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How To Deal With Chronic Inflammatory Response Syndrome (CIRS)

An image of a bee stinging someone on the handChronic Inflammatory Response Syndrome (CIRS) is the name given to a set of symptoms that arise from your body’s response to biotoxin exposure. Biotoxins are toxins or poisons that come from biological sources, such as plants and animals. And although anyone can have an inflammatory response from being exposed to them, CIRS is most common in those with a genetic susceptibility.

In this article, we will cover which biotoxins are involved in chronic inflammatory response syndrome, what the symptoms are, some general information about lab tests and analyses related to biotoxin exposure, and advice on how to handle this condition if you have it.

Let’s begin by listing the different CIRS symptoms, so you can check if they match yours. They are grouped in 13 clusters, according to Dr. Ritchie Shoemaker, whose work is on the leading edge of biotoxin research.

The Thirteen Clusters of CIRS Symptoms

Cluster 1:

  • Diarrhea
  • Abdominal pain
  • Numbness

Cluster 2:

  • Shortness of breath
  • Sinus congestion

Cluster 3:

  • Memory problems
  • Difficulty finding words

Cluster 4:

  • Skin sensitivity
  • Tingling and “pins and needles” sensation

Cluster 5:

  • Watery eyes
  • Disorientation
  • Metallic taste in the mouth

Cluster 6:

  • General weakness
  • Aches and pains
  • Headaches
  • Sensitivity to light
  • Difficulty learning

Cluster 7:

  • Blurry vision
  • Red eyes
  • Mood swings
  • Night sweats
  • “Icepick” type pain

Cluster 8:

  • Joint pain
  • Muscle cramps
  • Stiffness (especially upon waking)

Cluster 9:

  • Intense continuous fatigue

Cluster 10:

  • Difficulty concentrating

Cluster 11:

  • Dizziness
  • Static shocks

Cluster 12:

  • Confusion
  • Cough
  • Being very thirsty

Cluster 13:

  • Needing to urinate often
  • Difficulty regulating your body temperature
  • Shortness of breath
  • Frequent misdiagnoses

You need to have at least 1 symptom in at least 6 of the 13 symptom clusters to be considered for CIRS. IF you have at least 1 symptom in 8 of 13 symptom clusters, that indicates a high probability of CIRS.

Many of these symptoms are shared by other conditions, and that’s why people with CIRS are often misdiagnosed with one of them. This then prolongs the problem, creating more damage, and symptoms can worsen over time. Some of these conditions include:
An image of a young woman talking to her doctor while she's holding her head

  • Fibromyalgia
  • Allergies
  • Chronic Fatigue Syndrome
  • Irritable Bowel Syndrome
  • Anxiety
  • Depression
  • Post-Traumatic Stress Disorder
  • Hypochondria

The Relationship Between CIRS and Adrenal Fatigue

This confusion and misdiagnosis also usually happens with Adrenal Fatigue Syndrome (AFS), as it is not yet widely accepted by the mainstream medical community. It is frequently misdiagnosed as one of the above conditions, among others. And, like CIRS, it can leave you feeling hopeless trying to find answers. And no matter how many treatment methods you try, you can find yourself getting worse, not better.

It’s not often that these two specific conditions are confused with each other, however, even though they also share many symptoms. That’s due to the fact that most mainstream doctors don’t know about or don’t understand either one.

Symptoms of AFS include fatigue, easily gaining weight, difficulty losing weight, insomnia, brain fog, anxiety, mild depression, hair loss, dry skin, loss of libido, PMS, estrogen dominance, infertility, food and drug sensitivities, lowered immunity, recurring infections, hypoglycemia, salt and sugar cravings, dizziness and lightheadedness when getting up from a prone position, and heart palpitations.

But the thing is, you can actually get both conditions. This is because AFS is caused by chronic stress, whether physical or psychological. When faced with stress, your adrenal glands have to produce a lot of cortisol to deal with it. After a while, they can become exhausted and dysregulate. And CIRS is a huge source of both physical and psychological stress.

