Long COVID and CIRS: The Connection Nobody Is Talking About

 

*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.*

If you’re a COVID long hauler, you already know the frustration. You survived the infection. You did everything right. But weeks turned into months, and you’re still exhausted, foggy, achy, and running out of explanations. 

I want to offer you a different framework for understanding what might be happening in your body. Because when I look at long COVID through the lens of a Chronic Inflammatory Response Syndrome (CIRS) practitioner, something jumps out immediately: these two illnesses look remarkably alike. Not just in symptoms, but at the level of cellular biology.

That’s not a coincidence I’m willing to ignore.

What Is Long COVID, Exactly?

Long COVID also called post-COVID condition or post-acute sequelae of SARS-CoV-2 (PASC):  is a complex, multi-system illness that affects up to 36% of people who contracted COVID-19. It has no single defining feature. Every patient seems to experience it a little differently, which has made it frustratingly difficult for the medical community to define, diagnose, and treat.

The World Health Organization describes post-COVID condition as occurring in individuals with a confirmed or probable history of SARS-CoV-2 infection, usually three months after onset, with symptoms lasting at least two months that cannot be explained by another diagnosis.

Common symptoms include:

• Fatigue and post-exertional malaise
• Shortness of breath
• Cognitive dysfunction and brain fog
• Headaches
• Joint and muscle pain
• Sleep disturbances
• Mood changes
• Gastrointestinal symptoms including diarrhea and nausea
• Loss of or distorted sense of smell
• Temperature dysregulation
• Heart palpitations

Long COVID can affect virtually every system in the body: respiratory, neurological, cardiovascular, metabolic, gastrointestinal, and musculoskeletal. That breadth is one of the things that makes it so hard to pin down.

Sound familiar? It should. Because if you’ve ever read about CIRS, you’ve seen this list before.

What Is CIRS: And Why Does It Matter Here?

CIRS, or Chronic Inflammatory Response Syndrome, is a multi-system, multi-symptom illness triggered by an exposure to biotoxins. Biotoxins that most commonly come from water-damaged buildings. It was rigorously defined and characterized by Dr. Ritchie Shoemaker, and there is now a peer-reviewed, validated treatment protocol: The Shoemaker Protocol.

I’m one of two Shoemaker Protocol-certified practitioners in Canada, and I’ve worked with hundreds of patients who presented with chronic fatigue, brain fog, pain, and a long list of symptoms that no one had been able to explain. CIRS was the answer.

Here’s the symptom list that CIRS practitioners use in clinical practice. I want you to read it slowly, especially if you’re a long hauler:

Fatigue, weakness, aches, cramps, unusual pain, ice-pick pain, headache, light sensitivity, joint pain, memory problems, difficulty focusing or concentrating, mood swings, appetite swings, night sweats, static shocks, numbness, tingling, red eyes, blurred vision, tearing, sinus congestion, cough, shortness of breath, abdominal pain, diarrhea, confusion, disorientation, skin sensitivity, temperature dysregulation, excessive thirst, increased urination, vertigo, tremors, and metallic taste in the mouth.

How many of those apply to you?

If you checked off eight or more, I’d encourage you to keep reading because this overlap is not superficial.

The Biological Parallels Between Long COVID and CIRS

Beyond the symptom overlap, both illnesses share a number of striking biological and clinical characteristics that, in my clinical view, can’t be dismissed as coincidence:

• Both are progressive.
  • Without treatment, CIRS doesn’t stay stable, it changes over time. The same pattern appears in long COVID. Patients who don’t get better on their own tend to have labile symptoms.
• Both are driven by measurable inflammatory and metabolic dysfunction.
  • These aren’t illnesses without objective markers. Both long COVID and CIRS produce quantifiable changes in biomarkers, gene expression, and cellular function.
• Both are worsened by re-exposure.
  • CIRS patients relapse or decline when they return to a water-damaged building. Similarly, long COVID patients often worsen with re-infection or viral re-exposure.
• Both rarely resolve on their own.
  • Spontaneous recovery happens, but it’s the exception. The majority of patients need a structured, targeted treatment approach to improve.

These parallels alone would be enough to make a clinician curious. But there’s now research that takes the comparison much further.

What the Research Shows: A Study Worth Your Attention

A published study in the Medical Research Archives compared patients with long COVID and patients with CIRS across several measurable biological markers. The results were striking.

The Visual Contrast Sensitivity (VCS) Test

One of the tools I use when evaluating a potential CIRS patient is the Visual Contrast Sensitivity (VCS) test. Approximately 95% of people with confirmed CIRS fail the VCS test. Controls (people without either illness) fail it at a rate of 0–2%.

