​CIRS is a term coined by Dr. Richie Shoemaker who spent a career figuring out the cause and effective treatment of this complex array of symptoms that certain people develop after exposure to indoor environments that have experienced water exposure. It is now known, that 50% of the buildings in the US have some sort of interior water damage and do harbor certain species of molds and many other toxic elements that cause neurotoxins to be released from mast cells in our immune system. In the area of the country where it rains and heat and humidity prevail during the summer months, it is closer to 95% of the buildings. This includes any water damage that has EVER occurred in the building, even if it was thought to have been effectively remediated. During the time of the water damage and during the disturbance of the contents during the remediation, the air-born mold spores floated around the space, got circulated in the HVAC system and distributed wide and far in the building/home.

They landed on all the surfaces that were contained in that space, like door jams, window casings, books, documents, carpets, rugs, furniture, bedding and clothes. They are still there causing inflammation in your body. Do you decorate with antiques or have family heirloom furniture? Recall the smell that hits you walking into an antique store? They all smell the same – right? Guess where most of the contents that are displayed for sale were stored before the previous owner decided to sell them. Usually in someone’s basement.
​In 24% of people, they have a certain genotype that cannot clear these neurotoxins. A mast cell functions as a pack-man in the immune system that gobble up all kinds of substances and invaders and digests them so that they do not cause overwhelming disease. Why is it that CIRS seems to be associated with Lyme disease? The answer is that both inhaled species of molds and Lyme disease infection create neurotoxins in the body. So, it is likely that the same people with this particular genotype who get sick from exposures to indoor molds, if exposed to a bug bite that passes the spirochetes and/or other potential infective organisms that cause the symptoms of Lyme disease will also get sick.

​If you can imagine a fuzzy-looking mast cell covered with arms holding catcher’s mitts all over its surface. The mitts catch all these circulating neurotoxins and the arms bring them into the mast cell where they can be effectively gobbled up and done away with. The folks who have this certain HLA genotype are missing the arms and thus the mitts on the surface of their mast cells. So, therefore have no ability to clear these toxic elements. The liver tries its best, excretes them into the bile that then gets circulated through the digestive track and eventually reabsorbed. So, they never really leave the body and continue to build up and cause symptoms.

​Neurotoxins cause an array of symptoms that effect every organ system. Therefore, it is not unusual for patients affected with this condition to have visited several different medical specialists before they end up seeking the help of a physician who is aware of this condition. Or, they have scoured the internet and deduced on their own that they have symptoms consistent with either Lyme disease (which they might have as well) or hormone dysfunction, which is also part of CIRS. It is complicated.
​CIRS dysregulates the hormone (endocrine) system at any age. The endocrine system’s hypothalamus and pituitary work together to always be monitoring levels and sending signals to the glands that produce hormones to either make more or make or less of the hormones that regulate the bodies physiology. This communication system is complex and exquisitely, tightly managed. You can imagine the clip from old TV shows with the operator sitting at the phone bank with the plugs connecting the phone lines when Joe calls and wants to speak with Sally, the operator plugs Joe’s line into Sally’s home line and the conversation starts. When mold is present, it decreases a master regulatory hormone called melanocyte stimulating hormone (MSH). This is kin to the operator sitting at the phone switch board who suddenly went on break.


​This is why, as just one example, a person with CIRS can feel as if they have all the symptoms of hypothyroidism and have been to several doctors who have “checked” their thyroid function in the way we as physicians are trained to check it, with a simple Thyroid Stimulating Hormone (TSH) level. TSH can often look perfectly fine and in the normal range. The patient then gets the message that their thyroid function is normal. When, in fact it really isn’t. The TSH level is often not sufficient to assess the totality of thyroid function. Doctors who are trained to appreciate CIRS and Lyme disease must order more in depth thyroid markers such as a Free T3, Reverse T3, Thyroglobulin antibodies and TPO antibodies to fully understand what is truly going on. Free T3 is the end product of thyroid metabolism. It runs the body’s metabolism. Doctors are not trained to even order that test. We are trained to relay on the signaling hormone TSH which is why hypothyroidism is so often missed in Mold and Lyme.


​I say that lovingly, as I was one too, do you wonder why and now? Why are we seeing this occur in patients seemingly for the first time? Why didn’t my regular doctor mention it? Traditional medicine still does not consider CIRS a “real” diagnosis and insurance companies don’t consider it a valid condition. It is recognized in the specialty of environmental medicine, but try speaking to a peer to peer review doctor on the phone like I must do often times. I, like many of the patients feel as if we are operating in an alternate Universe.
​Many factors began changing in our indoor and outdoor environments in the 1970’s. Benomyl, an antifungal chemical was developed and sprayed on farm fields to prevent fruits and vegetables from molding in the fields. Pittsburg Paints then began adding it to their interior paint products to specifically prevent interior spaces from molding.


Something else was going on in the background at this same time. Building codes were changing to improve building heating and cooling efficiency. Buildings were being built to be tighter and tighter to prevent air exchange with the outdoors. This allowed the indoor environments of these buildings to increase in humidity. Mold grows at a certain level of heat and humidity. The perfect storm was being created. The Benomyl in the paints were killing off some species of mold, but allowing others to modify and change thus creating “super molds” to take over.


​Another interesting fact is that in 1975 the strain of Lyme disease that now bears Dr. Willy Bergdorf’s name was discovered to have been responsible for the 29 kids in Lyme Connecticut to show up with mono-articular knee swelling.


​CIRS is diagnosed with a series of blood work markers produced by the mast cells and a functional visual test, the VCS test on Dr. Shoemakers website SurvivingMold.com. If you are curious, go to his website and take the test. It is $15 to take and be sure to sit 18” from the computer screen. It has a 92% sensitivity and specificity. Meaning, it will diagnose the condition accurately 92% of the time if done correctly. You can falsely pass 8% of the time, but if you fail it is likely you are suffering from CIRS.
​The number one principal of the treatment of CIRS is to remove yourself from or remediate the offending environment immediately. You must stop the ongoing exposure and thus the recreation to the mold neurotoxins. That sometimes requires extraordinary means if it is your place of employment. You somehow have to convince not only your employer, but also the owner of the building that it is responsible for making you sick. If it is your home, we have a secret weapon that is a lower cost solution. It is also available as an option for commercial buildings as well.

​Once the patient is safely out of the ongoing exposure we can then go on to treatment. There is no pill in the traditional sense to treat mold neurotoxin disease.

​The treatment includes:

The detoxification of your body with the use of bile acid sequestrants (binders)
Using a spray in the nose to kill the multiple antibiotic resistive organisms (MARCoNS) that are now living in your nasal and sinus cavities causing the crash of your endocrine system
Treating complex biofilms in the GI tract and nasal, sinus passages using biofilm busters
Treatment usually takes 3-4 months.