The Chemical Sensitivity Podcast

Episode 27: An Environmental Physician Weighs In. A Conversation with Dr. John Molot.

June 05, 2023 Dr. John Molot Episode 27
The Chemical Sensitivity Podcast
Episode 27: An Environmental Physician Weighs In. A Conversation with Dr. John Molot.
The Chemical Sensitivity Podcast
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Check out Episode 27 of The Chemical Sensitivity Podcast!

The title is “An Environmental Physician Weighs In.” 

It features a Conversation Dr. John Molot, a doctor in Ontario, Canada who has specialized in MCS for over 30 years.

You’ll hear Dr. Molot explore:

·       The primary mechanisms of the illness. 

·       Why roughly 70% of people with MCS are women. 

·       MCS and Mast Cell Activation Syndrome (MCAS).

·       Why many people with MCS have other co-related illnesses. 

·       The need for new doctors to learn about MCS.

·       And more. 

Subscribe wherever you get your podcasts.
https://www.chemicalsensitivitypodcast.org/
   
2023 paper co-authored by Dr. Molot:
“Multiple Chemical Sensitivity: It’s Time to Catch Up to the Science.” 

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Special thanks to the Marilyn Brachman Hoffman Foundation for its generous support of the podcast.

Aaron Goodman  00:05

Welcome to the Chemical Sensitivity Podcast. I'm Aaron Goodman, host and founder of the podcast. I'm a longtime journalist, documentary maker, university instructor, and Communication Studies researcher, and I've lived with Multiple Chemical Sensitivity or MCS for years. The illness affects millions around the world. It's also known as environmental illness, chemical intolerance and toxicant induced loss of tolerance or TILT. So many people with the condition are met with the denialism and are dismissed the health care workers, friends and even family. Countless people with MCS struggled to find healthy housing and get necessary accomodation at work and school. And we suffer in all kinds of ways. 

The purpose of the Chemical Sensitivity Podcast is to help raise awareness about MCS and what it's like for people who live with it. We featured interviews with some of the world's leading experts and researchers on MCS and lots of people with the condition and we're just getting started. 

This is episode 27. The title is "An Environmental Physician Weighs In." It features a conversation with Dr. John Molot. Dr. Molot is an adjunct professor in the Faculty of Medicine at the University of Ottawa in Ontario, Canada and a staff physician at the University of Toronto affiliated environmental health clinic at Women's College Hospital. He's practiced environmental medicine for more than 35 years, and has assessed more than 12,000 people for possible environmental links to chronic medical conditions. In 2016, Dr. Molot was appointed by the Ontario Minister of Health and Long Term Care to the task force on environmental health, whose mandate was to identify gaps and informed policies to support patients with MCS as well as myalgic encephalomyelitis ,chronic fatigue syndrome and fibromyalgia. Dr. Molot has published many articles on MCS. He recently submitted an article titled “Multiple Chemical Sensitivity, It's Time to Catch Up to the Science.” The conversation you're about to hear is largely based on Dr.Molot’s recent paper, and I'll post a link to the paper in the show notes. 

 

Aaron Goodman  02:20

In this episode, you'll hear Dr. Molot explore the primary mechanisms of MCS why roughly 70% of people with MCs are women, MCS and mast cell activation syndrome. why many people with MCS have other co related illnesses, the need for new doctors to learn about MCS and more. I hope you enjoy the conversation and find it a benefit. We release new episodes twice a month. Subscribe wherever you get your podcasts. leave a review on Apple podcasts. It's a great way to help others learn about the podcast find us on social media, just search for the Chemical Sensitivity Podcast or podcasting MCS. Leave your comments about anything you hear on the podcast. And please share the podcast with others. You can find the podcast on YouTube and read closed captions in any language you like. You can find a link to buy me a coffee or contribute on our patrons site and the episode descriptions at ChemicalSensitivityPodcast.org Thanks so much for your support. And if there's someone you'd like to hear interviewed on the podcast, or a topic you'd like us to explore, just let me know email info@chemicalsensitivitypodcast.org and thanks for listening.

 

Aaron Goodman  03:39

Dr. Molot, thank you so much for joining me. I think a lot of people will be really delighted that you're speaking on podcast, would you be willing to provide a definition of MCS how you understand it? 

 

Dr. John Molot  03:51

There have been attempts to define MCS and people have argued that there is no classic definition. The bottom line is is that there was actually a study done, which looked at all the definitions and tried to see what's what's common. And the common characteristic is that people react to chemicals to which they have frequent exposures that are common in the environment, at levels that they used to tolerate and that other people tolerate but they no longer do. And it's a loose definition. But that's it there have been attempts to in the definitions to talk about. One of the characteristics is that multiple systems are involved and it's been found that the central nervous system is the most common system involved and one author actually emphasize that you don't have MCS if the central nervous system is not involved. I don't know whether that's true or not. But that just goes to show you that people continue to argue and one of the reasons for that is we don't have a marker where we can say, Oh, look, you you you failed the MCS test in the laboratory. And according to that this definition works the best to explain it. We don't have that marker. 

 

Aaron Goodman  05:10

Can you talk a little bit about the most common symptoms that people with MCS experience? 

 

Dr. John Molot  05:16

The most common symptoms include those from the brain. And so they're talking about cognition that people feel spaced out, it's hard to focus, short term memory, it seems to be cloudy, they're easily distracted, they also get pain, so they're gonna get headaches. Other systems, probably a second most common system would be the respiratory system. So people will complain of cough, runny nose, nasal congestion, chest tightness, even even wheezing, air hunger, those are the most common gastrointestinal symptoms can include things like like nausea, and they can feel palpitations, which is the cardiovascular system. So they'll end up but they'll get a multiple amount of symptoms most of the time, not just one. And again, the characteristic is that they associate the onset of symptoms with an identified chemical exposure. And and I use that term because there are chemicals that don't have odors, but those that do, you can identify, Oh, I smell perfume, I smell fresh pain, and therefore they can make a correlation. Sometimes they can't. 

