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Multiple chemical sensitivity
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== Diagnosis == {{One source|section|find=multiple chemical sensitivity diagnosis|date=October 2024}} In practice, diagnosis relies entirely upon the [[Self-report study|self-reported]] claim that the symptoms are triggered by exposure to various substances.<ref name="Current">{{Cite book|title=Current Occupational & Environmental Medicine|last=Harrison|first=Robert|publisher=McGraw-Hill Education/Medical|year=2014|isbn=978-0-07-180816-3|edition=Fifth|location=New York|pages=819–826|chapter=Multiple Chemical Sensitivity|oclc=898477589|url=https://archive.org/details/currentoccupatio0000unse_c5n1|quote=controversial methods have been used ... including elimination or rotary diversified diets, vitamins or nutritional supplements, oxygen, antifungal and antiviral agents, thyroid hormone supplement, supplemental estrogen or testosterone, transfer factor, chemical detoxification through exercise and sauna treatment, intravenous gamma-globulin, and intracutaneous or subcutaneous neutralization. A specially designed chemical-free environmental control unit has been used as a method to decrease blood pesticide levels and ... Controversial treatment methods offer hope of improvement to many individuals with MCS, and some patients do report symptom improvement over time. Many ... are expensive and rarely are covered by health insurance. These treatment methods have not been validated through carefully designed, controlled trials, may have unwanted side effects ... page 826}}</ref> Commonly attributed substances include scented products (e.g. perfumes), [[pesticide]]s, plastics, synthetic fabrics, smoke, [[petroleum]] products, and paint fumes.<ref name="Genuis2013" /> Many other tests have been promoted by various people over the years, including testing of the immune system, [[porphyrin metabolism]], provocation-neutralization testing, [[autoantibodies]], the [[Epstein–Barr virus]], testing for evidence of exposure to pesticides or heavy metals, and challenges involving exposure to chemicals, foods, or inhalants.<ref name="Current" /> None of these tests correlate with MCS symptoms, and none are useful for diagnosing MCS.<ref name="Current" /> The stress and [[Anxiety disorder|anxiety]] experienced by people reporting MCS symptoms are significant.<ref name="Current" /> [[Neuropsychological assessment]]s do not find differences between people reporting MCS symptoms and other people in areas such as verbal learning, memory functioning, or [[psychomotor learning|psychomotor performance]].<ref name="Current" /> Neuropsychological tests are [[Sensitivity and specificity|sensitive but not specific]], and they identify differences that may be caused by unrelated medical, neurological, or neuropsychological conditions.<ref name="Current" /> Another major goal for diagnostic work is to identify and treat any other medical conditions the person may have.<ref name="Current" /> People reporting MCS-like symptoms may have other health issues, ranging from common conditions, such as [[Depression (mood)|depression]] or [[asthma]], to less common circumstances, such a documented chemical exposure during a [[work accident]].<ref name="Current" /> These other conditions may or may not have any relationship to MCS symptoms, but they should be diagnosed and treated appropriately, whenever the [[patient history]], [[physical examination]], or routine [[medical test]]s indicates their presence.<ref name="Current" /> The [[differential diagnosis]] list includes [[solvent exposure]], [[occupational asthma]], and allergies.<ref name="Current" />
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