CIRS: Causes, Symptoms and Solutions

CIRS: Causes, Symptoms and Solutions

Chronic Inflammatory Response Syndrome (CIRS) is a complex and chronic biotoxin illness. CIRS is a collection of symptoms that affects multiple systems in the body. The most common symptoms of CIRS are fatigue, depression, brain fog, digestive problems, headaches and other aches, joint, muscle, and abdominal pains, blurred vision, cramping, and more.

Biotoxin illness is more likely in genetically susceptible people. The immune system of a person with CIRS does not recognize biotoxins and fails to remove them. This leaves the biotoxins circulating in the body indefinitely causing chronic and systemic inflammation.

Unfortunately, most people with CIRS suffer for months, or even years, without a diagnosis due to the lack of awareness within the medical community. They are often misdiagnosed because symptoms of CIRS overlap and can mimic symptoms of Lyme disease, ehrlichiosis, autoimmune, and other conditions.

The first step to improving symptoms of CIRS is to identify and remove the source of biotoxin exposure. This may include mold from water-damaged buildings, viral infections, bacterial infections, fungi, chemicals, and other toxins. Once the cause is identified and addressed, there are several natural strategies an individual can use to improve their symptoms.

What is CIRS?

Chronic Inflammatory Response Syndrome (CIRS) is a chronic condition with a wide range of symptoms. This inflammatory response in the body is triggered by exposure to a biotoxin. CIRS is also referred to as a biotoxin illness.

CIRS was first described and named by Dr. Ritchie Shoemaker. Dr. Shoemaker started studying CIRS in the late 1990s and coined the term to describe when a body’s immune system is not functioning properly (1).

To understand CIRS, it is important to discuss how it differs from a normal immune response. The immune system is comprised of the innate immune system (from birth) and the adaptive immune system (developed after exposure to an antigen).

CIRS and The Immune System

The innate immune system acts as the first line of defense against invading pathogens. It is a fast, non-specific response that acts on a wide range of pathogens.

Adaptive immunity is a slow immune response mediated by the T and B lymphocytes. These cells are capable of recognizing foreign antigens in a precise way. The adaptive immune response provides long-term immunity by creating immunological memory after the initial exposure to a specific pathogen.

The innate and adaptive immune systems normally function together to remove biotoxins from the body. The immune system produces antibodies to the biotoxins which bind to the biotoxins and clear them from the system.

CIRS occurs when genetically susceptible people are exposed to certain biotoxins (2). Their immune system does not properly recognize the biotoxins and does not produce antibodies against them. The biotoxins are not cleared properly and remain in the body indefinitely.

The biotoxins left in the body pass from cell to cell through cell membranes creating cell damage and causing systemic inflammation. This leads to a variety of symptoms throughout the body.

What are Biotoxins?

Biotoxins are hazardous organic substances that can cause significant damage to your health. Examples of biotoxins include mold and fungi, bacteria, volatile organic compounds (VOCs), endotoxins, and actinomycetes.

Most people are exposed to biotoxins through living in water-damaged buildings. Other ways to come into contact with biotoxins include ingesting contaminated food or water, inhaling airborne biotoxins, and tick or spider bites.

Symptoms of CIRS

CIRS can affect every system in the body and cause a large array of possible symptoms. Possible symptoms of CIRS divided by body system include:

• Respiratory: Blurred or hazy vision, eyes sensitive to light, eyes tear easily, puffy/dark circles below the eyes, night blindness, ringing in the ears, hearing loss, dizziness, sinus/nasal congestion, nose bleeds, sensitivity to odors, vocal cord polyps, nasal polyps, laryngitis or raspy voice, burning in the throat, or sore throat
• Musculoskeletal Symptoms: Joint pain, shooting pain, ice-pick sharp pain, burning pain, stabbing pain, muscle cramps, muscle aches, muscle weakness, fleeting pain/pain that moves around, tics, spastic muscles, charlie horses, hands curl up like a claw, toes/feet curl up, morning stiffness
• Lungs/Heart Symptoms: Shortness of breath and tachycardia (fast heartbeat) with exercise, cough, wheezing, asthma, swelling or edema, heart palpitations, heart pounds intermittently
• Digestive/Liver/Urinary Symptoms: Metallic taste in mouth, bile reflux, nausea, vomiting, diarrhea, constipation, abdominal pain, weight loss, weight gain, urinary frequency
• Nervous/Endocrine/Immune: Insomnia, headache, dizziness, mental confusion, poor concentration, poor short-term memory, forgetfulness, can’t remember names or words, poor word recall, disorientation, decreased learning ability, extreme thirst, low blood pressure, poor body temperature regulation, numbness, tingling, tremors, vertigo, Parkinson’s-like symptoms, mood swings, anxiety, irritability, lack of sex drive, swollen and painful lymph nodes
• Skin: Skin is sensitive, skin is itchy, feels like bugs crawling on skin, feels like bugs stinging or biting but there is nothing there, easy bruising, Itchy pimples, skin sores, bumpy skin, thickened skin, skin peeling, burning sensations, red face, sweats – especially at night, static shocks, skin reacts to sun, even through clothing sometimes, vitiligo, cherry hemangiomas, and urticaria, commonly known as hives
• Extremities: Cold hands/feet, discolored hands and feet such as white and red mottling, numbness in parts of the body, tingling, shaky hands, and clawing of fingers or toes

