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June 11, 2025

Chronic Inflammatory Response Syndrome (CIRS): Causes, Symptoms & Functional Medicine Treatment

Chronic Inflammatory Response Syndrome (CIRS) is a complex illness caused by biotoxin exposure. Discover symptoms, testing, and how to heal using functional medicine.

Chronic Inflammatory Response Syndrome (CIRS): Causes, Symptoms & Functional Medicine Treatment

Chronic Inflammatory Response Syndrome (CIRS): Causes, Symptoms & Functional Medicine Treatment

If you’re struggling with chronic fatigue, brain fog, joint pain, and unrelenting inflammation—and no one can figure out why—you may be one of the millions affected by Chronic Inflammatory Response Syndrome (CIRS).

Often triggered by mold exposure, Lyme disease, or water-damaged buildings, CIRS is a multi-system, multi-symptom illness that defies conventional diagnostic models. Most patients with CIRS are misdiagnosed with conditions like fibromyalgia, chronic fatigue syndrome (CFS), anxiety, or even psychosomatic disorders.

CIRS is real, measurable, and treatable. With the right testing, environmental assessment, and a personalized protocol, it’s possible to detoxify the body, downregulate inflammation, and restore health.

What Is CIRS?

Chronic Inflammatory Response Syndrome (CIRS) is a condition characterized by persistent, dysregulated inflammation caused by exposure to biotoxins in genetically susceptible individuals.

First defined by Dr. Ritchie Shoemaker, CIRS occurs when the innate immune system fails to clear biotoxins like mycotoxins (mold), Borrelia (Lyme), and other microbial toxins. This leads to a cascade of immune dysfunction, including:

Common Triggers of CIRS

CIRS can be triggered by a range of biotoxins and environmental exposures, including:

🔬 Mold and Water-Damaged Buildings

  • Mycotoxins (produced by molds such as Stachybotrys, Aspergillus, Penicillium)

  • Beta-glucans, hemolysins, and microbial VOCs

🦠 Tick-Borne Illnesses

  • Borrelia burgdorferi (Lyme disease)

  • Babesia, Bartonella, Ehrlichia, and other coinfections

🐚 Other Biotoxin Sources

  • Cyanobacteria (blue-green algae blooms)

  • Dinoflagellates (red tide toxins)

  • Spider bites (brown recluse)

  • Ciguatera toxin (from reef fish)

Not everyone exposed to these triggers develops CIRS. It typically affects those with a genetic susceptibility, particularly HLA-DR/DQ gene variants.

Genetic Susceptibility: The Role of HLA Genes

Roughly 24% of the population carries HLA haplotypes that make them susceptible to chronic inflammation from mold or Lyme exposure. These individuals:

  • Cannot properly tag and eliminate biotoxins

  • Mount an excessive innate immune response

  • Suffer prolonged inflammation and tissue damage

If you've been sick since a known exposure to water-damaged buildings, Lyme, or algae, and you're not getting better—even after antibiotics or antifungals—you may be HLA-susceptible.

Symptoms of CIRS

CIRS affects multiple systems in the body and can present with over 30 distinct symptoms, often cycling in and out. Common symptoms include:

System Symptoms
Neurological Brain fog, memory loss, difficulty concentrating, mood swings, sleep disturbances
Musculoskeletal Muscle aches, joint pain, weakness, cramping
Respiratory Shortness of breath, chronic cough, sinus congestion
Gastrointestinal Nausea, bloating, abdominal pain, IBS-like symptoms
Hormonal Fatigue, low libido, adrenal dysfunction, hypothyroid symptoms
Dermatological Itching, rashes, unusual tingling or numbness
Cardiovascular Heart palpitations, temperature dysregulation, dizziness
Immune Increased sensitivity to food, light, sound, chemicals

Patients often report worsening symptoms in damp environments, basements, old buildings, or after exercise.

Diagnosing CIRS: The Shoemaker Criteria

CIRS diagnosis is based on a combination of:

1. Symptom Clusters

Patients typically present with at least 6 of 13 symptom clusters, including cognitive dysfunction, fatigue, visual disturbances, respiratory issues, and more.

2. Exposure History

Confirmed or suspected exposure to:

3. Genetic Susceptibility

HLA-DR/DQ testing for susceptible haplotypes

4. Failed Response to Typical Treatment

Patients who don’t improve with antibiotics, antifungals, or steroids may have underlying CIRS.

