Is CIRS a Real Disease?
Here’s How to Know for Certain

*Note: this blog was written by me, Mark Volmer. All spelling mistakes, misquotes, errors, and omissions are my own doing. It is not AI generated.*

A few years ago, a patient I’ll call Sandra came to see me after a decade of searching for answers. She was exhausted in a way that a stellar sleep could never restore. Her joints ached. Some days, her brain felt like it was on fire; other days, it felt like it was on ice. She had been told, by different doctors over the years, that she had fibromyalgia, then chronic fatigue syndrome, then anxiety.

She came to my clinic skeptical. She had spent years and thousands of dollars chasing diagnoses that never led anywhere. Before we even got to her symptoms, she looked at me and said something I hear often:

I need to know this is actually real before I go down another rabbit hole.

It’s a fair question. A completely reasonable one. And I want to answer it directly.

Yes. CIRS is real. And I can show you exactly why. I’ll use the same framework I use to evaluate any diagnosis.

Why Some Diagnoses Are Real and Others Aren’t (in my opinion) 

Before we put CIRS under the microscope, it’s worth being honest about the fact that not every diagnosis in circulation is legitimate. Some conditions get popular names without the science to back them up.

You may have encountered adrenal fatigue or candida overgrowth as explanations for your symptoms. Both of these are frequently discussed online and in wellness circles. Both are also not recognized as real medical conditions by the evidence-based literature. I’m not saying these conditions don’t exist. Low cortisol levels are a bonafide condition. I see that all the time in CIRS treatment. Same for candida.. I see positive stool tests for candida quite often.

Where I take issue is when these conditions are used to explain a myriad of patient symptoms using DIY testing and without well thought out differential diagnosis. The candida spit test comes to mind. Spit in a glass of water in the morning: if it floats, you’re healthy. If it sinks, you have candida. Insert eye roll.

Again, I’m not saying patients don’t have candida. But let’s validate it clinically. We as practitioners have a duty to the chronically ill. And that duty is to provide them with the best possible evidence. If we don’t have the evidence, we have the duty to tell that to our patients.

Anyways, the problem with a lot of labels like adrenal fatigue and candida overgrowth are that the symptoms are entirely non-specific. Low energy, afternoon crashes, brain fog, and fatigue are symptoms shared by dozens of conditions, from thyroid dysfunction to depression to heart disease. When a symptom pattern fits everything, it diagnoses nothing.

This is important, because it means that not every skeptical doctor who has dismissed a diagnosis was necessarily wrong. Some diagnoses genuinely don’t hold up. I’m not picking on natural health practitioners either (I’m one of them!). Fibromyalgia and chronic fatigue are not much better diagnosis than candida overgrowth.

So, let’s get into it.

Can a CIRS diagnosis hold up to scrutiny? 

The Three-Criteria Test: How to Know If a Diagnosis Is Real

For a condition to qualify as a legitimate medical diagnosis, it needs to pass all three of the following:

1. Specific symptoms described in peer-reviewed literature

• The condition must have a defined, reproducible symptom pattern published in journals. Not on blogs or websites. It needs to be a place where other clinicians and researchers have scrutinized and validated the findings.

2. Objective diagnostic criteria in peer-reviewed literature

• There must be lab tests or measurable markers that can confirm the condition’s presence and track its response to treatment. A diagnosis built entirely on subjective symptoms is, at best, an educated guess.

3. Documented positive response to treatment in both the patient and lab values

• Feeling better alone isn’t enough. That could be placebo. Lab values normalizing alone isn’t enough. A patient could still feel ill. We need both. A normalization in lab values AND the subjective experience o=from the patient of feeling better. Both need to move in the right direction together.

A condition that passes all three is real. Full stop.

Let me show you why fibromyalgia, a diagnosis that so many CIRS patients carry before they find me, fails this test. And then let’s look at CIRS.

Why Fibromyalgia Fails the Test

I want to be careful here. I am not saying that fibromyalgia symptoms aren’t real, they absolutely are. I am saying that fibromyalgia as a diagnosis doesn’t pass the legitimacy test. And that distinction matters enormously for treatment.

Step 1: Specific symptoms?

• Fibromyalgia has a symptom list: widespread pain, fatigue, un-refreshing sleep, cognitive difficulties; but these are entirely non-specific. They describe dozens of conditions simultaneously. Fibromyalgia clears the bar here only barely, and primarily because the cluster has been consistently documented.

Step 2: Objective diagnostic criteria?

• This is where fibromyalgia collapses. The only physical test historically used is the tender-point exam: pressing on 18 specific body locations to assess pain response.
• Eleven of eighteen points need to be tender for a positive result. But fibromyalgia pain is variable by day, by hour, by mood. This test is so unreliable that it has largely been abandoned in modern practice. There are no blood markers. No lab panels. No imaging findings. Nothing objective.

Step 3: Documented treatment response in symptoms and labs?

• Without reliable diagnostic criteria, there is no meaningful way to measure treatment response. If you can’t confirm the diagnosis with a test, you can’t confirm whether treatment is working.

Fibromyalgia fails steps 2 and 3 definitively. At best it is a descriptive label.  A name for a pattern of suffering that hasn’t yet been explained. And in my clinical experience, a substantial number of fibromyalgia patients have undiagnosed CIRS.

Now, Let’s Apply the Same Test to CIRS

Step 1: Does CIRS have specific symptoms in the peer-reviewed literature?