Dr. Shoemaker broke CIRS symptoms down into 13 distinct clusters. According to Dr. Shoemaker, people with symptoms present in at least 6 clusters have possible biotoxin illness while 8 clusters indicate biotoxin illness (2).

Common Misdiagnoses With CIRS

People with CIRS often experience fatigue, flu-like symptoms, exhaustion, insomnia, and environmental sensitivities. Due to the complexity of the illness and the lack of awareness in the medical community, people struggling with CIRS have often received multiple possible diagnoses from different doctors. Common misdiagnoses include:

• Chronic Fatigue Syndrome (CFS)
• Fibromyalgia
• Depression and Anxiety
• Allergies
• Hypochondria (somatization)
• Attention Deficit Disorder (ADD/ADHD)
• Irritable Bowel Syndrome (IBS)
• Post-traumatic Stress Disorder (PTSD)

Diagnosing CIRS

Standard blood tests may not help diagnose CIRS because the biotoxins transfer through cell membranes and are not present in the body. To be diagnosed with CIRS, the following criteria are considered (3):

1. Complete medical history and exam documenting all of the signs and symptoms consistent with biotoxin exposure. In cases of mold toxicity, history should include exposure to toxin-producing molds as documented by the EPA-approved ERMI test. In other cases (microcystin, ciguatera, etc.), history should include likely exposure or laboratory evidence of exposure.
2. A genetic predisposition to biotoxin-related illness based on Human Leukocyte Antigen (HLA) testing.
3. Abnormalities documented by Visual Contrast Sensitivity (VCS) testing. Biotoxins cause neurological symptoms which include diminished ability to detect visual patterns. This test measures a person’s ability to detect visual patterns. It is highly accurate and sensitive to biotoxin exposure.
4. Biomarkers are consistent with the neuroimmune, vascular, and endocrine abnormalities that characterize CIRS. If you have a history consistent with biotoxin exposure, a susceptible genotype, and an abnormal VCS test, you are very likely to show the laboratory abnormalities seen in CIRS.

Genetic Predisposition For CIRS

CIRS occurs in people who are genetically predisposed. Approximately 25% of the population has the genetic predisposition to develop CIRS if exposed to sufficient amounts of biotoxin.

The reason is a genetic defect on chromosome 6 in the Human Leukocyte Antigen (HLA) system. HLA is a set of genes that are responsible for the regulation of our immune systems.  HLA controls our response to invasion from toxic organisms.

The immune system of people with this specific HLA genetic defect cannot identify these toxic mold organisms as “bad” and do not make antibodies to kill them.  The HLA type and related immune response are a key part of whether or not a person goes on to develop the inflammation that leads to CIRS.

Depending on a person’s individual HLA gene combinations, it is possible to be susceptible to one or more biotoxin-related illnesses. For example, one person could be “mold susceptible,” while another person is “Lyme susceptible,” and another is “multi-susceptible” (1).

Testing for Underlying Causes of CIRS

CIRS was initially thought to be only caused by mold exposure. However, bacteria, fungi, and various viral infections may also lead to the development of CIRS (2). It can be very helpful to test for possible underlying causes of CIRS.

Mold Toxicity

Most people with CIRS acquire biotoxin illness following exposure to water-damaged buildings. There is a persistent innate immune inflammatory response to the toxins present in the water-damaged buildings.