 

Aaron Goodman  06:27

Can we talk about the causes? And in your 2023 paper, you identify at least four causes? Can we talk a little bit about them, I'll just list them. And then if you want to talk in a little bit more depth, that would be helpful. You talk about oxidative stress, genetic predisposition, the inability to detoxify and systemic inflammation. So would you be willing to talk a little bit about what is oxidative stress? And how does it factor in to the development in some cases, for people who get MCS?

 

Dr. John Molot  07:07

The four causes, so to speak that you listed are, I think a better term of the mechanisms, they're the things that go on, and they're all linked. So if you only sort of look at the background, that we're all exposed to pollution, all kinds of pollution, every day, the focus has been air pollution outside, this is a bad air again, stay indoors, don't exercise, etc. And the World Health Organization has actually stated that air pollution is, is among the top five causes of chronic disease around the world, including relatively cleaner places like Canada, and the other four are things like not exercising and and drinking alcohol and being overweight, but that outdoor air all those long term studies 90% of that time is actually spent indoors. 

 

Dr. John Molot  08:00

So the building kind of filters some of that outdoor air when it comes in, or what's indoors greater than outdoors are chemicals, chemical exposures, and these chemicals are called volatile organic compounds, or VOCs. And they come from all kinds of things to come from building materials that come from furniture. And they certainly come from the products that we use, whether they're deodorizers, cleaning products, laundry products, fabric, softeners, personal care products, perfumes, and so on. And they're at least four times higher indoors than outdoors. And we're exposed to that. And there's sort of this, this concept, which is wrong, that nothing happens. So when you think about the fact that the human body is made of 3 trillion cells, and they're all working coordinated, so we got neurons and kidney cells, and, and so on, they all work together. And it's amazing Symfony that we call the human being, but every cell has a system in it to help it survive. It's the smallest unit of life, it needs food, it needs oxygen, but it also needs to protect itself from the environment. 

 

Dr. John Molot  09:09

And so billions of years ago, when cells started and life started on this planet, they the cells developed the ability to read the environment and to one of the ways they read the environment is they can sense foreign chemicals. And so this is something that has evolved over billions of years and still remains on the surface of cells are the sensors, which we call receptors, and they read the environment. They also read the environment inside the cell because it's so has metabolism. It makes energy it made maybe its job is to make hormones it all has. They all have different job descriptions, and so there are little factories going on. And they're byproducts of all these chemical reactions and some of which can be reused somewhere else and others got to get rid of it. 

 

Dr. John Molot  09:54

Why? Because they're toxic, they cause no good whatsoever, and they can cause damage. So we have a system inside the cells to to get rid of them, this system is less than perfect. And so over time damage occurs, we call that process aging. So sooner or later the cell say, Okay, we're out of here, and that's the end of life. But meanwhile, things have gotten older and older and older. And it's the constant slow damage. So what happens is when those chemicals are being produced being sensed, the sensing of those chemicals stimulates a system, which we call the detoxification system to break them down, get rid of them, if we can't break them down inside the cell, we send them out to the bloodstream goes to the liver, and the liver is the toxification organ, it's really good at that, break things down, get rid of it, send it to the kidneys get rid of these things. And this goes on all the time for billions of years, or the millions that we've been present as, as human beings on the planet to deny that the body and the cells do not have any kind of an effect from what we've done into the planner over the last 50 years, which is polluted and increase our chemical exposures is silly, that system is being overwhelmed. 

 

Dr. John Molot  11:10

The detoxification system is being overwhelmed. And so when these little byproducts aren't capable of causing damage before we can break them down, we call that damage which we can measure in research laboratories, oxidative stress, and this is why we need antioxidants because they are anti oxidative stress, we need to eat our vegetables and fruit and get all those antioxidants in there to support the detoxification system even more now, because damage is occurring. Now what happens in that damage varies from person to person. It's kind of like if you smoke cigarettes, lots of people smoke cigarettes, what's going to happen, wow, they get lung cancer, they can get 13 different kinds of cancers, or they can get lung disease, or they can get heart disease, or they can get asthma, there's so many different things. It depends on many other factors, one of which is genetics. So we go back to the oxidative stress C damages starting to occur in cells, how's it going to manifest we know that oxidative stress is a major player for chronic disease. And it is a major player in the chronic diseases associated with pollution. And now it's cardiovascular disease, respiratory diseases, neurodegenerative diseases, we also know that oxidative stress can sensitize those receptors on the surface that look for and react to chemicals so that people have MCS, that's how it manifests other people, they may not manifest, they feel nothing. 

 

Dr. John Molot  12:35

And suddenly, gee, I'm starting to get Parkinson's disease, or heart disease or asthma. And that's how pollution plays a role in particular, where major exposures are occurring, which is in the indoor environment, duty chemicals. That's a very long answer to that question. But hopefully, that gives people a picture of how pollution is playing a role in making people sick, especially those with MCS. So when you look at the other factors, oxidative stress causes changes. So one of our systems to try in and manage and respond to environmental factors is the immune system, it's looking for bad guys. And one of the bad guys is physical damage, inflammation. And how that works is those cells, when they sense something, they send out a message to the entire body, we got a big problem down here in the foot, everybody slow down what they're doing, pack up their energy and send it to me the immune system, because I got to deal with a major thing here, you cut yourself or you been attacked by a bear or whatever may have happened. That's how the immune system are being attacked by a virus. 