NEM's Involvement

Any form of chronic inflammation puts a lot of stress on your NeuroEndoMetabolic (NEM) Stress Response. Your NEM is your body’s global response to stress, and it’s composed of six circuits of organs and systems that work together to fight stress. They are the Hormone, the Bioenergetics, the Cardionomic, the Neuroaffect, the Inflammation, and the Detoxification circuits.

We’ll focus on the Inflammation circuit, since it’s the one most affected by biotoxins. But before we can discuss how biotoxins affect the body, you will need to know how you were exposed to them in the first place.

Types of Biotoxin Exposure Involved in CIRS

Exposure to biotoxins can occur in several ways, such as inhalation, ingestion, and insect bites.


The most source of exposure is through the inhalation of airborne toxins when in or around water-damaged buildings. These buildings can have several types of toxins mixed together, such as mold, chemicals, and bacteria. Just one of these can be enough to trigger an inflammatory response, but CIRS is usually triggered by the mix of multiple toxins together. Also, most people that end up with the condition are regularly exposed to this mix because they either work or live in these water-damaged buildings. Most of the time, they aren't even aware of the water damage.

Contaminated Water and Ingestion

An image of a fish dyeing in contaminated waterNext, you can get this syndrome by being in direct contact with contaminated water. Usually, this kind of water is contaminated with what are termed “fish killers.” Fish killers are dinoflagellate, a form of algae that release toxins that can kill fish. They include Pfiesteria and Cyanobacteria. This means you can also develop the condition from eating fish that contain these contaminants.

Insect Bites

Another source of contamination is through insect bites. Specifically, ticks and recluse spiders. There is a difference between Lyme disease and CIRS, although Lyme disease can and does cause chronic inflammation. Less commonly, ticks can also cause babesiosis, which is a rare, life-threatening disease. But that is also different from chronic inflammatory response syndrome.

What’s interesting is that these different biotoxins can all cause chronic inflammatory response syndrome as well as one or more other conditions. We’ve mentioned Lyme disease, for example. But there’s also mold sickness, babesiosis, and a general increase in the toxic load on the body. This can lead to a dysregulated Detoxification circuit. And a smoothly running Detoxification circuit is crucial for a smoothly running Inflammation circuit.

Inflammation: When It Turns From Friend to Foe

Your NEM’s Inflammation circuit is composed of your immune system, your gastrointestinal (GI) tract, and your microbiome. Your microbiome is the ecosystem of flora in your gut, and it’s composed of some beneficial and some harmful bacteria. The balance between these two types plays a huge role in your health and in disease progression.

This circuit is responsible for very important functions, such as ridding the body of dead and damaged cells, as well as attacking and disposing of the source of injury to these cells. Those include things like toxins, pathogens, and metabolic by-products.

Meanwhile, your Detoxification circuit has to be in optimal condition for your Inflammation circuit to function. Detoxification is the method by which these dead and damaged cells, as well as what damaged them, are expelled from the body altogether. This circuit is composed of your liver, interstitium, and immune system.

So, as you can see, inflammation is integral to protecting your body from harm. And detoxification is how your body cleans itself out. If either of these circuits dysregulates, the recovery process will have to include addressing them.

But how does something that is supposed to protect your body from harm turn into the thing that causes your body the most harm? When it is consistently or continuously triggered into action, rather than being used once in a while when needed. Chronic inflammation is at the root of many chronic diseases, and it wreaks havoc on your entire system.

How Chronic Inflammation Is Triggered by Biotoxins

Generally, being exposed to something unhealthy once doesn’t elicit chronic inflammation. It creates an acute bout of inflammation that then subsides as soon as its job is done. Chronic inflammation, on the other hand, is a bit different. It means that your body is unable to handle whatever it is fighting properly.

