Research Director, The Tenth Paradigm Research Group.
19. The Role of Food Intolerance in Chronic Fatigue SyndromeRobert H. Loblay, MD, PhD1 and Anne R. Swain, PhD21Senior Lecturer in Immunology, University of Sydney and Director, Allergy Service, Department of Clinical Immunology, Royal Prince Alfred Hospital 2Research Dietitian, Allergy Service, Royal Prince Alfred Hospital, Sydney, Australia
20. Toxicant-induced Loss of Tolerance-An emerging theory of disease?Miller CS. Environ Health Perspect 1997 Mar;105 S:445-453.
21. Empirical approaches for the investigation of toxicant-induced loss of toleranceMiller CS, Ashford NA, Doty R, Lamielle M, Otto D, Rahill A, Wallace L. Environmental Health Perspectives 1997 Mar;105(2):515-519.
22. Treatment Options in Multiple Chemical Sensitivity by Gerald H. Ross, MD, CCFP, DIBEM, FAAEM?Environmental Health Center-Dallas, Dallas, TX http://www.aehf.com/articles/treatment_options_mcs.html
23. Dr Sarah Myhill Chemical Poisoing – general principles of diagnosis and treatment http://drmyhill.co.uk/wiki/Chemical_poisoning_-_general_principles_of_di...
24. An Overview of the Canadian Consensus Document 2005/2006Jain AK and Carruthers BM, co-editors. van de Sande MI, Barron SR, Donaldson CCS, Dunne JV, Gingrich E, Heffez DS, Leung F Y-K, Malone DG, Romano TJ, Russell IJ, Saul D, Seibel DG. FIBROMYALGIA SYNDROME: Canadian Clinical Working Case Definition, Diagnostic and Treatment Protocols. A Consensus Document. Journal of Musculoskeletal Pain 11(4), 2003
25. Fibromyalgia Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners – An Overview of the Canadian Consensus Document.
26. Lacour M, Zunder T, Dettenkofer M, Schönbeck S, Lüdtke R, Scheidt C (February 2002). "An interdisciplinary therapeutic approach for dealing with patients attributing chronic fatigue and functional memory disorders to environmental poisoning—a pilot study". Int J Hyg Environ Health 204 (5-6): 339–46. doi:10.1078/1438-4639-00103. PMID 11885358.
27. Bottiglieri T. Folate, vitamin B12, and neuropsychiatric ? disorders. Nutr Rev 1996;54:382-90. ?
28. Van Goor L, Woiski MD, Lagaay AM, Meinders AE, Tak PP.Review: ? cobalamin deficiency and mental impairment in elderly people. Age ? Ageing. 1995 Nov;24(6):536-42.
29. Ferguson E, Cassaday HJ. Theoretical accounts of Gulf War ? Syndrome: from environmental toxins to psychoneuroimmunology and ? neurodegeneration. Behav Neurol. 2001-2002;13(3-4):133-47.
30. Lucas HJ, Brauch CM, Settas L, Theoharides TC. ? Fibromyalgia--new concepts of pathogenesis and treatment. Int J ? Immunopathol Pharmacol. 2006 Jan-Mar;19(1):5-10.
31. Mease P. Fibromyalgia syndrome: review of clinical ? presentation, pathogenesis, outcome measures, and treatment. J ? Rheumatol Suppl. 2005 Aug;75:6-21.? 46.) Fiedler N, Kipen HM, DeLuca J, Kelly-McNeil K, Natelson B. A ? controlled comparison of multiple chemical sensitivities and ? chronic fatigue syndrome. Psychosom Med. 1996 Jan-Feb;58(1):38-49.
32. 50.) Aaron LA, Burke MM, Buchwald D. Overlapping conditions among ? patients with chronic fatigue syndrome, fibromyalgia, and ? temporomandibular disorder.Arch Intern Med. 2000 Jan ? 24;160(2):221-7.? 51.) Paul M. Explaining 'Unexplained Illnesses': Disease Paradigm ? for Chronic Fatigue Syndrome, Multiple Chemical Sensitivity, ? Fibromyalgia, Post-Traumatic Stress Disorder, and Gulf War ? Syndrome. The Hawthorne Press Inc., 2007.?