Mold toxicity occurs when mycotoxins produced by mold lead to a chronic inflammatory immune response. To test for mold toxicity, you can do a Mycotoxin Test. This urine test screens for seven different mycotoxins from four species of mold.

Lyme Disease

Lyme disease is an infectious disease caused by four main species of Borrelia bacteria. It is transmitted by the bite of an infected tick. Lyme disease, as with other infections, can cause the immune system to react and secrete proinflammatory cytokines (4).

Lyme disease can be very difficult to accurately diagnose. To test for Lyme disease, the Igenex Lyme Test is a sensitive and reliable antibody screening that also screens for the DNA of Borrelia.

Lyme disease can be very challenging to overcome. However, there are effective natural strategies that you can find here.

Gut Infections

The gastrointestinal tract is a major entry point for pathogens which can cause gut infections. Infections in the gastrointestinal tract may lead to a chronic inflammatory response. These infections must be eliminated to reduce inflammation and improve your symptoms.

To test for gut infections, the GI-MAP™ Stool Analysis Test is the most thorough stool test on the market. It is the only FDA-approved DNA test for gastrointestinal microbes and pathogens available.

The GI Map tests for imbalances in the gut microbiome, candida, and other fungi, viruses, and parasites, including both protozoa and worms. This comprehensive test reveals the integrity of your gastrointestinal system with digestion, immune response, and gliadin, and inflammation markers.

Viral Infections

A virus is a small infectious agent with genetic material, RNA, or DNA, surrounded by a coat of protein, lipid (fat), or glycoprotein. They can only replicate inside the cells of another organism, so they are parasitic. Viruses can infect humans, animals, plants, and microorganisms.

There are more than 400 viruses that can cause infections in your body. When our bodies encounter a virus, our adaptive immune response acts to clear the primary infection. With some viruses, the immune response is not enough to eradicate the virus and it becomes chronic.

Chronic viral infections can result from a variety of viruses (5). They escape from our immune system by modulating, or regulating our immune response. These viruses cause persistent infections which may last for life.

Blood Tests for Viral Infections

There are blood tests to help determine whether you have a viral infection and which type of infection is chronic or active in the body. The Comprehensive Blood Analysis is a comprehensive test that includes a Complete Blood Count (CBC). The CBC shows the distribution of white blood cells and red blood cells. White blood cells regulate the immune system and can indicate altered immune activity.

The Comprehensive Viral Panel tests for the major viruses that impact human health including EBV, CMV, HSV, HHV-6, Varicella Zoster, and Rubeola. This test measures antibodies and viral antigens to determine how the body’s immune system is reacting to these viruses.

This test can reveal which infections are present and whether they are active or chronic infections. If you have a history of chronic pain or fatigue and increased lymphocytes and/or monocytes on the CBC, this test may be helpful.

Natural Strategies to Improve CIRS

Once you have identified the underlying cause of your symptoms, it is important to use targeted strategies to address the cause. Dr. Shoemaker has a very detailed 12-step protocol for individuals suffering from CIRS (2).

Alternatively or in conjunction with Dr. Shoemaker’s protocol, you may find relief and improvement using the following natural strategies.  These strategies are designed to help reduce the biotoxin load and improve the body’s natural immune response.

1.   Identify and Avoid or Remove Cause

The first step to improving CIRS is to identify and address a person’s specific underlying cause. For some people, there may be more than one issue that needs to be addressed.

While mold toxicity from water-damaged buildings is the primary cause of CIRS, other factors may be contributing to your symptoms. Running the tests discussed above can give you insight into possible causes.

2.  Good Hydration

Optimal hydration is key when eliminating biotoxins. Filtered water, fermented vegetables, filtered water, bone broths, and herbal teas are all great to use while cleansing.

For water, aim to drink at least half of your body weight in ounces per day. It is great to use reverse osmosis water with added minerals (or add ¼ tsp of pink salt per gallon). Filtering chlorine, fluoride, heavy metals, and pharmaceutical drugs from your water with a high-quality filter is critical.  You can also get a quality Berkey filter or take it up a notch and use a hydrogen water system which adds molecular hydrogen to combat oxidative stress and improve immune health.

Fermented beverages provide organic acids, probiotics, potassium, and enzymes. Organic acids and probiotics help to balance your intestinal microflora. Potassium helps to flush toxins from the cells through the elimination channels, and enzymes assist the body in healing.

