You have a friend or loved one who has CIRS (Chronic Inflammatory Response Syndrome).
First, let’s clear up any doubt: CIRS is very real.
CIRS stands for Chronic Inflammatory Response Syndrome, a complex, multi-system illness caused by biotoxin exposure. It was first identified and mapped out by Dr. Ritchie Shoemaker, who developed the only peer-reviewed, evidence-based treatment protocol for CIRS.
This page is for you—the partner, friend, or family member—trying to understand what your loved one is going through, and how best to support them.
What is CIRS?
CIRS is a condition that arises when the immune system is triggered by biotoxins—such as mold, Lyme bacteria, or toxic algae—and fails to return to a balanced state.
Our immune system is made up of two main parts:
- Innate immune system: The first responder. It reacts quickly to threats like viruses and bacteria, typically using inflammation as a defense.
- Adaptive immune system: The strategist. It analyzes threats and creates long-term immunity.
In people with CIRS, the adaptive immune system doesn’t activate properly in response to biotoxins. That leaves the innate immune system stuck in “attack mode,” generating widespread inflammation that never turns off. It’s this runaway inflammation that causes the complex and often misunderstood symptoms your loved one is experiencing.
What causes CIRS?
CIRS is most commonly triggered by exposure to biotoxins, which can come from:
- Mold in water-damaged buildings (WDB)
- Bacterial toxins from infections like Lyme disease (Borrelia burgdorferi)
- Endotoxins
- Algal toxins from blue-green algae blooms
These toxins are often invisible. Mold, for instance, doesn’t need to be visible or have a musty smell to make someone sick. It can hide in walls, HVAC systems, carpeting, and furniture—and just 48 hours of moisture is enough to create a toxic indoor environment.
Why Your Loved One Reacts—Even If You Don’t
It’s easy to question how a building can make someone so sick—especially when it seems to have no effect on others. But approximately 24% of people carry a genetic variant that prevents them from clearing biotoxins from their system. For these individuals, even minor exposures can lead to debilitating illness.
Once this gene is activated (by infection, trauma, or inflammation), the immune system becomes hypersensitive to future exposures. Every time your loved one enters a water-damaged space, their symptoms worsen—often significantly.
The so-called CIRS gene must be activated for the immune system to be triggered. The gene can be activated by infection, allergic reaction, pregnancy, surgery, severe physical or emotional trauma, or any event that results in acute inflammation. Once the gene turns on, every exposure to a water-damaged building will make your loved one sicker and sicker.
Mold does not even need to be visible to make your loved one sick. They may be inhaling microscopic particles of mold toxins from heating or air conditioning ducts, carpets, upholstered furniture, and air drawn from within wall spaces in tightly sealed buildings.
Only 48 hours of dampness from a minor leak or water intrusion is enough to make carpet, drywall, furniture, and other porous surfaces a reservoir of mold, mold fragments, bacteria, and mold/bacterial toxins.
Your loved one must avoid exposure to water-damaged buildings. Failure to follow this advice will make recovery impossible. Please understand if a friend or family member tells you they can’t visit your home, workplace, or favorite restaurant. Their health depends on it!
How to Support Your Loved One
One of the most important things you can do is believe them and support their need to avoid exposure. If they say they can’t come to your house, workplace, or a restaurant due to air quality—it’s not a personal rejection. It’s a medical necessity.
Support also means being patient. Many people with CIRS experience cognitive issues, mood changes, and fatigue that affect how they show up in relationships. Your understanding and empathy can make all the difference.
What to Say (and What Not to Say)
Supporting someone with CIRS involves both your actions and your words. Here are a few tips:
Helpful things to say:
- “I believe you.”
- “How can I help make this space safe for you?”
- “I’m learning more about CIRS so I can better understand.”
Avoid saying:
- “You don’t look sick.”
- “It’s probably just allergies.”
- “It’s all in your head.”
Empathy and curiosity go a long way in building trust and helping your loved one feel less isolated.
Coping with Lifestyle Changes as a Family
CIRS doesn’t just affect the person diagnosed—it can impact entire households. You may need to:
- Avoid burning candles, using scented products, or bringing home secondhand furniture
- Support remediation efforts in the home
- Change travel plans or social habits to accommodate their needs
These shifts can be inconvenient, but they’re often essential for recovery. Open communication and shared problem-solving can help everyone adjust.
Taking Care of Yourself, Too
Caring for someone with a chronic illness can be emotionally exhausting. It’s okay to have your own feelings—grief, confusion, anger, or fear. Don’t ignore your needs.
- Seek out your own support system
- Learn about the illness so you feel empowered, not overwhelmed
- Take breaks when you need to recharge
You can only support your loved one well if you’re taking care of yourself, too.
How is CIRS treated?
he only scientifically validated treatment for CIRS is the Shoemaker Protocol, a 12-step process developed by Dr. Ritchie Shoemaker. This protocol typically takes 12–18 months and must be completed in sequence under the guidance of a certified Shoemaker practitioner.
Treatment includes:
- Removing all biotoxin exposures (especially mold)
- Using binders to help the body clear toxins
- Correcting inflammation, hormonal imbalances, and immune dysfunction
CIRS cannot be treated with a single medication or supplement. It requires a comprehensive and disciplined approach. 88% of patients improve significantly when they follow the full protocol.
A Final Note for Family and Friends
CIRS is an invisible illness that demands visible support. Your loved one is navigating a complicated, exhausting recovery. Your role as a supportive partner or friend—validating their experience, learning about the illness, and adapting your environment when needed—can make a profound difference.
If you have questions or would like more resources, we’re here to help.
Mark Volmer has attained the highest level of Shoemaker Protocol certification, and is one of only two of Canada’s Shoemaker Protocol practitioners. The Shoemaker Protocol is the only scientifically proven method of treating CIRS.