33. Phillips, K. & Clauw, D. J. (2011). Central pain mechanisms in chronic pain states – maybe it is all in their head. Best Practice Research in Clinical Rheumatology, 25, 141-154. [back]
34. Yunus, M. B. (2007). The role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain. Best Practice Research in Clinical Rheumatology, 21, 481-497.
35. Curatolo, M., Arendt-Nielsen, L., & Petersen-Felix, S. (2006). Central hypersensitivity in chronic pain: Mechanisms and clinical implications. Physical Medicine and Rehabilitation Clinics of North America, 17, 287-302.
36. Wieseler-Frank, J., Maier, S. F., & Watkins, L. R. (2005). Immune-to-brain communication dynamically modulates pain: Physiological and pathological consequences. Brain, Behavior, & Immunity, 19, 104-111.
37. Meeus M., & Nijs, J. (2007). Central sensitization: A biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clinical Journal of Rheumatology, 26, 465-473
38. Melzack, R., Coderre, T. J., Kat, J., & Vaccarino, A. L. (2001). Central neuroplasticity and pathological pain. Annals of the New York Academy of Sciences, 933, 157-174.
39. Flor, H., Braun, C., Elbert, T., & Birbaumer, N. (1997). Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neuroscience Letters, 224, 5-8
40. O’Neill, S., Manniche, C., Graven-Nielsen, T., Arendt-Nielsen, L. (2007). Generalized deep-tissue hyperalgesia in patients with chronic low-back pain. European Journal of Pain, 11, 415-420.
41. Schwartzman, R. J., Grothusen, R. J., Kiefer, T. R., & Rohr, P. (2001). Neuropathic central pain: Epidemiology, etiology, and treatment options. Archives of Neurology, 58, 1547-1550. [
42. Alexander, J., DeVries, A., Kigerl, K., Dahlman, J., & Popovich, P. (2009). Stress exacerbates neuropathic pain via glucocorticoid and NMDA receptor activation. Brain, Behavior and Immunity, 23, 851-860.
43. Imbe, H., Iwai-Liao, Y., & Senba, E. (2006). Stress-induced hyperalgesia: Animal models and putative mechanisms. Frontiers in Bioscience, 11, 2179-2192
44. Kuehl, L. K., Michaux, G. P., Richter, S., Schachinger, H., & Anton F. (2010). Increased basal mechanical sensitivity but decreased perceptual wind-up in a human model of relative hypocortisolism. Pain, 194, 539-546
45. Rivat, C., Becker, C., Blugeot, A., Zeau, B., Mauborgne, A., Pohl, M., & Benoliel, J. (2010). Chronic stress induces transient spinal neuroinflammation, triggering sensory hypersensitivity and long-lasting anxiety-induced hyperalgesia. Pain, 150, 358-368
46. Hauser, W., Wolfe, F., Tolle, T., Uceyler, N. & Sommer, C. (2012). The role of antidepressants in the management of fibromyalgia: A systematic review and meta-analysis. CNS Drugs, 26, 297-307.
47. Hauser, W., Bernardy, K., Uceyler, N., & Sommer, C. (2009). Treatment of fibromyalgia syndrome with gabapentin and pregabalin – A meta-analysis of randomized controlled trials. Pain, 145, 169-181
48. Straube, S., Derry, S., Moore, R. A., & McQuay, H. J. (2010). Pregabalin in fibromyalgia: Meta-analysis of efficacy and safety from company clinical trial reports. Rheumatology, 49, 706-715.
49. Tzellos, T. G., Toulis, K. A., Goulis, D. G., Papazisis, G., Zampellis, Z. A., Vakfari, A., & Kouvelas, D. (2010). Gabapentin and pregabalin in the treatment of fibromyalgia: A systematic review and meta-analysis. Journal of Clinical Pharmacy and Therapeutics, 35, 639-656
50. . Thieme, K. Flor, H., & Turk, D. C. (2006). Psychological pain treatment in fibromyalgia syndrome: Efficacy of operant behavioral and cognitive behavioral treatments. Arthritis Research & Therapy, 8, R121.