 

Dr. John Molot  13:38

So we just went through this experience with COVID, we got attacked by a virus, and we saw a lot of what's called systemic inflammation. And what that means is all of those chemical messengers from the immune system are much higher when the immune system is being notified and is notifying the rest of the body. So we call that systemic inflammation and systemic inflammation can also sensitize those same receptors that read chemicals. So we see a problem with detoxification, we see a problem with systemic inflammation, oxidative stress, all kinds of links. Some people are genetically different with respect to detoxification, just like some people are taller, and some people are shorter. There's a range of of normal, we call these things variants in genetics and a variant is it's not the main way we we are genetically, but it's more than 10% of the population. So it's not that unusual. And there are variants for detoxification in the general population, that makes some people poor detoxifiers. And they were okay. For millions of years, they now we put this extra burden on the system, and these people are more likely to get diseases associated with air pollution and other pollution, including MCS so you don't mean to have that flaw. You don't need to smoke cigarettes to get lung cancer, but it helps and that's the same kind of explanation for you can have a genetic predisposition to be a pretty toxic fire, you're going to get even more oxidative stress and other things you're going to happen as well. 

 

Aaron Goodman  15:08

Very helpful. You also write that women are at higher risk of developing MCS because of their frequent use of cosmetics and hair products, skincare products, and more, which can be sources of VOCs that are inhaled and absorbed through the skin. 

 

Dr. John Molot  15:26

Well, yeah, that, you know, 70% of people with MCS are female. And obviously, the question is raised, why, and that is one repeated exposure, increased burden, and so on. So it's, it's, it's the behavior some of it is, is also you know, our social norms have not quite improved enough yet. So women tend to do more of the housework, then do more of the laundry. And so they've got those exposures to the other thing is, as those receptors that read the environment, there is a big long fancy name, transient receptor potential, and there's many different kinds. 

 

Dr. John Molot  16:04

So one is called transient receptor potential, vanaloyd, number one, and there's another one called anchoring number one TRPV, one TRPA, when I'm going to refer to them as that TRPV, one for whatever reason that I don't know is more likely to respond at a lower threshold than women. And these are the receptors that are sensitized in MCS, so they're more likely that for that reason, one of the explanations can be that estrogen and progesterone is also sent since by these receptors, and therefore the repeated exposures as women enter into middle age and so on, can be contributing to that as well. So there's biological factors, as well as behavioral factors that are playing a role. 

 

Aaron Goodman  16:50

Is the science the TRP receptors, is that science new? And is that if it's new information, does it potentially open up an opportunity for treatment? If it's new, is it a new discovery? 

 

Dr. John Molot  17:04

I think it's new with respect to my lifetime, or my career is, as a physician, when people have sore muscles pain, they put ligament on the skin that generates heat, and it seems to help pain. And they, in 1999, which is I guess, not very long ago, there was a doctor named David Julius, who, who found the receptor, which turned out to be TRP D one, which seemed to respond to the application of these limits. And he identified the component, it's a component found in hot peppers, it's called capsaicin. And this led to a lot of, of further research that helped us to understand how the sensory system works, how when, when you touch yourself, or you're hurt yourself, or, or you feel something otter cold, or whatever it may be the different senses where we have a sense of smell, how though that impact is translated by the nervous system into a message up to the brain, and we can say, Oh, that's hot, or Oh, that hurts, or, well, that smells nice, or whatever it may be. 

 

Dr. John Molot  18:13

So it's a very complex system, but it's based on those receptors, they are involved in the sensory system, so that that's relatively new. In fact, David Julius and another doctor kind of puts in I think, is how we pronounce it. They received the Nobel Prize for Medicine in 2021 for that discovery, so it's pretty major. So those receptors our understanding of that is is relatively new clinically, doctors don't care because it doesn't matter if it hurts, I gotta give you something for the pain but pain is a really really common phenomenon worldwide it is a major issue is a major reason why there are so many medications for pain on the market and and some of them are obviously addicting and causing other kinds of problems. 

 

Dr. John Molot  18:59

But the drug research people have spent an enormous amount of time studying receptors like TRPV one and TRPA one because of their role in pain so there's a lot that they have discovered what they haven't been able to generate yet is a medication that is safe to use, that calms those receptors down and those receptors involved in many many different biological mechanisms are involved in your old bowel syndrome. They're involved in, in in migraine headaches they're involved in in chronic cough so there's a huge market which is how the world works. It generates research so it's relatively new but we don't know how to push back against it in a safe manner yet maybe they'll discover something that safe a little that's never happened to him but maybe safe enough to be tried for for people with problems with those receptors, and maybe it'll help calm down chemical sensitivity but right now we have we have no treatment. The only treatment we have that is reported by the patients to be beneficial is to avoid chemicals and have a safe home. 

 

Aaron Goodman  20:09

Can we talk a little bit about mast cell activation syndrome M-casts? Some scientists have recently argued that there's a close connection between M-casts and multiple chemical sensitivity. What are your thoughts on that, please? 

 

Dr. John Molot  20:27

The first point to make is that our diseases are complex, including MCS. And by that we mean there are multiple factors involved. So well known chronic diseases like neurodegenerative disorders, for example, cardiovascular disease, there's billions of dollars being collected and spent on research and the keep finding more and more things to help understand it, but we don't know how to push back against it. And again, the drug companies are looking for can we find a magic pill that hits on seven or eight different things that are going wrong at the same time without doing any harm, and they haven't been able to do that yet either. So they're very complex. And so when when when we look at at MCS, and M casts. 


