What is the most effective Mold Illness Treatment?
Your guide to the four thought leaders in mold treatment
This is an introduction to a series of blogs where I map the major thinkers in CIRS and mold-related illness: what each one believes, where each one is strong, and where each one breaks down.
This four-part series is a passion project for me. It’s something I’m thrilled to be writing 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. *
Expert Recap: The Most Effective Mold Illness Treatment
Now that a mold illness/CIRS diagnosis has become more widely accepted in the medical space, multiple practitioners are offering treatment based on different points of view. Each practitioner claims success in their space, proving that their method of treatment, and only their treatment, works to treat mold illness/CIRS:
- Dr. Shoemaker focuses on the body’s reaction.
- Dr. Nathan and Dr. Crista look at the patient’s capacity to be treated.
- Dr. Campbell points at the immune system’s reaction to a toxin.
- Dr. Holtorf examines at the underlying immune dysfunction.
On closer inspection, you realize that these aren’t four competing answers to one question. They’re four different layers of the same sick patient.
This is because complex chronic illness requires complex treatment.
Who has the most effective mold illness treatment?
More and more over the last few years, patients come to our clinic saying they have CIRS or mold illness and that they want treatment. It’s a completely different world from only a few years ago, when our clinic team had to introduce CIRS to every patient who was suffering from CFS or fibromyalgia.
With this shift in awareness, we have new interpretations and understandings of how mold illness should be diagnosed and treated. This is an exciting development for the space. But with this explosion in knowledge, we inevitably have conflicting points of view.
Here lies the problem in the CIRS/mold illness space:
Who offers the best mold illness treatment?
After doing some online searching, most patients will have come across the following experts and their conflicting treatment methods:
- Dr. Ritchie Shoemaker tells you the answer is in your bloodwork; that there’s a specific pattern of inflammatory markers that define the illness.
- Dr. Jill Crista and Dr. Neil Nathan tell you the bloodwork misses the point, urinary mycotoxins are how to test and what really matters is whether your nervous system is calm enough to tolerate treatment at all.
- Dr. Andrew Campbell says you should be measuring your body’s immune response to mycotoxins.
- Dr. Kent Holtorf says you’re chasing the wrong thing; the real problem is a broken immune system, and you can fix it with peptides.
For a patient who is exhausted, cognitively foggy, and desperate for a clear path, this is maddening. It can feel like the field is a mess, or that nobody really knows anything.
What if we looked at it differently?
What if these viewpoints are not contradictory, but complementary?
After years of treating complex chronic illness (specifically, patients who don’t respond to or tolerate treatment), I’ve come to believe these camps aren’t actually contradicting each other. They’re answering the same question in four different ways. Once you see the question they’re each answering, the whole field stops looking like chaos and starts looking like different parts of a whole.
The question is:
What is making you sick?
My experience with mold illness treatment
Before I introduce you to the four thought leaders in mold illness, let me tell you about where I’m coming from:
Dr. Ritchie Shoemaker and the Shoemaker Protocol
I’m intimately familiar with the Shoemaker Protocol. I studied directly with Ritchie and have been following his work for more than a decade.
Dr. Jill Crista and Dr. Neil Nathan
I have read all of Dr. Neil Nathan’s and Dr. Jill Crista’s books. I took Dr. Crista’s practitioner training but stopped before completing it as I did not find the information was at the level I needed it to be for my complex patients.
Dr. Andrew Campbell
I’m familiar with Andrew Campbell through my readings on his research and the information posted on his website.
Dr. Kent Holtorf
I’m using Kent Holtorf as a placeholder for the use of peptides to treat complex chronic illness. I’ve read Holtorf’s work on why he thinks the Shoemaker Protocol is misguided and I greatly appreciate how he is integrating and shifting the thinking around peptides and complex chronic illness.
I’ve also studied and am familiar with the following experts in chronic illness:
Dr. Jack Kruse
I integrate Jack Kruse’s quantum biology principles into my thinking; especially in the context of mitochondrial health and function.
Dr. Robert Naviaux
Robert Naviaux’s work on the Cell Danger Response is truly remarkable. I use his philosophical lens to explain and understand how cell physiology changes in the face of chronic illness.
Dr. Bruce Hoffman
I also took Bruce Hoffman’s practitioner training course where he integrates a unique point of view that blends Naviaux’s Cell Danger Response with Kruse’s quantum biology through a practical approach as a clinician, not a researcher. I did not complete the training with Hoffman as I found the information was not at the level I needed it to be for my patient population.
All this to say, I’m writing this series of posts as someone who has invested a lot of time in each expert’s point of view. Each practitioner makes great arguments for their cases and they all have glaring blindspots (as do I). My hope is that this article shows you that the most effective mold illness treatment has to focus on the unique individual in front of you.
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Camp 1: Dr. Ritchie Shoemaker
Your innate immune system is making you sick
This is the position of Dr. Ritchie Shoemaker, the physician who coined the term CIRS: Chronic Inflammatory Response Syndrome. If not for Dr. Shoemaker, there would be no mold illness revolution.
Dr. Shoemaker’s argument is that the problem isn’t really the mold. It’s what your body does in response to the mold. In genetically susceptible people, biotoxin exposure triggers a sustained, self-perpetuating activation of the innate immune system. That cascade is measurable. There is a specific signature of inflammatory markers, and a specific pattern of gene expression that defines the illness.
Mold is the trigger. But your symptoms are maintained by an unpredictable innate immune system.
What makes the Shoemaker camp distinctive is its insistence on objectivity. You can prove someone has CIRS. You can prove when they no longer have CIRS. The treatment is a defined, rigidly sequential protocol. You don’t move to the next step until you’ve completed the previous one.
