CIRS Chronic Inflammatory Response Syndrome - August 15th, 2022 Episode

Updated: Oct 17


In genetically susceptible people, biotoxins binds to pattern receptors, causing continuing, unregulated production of cytokines.

Break that down:

genetically susceptible - those with changes in the control codes that alter ability to do the job of removing biotoxins effectively

Biotoxins - a poisonous substance produced by a living organism

Pattern receptors - “antennae” on immune cell surfaces that recognize foreign substances and trigger an action by the cell

Cytokine - communication molecule made by immune cells and other cells that attract more immune cells and induce inflammation

Cytokines damage tissues directly

Capillaries leak - like in Covid

Inflammation symptoms like unstable temperature, difficulty concentrating, muscle aches, fatigue, headaches.

Combines with PAI-1 to increase clots - sounds like Covid

In the nervous system damage can result in dysregulation of production of important hormones like MSH

Decreased MSH can result in sleep disorder, chronic pain, malabsorption, changes in the adrenal function and sex hormones especially testosterone

The CIRS Case Definition

To warrant a diagnosis of CIRS, the following criteria should be met:

1. History, 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 identification of an HLA susceptible haplotype.

3. Abnormalities documented by Visual Contrast Sensitivity (VCS) testing.

4. Biomarkers 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. Major and minor criteria are a work in progress.

The Most Common Signs and Symptoms Seen in Patients with CIRS

Listed below are the most common of over 30 signs and symptoms that Shoemaker has documented in his patients suffering from exposure to biotoxins:

• Fatigue, weakness

• Post-exertional malaise

• Memory problems, difficulties with concentration and executive function

• Disorientation and confusion

• Headaches

• Vertigo, lightheadedness

• Muscle aches, cramping, joint pains without inflammatory arthritis

• Hypersensitivity to bright light, blurred vision, burning or red eyes, tearing

• Cough, asthma-like illness, shortness of breath, chronic sinus congestion

• Air hunger or unusual shortness of breath at rest

• Chronic abdominal problems including nausea, cramping, secretory diarrhea

  • A propensity to experience static shocks

Chronic fatigue syndrome

Symptoms of chronic fatigue syndrome can vary from person to person, and the severity of symptoms can fluctuate from day to day. Signs and symptoms may include:

  • Fatigue

  • Problems with memory or concentration

  • Sore throat

  • Headaches

  • Enlarged lymph nodes in your neck or armpits

  • Unexplained muscle or joint pain

  • Dizziness that worsens with moving from lying down or sitting to standing

  • Unrefreshing sleep

  • Extreme exhaustion after physical or mental exercise

The cause of chronic fatigue syndrome is still unknown. Some people may be born with a predisposition for the disorder, which is then triggered by a combination of factors. Potential triggers include:

  • Viral infections. Because some people develop chronic fatigue syndrome after having a viral infection, researchers question whether some viruses might trigger the disorder {through viral protein mimicry}. Suspicious viruses include the Epstein-Barr virus, human herpes virus 6. No conclusive link has yet been found.

  • Immune system problems. The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly, but it's unclear if this impairment is enough to actually cause the disorder.

  • Hormonal imbalances. People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands. But the significance of these abnormalities is still unknown.

  • Physical or emotional trauma. Some people report that they experienced an injury, surgery or significant emotional stress shortly before their symptoms began.

Here you can see that they flounder because they are using a symptom based rather than systems based approach. When you look at the situation through the functional medicine lens, as they have done with CIRS, you can understand a deeper causality than simply stating a viral infection or an immune system problem. There was even a recent article in Scientific American discussing our current new insights on autoimmune disease that specifically says that the viral protein mimicry concept is not accurate.

Recent genetic studies indicate that cells afflicted in rheumatoid arthritis and multiple sclerosis have overactive genes that code for disease-related proteins, and immune cells home in on such targets. Dr Sonia Sharma from La Jolla Institute for Immunology says there could be 10 steps between and initiating event in the ultimate attack on a target tissue by immune system cells. "We've been looking at step 10 whereas we should be looking at steps one, two and three,” she says. “It's almost like we've been working backwards. If researchers could understand those early steps,” she says, “that could lead to better treatments cures or even measures to prevent disease.”

They are FINALLY getting it! This is the basis of functional medicine!

According to an Institute of Medicine report, an estimated 836,000 to 2.5 million Americans suffer from ME/CFS. However, most of them have not been diagnosed.


Fibromyalgia (fi·bro·my·al·gi·a) is a condition that causes pain all over the body (also referred to as widespread pain), sleep problems, fatigue, and often emotional and mental distress. People with fibromyalgia may be more sensitive to pain than people without fibromyalgia. This is called abnormal pain perception processing. Fibromyalgia affects about 4 million US adults, about 2% of the adult population. The cause of fibromyalgia is not known, but it can be effectively treated and managed.

The most common symptoms of fibromyalgia are

  • Pain and stiffness all over the body

  • Fatigue and tiredness

  • Depression and anxiety

  • Sleep problems

  • Problems with thinking, memory, and concentration

  • Headaches, including migraines

Other symptoms may include:

  • Tingling or numbness in hands and feet

  • Pain in the face or jaw, including disorders of the jaw known as temporomandibular joint syndrome (also known as TMJ)

  • Digestive problems, such as abdominal pain, bloating, constipation, and even irritable bowel syndrome (also known as IBS)

Known risk factors include:

  • Age. Fibromyalgia can affect people of all ages, including children. However, most people are diagnosed during middle age and you are more likely to have fibromyalgia as you get older.

  • Lupus or Rheumatoid Arthritis. If you have lupus or rheumatoid arthritis (RA), you are more likely to develop fibromyalgia.

Some other factors have been weakly associated with the onset of fibromyalgia, but more research is needed to see if they are real. These possible risk factors include:

  • Sex. Women are twice as likely to have fibromyalgia as men.

  • Stressful or traumatic events, such as car accidents, post-traumatic stress disorder (PTSD)

  • Repetitive injuries. Injury from repetitive stress on a joint, such as frequent knee bending.

  • Illness (such as viral infections)

  • Family history

  • Obesity

Post-Lyme disease syndrome

• A patient with a documented episode of early or late Lyme disease fulfilling the case definition of the Cen- ters for Disease Control and Prevention [5];

• After recommended treatment of the episode of Lyme disease, these is resolution or stabilization of the ob- jective manifestation(s) of Lyme disease;

• Onset of any of the following subjective symptoms within 6 months of the diagnosis of Lyme disease and

persistence of continuous or relapsing symptoms for at least a 6-month period after completion of antibiotic therapy: fatigue, widespread musculoskeletal pain, complaints of cognitive difficulties, sleep disturbances.

Post-treatment Lyme Disease as a Model for Persistent Symptoms in Lyme Disease

Although fatigue, musculoskeletal pain, and cognitive dysfunction are the most commonly reported symptoms, a host of others, including sleep disruption, paresthesia, headache, dizziness, and mood changes, visual changes are variably distributed across patients