51. Brown MM, Jason LA. Dynamic medicine. 2007 May 31;6:6. Functioning in individuals with chronic fatigue syndrome: increased impairment with co-occurring multiple chemical sensitivity and fibromyalgia.
52. De Luca C, et al. International journal of environmental research and public health. 2011 Jul;8(7):2770-97. The search for reliable biomarkers of disease in multiple chemical sensitivity and other environmental intolerances.
53. De Luca C, et al. Indian journal of experimental biology. Idiopathic environmental intolerances (IEI): from molecular epidemiology to molecular medicine.
54. Gibson PR, Lindberg A. ISRN nursing. 2011;2011:838930. Phsicians' perceptions and practices regarding patient reports of multiple chemical sensitivity.
55. Merkes M. Australian journal of primary health. 2010;16(3):200-10. Mindfulness-based stress reduction for people with chronic diseases.
56. Nogue S, et al. Medicina clinica. 2007 Jun 16;129(3):96-8. Article in Spanish. Abstract referenced. Multiple chemical sensitivity: study of 52 cases.
57. The Ohio State University Extension. Multiple Chemical Sensitivity. Accessed March 2013.
58. Sampalli T, et al. Journal of multidisciplinary healthcare. 2009 Apr 7;2:53-9. A controlled study of the effect of a mindfulness-based stress reduction technique in women with multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia.
59. Smith HS, Harris R, Clauw D. Pain physician. 2011 Mar-Apr;14(2):E217-45. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome.
60. Eek F, et al. Journal of psychosomatic research. 2010 Jul;69(1):9-15. Factors associated with prospective development of environmental annoyance.
61. Genuis SJ. Clinical therapeutics. 2013 May;35(5):572-7. Chemical sensitivity: pathophysiology or pathopsychology?
62. Gibson PR, et al. Nursing & health sciences. 2011 Sep;13(3):232-7. Isolation and lack of access in multiple chemical sensitivity: A qualitative study.
63. Hillert L, et al. PLoS One. 2013;8(1):e54781. Women with multiple chemical sensitivity have increased harm avoidance and educed 5-HT(1A) receptor binding potential in the anterior cingulate and amygdala.
64. Katherndahl DA, Bell IR, Palmer RF, Miller CS. Annals of family medicine. 2012 Jul-Aug;10(4):357-65. Chemical intolerance in primary care settings: prevalence, comorbidity, and outcomes.
65. Skovbjerg S, et al. Environmental health and preventive medicine. 2012 Jan;17(1):2-9. The association between idiopathic environmental intolerance and psychological distress, and the influence of social support and recent major life events.
66. Skovbjerg S, et al. Scandinavian journal of psychology. 2012 Jun;53(3):233-8. Mindfulness-based cognitive therapy to treat multiple chemical sensitivities: a randomized pilot trial.
67. Merkes M. Australian journal of primary health. 2010;16(3):200-10. Mindfulness-based stress reduction for people with chronic diseases.
68. Nogue S, et al. Medicina clinica. 2007 Jun 16;129(3):96-8. Article in Spanish. Abstract referenced. Multiple chemical sensitivity: study of 52 cases.
69. Sampalli T, et al. Journal of multidisciplinary healthcare. 2009 Apr 7;2:53-9. A controlled study of the effect of a mindfulness-based stress reduction technique in women with multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia.
70. Smith HS, Harris R, Clauw D. Pain physician. 2011 Mar-Apr;14(2):E217-45. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome.
71. Yunus MB. Seminars in arthritis and rheumatism. 2008 Jun;37(6):339-52. Central sensitivity syndrome: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness.