 Dr. John Molot  21:09

M casts is you need to understand what mast cells are met. Mast cells are cells of the immune system, they don't float around in the bloodstream, they're out there in the periphery in different tissues. And they are famous because they they release histamine. So when they release too much histamine, we need anti histamine. So we use those things for for each and for allergies, and, and so on. But they release a lot of other chemicals to that, that communicate in the body. So they are actually the prime cells that communicate between the immune system and the brain. So when I first started seeing people with chemical sensitivities, and people were saying, well, there's something wrong with the immune system, and there's no there's something wrong with the brain. And there was this concept back in the 80s and 90s, that the brain and the immune system didn't talk to each other. And so it's impossible, and that was wrong. 

 

Dr. John Molot  22:02

And the the the now there is a whole world called psychoneuroimmunology, their journals dedicated to psychoneuroimmunology studies, and so on. And what that means is the brain and immune system are in constant communication with each other. And how they communicate is with those chemical messengers. So mast cells, mast cells, release chemical messengers and talk to the immune system. But the immune system releases their own chemical messengers called neurotransmitters. It's how they talk to each other, but they also can talk to the immune system. So mast cells can receive information from the nervous system and tell the other guys that immune system what's going on. And they are the the the focus of the connection between the brain and immune system. So for example, in in, during the gastrointestinal system, they're watching what's going on and telling the brain what's going on. And vice versa, when you get in an irritable bowel syndrome, which is supposedly, gee, we looked up the bowel, there's nothing wrong, you don't have colitis, you don't have cancer, but it's not working right. If you do biopsies, and you don't see anything, but if you compare those biopsies to people who don't have MC, MC, IBS, what you see is those mast cells that started to collect between the were they nervous system enters into the gastrointestinal system, because they're increasing communication. So a little message from the bowel becomes yelled up to the brain and yet can yells back and restrict getting all these abnormal movements, which we call irritable bowel syndrome. They're very much involved. Why am I telling you this? Because mast cells also have TRPV, one and TRPA one receptors, and so they if they are sensitized, they're going to contribute to the mast cell dysfunction. I know that one of your earlier podcasts you had experts on on an M casts. So your audience can learn about it a lot more. There seems to be in the more conservative M casts community a focus on histamine if there's no evidence that histamine is released, you don't have it. And to me and say that's really simplistic and reductionist. If you have evidence that they those mast cells are not functioning right clinically, then maybe there is another explanation besides just histamine. Histamine, by the way, also stimulates the TRP villain receptors. So it's complex. It's complex. I'm sure this relationship you don't see you don't see it much in the literature yet, but clinicians will tell you that they're seeing what they think is the M-cast phenomenon more commonly in people with chemical sensitivities. And the chemical reactions sometimes seem to encompass the same kind of symptoms. Why did they get nasal congestion? Why is it helped with histamine? Where'd that come from from a chemical exposure? So they're linked to me they're, they're linked in a very complex way and um, I mean, I hope that answers your question. There's a connection.

Aaron Goodman  25:02

And yet, is it fair to say that not everyone who has Multiple Chemical Sensitivity also has mast cell activation syndrome? 

 

Dr. John Molot  25:12

No, it's it's absolutely true. But that's something that's defined. And the definition has to be related to some kind of biological measurement. So they're looking at histamine, but you can have IBS and not qualify, according to the definition for mast cell activation syndrome. But if you have IBS, you've got abnormal function. On some level, they're behaving differently. They're found in different areas of the brain, or the gastrointestinal system, for example, in people with IBS, and IBS is more common in MCS, there's an overlap, it's complex. And to simplify it just by by putting in labels, and you have many different diseases is, I think we have to get away from that there is a concept now called systems biology or systems medicine and saying, 

 

Dr. John Molot  26:06

Look, we have to look at all these systems, not just organ systems, like the bowel in the brain, but the gene role being played by different kinds of factors going on inside different kinds of cells. All of these things are going on at the same time. And we need to learn to study it from a systems approach. It's really complex, it takes a lot of computers to do it. But that's where we're going rather than looking for one thing, because it doesn't work for chronic disease. 

 

Aaron Goodman  26:33

You write that about 70% of people with MCS have other illnesses that are related to the condition. Can you say a little bit more about that? 

 

Dr. John Molot  26:41

When you have a chronic disease, when one has a chronic disease, I don't use statistically more likely to have more than one, you don't start off with three that you're going to end up with more than one because whatever is going on in that chronic disease to make it manifest is still going on. So why is this occurring? Because when things are more likely to occur together, rather than a coincidence, so if you have arthritis, but you cut your finger, that's a coincidence. moment things are more likely to occur together. significantly. That's a comorbidity that interests clinicians and researchers because it what it says is that you're sharing something you might be sharing the same risk factor, gee I smoke cigarettes. 

 

Dr. John Molot  27:25

So you've got more than one thing going on now. But it may also be that you're sharing mechanisms, that there's an overlap. So for example, when we watch what happens in the brain to people with MCS, we can see similarities in chronic pain and urge to cough, that are also much more common in people with MCS, they are sharing mechanisms, and we can actually watch it in functional brain scans. So comorbidity is is significant. And what we also see it's a significant for another reason, I think people who experienced MCS have a hard time being understood. 

 

Dr. John Molot  28:03

And I mean, generally speaking, they're not believed by family members or employers or people in the social network, but they also have problems being understood by their physicians because there's no medical education formally in the medical system, either in the training or in continuing professional development, there is none, there is no understanding of this disorder. And it makes it more complex to be understood if you've got more than one condition going on at the same time, especially in a 10 minute appointment. 