Herbal teas are another option for hydration. They provide immune-stimulating superfood herbs that contain antioxidants and phytonutrients. This clean energy source facilitates deeper cleansing and has detoxifying properties.

3.   Anti-Inflammatory Nutrition Plan

CIRS is a chronic inflammatory response. Implementing a ketogenic diet may help reduce chronic inflammation. The ketogenic diet is a high-fat, low-carbohydrate, moderate protein nutrition plan that helps your body use fat (stored fat and dietary fat) rather than sugar for fuel. Burning fat for energy is much more efficient and produces less inflammation than burning sugar.

The ketogenic diet decreases the amount of free radical production, stabilizing blood sugar levels, and reducing insulin levels. With lower levels of inflammation and stabilized blood sugar levels, your mitochondria will produce more of the energy-carrying molecule Adenosine Triphosphate (ATP).

Foods included in the ketogenic diet include healthy fats, clean-sourced protein and low carbohydrate vegetables, low glycemic fruits, and herbs. These foods help to reduce inflammation and support the immune system.

For anyone with CIRS, it is critical to avoid foods that cause inflammation. These include:

• Sugar
• Refined carbohydrates (white flour, white rice, white potatoes)
• Conventionally raised meat and dairy
• Farm-raised fish
• Processed meats
• Trans fats (partially hydrogenated oils)
• Mono-sodium Glutamate (MSG) and other food additives and preservatives
• Highly processed vegetable and seed oils, such as canola, corn, sunflower, peanut, grapeseed, cottonseed, and safflower
• Artificial sweeteners

4. Support Good Elimination and Detoxification Pathways

Use Enemas For CIRS

Enemas are extremely effective at ridding the body of putrefied waste that is encased on the colon walls. There are different types of enemas, including water enemas, probiotic enemas, wheatgrass juice enemas, and organic coffee enemas.

Coffee enemas stimulate the liver to produce greater amounts of the master antioxidant glutathione. This can accelerate your results by removing biotoxins from the body.

Daily Bowel Movements

Daily bowel movements are important during a biotoxin protocol. You want to eliminate the biotoxins as they are absorbed by the binders or your symptoms may worsen. When you are not eliminating daily, waste sits or moves slowly through your digestive tract. This waste is fermented by bacteria and becomes a breeding ground for bad microbes. These microbes release toxins that create more inflammation throughout the body.

A fantastic supplement for natural, gentle relief from constipation is Bowel Mover. This product is specifically designed to promote digestive and detoxification support without causing cramping or dependency.

Dry Brushing, Saunas, and Sunbathing

Supporting detoxification during biotoxin elimination is very important. Dry brushing, saunas, and sunbathing are great for detoxification.

For dry brushing, brush your skin in a circular manner beginning with your extremities and moving towards your torso and heart. It is best to do this before your shower using a natural bristle brush and following the brushing with a warm shower. Dry brushing has many health benefits such as cleansing the lymphatic system, removing dead skin layers, improving the nervous system, and removing excess fluid from the body.

Spending time in an infrared sauna is a great way to stimulate the release of toxins. Sunbathing also enhances immunity and stimulates deeper cellular cleansing. Spending time in the sun with help to boost your vitamin D levels and charge your system with biophotons.

5.   Remediation and Air Purification

If you find elevated mold toxins in your body or find mold in your environment, it is critical to re-mediate the source of mold properly. To remove mold from your home, follow the plan of action in this article.

Using an air purification system like The EnviroKlenz Mobile UV Air System is an important step in a comprehensive mold mitigation protocol. The EnviroKlenz Mobile UV Air System is a portable air filtration machine that contains enhanced chemically reactive technology. This system can effectively capture mold spores and other airborne particulates and remove them from your air.

This UV system has the ability to completely destroy microorganisms such as mold spores that are in your air, by utilizing UVC (ultraviolet germicidal radiation) lights that shine upon the collected spores on top of the hospital-grade HEPA filter. With VOC elimination, particulate removal, and the ability to kill mold spores, this air purification system is the ideal purifier for any type of mold, bacteria, or virus in your home.

6. Use Targeted Supplementation

There are several nutrients and natural supplements that may help to improve your symptoms and support your healing from CIRS. These include:

BioToxin Binder

One of the most important supplements for improving CIRS is a binder to remove the biotoxins from your body. BioToxin Binder contains a special form of carbon that has optimized binding ability. It also contains wild-crafted yucca root and fulvic acid.

