title: Approach to patients with unexplained multimorbidity with sensitivities.
abstract: OBJECTIVE
  To explore the underlying causation of unexplained multimorbidity with sensitivities and to discuss the management of patients who present with this perplexing condition.
  
  
  METHODS
  Medical and scientific literature was used from MEDLINE (PubMed), several books, toxicology and allergy journals, conference proceedings, government publications, and environmental health periodicals.
  
  
  RESULTS
  Multimorbidity with sensitivities has become an increasingly common and confusing primary care dilemma. Escalating numbers of debilitated individuals are now presenting to family physicians and specialists with multisystem health complaints, including sensitivities and fatigue, with no obvious causation, a paucity of laboratory findings, and a lack of straightforward solutions. In the recent scientific literature, there is discussion of sensitivity-related illness, an immune-mediated disorder that frequently manifests with multisystem symptoms, commonly including sensitivities and fatigue. This condition appears to be originally caused by adverse environmental exposures and toxicant bioaccumulation-an increasingly prevalent and well-documented problem in contemporary culture.
  
  
  CONCLUSIONS
  Various toxic exposures and their bioaccumulation within the body frequently manifest as sensitivity-related illness. In clinical settings, patients with this disorder often present with otherwise unexplained multimorbidity and sensitivities. The health status of patients with this condition can be ameliorated by removing triggers (eg, scented products), optimizing biochemistry, removing further sources of toxicant exposures, and eliminating the internal dose of persistent toxicants.
authors.affiliation: Clinical Professor in the Faculty of Medicine and Dentistry at the University of Alberta in Edmonton. sgenuis@shaw.ca.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Genuis
authors.affiliation: Medical student in the Faculty of Medicine and Dentistry at the University of Alberta in Edmonton.
authors.forename: Marko G
authors.initials: MG
authors.lastname: Tymchak
mesh_terms: D015897:Comorbidity; D019468:Disease Management; D004781:Environmental Exposure / Q000009:adverse effects*; D018876:Environmental Illness / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D015995:Prevalence; D063189:Symptom Assessment