“I Am The Allergen”: The Super-Rare Condition That Makes Everyone Else Allergic To You

It sounds like the monkey’s paw interpretation of an asthmatic’s lament, but it’s an oh-so-real phenomenon. It’s called “People Allergic To Me” – often shortened to PATM – and it means that, as one 23-year-old sufferer told Sky News in 2024, “I am the allergen.”

And the worst part of all? There’s no cure. No treatment. In fact, we barely even understand it at all.

A mystery problem

The internet may have many drawbacks, but at least we can say this: without it, we might never know that PATM is a thing. That’s because the earliest mentions of the phenomenon come not from the medical literature – indeed, sufferers most often report health professionals brushing their symptoms off as psychosomatic – but from online forums, circa 2007.

“I have […] been going through this hell for the last 5 years – I somehow trigger allergies in others,” wrote one person in July of that year. “I don’t think there is an odor issue here […] it is making people sniffle, cough to clear their throat and sneeze as if they were surrounded by dust.”

Despite this online community – including, with the growing use of platforms like YouTube, video evidence provided by sufferers in support of their suspicions – PATM doesn’t seem to have been noticed by professionals until about a decade later. The first mention seems to come from a 2017 preprint by independent biomedical researcher Irene Gabashvili, and only as a side quest to the main topic of investigation, which was the equally weird Trimethylaminuria (TMAU) disorder – it makes you stink, no matter how much you wash. 

A couple of years later, another paper from Gabashvili hit the internet – again, a preprint, and like its predecessor, mainly focused on figuring out what PATM even really looks like. A year later, she had shown some kind of link between the disorder and sufferers’ gut biomes – not bad at a time when PATM was more likely to be mentioned in psychiatric health journals than in biomedical ones.

More recently, though, it’s starting to get a little more attention. Starting a couple of years ago, researchers first in Japan and then in Sunnyvale, California – specifically, the bit of it where Irene Gabashvili is based – finally figured out the likely cause.

The hunt for a culprit

All of us, no matter how clean or polished we are, move through the world surrounded by a cloud of gas telling tales about our health. 

“Even dating back to ancient Greece, physicians knew that a patient’s breath could offer clues to their ailments. And nowadays, everybody has heard of the breathalyzer,” pointed out Kohji Mitsubayashi, a professor in the Department of Biomedical Devices and Instrumentation at the Tokyo Medical and Dental University, and coauthor of a 2019 article describing a novel method of imaging human skin gases, in a statement. 

These kinds of gases – ethanol, methanol, plus things like isoprene and acetone – are examples of what are called volatile organic compounds, or VOCs. They’re the result of our bodies breaking down various molecules into simpler versions so as to release energy; the bits we don’t want or need are passed from our bodies’ tissues and organs into the bloodstream, and from there into the lungs, after which we exhale them into the air.

But that’s not the only way we get rid of these waste products. Out of the more than 1,800 VOCs that have been so far identified in humans, around 500 are emitted through the skin – and they, shall we say, stick around. 

“The problem with breath is that it is not suitable for long-term monitoring of VOCs,” explained Mitsubayashi. “The skin, on the other hand, offers an easy way for the continuous monitoring of VOCs.”

So, what’s all this got to do with PATM? Well, in 2023, a research team in Japan decided to investigate the VOCs in the skin gases of people affected by the condition – and they found something very unusual.

The sneezy substance

Of the 75 skin gases analyzed in the 2023 study, one VOC seemed to be especially likely to be present. Toluene, a hydrocarbon best known for giving paint thinner and permanent markers their signature brain-killing aroma, was found in the skin gas of those in the PATM group at levels almost 40 times those found in people without the condition.

Why might that make people sneeze at you? Well, toluene is not exactly good for your health: it’s irritating to the eyes, skin, and respiratory tract, and inhaling it can produce a whole bunch of gnarly mental effects – hence its reputation for huffability – as well as, you know, seizures and death.

Normally, that’s not a problem. “Toluene is inhaled through the air during breathing,” Yoshika Sekine, a professor of chemistry at Japan’s Tokai University and coauthor of the 2023 paper, told BBC Future earlier this year. “As a harmful compound, it is typically metabolised by the liver and excreted in the urine.”

“However, PATM patients have a diminished ability to break down toluene,” he explained, “leading to its accumulation in the bloodstream and subsequent release through the skin.”

In other words? PATM isn’t necessarily some kind of paranoia or neuroticism. There’s physical evidence that it is what sufferers always thought: there really is something about them – like, literally, all about them – that is causing bystanders to have a reaction.

People are allergic to them.

“I am the allergen”

So, now we know the likely culprit, what can we do about PATM?

Well, sadly for those who suffer from it, the answer really is “not a lot”. It’s simply so rare, and so new to the literature, that there are so far no real treatment options. 

“With PATM, doctors say even if you want to get tested, there’s no diagnosis,” one sufferer, “Fahima”, told Sky News. “There’s no way to treat it.”

Anecdotally, it seems like diet may play a part – days following higher intake of sugar, meat, or carbs seem to involve more people reacting, the sufferer said, and Sekine reported hearing good results from cutting out dairy and boosting antioxidants. But specific, proven dietary links to PATM are yet to be found, he said.

For sufferers, it’s a tough situation. The mental cost of living with PATM is extraordinarily high – people report feeling ostracized from society, guilty, depressed, and even suicidal due to their condition – but with no formal diagnosis or even settled description of the illness, there’s no hope for any treatment or cure in the near future.

“It crushes you,” another sufferer told Sky. “It crushes you in a way that nothing has ever crushed you before.”

“I don’t feel excited [about the future] at all. I don’t even like to think about it,” she said. “The reality is so sad. I can’t even go to the local park, I can’t do anything.”