 

Dr. John Molot  28:34

And so it's I think it's important for your listeners to hear about the comorbidity, people with MCS are much more likely to have chronic pain, they're much more likely to have chronic migraine and much more likely to fibromyalgia and with fibromyalgia and chronic migraine, they're much more likely to have chronic fatigue syndrome or myalgic encephalomyelitis. They're often there was actually a taskforce in Ontario, struck by the Minister of Health that lasted three years. And their mandate was to study the gaps in knowledge and and the gaps in support for people with three conditions, MCS, myalgic encephalomyelitis, chronic fatigue syndrome and fibromyalgia like because they're so commonly occurring together. They also have more likely to be asthmatic and allergic, they're more likely to have IBS. And so what we're seeing again, is these multiple systems involved and multiple categories that we give them different labels, but the comorbidity is that there's common denominators that make them overlap frequently, and this needs to be understood too. 

 

Aaron Goodman  29:40

You talked about how many physicians aren't adequately informed about Multiple Chemical Sensitivity, and there is an often, a frequent misdiagnosing that happens. Physicians often diagnose people with MCS as having psychological disorders or commonly anxiety and panic and you write Dr. Molot, the simplistic argument as to whether MCS is physical or mental needs to put needs to be put to rest. And you write that, that scientific studies that claim that MCS is as a psychological illness failed to recognize that people who experience symptoms like panic and anxiety could be having these responses due to MCS, and not because of underlying psychological disorders. Do we have that right? How do you view this overarching misdiagnosis? And why do you write that it needs to end?

 

Dr. John Molot  30:38

Well I write that because thinking that's a psychological condition with no biological support for it as a physical entity is wrong. And the reason I wrote this paper is to get that that out there, it's time to catch up to the science, because when you're trying to understand why this phenomena has occurred, you go back to when it was first actually ever even discussed, anywhere was back in the in the 1960s. 

 

Dr. John Molot  31:06

So like 60 years ago, and someone started saying, gee, I think people are reacting to chemicals at levels that don't we think don't bother people. So the immediate response was, Well, that can't be it doesn't make sense. And one of the one of the major reasons why it didn't make sense was our understanding of toxicology is toxicology, the disk that that studies, poisons, and studies, toxic chemicals. And it's been around as a phenomenon for 500 years. And there was a dictum, which is, the dose makes the poison. What that means is that anything can be poisonous if taken on a high enough dosage, I'll give you an example. If you went and drank 25 glasses of water in a row, you would end up in the intensive care unit, because you've diluted all the electrolytes in your body so badly that nothing is functioning properly, and we hope you don't die. 

 

Dr. John Molot  31:55

So even water at a high enough dose can be toxic. And that phenomenon existed for a very long time. And as more and more people started to complain, and more and more doctors started to take an interest in this phenomenon to try and help their patients, those doctors who previous generation from from me that I learned from as a young doctor, they tried to develop tests to prove their point. And the pushback was those tests have no scientific validity, and they don't prove anything. And so the doctors who were trying to help these patients are also painted with the same brush. Well, I guess you're nuts, too, right. 

 

Dr. John Molot  32:32

And so this as more and more noise was made by the patient community and and government started to have to hear this phenomenon. And look at the look at it, the argument became more intense. And so by the late 1990s, maybe 2000, many different medical bodies had said, we looked at the literature, which was very, very parts sparse. And we don't see any evidence that this phenomenon can exist. So the only explanation can be that it's not real, it must be a psychological false belief system. And there were people who, who carry that message forward very loudly. And so the phenomenon of press didn't go away, it became a problem and litigation people, I got injured by this, I can't work I need, I need my insurance to pay. I need workers compensation, whatever, just get denied over and over again. 

 

Dr. John Molot  33:28

So there is it became an entrenched belief. What's happened since then, is that people try and produce studies to prove their point. And the majority of people vastly think that MCS has done a biological condition. It doesn't make sense, according to that traditional paradigm, the dose makes the poison. But what happened was we started to discover other phenomena that occurred from chemical pollution. And one of those phenomenon phenomena are called them. It's called them endocrine disruption. So endocrine is a hormone system, hormones are chemical messengers in the body, and they're secreted from one place, like thyroid to other parts of the body. And a message is received by receptors. So when the certain fame, we think that they're chemical pollutants that can disrupt that system, they started to study it, they can disrupt it a variety different ways it can, it can affect how much hormone is produced, or it can affect how quickly it's broken down. So it can mess it up that way, but it can also influence them receptors for those hormones, hormones, the messages received by receptors. 

 

Dr. John Molot  34:36

So the the concept that low dose chemicals at doses that are not considered to be traditionally toxic, can actually create changes in biological systems is relatively new and not being taught within the medical practitioner community because they're not taught anything about the environment. It's a big problem getting that into the medical school curriculum or otherwise, is a big problem, great resistance. 

 

Dr. John Molot  35:05

Meanwhile, we discovered scans. So I'm a little guy, when they did discovered scans, when I was a medical student, it was called the lung scan, you could actually take a picture of the lung, much more accurately than an x ray with a scan. And later on, they had brain scans. And now you can scan anything of different kinds of scanning systems. And what's also new is that they develop functional brain scans, which means we can put you into a scanning machine, let you lie there and rest, and then make you do something like, do a mathematical problem, like what the brain does, or maybe inhale a chemical and watch what the brain does. 

 

Dr. John Molot  35:43

And so what happened in the last, oh, 20 years, maybe less 15 years, people produce some functional brain scan studies on MCS. And what they did is they gave them different things that have an odor, expose them to different things that have an odor, and while they're being scanned, and they watched what happened to the brain, and basically what they saw was changes in the brain that would be consistent with things that happen when there's emotion when there is fear and anxiety and s&c that proves it. What they didn't realize is this. 