5. Lab Markers of Inflammation and Immune Dysregulation

Key labs include:

  • MSH (Melanocyte Stimulating Hormone) – usually low

  • VIP (Vasoactive Intestinal Peptide) – usually low

  • TGF-β1 (Transforming Growth Factor Beta 1) – usually elevated

  • C4a – complement marker, usually high in Lyme or mold

  • MMP-9 – inflammatory marker

  • ADH/osmolality – dysregulated fluid balance

  • ACTH/cortisol – adrenal stress dysfunction

  • VEGF – often low, indicating tissue oxygen issues

  • Leptin – often elevated, impairs metabolism

  • CD57 – immune suppression, especially in Lyme

  • HLA DR/DQ typing – susceptibility genotype

Visual Contrast Sensitivity (VCS) Test

The VCS test is a non-invasive, functional vision test that evaluates your ability to distinguish contrast—a process often impaired in CIRS. A failed VCS test supports the diagnosis and is used to monitor treatment progress.

Available online (e.g., SurvivingMold.com), it’s a useful screening tool, especially when access to labs is limited.

Functional Medicine Approach to CIRS

A root-cause, integrative approach to CIRS involves removing the source, supporting detoxification, repairing immune dysfunction, and rebuilding resilience.

Step 1: Remove the Source

🏠 Environmental Testing

  • ERMI or HERTSMI-2 testing to assess home mold load

  • Mycometrics is a trusted source for home ERMI testing

  • Hire an IEP (Indoor Environmental Professional) if needed

🧹 Remediation

  • Proper mold remediation by certified professionals

  • HEPA filtration and dehumidifiers

  • Avoid antifungal foggers that don’t remove source material

🚪 Relocate Temporarily (If Necessary)

If remediation isn’t possible, getting out of exposure is critical to recovery.

Step 2: Bind Biotoxins

Biotoxins are fat-soluble and recycled via bile unless intercepted by binders.

Effective Binders:

  • Cholestyramine (CSM) – prescription bile acid sequestrant

  • Welchol – milder prescription option

  • Activated charcoal

  • Bentonite clay or zeolite

  • Chlorella (binds some heavy metals, weak mycotoxin binder)

  • Modified citrus pectin

  • Prescription binders (if needed, e.g., colesevelam)

CSM is the gold standard for mold-related CIRS. Take binders away from food, meds, and supplements.

Step 3: Treat Colonized or Infected Sinuses and Gut

Mycotoxins and molds may colonize:

  • Sinuses → use antifungal nasal sprays (e.g., BEG spray, amphotericin B)

  • GI tract → treat with antifungals (nystatin, fluconazole) and binders

Recommended:

Step 4: Repair and Modulate the Immune System

Once exposure and colonization are addressed, address immune signaling.

Key Supportive Supplements:

Step 5: Support Vasoactive Peptides and Neuroimmune Repair

As inflammation resolves, support MSH, VIP, and VEGF levels.

Peptides:

  • BPC-157 – Repairs mucosa, gut, brain

  • TB-500 – Immune modulation and tissue repair

  • KPV peptide – Potent inflammation suppressor

  • LL-37 – Antimicrobial peptide useful if colonization is present

  • VIP nasal spray (prescription) – Restores immune and hormonal balance

Step 6: Rebuild Hormonal and Neurological Balance

CIRS often causes HPA axis dysfunction, thyroid resistance, and neurotransmitter imbalance.

Support:

Step 7: Monitor Progress and Retest

Track:

  • Symptom severity

  • VCS test improvement

  • Inflammatory markers (TGF-β1, MMP-9, VEGF, MSH)

  • Reexposure risk

Reintroduce exercise and stressors gradually—CIRS recovery is a marathon, not a sprint.

Final Thoughts

CIRS is one of the most overlooked causes of chronic illness in modern medicine. But with accurate testing, environmental awareness, and a functional medicine plan, it’s possible to reverse inflammation, restore immune balance, and get your life back.

If you’ve been struggling with unexplained symptoms and told “your labs are normal,” don’t give up. The missing link may be biotoxins—and the solution may be waiting just beyond the mold.

Ready to Start Your Recovery from CIRS?

At Revolution Health & Wellness, we specialize in identifying and treating CIRS using advanced testing, peptide therapy, detoxification, and functional root-cause protocols.

📞 Schedule your consultation today and let’s create a plan to help you heal.

References

  1. Shoemaker RC, et al. (2010). Diagnosis and treatment of chronic inflammatory response syndrome: a consensus. Toxins (Basel).

  2. Patel D, et al. (2020). Mycotoxins and chronic illness: the evidence and approach. Integrative Medicine.

  3. Riedl MA. (2017). Chronic inflammatory response syndrome: diagnostic challenges and integrative options. Alternative Therapies.

  4. Brewer JH, et al. (2013). Detection of mycotoxins in patients with chronic fatigue syndrome. Toxins.

  5. Berndtson K. (2013). Biotoxin pathway: chronic inflammatory response syndrome explained. Surviving Mold Education Series.