Chronic Inflammatory Response Syndrome – CIRS

Chronic Inflammatory Response Syndrome (CIRS), also known as Sick Building Syndrome (SBS), is a combination of illnesses or aliments that are in direct relation with an individual’s place of work or home environment (i.e. mold toxicity).

Dr. Ritchie Shoemaker was the first recognized leader in mold toxicities, having appeared on a variety of national TV shows, such as Good Morning America, NBC News, CBS News, and CNN. Trained in family medicine, Dr. Shoemaker investigated areas that reveal important insights into how we can treat chronic illness caused by mold.

Dr. Shoemakers research and treatment of mold toxicities has led to an eye-opening area of medicine previously (and still) overlooked.

According to Dr. Shoemaker, the proper definition of Chronic Inflammatory Response Syndrome is “an acute and chronic, systemic inflammatory response syndrome acquired following exposure to the interior environment of a water-damaged building with resident toxic organisms (mold).”



Chronic Inflammatory Response Syndrome – The Causes

The term “Sick Building Syndrome” was first coined by the World Health Organization in the 1980s and it is believed that it is caused by poor air quality that is likely caused by water damage.

According to Shoemaker, “This illness happens after exposure to the interior environment of a Water-Damaged Building (WDB). There are many ways buildings become home to a toxic mix of microbes, fragments of microbes, and harmful chemicals. Buildings can host molds which can be toxic as a result of construction defects like inappropriate ventilation; faulty construction of crawl spaces or inadequate building design; flat roofs or fake stucco cladding without adequate caulking; incomplete basements exposed to saturated ground water conditions; or not correcting water leaks.“

Chronic Inflammatory Response Syndrome is an auto-immune reaction. Research has shown that 25% of the population has a genetic predisposition to CIRS and that women tend to report more symptoms than men. In other words, some people get sick because their genes made them prime targets for an assault by their own immune systems. Exposure to the interior environment of a Water-Damaged Building (WDB) causes an immune response that has gone haywire.

Most often genetically predisposed people exposed to the mold toxins in a water damaged building suffers from chronic illness because their bodies are constantly trying to eliminate the foreign substances that stay in the body. This leads to chronic inflammation resulting in the multiple symptoms listed below.

Chronic Inflammatory Response Syndrome – The Symptoms

Frequently these patients present to their physician with a variety of chronic and vague complaints. Symptoms such as fatigue, general weakness, muscle aches and cramps, unusual pain, ice pick pain, headache, sensitivity to light, red eyes, blurred vision, tearing, sinus problems, chronic cough, chronic shortness of breath, chronic abdominal pain, chronic diarrhea, joint pain, morning stiffness, memory issues, trouble with focus/concentration, skin sensitivity, mood swings, feeling hot then cold then hot again, excessive thirst, increased urination, numbness, tingling, vertigo, metallic taste in their mouth and tremors.

Unfortunately, because of the large number of symptoms and different combination that a patient can have, CIRS is often misdiagnosed.

If you have these symptoms and have made repeated visits to your doctor and your condition continues to worsen, you should consider examining the living or working environment to determine if this is the cause of your sickness.

Chronic Inflammatory Response Syndrome – The Diagnosis

Labs which may help determine if you are genetically predisposed to mold toxicity

  • HLA Class II DRB1, DQ
  • HLA DRB 3*4*5

Labs which do determine the extent to which your immune system is over-activated or under-activated:

  • Complement C3a
  • Complement C4a
  • Melanocyte Stimulating Hormone (MSH)
  • Leptin
  • Antidiuretic Hormone (ADH)
  • Osmolality
  • Vascular Endothelial Growth Factor (VEGF)
  • Matrix Metalloproteinase-9 (MMP-9)
  • Vasoactive Intestinal Peptide (VIP)
  • Transforming growth factor beta-1 (TGFβ1)

Chronic Inflammatory Response Syndrome – The Treatment

1. Seek out an Integrative Medicine Physician experienced in diagnosing and treating mold toxicity.

2. If you are concerned that your home or work place may be implicated in your health problems due to mold toxicity, you may want to test your home for mold. A Chicago based company, SafeStart, will evaluate and develop a plan specifying corrections to get rid of microbial contamination and prevent further problems. It is possible that you may have to evacuate the location which is making you sick.

3. Eradicate other biofilm-forming infectious agents

4. Elimination of gluten from you diet

5. Cholestyramine (Questran) is a bile acid sequestrant, which binds bile (and toxins) in the gastrointestinal tract to prevent its reabsorption. (Shoemaker’s Protocols)

6. Immune system support may be required including nutritional therapy.

More on Dr. Shoemaker’s work can be found at