 

Dr. John Molot  36:18

Most people who do not understand MCS, blame the odor, you notice it's called chemical sensitivity. It's not called multiple odor sensitivity, because it's not the odor. So when we breathe in these chemicals, and we smelled them that perfume, they're actually two different nerves look to the brain. One is called the olfactory nerve, it says, Oh, I recognize this pattern that smells like roses or grandma's chicken soup, or whatever it may be. And the brain takes that messaging and interprets what it is. So we understand it. 

 

Dr. John Molot  36:48

But there's another nerve in there. And it's called the trigeminal nerve. And it doesn't sense odor, it senses other phenomena. So for example, if you tickle your nose, it'll make you sneeze. If you inhale dust, it'll make you cough. And how does that work? There are sensors to feel those physical changes, and they happen to be TRPV one receptors. And so what these people did when they showed these changes in the brain, as they took chemicals within odor, not necessarily what the person the patient, the subject said was that they were sensitive to just these are well known odors, and got them to inhaler, and saw these changes in the brain. And they never acknowledged the fact that every single chemical that they use was a volatile organic compound that could be stimulating TRPV learned receptors, which also are in the brain in those areas of the brain that responded. So basically, what those scans showed was that areas of the brain that have these receptors, if you give them something that stimulates those receptors, they behave differently in MCS patients compared to controls, they never figured that out, because they don't understand the biology of these receptors. 

 

Dr. John Molot  38:03

They just said, Oh, look, they're more ahead of anxiety than than others. They saw also, those same kinds of changes in people with chronic pain never made the connection, it's the same mechanism is occurring, which is this is how pain works. If you stub your toe message goes up to the brain toe stub and you hop up and down go Ouch ouch ouch. And if you didn't break anything, or hurt anything badly the pain goes away in a couple of minutes. So that's a normal phenomenon of pain getting a message brain to something happening down here, watch out what you're doing watch over your walking, move the chair whatever the conclusion of that pain episode was no damage done. Pain turned off pain this turned off because when the message goes up to the brain, and the pain is perceived the semesters from the brain back down to where it came from saying, Okay, I heard you This is very annoying, would you please calm down and shut up and it works really well. 

 

Dr. John Molot  38:53

When there's no damage, it doesn't work very well when there is damage because it keeps sending messages. When you have a chronic pain disorder like fibromyalgia or chronic migraine headache, the ability for the brain to tell the periphery okay, I heard you shut up is diminished. And so there's a vicious cycle of pain messaging and not being able to turn it off and felt that those same areas of the brain are also showing the same abnormality in MCS so there's a lot of overlap and that explains the comorbidity and also explains this is not an anxiety disorder. Here's the other problem anxiety and depression contributes to the development of many chronic diseases don't get so stressed you're gonna have a heart attack we know that chronic anxiety depression these an increased risk for Neuro degeneration as we get older we know these things we know that that early childhood abuse etc can contribute to the likelihood of biological diseases later in life. We know these things. 

 

Dr. John Molot  39:53

So we looked at an MCS and said, Oh, look that can do that. That's the cause that was a great leap in in in fact that that is not necessarily backed up. So we see these statistics, we when you take people, a lot of people with MCS and we say okay, do you have a history of, of anxiety or depression? And some people will say yes, other people will say no, then they'll study them say, do you have anxiety and depression? Now, some people will say yes, and other people say no, but we do see that more people with MCS have anxiety or depression. So try living on this world in on this planet, when you can't go places you can't use public transportation, you can't go to work, you can't go to the library, it can't go to your church or mosque or synagogue, because everybody's wearing perfume products and your spouse doesn't believe you and your teenage children find you really annoying and your your boss doesn't believe you and won't accommodate you trying to make with that. And so now you don't have an income. So you go to the insurance company, and they don't believe you either. And the lawyers make you look really bad. If you go to court, they make you look like you're lying or crazy, because that's the theory. Try moving with that and see if you don't have more anxiety or depression. It's a horrible way to live. 

 

Dr. John Molot  41:02

Meanwhile, in law, the Canadian Human Rights Commission recognizes MCS as a biological medical disability. With the right to accommodation. The bad news is that the Canadian Human Rights Commission only has the ability to influence things that are federal. Federal government buildings going to a federal government building, and you will see signs, okay, this is sent free, but going to places that are not under the jurisdiction of federal law that may be provincial, you're less likely to see them. So we see things like here in Ontario, we have more than 100 hospitals that have a century policy really hard to enforce. But if you fall in there for your your appointment at your clinic, you will hear on the recorded message, it's a sedentary policy, please do not resend it products go to Quebec second highest population for provincially. In Canada, they have one emergency department in the entire province that has a century policy. So why is that?

Dr. John Molot  41:59

I don't know that I do know that that you don't have an argument with them, according to the Canadian Rights Commission, because there's no Canadian Human Rights jurisdiction, it's a problem. And it's not well understood. These are gaps over identified by that taskforce in Ontario. But the gap still persists because the message from the patients from the science is not getting out there, which I thank you for helping to get the message out there. Because the concept that MCS is not real, the concept that it is a psychiatric condition is that by liberal science is overwhelmed by the science on the other side, and it's wrong. And it's actually to build to continue to to behave that way is morally wrong by society and professionally wrong by physicians,. 

 

Aaron Goodman  42:47

You write, physicians must be held accountable to maintain a high level of evidence based education. So I want to ask you, you've been deeply engaged in this this work for decades, what feels most urgent for you at this stage? Is it about introducing MCS in medical training, or regulating chemicals, informing policymakers what feels most urgent for you? 

 

Dr. John Molot  43:12

What's most urgent for me? I think I'm a physician proud of, of my colleagues, I think we serve a tremendously important and positive role in the community. One of the studies that has come out years ago was the average period of time to change physician behavior. And practice after a discovery is made this about 19 years. Hey, why? And the answer is that everyday doctors get up and go to work with paradigms of how to approach different things that they deal with every day, and it takes a long time to change. 