He has also discovered that mold makes up a very small percentage of CIRS cases. The main drivers of this illness are actinomycetes, endotoxins, and beta glucans. This is something all the other camps are missing.
The Shoemaker camp is the most rigorous, most reproducible, most published approach in the field. It is also the most demanding of both the patient and of the practitioner. This is both its greatest strength and weakness.
Read my in-depth breakdown, Does the Shoemaker Protocol work?
Camp 2: Dr. Neil Nathan and Dr. Jill Crista
Mold is inside of you and it’s making you sick
This is the territory of Dr. Neil Nathan and Dr. Jill Crista, who now teach together and represent, in different ways, a more individualized and patient-centred school of thought.
Their argument starts from an observation that anyone treating CIRS patients eventually runs into: some people are so sensitive that they can’t tolerate treatment at all. Give them a binder, and they crash. Try to detox them, and they get worse. For this population, the bottleneck isn’t identifying the right protocol, it’s that their system is too reactive to receive any protocol.
So this camp reframes the issue. The problem isn’t only the inflammation or the toxin; it’s the state of the patient’s nervous and immune system. The cell danger response, limbic and vagal dysregulation, mast cell activation. Before you can treat anything, you have to calm the system down. The watchword is “low and slow.” Dr. Crista adds an accessible, naturopathic, food-and-foundations-first layer; Dr. Nathan brings the framework for the hypersensitive patient.
This is the most humane corner of the field. It meets patients where they are, and it rescues exactly the people the rigid protocols leave behind. Its weakness, as we’ll see, is the flip side of that flexibility: when the endpoints are soft and the diagnosis leans on clinical intuition, it gets harder to say objectively what’s wrong and when it’s fixed.
Camp 3: Dr. Andrew Campbell
Your adaptive immune system is reacting to a toxin
This is the position of Dr. Andrew Campbell, an immunologist who has spent his career on toxic exposures.
It’s tempting to summarize this viewpoint as “just measure the toxin,” but that’s not quite what Dr. Campbell argues. Dr. Campbell is openly skeptical of measuring mycotoxins via urine (urinary mycotoxin tests). He states that urine is excretion, and a high level in the urine may mean your body is successfully clearing the poison. This is a good sign, but not a diagnosis.
What Dr. Campbell wants to measure instead is your immune system’s response to mycotoxins: the IgG and IgE your body produces when it reacts to them. This is along the lines of a food sensitivity test. Dr. Campbell’s reasoning is that your immune system is unique to each person, so there is no one-size-fits-all protocol. The right question is simply whether this specific patient’s immune system has mounted a reaction to mold’s toxins.
The appeal here is a kind of biological logic. Rather than chasing toxin levels that come and go, you ask whether the body has registered the toxins as a threat and responded. What is very appealing about this point of view is that you can track that response over time. Lessen the mycotoxin burden, and you’ll see your immune system respond in favourable direction.
The trouble is that the antibody test at the centre of this approach hasn’t been independently validated the way its strongest claims suggest, and Campbell himself directs the laboratory that sells it.
Camp 4: Dr. Kent Holtorf
Immune dysfunction is the root cause
This is the most directly oppositional camp to Dr. Shoemaker’s work.
Dr. Holtorf’s argument cuts underneath all the others. He asks, Why do some people get devastatingly ill from a building that barely affects the person sitting next to them?
The answer he has come up with isn’t genetics and it isn’t the dose of toxin. It’s that the susceptible patient already had a dysfunctional immune system. The mold didn’t create the problem so much as expose a problem that was already present.
Treat the immune dysfunction directly (primarily with what he calls bioregulators) and Dr. Holtorf argues you can augment or even replace large parts of the Shoemaker Protocol, faster and with better tolerance. He’s explicit that this is a challenge to the established approach, not a supplement to it.
For a clinic like mine that spends its days with non-responders, this camp is impossible to ignore, because it offers tools for exactly the patients who have been unable to tolerate everything else. But bold claims like “rapid,” and “superior efficacy” are currently not reflected in the published evidence, and the entanglement between the protocol and the products it requires deserves a critical look. We’ll give it one.
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What every camp is missing
These four camps are presented as rivals. Patients and practitioners side with one and call the other camps bogus. But look again at what each one is actually claiming:
- Dr. Shoemaker is describing the host’s inflammatory response: the body’s reaction.
- Dr. Nathan and Dr. Crista are pointing at the nervous system’s tolerance: the patient’s capacity to be treated at all.
- Dr. Campbell is pointing at the immune system’s reaction to a toxin.
- Dr. Holtorf is pointing at the underlying immune dysfunction: the terrain that made the patient vulnerable in the first place.
Those aren’t four competing answers to one question. They’re four different layers of the same sick patient:
- The exposure,
- The immune terrain that let it take hold,
- The inflammatory cascade it set off, and
- The state of the nervous system that now governs how much treatment the patient can handle.
All of these are real, and all of them are present, in varying proportions, in the people I see.
The thing that keeps patients stuck is practitioners arguing that their point of view is the only point of view. It isn’t. The art of treating complex cases is figuring out which layer needs your immediate attention for the patient sitting in front of you.
That’s the lens I’ll carry through the rest of this series. In the posts that follow, we’ll go through each practitioner’s point of view and lay out the strongest and weakest points.
In my opinion, to best serve the chronically ill, we need to set aside our desire to be right and instead focus on the human being in front of us. The goal of this series is to understand where each camp is right, what each camp misses, and how to discern which point of view to focus on for each patient now and down the line.
Because the patients who land in my office are usually the ones for whom a single camp’s answer already failed. Helping them starts with understanding the whole map.
Next in the series: Dr. Ritchie Shoemaker and the case for CIRS.
Ready to start real recovery?
Book a consult with our team today.
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.