In the long COVID study, 75% of participants failed the VCS test.

Coincidence? Unlikely. 

Molecular Hypometabolism (MHM)

This one gets a bit technical, but stay with me, it’s worth understanding.

Dr. James Ryan, one of the leading researchers in CIRS, coined the term molecular hypometabolism (MHM) to describe suppressed messenger RNA (mRNA) activity, particularly in the mitochondria. Your mitochondria are your cells’ power plants. When CIRS suppresses mitochondrial mRNA activity, your cells produce less energy (ATP). The resulting effect: you feel profoundly fatigued.

Around 80% of CIRS patients show evidence of MHM. In the long COVID cohort studied, MHM was present in 100% of cases. Zero controls had it.

This matters enormously because it tells us that long COVID isn’t simply lingering inflammation. There is something happening at the level of gene expression and cellular energy production. It’s the same kind of disruption we see in CIRS. 

Impaired Cellular Energy Production

Here’s the energy production piece in plain terms. Your body converts glucose (from the food you eat) into ATP: the fuel your cells actually run on. This process depends on a molecule called pyruvate entering your mitochondria and running through the Krebs cycle, which is highly efficient: one molecule of pyruvate produces roughly 26 molecules of ATP.

When pyruvate can’t get into the mitochondria properly, your body falls back on an older, far less efficient pathway called glycolysis. A pathway which produces only about 2 ATP per molecule of glucose. The result is that your cells are running on backup power. Your battery is always low. No amount of sleep or rest fixes it, because the problem isn’t effort. It’s fundamental cellular energy failure.

Compromised energy production of this kind was found in 79% of long COVID patients in the study. In CIRS patients, the rate is 88%.

How many control patients had this phenomenon?

ZERO. 

What This Data Means. And What It Doesn’t

I want to be honest with you about the limitations of this study. Twenty-one participants is not a large sample. We can’t draw firm causal conclusions from it. More research is needed, and I say that sincerely not as a disclaimer.

But the directionality of every single finding points the same way. VCS failure, molecular hypometabolism, cellular energy dysfunction… All of them are elevated in long COVID at rates that closely mimic CIRS. None of the healthy controls showed these markers. That’s not coincidence. That’s a pattern.

There’s another piece of this worth sitting with. The authors note that the data suggests many long COVID patients may have had a prior biotoxin exposure. Perhaps mold in a water-damaged building before they ever contracted COVID. The viral infection may have been the straw that broke the camel’s back in an immune system already under strain.

The study didn’t include environmental sampling to test this hypothesis directly, but it’s a logical and testable next step. One I hope future researchers will pursue.

Could the Shoemaker Protocol Help Long Haulers?

This is the question I keep coming back to.

The Shoemaker Protocol is a 12-step, evidence-based treatment framework that has been validated in multiple peer-reviewed studies for the treatment of CIRS. It works systematically.  

Given how closely long COVID mirrors CIRS, in symptom profile, in biological markers, in clinical behaviour,  it is a reasonable, evidence-grounded hypothesis that long COVID patients may respond to the same protocol. Not every patient will have the same underlying picture. But for those who do, this could be the framework that finally moves the needle.

I’m not claiming to have the cure for long COVID. No one has that. What I am saying is that there is a new way to look at this illness. One that opens up new diagnostic tools and new treatment pathways that most long haulers have never explored.

A Practical Next Step

If you’ve been struggling with long COVID and any of the following are true, it may be worth pursuing a CIRS workup:

• You checked off eight or more symptoms from the CIRS list above
• You failed the Visual Contrast Sensitivity test online
• You have a history of living or working in a water-damaged building
• Your conventional testing has come back normal, but you’re clearly not well
• Your symptoms have worsened over time rather than gradually improving

A formal CIRS evaluation involves specific lab markers, a VCS test, a detailed history, and in some cases, environmental testing of your home or workplace. It’s not a simple process but if this post is resonating with you, it can be the beginning of a real answer.

CIRS and Long COVID: Next steps

Long COVID is still being unraveled. Anyone who tells you otherwise is oversimplifying a genuinely complex and evolving picture. But complexity is not the same as hopelessness.

The data connecting long COVID and CIRS is preliminary, but it is compelling. Two illnesses that look alike on the surface also appear to share the same cellular and molecular fingerprints. That parallel deserves serious scientific attention.

If this post resonates with you, I’d encourage you to learn more about CIRS and reach out. There may be more options than you think.