 

Dr. John Molot  43:49

What's frustrating for me, and therefore I put it on the top of the list is it's time for people to recognize physicians, healthcare professionals, so it's not just physicians and nurses, it's dentists, it's pharmacies, it's pharmacies, pharmacists, why is it that you can't go into a major pharmacy without passing through the perfume section? 

 

Dr. John Molot  44:12

First, why is that there? And I know the answer is because those guys pay for that space. So it's time to get the information out there. That was the reason I wrote this paper. And I submitted the paper for publication last June. So it's almost three quarters of a year now it is three quarters of a year that there's to peer reviewing it, it's huge number one and number two, they couldn't find anybody to peer review. People have no interest in and it's huge. So it takes a long time well publishing this paper and make a difference. Maybe a little bit because you got to get people to read it practicing physicians won't read it because it's all basic science. Teachers aren't going to read it even though the last part of the paper talks about the lack of education for medical students that's been acknowledged in, in research papers, the lack of education comes from the fact that the mentors don't have the education. And so what people do medical students, young doctors, they they refer to information that's published online. And there's a medical textbook and several medical textbooks published online that they can refer to, because they've got the app.


Dr. John Molot  45:21

And in that app, MCS is described as a psychiatric condition paper written by a psychiatrist, nothing mentioned about any of the biology, it's the inertia of the medical profession with respect to the impact of pollution is going to change. And the reason I say that is that the people who are the most interested in wanting to learn, and now they're starting to demand the information or the medical students, so I have faith that things will evolve in a positive way. It's just very frustrating that it didn't happen yesterday. 

 

Aaron Goodman  45:55

Yeah. And I, that's really interesting to hear you talk about, you know, as a physician, and as a scholar, that I mean, the peer review process takes a long time for anybody but you know, do you face as someone who has long specialized in multiple chemical sensitivity? Could you draw a parallel between the level of skepticism that people with MCS, the patients, the people who live with it also experience? Do you face that same skepticism? How is your work viewed by the wider scientific and medical community? And and you mentioned the the very little amount of information that medical students have, and in fact, the damage that's caused because they are taught to diagnose it as psychiatric condition. I know I'm putting a lot on the table. But how do you view your place in this wider context? And you mentioned, we hope it will change sounds pretty grim, though, you know, we don't know many doctors and scientists who specialize in this field, will there be more? Is there any hope that we can have as a population who you noted the challenges that we face living with his condition? When you talk about the medical training, it's, it sounds pretty grim. So anything you'd like to touch on? What I've put on the table would be great. 

 

Dr. John Molot  47:18

It sounds pretty grim. I agree with you. That's what it sounds like. I'm a voice in the wilderness in it in a sense, when I first held on to the concept of, you know, people of MCS would come in and say, Ah, I'm the canary in the coal mine. And you know, that that metaphor, right? The Canaries would, would would signal by falling unconscious or dying, that there was poisonous gases in the mind, because they were more sensitive to the gases than the miners. And the miners would run out and be saved till the invented. were highly technical devices to measure the gases, the canary in the coal mine. And I used to think to myself, I would be very good. 

 

Dr. John Molot  47:58

So yeah, you're the canary in the coal mine. The theme is so no, you're not there's something the matter with you. You're not You're What are you learning the rest of us about those things don't bother us. That was I was there too. And then one day, I went to a conference in toxicology and and heard what these low continuous in levels of chemicals were actually doing to contribute to the development of chronic disease. This is This blew my mind. And I said there are canaries in the coal mine. And that inspired me to create a book, it took me several years, it's already 10 years old. So that's 12 years ago. And it's got 12,000 canaries can't be wrong, because I talk to 1000 people at that point in time, who said I'm a canary Well, they didn't say it, but they you know, that was some plan. I'm sensitive to things that other people aren't. They're toxic, they actually are we're right, this this whole change in in understanding is is accumulating in the medical literature.


Dr. John Molot  48:53

There's the resistance to change. That is frustrating. I'll give you an example. I work at the environment health clinic and Women's College Hospital in Toronto. There's only three clinics in Canada that that are looking at these conditions. And the taskforce in Ontario said this is the only place in Ontario are the experts where there's any expertise and these conditions exist. So my colleagues and I wrote a two page paper letter saying it's time for these concepts to enter into the education system. And in particular, the evidence showing that it's not was by studying residents and family medicine. And so we use that quote, because the family medicine residents residency program is being expanded from two years to three. And for the next five years. They're developing a curriculum so there is room to put more stuff in there so to speak. So we wrote a letter to the Canadian Family Practice journal, and it got rejected because they couldn't find a peer reviewer. So there's two thoughts. A that's not true, or B. It's true in the confinement peer reviewer, but whatever you, whatever you want to use to explain it, there's something wrong with that. Because what it also said was environmental health needs a seat at the table as you develop the curriculum, it is the fifth most common reason why people develop chronic disease is pollution. 

 

Dr. John Molot  50:14

Why aren't doctors asking their patients about their exposures? It's called an environmental exposure history, no training zero, and that that concept of that exposure history was was published 15 years ago, why isn't it being done, women who are of childbearing age, who are being exposed to these chemicals on a daily basis are at increased risk for poor outcomes in pregnancy, poor outcomes in fertility, and poor or poor outcomes in child health of a newborn. And those facts are out there. So you've got around the world, different organizations of Obstetricians and Gynecologists saying, we need to take an environment exposures, preconception, or at least that could not act consumption. But right after conception. These are opportunities to get the patients that women who are pregnant in our patients are going through a normal phenomenon. We need to get them to decrease their exposures. It's not done, it's just not done. 