• Yes. And in remarkable detail.
• Dr. Ritchie Shoemaker’s research identified and published 37 individual symptoms across 13 symptom clusters that characterize CIRS. These span the neurological, cardiovascular, respiratory, gastrointestinal, musculoskeletal, and endocrine systems. The symptom cluster has been replicated across thousands of patients and published multiple times in peer-reviewed journals.
• The US Government Accountability Office has also formally recognized CIRS as a legitimate medical condition caused by water-damaged buildings. Thus adding an institutional layer of validation to the peer-reviewed foundation.

These symptoms aren’t vague. Patients with CIRS don’t just have “fatigue.” They have fatigue combined with visual contrast sensitivity loss, elevated MMP-9, low MSH, abnormal C4a, and the specific HLA-DR genetic profile. The pattern is specific. It is reproducible. It is documented.

CIRS passes step 1.

Step 2: Does CIRS have objective diagnostic criteria in peer-reviewed literature?

• This is where CIRS separatesccitself from almost every condition it gets confused with.
• The diagnostic laboratory panel for CIRS includes measurable, quantifiable biomarkers drawn from standard reference labs. These markers reflect the downstream consequences of chronic innate immune dysregulation and include:
  • MSH (Melanocyte-Stimulating Hormone): typically low; a master anti-inflammatory neuropeptide
  • TGF-β1 (Transforming Growth Factor Beta-1): typically elevated; drives autoimmune-like inflammation
  • C4a: typically elevated; a complement split product that rises within hours of biotoxin exposure
  • MMP-9 (Matrix Metalloproteinase-9): typically elevated; causes tissue breakdown across multiple systems
  • VEGF (Vascular Endothelial Growth Factor): typically low; explains exercise intolerance and fatigue
  • HLA-DR genetics: confirms the genetic susceptibility that drives the mechanism of illness
  • ADH and osmolality: often dysregulated; explains excessive thirst, urination, and static shocks
  • ACTH/cortisol: often abnormal; explains dysregulated stress response

Beyond blood markers, the Visual Contrast Sensitivity (VCS) test detects CIRS-specific changes in a nerve pathway of the eye and has been documented in Shoemaker’s published work to be positive in the majority of CIRS patients.

Structural brain changes have also been documented. Shoemaker and colleagues published MRI findings showing measurable grey matter loss and specific volumetric changes in CIRS patients compared to controls. This shows objective neuroimaging evidence of what the disease is doing to the brain.

CIRS passes step 2  definitively.

Step 3: Is there documented positive response to treatment in both symptoms and lab values?

• This is the criterion I find most meaningful, because it connects science to people.
• A 2024 peer-reviewed literature review published in PMC examined published treatment outcomes across CIRS, ME/CFS, and Sick Building Syndrome. The finding was unambiguous: the Shoemaker Protocol was the only treatment with documented clinical efficacy. It was referenced in 11 of the 13 articles that addressed CIRS treatment.

Dr. Shoemaker’s own published data covers more than 6,000 patients treated across all 50 US states and 30 countries. Including more than 2,000 cases and 450 controls. These datasets document improvements in both subjective patient experience and objective lab normalization across every major biomarker in the CIRS panel.

This matters because the protocol’s treatment response isn’t just “patients feel better.” Inflammatory markers fall. Neuropeptide levels rise. VCS scores normalize. HPA-axis dysregulation corrects. These are measurable, reproducible, documented changes in the underlying biology.

CIRS passes step 3 with data from thousands of patients.

A Note on Why Your Previous Tests Came Back “Normal”

This is something I need to address directly, because it’s one of the most disorienting experiences CIRS patients carry into my clinic.

Your labs came back normal because the wrong labs were run.

A standard metabolic panel, CBC, thyroid panel, and inflammatory markers like CRP and ESR are the tools of conventional medicine. They are useful for what they are designed to detect. They were not designed to detect chronic innate immune dysregulation from biotoxin exposure. They will look completely normal in a person with severe CIRS.

The CIRS biomarker panel: C4a, TGF-β1, MMP-9, MSH, VIP, VEGF, HLA-DR, ADH/osmolality is not part of routine bloodwork. Most physicians have never ordered these tests. Most labs can run them, but no one ever asks.

When Sandra heard this for the first time, she was quiet for a long moment. Then she said:

So I wasn’t crazy. Someone was just looking in the wrong drawer.

That’s exactly right.

What CIRS Getting Dismissed Actually Costs People

I want to be direct about something, because I think it matters.

The years that patients like Sandra spend in diagnostic limbo are not neutral. They are years of disability, of relationships strained by illness, of careers derailed, of hope gradually eroding. The dismissal of CIRS as a fringe diagnosis is not a minor inconvenience, it is a genuine harm being done to people with a real, treatable condition.

CIRS has peer-reviewed symptom documentation. It has objective diagnostic biomarkers. It has published treatment outcomes spanning thousands of patients. It passes every criterion we use to establish medical legitimacy.

The fact that most physicians don’t know about it is a gap in medical education, not a gap in the evidence.

You Deserve a Real Diagnosis

If you are reading this because you are carrying a diagnosis that doesn’t explain you, or no diagnosis at all,  I want you to know something.

Your symptoms are real. They have not been properly investigated yet.

You can start by taking our free mold illness quiz to see if your symptom pattern fits CIRS. If it does, I’d encourage you to book a discovery call with our team at Flourish Clinic. We don’t rush this. We take the time to look at your whole picture before we make any recommendations.

You’ve been sick long enough without an explanation. Let’s find the right one.

 

Mark Volmer, FMP, is a certified Shoemaker Protocol practitioner and Clinical Director of Flourish Clinic in Cochrane, Alberta. He specializes in CIRS, chronic fatigue, and complex chronic illness. He is one of only two certified Shoemaker Protocol practitioners in Canada.