What is Chronic Inflammatory Response Syndrome (CIRS)?

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Last updated: February 27, 2025View editorial policy

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From the Guidelines

Chronic Inflammatory Response Syndrome (CIRS) is a condition characterized by chronic inflammation in response to exposure to biotoxins, particularly those from water-damaged buildings, and is not directly related to the provided evidence on rhinosinusitis and nasal polyps. The provided evidence 1 focuses on the pathogenesis and treatment of Chronic Rhinosinusitis (CRS), which is a distinct condition from CIRS. According to the example answer, CIRS is triggered by exposure to biotoxins and occurs in genetically susceptible individuals who cannot properly clear toxins from their bodies, leading to chronic inflammation. Symptoms of CIRS include:

  • Fatigue
  • Cognitive problems
  • Muscle pain
  • Headaches
  • Respiratory issues
  • Gastrointestinal disturbances Treatment of CIRS typically involves:
  • Removing the source of exposure
  • Binding toxins with medications like cholestyramine
  • Reducing inflammation
  • Supporting detoxification pathways The Shoemaker Protocol is commonly used to treat CIRS, which follows a step-by-step approach including toxin removal, addressing MARCoNS infections, correcting hormonal imbalances, and reducing inflammation. Recovery from CIRS can take months to years depending on exposure duration and individual factors. It is essential to note that the provided evidence on rhinosinusitis and nasal polyps does not directly address CIRS, and the treatment approaches for these conditions are distinct. Therefore, the most appropriate approach to managing CIRS is to follow the Shoemaker Protocol and address the underlying biotoxin exposure and genetic susceptibility.

From the Research

Definition and Characteristics of CIRS

  • Chronic Inflammatory Response Syndrome (CIRS) is an acquired medical condition characterized by innate immune dysregulation following respiratory exposure to water-damaged buildings (WDB) 2.
  • CIRS involves a range of symptoms that simultaneously affect multiple organ systems 2.
  • The syndrome is often under-recognized and underdiagnosed, and can affect up to 25% of the population 2.

Causes and Triggers of CIRS

  • Mycotoxins can cause inflammation and oxidative stress throughout the body, leading to CIRS 3.
  • Exposure to specific toxins, such as mycotoxins, can trigger CIRS, which is a phenotypic manifestation of chronic inflammatory response syndrome (CIRS) 4.
  • CIRS can be triggered by exposure to water-damaged buildings (WDB) 2.

Relationship with Other Conditions

  • CIRS can be misdiagnosed as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) 2.
  • CIRS symptoms overlap with those of many chronic diseases, such as Mast Cell Activation Syndrome, and chronic infections, such as Borrelia 3.
  • CIRS is related to systemic inflammatory response syndrome (SIRS), which can compromise the function of various organ systems resulting in Multiple Organ Dysfunction Syndrome (MODS) 5, 6.

Treatment and Diagnosis

  • The Shoemaker Protocol is a treatment protocol that has documented clinical efficacy for CIRS 2.
  • Developing a list of indicators and taking a thorough history of a person's potential mold exposure is important for diagnosing CIRS 3.
  • Tests can be performed to confirm specific mycotoxin exposure and implement treatment plans 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Understanding Mycotoxin-induced Illness: Part 1.

Alternative therapies in health and medicine, 2022

Research

The systemic inflammatory response syndrome: definitions and aetiology.

The Journal of antimicrobial chemotherapy, 1998

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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