Chronic Inflammatory Response Syndrome: Treatment & Recovery Tips That Actually Work
It often starts with the kind of fatigue you can’t shake. Not tiredness. Not burnout. But a bone-deep exhaustion that no amount of sleep or supplements seems to touch. Maybe your muscles ache without reason, or your brain feels like it’s trapped in a fog. One day you notice that you’re reacting to scents that never used to bother you. The next, you’re struggling with dizziness, night sweats, gut issues, and a growing list of food sensitivities. Your doctor runs bloodwork, and everything comes back “normal.”
Sound familiar?
If you’re nodding along, you’re not alone. Many people are quietly battling Chronic Inflammatory Response Syndrome (CIRS) without ever hearing the name.
Let’s change that.
What Is Chronic Inflammatory Response Syndrome (CIRS)?
CIRS is a complex, multi-system, multi-symptom illness that occurs when a genetically susceptible person is exposed to a biotoxin—most commonly from water-damaged buildings (mold), though it can also come from Lyme disease, cyanobacteria in freshwater, actinobacteria from your home or skin, endotoxins from sewer pipes, and most recently beta glucans. The immune system, instead of clearing the toxin, becomes dysregulated. This results in widespread inflammation that can affect nearly every system in the body.
A landmark study by Dr. Ritchie Shoemaker identified that approximately 24% of the population is genetically predisposed to develop CIRS after biotoxin exposure. (Shoemaker et al., 2010)
Why Most CIRS Treatments Fail
A lot of people with CIRS symptoms are treated for everything but CIRS. They’re told they have fibromyalgia, chronic fatigue syndrome (CFS), irritable bowel syndrome, depression, or anxiety. Sometimes they’re placed on SSRIs or prescribed low-dose naltrexone. Others are sent for cognitive behavioural therapy or handed a stack of supplement bottles, including binders like activated charcoal or glutathione, without any lab work to guide treatment or evidence to support said supplement’s efficacy.
And increasingly, patients are being diagnosed via urinary mycotoxin testing, which sounds promising but is not a valid method of diagnosing CIRS. In fact, a 2019 review concluded that urinary mycotoxin testing lacks specificity and reliability in diagnosing mold-related illness.
The Shoemaker Protocol: The Only Peer-Reviewed Treatment for CIRS
While countless “mold detox” programs exist online, the Shoemaker Protocol remains the only medically recognized and peer-reviewed method of diagnosing and treating CIRS. It is evidence-based, structured, and highly individualized.
It involves a sequential, step-by-step process that addresses the root immune dysfunction, rather than just managing symptoms. Here’s a simplified overview:
- Remove exposure to biotoxins** (most often mold from water-damaged buildings).
- Bind and remove biotoxins from the body using a bile acid sequestrant like cholestyramine or Welchol.
- Test for and correct (if needed) MARCoNS colonies
- Rebalance hormones (primarily androgens)
- Correct ADH and osmolality
- Correct inflammatory markers such as C4a, MMP-9, TGF-beta1.
- Address neuroinflammation and VEGF (common in long-term CIRS) using therapies like intranasal VIP.
What most websites don’t tell you is that skipping steps—or self-medicating with binders—can worsen symptoms. That’s because the immune system remains dysregulated until inflammation is corrected at the cellular level. It’s like trying to drain a flooded basement while the pipes are still leaking.
Every week we have a potential patient tell us that the Shoemaker protocol didn’t work for them. After further discussion we quickly learn that they’ve been treating MARCoNS or tried DHEA supplementation and neither helped. And it never will. The Shoemaker protocol is designed to be completed in sequence. We need to start at the start – every time.
The start is always removing you from exposure. It’s the hardest and most important step in all of treatment. No treatment is going to work so long as you remain exposed to biotoxins. Period.
The Role of Neuroinflammation in CIRS
One of the lesser-discussed but critical features of CIRS is its effect on the brain. MRI studies (NeuroQuant imaging) have shown that patients with CIRS often have volume loss in the caudate nucleus and gray matter, along with swelling in the forebrain and amygdala. This leads to symptoms like memory loss, emotional instability, poor concentration, and sleep disruption.