 

Dr. John Molot  51:12

Meanwhile, autism is going up neurodevelopmental disorders in general going up, ADHD is going up. Why are they going up? It's not genetic. So there's something wrong with this picture, we tried to get that message out there. It's not being heard. That's frustrating, like the medical students are asking us for the information. In Quebec, there is a patient organization, the Environmental Health Association of Quebec, and they're an amazing organization. And I have my bias because I work with them. 

 

Dr. John Molot  51:40

But they have been able to get funding for a variety of programs, including they are now the Environmental Health Association of Canada and getting funding from the federal government to get the message out to get people trained to get the message out to spread the message. And maybe doctors will hear the message enough to make the change, because they're on the list of people that we talked to. And so this is this is happening. And hopefully it will generate enough momentum to make changes, when people in general and the population have an awareness that pollution can be bad. And so who do they trust for their information, to the trust the government? Nobody trusts the government, but no, do they trust the industry? Absolutely not? Do they trust the media? No. Who do they trust physicians to physicians know anything about this? No, they just pretend they do. Because that's the concept. We know these things. We're the experts in health. Okay, patient population, we expect you to know these things. And they don't. But I think that there's a momentum. 

 

Dr. John Molot  52:43

Now momentum by being supported by the federal government was supported by the previous government, Ontario, that Ontario task force report was was generated by the previous administration. Now the Ford administration received the results at the very end of 2018. So it's like four and a half years ago, it's been sitting on the shelf, nothing been done. That's, that's horrible. That's horrible. It's being ignored, whatever forces there are that we can have discussions about that, that push back against this phenomenon being heard. That's a discussion for another time. But there's a momentum now. And you are part of that momentum. And I thank you very much for this opportunity to be heard. 

 

Aaron Goodman  53:24

Do you feel the stakes are getting higher? I think it's probably fair to say that most of us are aware of more and more chemicals in our day to day environments that we're exposed to, even though we may not want to be to the for example, for example, drop my young children off at school. The scents from the chemicals that emanate from the classrooms is pretty overwhelming. And that's just one environment, you know, so, and people share all the time that just anecdotally that, and we know that the chemicals are getting stronger, or getting stronger. Is that something that you think about? And does that make the stakes even higher in your view, for there to be greater awareness and education and change? 

 

Dr. John Molot  54:20

Well, if you if you look at the cement industry, go to their website, our numbers are going up because there's so many more products. There was a paper published two months ago, maybe heard of England, and they looked at volatile organic compound voc exposures in the indoor air over the last 20 years in England, because they're the data and they saw some interesting things, the VOC exposures from scented products going up the VOC exposures from paint going down. So they looked at that and said, Well, how'd that happen? So for some reason, people associated the chemicals and paint has been harmful more easily than they do to the on her lovely salad smell of fresh laundry or perfumes, etc. And so they started say maybe it should be paint with low VOC emissions. And he did and they were expensive, but people kept asking for and so more and more people started to buy them. Because the price went down, the market changed. And it was the market that drove that change. 

 

Dr. John Molot  55:20

The market, meanwhile, is being inundated with the advertisement that you need to make your clothes smell fresh. In fact, we have an a way of doing this which is obviously chemical as well that we can keep the sense in your clothes for several months. Your your your clothes can smell fresh to me freshers, you go to the forest, and you smell the forest, that's fresh, okay, when I was a little boy and my mother needed to go outside to get fresh air, you go outside for fresh air now, and it's actually really polluted. But what's the smell of fresh, that's being sold, it's being advertised everywhere, then the population is being pushed in a certain direction that people are now major corporations are branding themselves. With specific orders, you can go into certain chain stores, and its has a certain odor in there that is associated with that brand. And it's in there. It's in a ventilation system. 

 

Dr. John Molot  56:12

So it's in the store, but it's also in the products. And it's also going outside into the mall hallway. And these things are going up and up and up and people are getting more and more sick. And those are our major exposures indoors and our May our our exposures indoors are contributing to what we're being affected by from the outdoor pollution that comes indoors, this soup that we live in, and we're seeing levels going up chronic disease going up. It's going up for obesity, it's going up because of lack of exercise going up for lots of reasons. But one of the reasons is chemical pollution. And it's wrong. 

 

Aaron Goodman  56:45

Thank you so much, Dr. Molot, for everything you've shared for all the work you do. Thank you so much. 

 

Dr. John Molot  56:50

Thank you for having me. 

 

Aaron Goodman  56:52

That brings us to the end of this episode of the Chemical Sensitivity Podcast. Thank you very much to Dr. John Molot for speaking with me. The podcast is produced by me Aaron Goodman and Raynee Novak. We release new episodes twice a month. Subscribe wherever you get your podcasts. Leave a review on Apple podcasts. It's a great way to help others learn about the podcast and find us on social media. Just search for the Chemical Sensitivity Podcast or podcasting MCS. We love hearing from you. Leave your comments about anything you hear and please share the podcast with others. You can find the podcast on YouTube and read captions in any language you like. You could find a link to Buy Me a Coffee contribute on our Patreon site and the episode descriptions. And if there's someone you'd like to hear interviewed on the podcast or a topic you'd like us to explore, just let me know email info@chemicalsensitivitypodcast.org and thanks for listening.

Introduction
Definition
Symptoms
Causes
Detoxification
Virus
Women and MCS
TRP Receptors
MCASTS
Psychoneuroimmunology
Comorbidity
Diagnosis
Patient Advocacy
Scans
Nerves
Damage
Canadian Human Rights Commission
Urgent
Grim
Change
Neurodevelopmental Disorders
VOC Exposures
Stronger Scents
Conclusion