Chronic Inflammatory Response Syndrome (CIRS): What It Is, Why It Happens, and Why It’s So Often Missed
CIRS is a biologically driven inflammatory illness, not a vague diagnosis or a catch-all label. It occurs when the immune system becomes stuck in a chronic inflammatory loop after exposure to biotoxins, most commonly from water-damaged buildings.
What Is CIRS?
Chronic Inflammatory Response Syndrome (CIRS) is an acquired, multisystem illness that develops in genetically susceptible individuals who are unable to properly clear biotoxins from their body.
The condition was first defined and extensively researched by Dr. Ritchie Shoemaker, a former ER physician who identified a distinct pattern of symptoms, biomarkers, and genetic markers in patients exposed to mold and other biotoxins.
Rather than resolving after exposure ends, the immune system remains chronically activated, leading to ongoing inflammation, even in the absence of a current infection.
What Causes CIRS?
CIRS is triggered by exposure to biotoxins, including:
Mold toxins (mycotoxins) from water-damaged buildings
Actinobacteria and endotoxins
Cyanobacteria (blue-green algae)
Tick-borne pathogens (e.g., Lyme and coinfections)
What makes CIRS unique is genetics.
Approximately 25% of the population carries specific HLA-DR haplotypes that impair their ability to tag and eliminate these toxins. Instead of clearing them, the immune system stays turned “on”, driving chronic inflammation.
Common Symptoms of CIRS
CIRS affects multiple systems in the body, which is why it’s often misdiagnosed as “chronic fatigue”, “fibromyalgia”, “MS”, “stress,” “autoimmune” , “IBS”, or “depression & anxiety”
Common symptoms include:
Neurological
Brain fog
Poor memory or concentration
Headaches
Mood changes, anxiety, or depression
Hormonal & Metabolic
Low libido
Irregular cycles
Weight-loss resistance
Low testosterone or DHEA
Sleep disturbances
Immune & Inflammatory
Chronic sinus congestion
Frequent infections
Allergies or chemical sensitivity
Joint and muscle pain
Visual & Sensory
Light sensitivity
Blurred vision
Difficulty with contrast (often fails VCS testing)
‘Tearing’ of the eyes
Why CIRS Is So Often Missed
CIRS does not show up on routine labs.
Standard blood work may appear “normal,” even while inflammatory markers are quietly dysregulated at the cellular level. Many conventional providers are not trained to recognize:
Neuroimmune inflammation
Biotoxin-driven illness
Genetic susceptibility patterns
As a result, patients are often told their symptoms are psychosomatic, or they’re treated symptom-by-symptom without addressing the root cause.
Key Lab Markers Used to Identify CIRS
CIRS is diagnosed using a pattern, not a single test. Common biomarkers include:
MSH (Melanocyte-Stimulating Hormone) - typically low
C4a & TGF-β1 - often elevated
MMP-9 - reflects inflammatory damage
VEGF - may be low, impairing oxygen delivery
ADH & Osmolality - often dysregulated
HLA-DR genetic testing - identifies susceptibility
VCS (Visual Contrast Sensitivity) testing - screens neurologic impact
When viewed together, these markers tell a very clear story.
The Role of MARCoNS
Many individuals with CIRS also develop MARCoNS (Multiple Antibiotic-Resistant Coagulase-Negative Staphylococci), a biofilm-forming staph infection in the nasal sinuses.
MARCoNS further suppresses MSH, worsening:
Sleep
Hormonal signaling
Pain regulation
Immune balance
This is why addressing the sinuses is often a critical step in recovery.
Can CIRS Be Treated?
Yes, but order matters.
CIRS requires a step-by-step, structured approach that includes:
Removing ongoing toxin exposure
Binding and eliminating biotoxins, with a specific and targeted protocol
Addressing MARCoNS (if present)
Calming immune overactivation
Supporting hormonal, neurological, and metabolic recovery
Jumping ahead, or detoxing aggressively, can backfire if the inflammatory pathways haven’t been stabilized first.
The Takeaway
CIRS is real, measurable, and manageable when properly identified and addressed properly.
If you feel stuck despite “doing all the right things,” it may not be a motivation or compliance issue, it may be a biotoxin-driven inflammatory condition that’s been overlooked.
Root-cause healing starts with asking better questions, and knowing what patterns to look for.