The Shoemaker Protocol includes tools to reverse these changes—not just manage them. Treatment with VIP (vasoactive intestinal peptide), for example, has been shown to normalize brain inflammation, reduce symptom clusters, restore grey matter nucleic, and improve visual contrast sensitivity (VCS), which is often impaired in CIRS.
Why Recovery Takes More Than Supplements
CIRS is not a condition that can be solved with supplements alone. In fact, indiscriminate supplement use can sometimes worsen symptoms—especially in patients also dealing with mast cell activation syndrome (MCAS) or multiple chemical sensitivities (MCS). These conditions often overlap with CIRS, and they require a careful, medically guided approach.
At Flourish Clinic, we specialize in helping patients with CFS, fibromyalgia, MCAS, and MCS navigate the Shoemaker Protocol. Our team is trained to interpret the specific lab markers required to make an accurate diagnosis, and we understand how to modify the protocol to suit each patient’s biochemistry, environment, and tolerance level.
Real Recovery Is Possible
Let’s be honest: recovery from CIRS is not fast. It’s an ultra-marathon, not a sprint. But with the right roadmap, it is possible to feel like yourself again.
Here are some lesser-known recovery tips that go beyond the protocol:
- Prioritize sleep hygiene: Deep, restorative sleep reduces neuroinflammation and supports immune regulation.
- Avoid immune triggers: That includes not just mold, but fragrances, certain foods, and stressful environments.
- Use nasal sprays wisely: MARCoNS (multiple antibiotic-resistant coagulase-negative staph) colonization in the sinuses is common in CIRS and must be treated appropriately.
- Track your VCS test: This visual test offers a reliable, non-invasive way to measure recovery over time.
- Address emotional trauma: Limbic system retraining, somatic therapy, and gentle neuroplasticity work can help calm the overactive danger response wired into many CIRS patients’ brains.
- Balance your blood sugar: A lot of CIRS patients have extreme dysregulation in their blood sugar levels. Using a continuous glucose monitor can give you invaluable data regarding how your food choices are affecting your energy.
Why a DIY Approach Can Backfire
Because CIRS is still relatively unknown in conventional medicine, many patients try to cobble together their own recovery based on forums, social media, and guesswork. While it’s empowering to take charge of your health, the truth is: CIRS is too complex to DIY. I’m not saying this as a practitioner wanting you to work with my clinic. I’ve seen the DIY method hundreds of times. I’ve never seen it lead someone through to cure.
Some of the most common missteps of the DIY method include:
- Misdiagnosing yourself with mold illness based on urine tests can lead to unnecessary detox protocols.
- Misinterpreting lab values.
- Using binders that don’t work.
- Pursuing treatments for parasites, hidden infections, heavy metals, or other mystery illnesses.
- Skipping necessary lab testing.
- Improper sampling techniques for home testing can lead to false negatives.
- Applying contractor-level remediation techniques when a medical-level of remediation is required.
- Mis-identifying which biotoxin is triggering/maintaining the illness.
- Ignoring or not identifying environmental exposures outside of the home can lead to endless relapse cycles.
DIY initially seems like it will save you money. But what I see time and time again is years wasted, thousands of dollars spent, and a deep distrust in any future treatments being beneficial. The fastest, most cost-effective way to overcome CIRS is to work with a Shoemaker trained provider.
That’s why Flourish Clinic is committed to a medically guided approach. We’re not here to sell you products—we’re here to guide your recovery using the only proven method that gets to the root cause.
Final Thoughts
If you’ve been living with unexplained fatigue, pain, sensitivities, or brain fog—and nothing has worked—there’s a chance you’re dealing with CIRS. With the Shoemaker Protocol, there is hope. Real, clinical, measurable hope.
Are you ready to find out what’s actually causing your symptoms?