BioToxin Binder will bind to the biotoxins in the gut and bloodstream and help to remove them from the body. This will prevent waste from being released into the GI tract which can have a negative impact on your health.  I recommend taking 1 cap, 3 times daily (1 in the morning, 1 at mid-day, and 1 at night).

Mito Support

Your mitochondria are the powerhouses of your cells. Biotoxins slow down your mitochondria and hamper their ability to generate the energy you need for everyday cellular function as well as detoxing and healing efforts.

Mito Support is a formulary blend of nutrients, nutraceuticals, botanicals, and Krebs cycle intermediates designed to support efficient mitochondrial metabolism and energy (ATP) production for increased vitality.  Mito Support promotes overall cellular and tissue vitality and health.  I recommend taking 2 caps, 2 times daily (morning and mid-day) of this product.

Trace Minerals

Minerals are inorganic, naturally occurring substances that enable the cells to carry out essential functions. They are necessary for our bodies to function properly and maintain good health.

CT-Minerals contains extracts of humic and fulvic acid with 12 amino acids and over 70 plant-derived minerals. The bioactive carbon molecules bind with toxins in the body to support detoxification pathways. They protect to move and push nutrients through the gastrointestinal tract and into the cell where they are most effective.

CT-Minerals promote molecular synthesis in the body, help regulate cellular energy (ATP) production, and promote optimal utilization of enzymes. This product may help to restore and protect the body.  I recommend taking 10 drops, 3 times daily of this product (morning, mid-day, and at night).

Advanced TUDCA

Advanced TUDCA is a water-soluble bile acid combined with N-Acetyl Cysteine (NAC), fulvic acids, milk thistle, beet, marshmallow, and parsley to amplify its benefits. Advanced TUDCA helps to stimulate the release of bile and detox a range of potentially harmful substances.

This product helps reduce oxidative stress and inflammation throughout the body.  I recommend taking 1 cap in the morning and 1 cap at night.

7.   Treat Gut Infections

It is important to address underlying infections such as bacterial overgrowths to improve CIRS symptoms. For sensitive individuals, starting with a probiotic and immune support prior to antimicrobials may be beneficial.

A good probiotic option for people with CIRS is MegaSporeBiotic™. This broad-spectrum spore-forming probiotic has been shown to recondition the gut and may be beneficial for very sensitive individuals who struggle with food sensitivities, poor oxalate metabolism, and histamine intolerance.

Mega IgG2000 is a dairy-free immunoglobulin concentrate that supports a healthy mucosal immune system. This formula helps to decrease immune activation and strengthen gut barrier function. Once a person is more stable, infections can be addressed with an antimicrobial protocol.

Final Thoughts on CIRS

CIRS is a complex and chronic condition that can substantially decrease a person’s quality of life. It occurs when genetically susceptible people, based on their immune response genes, are exposed to water-damaged buildings or other biotoxins. In these people, the immune system does not clear biotoxins and the biotoxins stay in the body indefinitely causing inflammation. Over time, there is so much inflammation that it leads to chronic illness and many debilitating symptoms.

There are natural strategies that may provide relief from CIRS. Identifying a person’s underlying cause with testing is essential. Once the cause is identified, you should take steps to remove and address the root cause.

If you have followed the suggestions in this article and are still struggling with your health, I would consider hiring a functional health coach.  Here is an article with tips on how to find a great coach.  We offer long-distance functional health coaching programs with our well-trained functional health team. For further support with your CIRS recovery and other health goals, just reach out and our fantastic coaches are here to support your journey.

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Sources for this Article Include:

1. Thomas N, Understanding Chronic Inflammatory Response Syndrome (CIRS). Link here

2. Vosloo W, Steps of the Shoemaker Protocol for treating Chronic Inflammatory Response Syndrome acquired following exposure to Water Damaged Buildings [CIRS-WDB]. Link here

3. Berndtson K, Chronic Inflammatory Response Syndrome: Overview, Diagnosis, and Treatment. Link here

4. Talkington J, Nickell S, Borrelia burgdorferi Spirochetes Induce Mast Cell Activation and Cytokine Release, 1999 Mar; 67(3): 1107-1115. PMID: 10024550

5. Godkin A, Smith K, Chronic infections with viruses or parasites: breaking bad to make good. 2017 Apr., 150(4): 389-396. PMID: 5343343