Could lowering inflammation help MCS? What is known, and what you can try

What has been measured in MCS

In a Danish study of 150 people with MCS and 148 healthy people of the same age and sex, four inflammatory signals in the blood were clearly higher in the MCS group.[1]

An Italian study found a raised inflammatory pattern as well.[2] The Danish researchers described it as low-grade inflammation throughout the body.

This is a physical finding, measured in blood. It is one more piece of evidence that MCS is a bodily illness.

Why it could matter

The leading explanation for MCS is that nerve receptors which detect chemicals have become over-sensitive. In research on mice, one inflammatory signal made the sensory nerves of the lungs and airways react more strongly to the same trigger, and the effect lasted more than a week.[3]

If the same thing happens in people, it would explain something many people with MCS describe: after one or two reactions, the next one comes faster and more easily. Each reaction would leave the nerves a little more sensitive than before.

What is not known

Which comes first.

The inflammation could be turning up the sensitivity, or it could be the result of repeated reactions. No study has lowered inflammation in people with MCS and then checked whether their reactions eased.

Lowering exposure comes first

Fewer reactions means fewer flares of inflammation.

In a program of house calls to the homes of people with chemical intolerance, symptoms eased as the measured chemicals in the indoor air, mostly fragrances, came down.[4] Does detox help MCS? →

Movement

Across 83 trials, regular exercise lowered a standard blood marker of inflammation, even in people who lost no weight.[5] In a survey of people with MCS, about 6 in 10 who exercised said it helped.[6]

Two things explain most of the bad experiences. Anyone who does too much too soon feels worse afterward. And for a person who normally stays in filtered air, going out to exercise means meeting exposures, which can send you home feeling worse for a reason that has nothing to do with the exercise.

So the place matters as much as the activity. Exercise at home in your clean air if you can. If you go out, choose somewhere you already know is safe for you, and wear a mask if you need one. Start small and build slowly.

If you are wiped out for a day or more after even gentle exertion, stop and talk to a doctor, because that pattern points to a separate condition. ME/CFS and MCS →

Sleep

In a review of 72 studies covering more than 50,000 people, disturbed sleep was tied to higher levels of two inflammatory markers.[7]

If you work on it: make the bedroom the cleanest room in your home, since you spend a third of your life breathing its air.

Omega-3 fats

Omega-3 fats, found in oily fish, have been studied more than almost any other nutrient. A review that pooled 32 earlier analyses found they lower three inflammatory markers in adults.[8]

If you try them: food comes first, such as salmon, sardines and mackerel. If you use a supplement, introduce it the way you would anything new, check the other ingredients, and ask your doctor first if you take a blood thinner.

Low-dose naltrexone

Low-dose naltrexone is a prescription medicine taken at about a tenth of its usual dose or less. It could be worth studying in MCS. It has not been tested in MCS.

What is known so far is mixed. In a small study of women with fibromyalgia, eight weeks of it lowered a wide range of inflammatory signals.[9] Two larger trials in fibromyalgia then found it no better than a dummy pill for pain.[10][11]

At low dose it appears to be well tolerated. In those two trials, side effects were about as common with the dummy pill as with the medicine.[10][11] The ones most often reported are vivid dreams, trouble sleeping, headache and nausea.

It must not be combined with opioid painkillers. The body clears it through the kidneys, and it has not been studied in people whose kidney function is unsteady.

This is a decision for you and your own doctor. If you do try it, it is made up by a compounding pharmacy, so you can ask for a very low starting dose and ask what else goes into the capsule.

Is there a natural equivalent?

Not a true one. Nothing sold without a prescription works the way low-dose naltrexone does.

The nearest thing that has been studied is palmitoylethanolamide, usually shortened to PEA. It is a fatty substance your own body makes, and it is sold as a supplement. In 11 double-blind trials covering 774 people with chronic pain, it lowered pain more than the comparison treatment, and no major side effects were reported.[12] It has not been tested in MCS. If you try it, introduce it cautiously, as you would any new supplement.

What we would like to know

Whether people with MCS who move more, sleep better or get more omega-3 fats find that their reactions change.

If you try any of these, keep a simple record: what you changed, when, and how your reactions were in the weeks before and after. That is the information no study has collected yet.