What to Ask Before Starting the Shoemaker Protocol: A Patient’s Guide To Finding The Right Practitioner
A Story Too Many Patients Know
You’ve finally discovered Chronic Inflammatory Response Syndrome (CIRS). Maybe it was after years of fatigue, brain fog, pain, or mysterious symptoms that no doctor could explain. Maybe it was after bouncing between specialists who gave you labels like fibromyalgia, chronic fatigue syndrome, or depression.
Now you’ve found the Shoemaker Protocol—the only peer-reviewed, evidence-based treatment path for CIRS. You feel both relieved and anxious: Finally, an explanation! But also, How do I find the right person to guide me through this?
Not all providers have the same level of training or experience. Some may say they treat mold illness, but only a handful are actually Shoemaker-certified or follow the protocol properly. That’s why asking the right questions before you begin is so critical.
This guide gives you a practical checklist of questions to ask, so you can feel confident choosing the right provider to walk alongside you in recovery.
1. Are You Shoemaker Certified (or Shoemaker-Trained)?
Why this matters:
The Shoemaker Protocol is specific, stepwise, and supported by peer-reviewed research. Providers who are officially certified (or trained by Dr. Shoemaker or his network) understand the details—what order steps must be taken, which labs matter, and how to interpret them.
What to look for in an answer:
- Ideally: “Yes, I am Shoemaker certified.”
- If not: “I have completed Shoemaker training” or “I follow the Shoemaker Protocol in full.”
- Be cautious if they only use binders or antifungals—this is not the protocol.
2. How Do You Confirm a Diagnosis of CIRS?
Why this matters:
CIRS is a clinical diagnosis supported by labs and testing. Without the right diagnostic process, you risk being treated for the wrong condition—or missing key steps.
What to look for in an answer:
- Use of symptom clusters (8 of 13 clusters = likely CIRS).
- Visual Contrast Sensitivity (VCS) testing.
- CIRS-specific labs like TGF-β1, MSH, C4a, MMP-9, VEGF, HLA haplotypes.
- Avoid providers who diagnose only with urine mycotoxin testing—it does not diagnose CIRS.
3. How Do You Handle Environmental Assessment and Testing?
Why this matters:
CIRS treatment fails if patients remain exposed to biotoxins. The right clinician knows how to test and interpret building results.
What to look for in an answer:
- Knowledge of ERMI or HERTSMI-2 testing.
- Awareness of biotoxins beyond mold causing CIRS – beta glucans, endotoxins, and actinomycetes.
- Guidance on remediation or relocation.
- Collaboration with environmental inspectors who understand CIRS.
- Red flags:
- Providers who dismiss the importance of environment altogether.
- Using air sampling as the sole means of environmental analysis
- Not testing for ALL the biotoxins that are known to cause CIRS
4. What Is Your Approach to steps 1 and 2?
Why this matters:
Steps 1 and 2 are the foundation. If a provider skips it or rushes ahead, you’re likely to relapse later.
What to look for in an answer:
- Stepwise approach: remove exposure → start binders → address MARCoNS if present.
- Clear education on how binders work and why skipping exposure removal won’t work.
- Be cautious of anyone promising quick fixes or selling supplement-only solutions.
5. How Do You Monitor Progress?
Why this matters:
CIRS labs shift as treatment progresses. Without repeat testing, you and your provider are flying blind.
What to look for in an answer:
- Plans for retesting key markers (TGF-β1, C4a, MMP-9, VEGF, MSH).
- Regular VCS testing.
- Symptom tracking and patient check-ins.
- A timeline for lab re-checks
6. How Do You Individualize the Protocol?
Why this matters:
The Shoemaker Protocol is standardized, but every patient is unique. Some may need slower pacing, additional gut support, or extra help with detox.
What to look for in an answer:
- Willingness to adjust binder dosing/type based on tolerance.
- Careful introduction of steps (not rushing ahead).
- Attention to diet, sleep, and nervous system regulation.
7. What Experience Do You Have With Patients Like Me?
Why this matters:
CIRS shows up differently in each person. Some present with fibromyalgia-like pain, others with fatigue, others with cognitive decline.
What to look for in an answer:
- A provider who has seen patients with similar symptom clusters.
- Stories of how they guided patients with complex presentations.
- Empathy and patience—CIRS recovery is rarely linear.
8. Do You Educate Patients About the Entire Protocol?
Why this matters:
CIRS treatment is long (often 12+ months) and involves multiple steps. You should know what’s coming so you’re not blindsided.
What to look for in an answer:
- Provider explains all 11–12 steps of the protocol.
- They clarify that skipping steps leads to relapse.
- They empower you with resources to understand each phase.
9. What Are Common Challenges in Treatment, and How Do You Support Patients Through Them?
Why this matters:
Binders can cause constipation. Removing environmental exposure can mean leaving a home. Symptoms can flare before improving. How your provider helps you through these challenges matters.
What to look for in an answer:
- Honest acknowledgment of common difficulties.
- Practical solutions (gut support for binders, counseling around relocation, etc.).
- Clear communication plan if you feel worse at any step.
10. What’s Your Philosophy on Long-Term Recovery?
Why this matters:
Some providers see CIRS treatment as “get through the protocol and you’re done.” But for many patients, ongoing vigilance and environment control are key.
What to look for in an answer:
- Emphasis on resilience and relapse prevention.
- Strategies for monitoring long-term health.
- Support for nervous system and lifestyle changes that promote recovery.
Why Asking These Questions Matters
Starting the Shoemaker Protocol is a big commitment. Choosing the wrong provider can mean wasted time, money, and prolonged illness. Choosing the right one can change your life.
At Flourish Clinic, we believe patients should be active partners in their healing journey. Asking these questions ensures you find a provider who will guide you with competence, compassion, and clarity.
FAQ: Choosing a Provider for the Shoemaker Protocol
Q: What if my doctor doesn’t know about CIRS?
Most conventional doctors aren’t trained in CIRS. That doesn’t mean you can’t keep them on your care team, but you’ll need a CIRS-literate provider for treatment.
Q: How long does the Shoemaker Protocol take?
On average, 12–18 months. Some patients move faster, others slower.
Q: Can I just do part of the protocol?
Skipping steps almost always leads to relapse. Success comes from following the full sequence.
Q: How much does treatment cost?
Costs vary depending on binders, labs, remediation, and provider fees. A transparent provider should give you an estimate up front.
Q: How do I know if a provider is truly Shoemaker-certified?
Check the Surviving Mold website for the list of certified practitioners.
Remember this
CIRS is different than mold illness. CIRS is the resulting immune dysregulation caused by an exposure to biotoxins. Checking for mycotoxins in your urine tells you nothing about CIRS. Many providers will group CIRS together with mold illness. They are not the same.
Before starting the Shoemaker Protocol, don’t just ask “Does this provider treat mold?” Ask the right questions to ensure you’re in capable hands. Recovery is possible, but only when guided by someone who truly understands the path.