72. Supplements: Nutrition in a pill? By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/supplements/NU00198
73. Chronic Conditions Self Management http://www.selfmanagement.health.wa.gov.au/index.php?option=com_content&...
74. Monitoring the Use of All Medicines and Supplements Over-the-Counter and Prescription Medicines http://www.cdc.gov/cfs/management/medicines.html
75. Roberts AD, Charler ML, Papadopoulos A, Wessely S, Chalder T, Cleare AJ. Does hypocortisolism predict a poor response to cognitive behavioural therapy in chronic fatigue syndrome? "Psychol Med"[jour], 2010 Mar.
76. .Myhill S, Booth NE, McLaren-Howard J. Int J Clin Exp Med (2009) 2, 1-16. Chronic fatigue syndrome and mitochondrial dysfunction
77. Articles by Dr Paul Cheney ME/CFS http://aboutmecfs.org/Trt/CheneyFiles.aspx
78. .The MCS Canadian Source: Resources and Support for Multiple Chemical Sensitivity, Environmental Illness, and Chemical Injuries has a number of good resources regarding healthcare and hospital visits www.mcscanadian.org/hospital.html
79. Neural Sensitization: The Medical Key to Treatment of Chemical Injury www.chemicalinjury.net
80. South Australia. Department of Human Services. Myalgic encephalopathy (ME) and chronic fatigue syndrome (CFS): management guidelines for general practitioners.
81. Diagnosing and Treating Chronic Fatigue Syndrome (CFS) by Dr Sarah Myhill www.drmyhill.co.uk/cfs_book.pdf
82. Chronic Fatigue Syndrome and Fibromyalgia by Dr Michael Serafin www.custommedicine.com.au/chronic-fatigue-syndrome/
83. Adrenal Fatigue/Adrenal Exhaustion by Dr M Serafin http://www.custommedicine.com.au/adrenal/
84. Low salicylate Medications: Medications listed as suitable for those with salicylate and amine (Phenolic) sensitivities by the Royal Prince Alfred Hospital Allergy Clinic. Refer guide: Medications for use with a Low Phenolic Diet at www.asehaqld.org.au.
85. Environmental Working Group: Body Burden the pollution in people http://archive.ewg.org/reports/bodyburden1/es.php
86. Friendly Food – The essential guide to avoiding allergies, additives and problem chemicals by Dr Anne Swain, Dr Velencia L Soutter and Dr Robert H Loblay from Royal Prince Alfred Hospital Allergy Unit
87. RPAH Elimination Diet Handbook with food and shopping guide www.sswahs.nsw.gov.au/rpa/allergy/
88. The Mood Cure by Juila Ross M.A. 2002
89. Chemical hypersensitivity and multiple chemical hypersensitivity syndrome?Miller CS. In: Doty R, ed.. Handbook of Olfaction and Gustation, 2nd edition. New York: Marcel Dekker, Inc.; 2003.
90. Multiple Chemical Intolerance and Indoor Air Quality?Miller CS, Ashford NA. In: Spengler J, Samet J, McCarthy J, eds.. Indoor Air Quality Handbook. New York: McGraw-Hll, Inc.; 2000.
91. Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes.?Katerndahl DA, Bell IR, Palmer RF, Miller CS. Ann Fam Med. 2012 Jul;10(4):357-65.
92. Chemical Intolerance Among Women With Panic Attacks In A Family Medicine Clinic?Katerndahl DA, Miller CS. Texas Family Physician 2005 Oct;56(4):47-50.
93. Cognitive performance and cerebrohemodynamics associated with the Persian Gulf Syndrome ?Bunegin L, Mitzel HC, Miller CS, Gelineau JF, Tolstykh GP. Toxicol Ind Health 2001 May;17(4):1-10.
94. Toxicant-induced loss of tolerance: Mechanisms of action of addictive stimuli?Miller CS. Journal of Nutritional and Environmental Medicine 2001;11(3):181-204.
95. Miller CS. Addiction 2001 Jan;96(1):115-137.Toxicant-induced loss of tolerance: Mechanisms of action of addictive stimuli?
96. Hawkins H, Acupuncture Today December, 2000, Vol. 01, Issue 12 Multiple Chemical Sensitivity
97. Hawkins H, Acupuncture Today February, 2001, Vol. 02, Issue 02. Multiple Chemical Sensitivity, Part II