This is usually due to one of a combination of the following:

  • Exposure to the biotoxin is continuous, as is the case with water-damaged buildings that you live or work in. This means that your body doesn’t get a break from fighting this biotoxin since you are inhaling it for hours and rarely get away from it. Some people only notice that their building was the problem all along after moving and seeing a change in symptoms.
  • The biotoxin has been circulating your system for a while and isn’t being recognized properly by your immune system. This can be due to the genetic vulnerability that impairs the immune system’s ability to identify and destroy the biotoxins. And CIRS-causing biotoxins are able to move from cell membrane to cell membrane, without going into the bloodstream. This makes them a little more difficult to detect. This problem is similar to what happens with stealth viruses, where they are more difficult to detect by your immune system and are then able to do what they want, sometimes for years, all the while causing harm and creating symptoms.
  • Your immune system is so weak it is unable to get rid of the biotoxin even though it can identify it. Many conditions can compromise your immune system, including conditions that require you to take immunosuppressant drugs. Adrenal fatigue can also weaken your immune system, making it unable to fight the biotoxin properly.

How A Healthy Immune System Deals With Biotoxins

An image of white and red blood cells flowing in a veinYour immune system has different components, and these components evolved at different times and have different functions. Your innate, or natural, immunity is the older component. It's a very fast-acting response, but it has a broader range. It’s not as precise as the newer component, which is your adaptive immunity. Innate immunity also has a very short span of action, a few hours or days at most.

When your innate immunity senses the presence of biotoxins, it releases a large number of substances meant to ensure that at least one of them can fight off the attackers. At least until your adaptive system can take over. This is why it creates a lot of acute inflammation. This is also how you can test for the activation of your innate immune system, since it releases many inflammatory molecules.

Your adaptive immune system then starts making specific antibodies against the biotoxins. Its job is to take over the burden. It attacks the biotoxins much more precisely, without needing to flood the body with white blood cells. This is why it’s called adaptive. Adaptive immunity takes longer to respond since it has to create specialized antibodies. But it also lasts longer, usually a few days.

The Most Important Element of Your Adaptive Immunity

What is really special about adaptive immunity is that it leaves behind memory cells that can recognize biotoxins it has dealt with next time they enter the body. This does not happen with innate immunity.

What this means is that if you are exposed to the same biotoxin again, your adaptive immunity will get triggered much faster, and mount a focused attack. This also means your innate immunity doesn't need to flood your body with inflammatory molecules again, like the first time, so there is less inflammation overall.

This kind of coordinated functioning leads to the greatest efficiency with the least amount of stress on your body. Your Inflammation circuit and Detoxification circuit can handle this kind of response, and your adrenals are not under too much stress.

Genetically Susceptibility to Biotoxins?

If you have a genetic susceptibility, it’s not that your immune system is completely blind to the presence of the biotoxin, it’s just that there is a lapse between your innate and your adaptive immune system. Your innate immune system does indeed recognize the presence of biotoxins, and so it gets activated with that recognition.

But then, your more specialized adaptive immunity doesn’t recognize the presence of the biotoxin, and so doesn’t make specialized antibodies that can take over. And, since it doesn’t create memory cells, every time the same biotoxin enters your body, your innate immune system has to flood your body with all the different weapons it has.

That means that your innate immunity is triggered over and over again. It eventually becomes so overreactive that it creates very high levels of inflammation. And this continuously high level of inflammation is what damages the different systems affected in CIRS development.

Similarly, you may be genetically susceptible to Lyme disease, where your body has a more difficult time responding to antibiotic treatment and is more likely to develop a chronic condition after getting Lyme disease. This is sometimes referred to as Post-Lyme Syndrome. Also, you may have a genetic susceptibility to mold illness.

All of these kinds of chronic, dysregulated immune responses will negatively affect your NEM and your adrenal glands. That’s why we often see AFS accompany mold illness, Lyme disease, and the multiple susceptibilities that lead to CIRS.

The Phases of CIRS Progression

The fact that biotoxins can avoid going into the bloodstream means that you can’t find them through blood tests. So even if you do go to your doctor and get blood work done, your blood might show nothing. This leaves you to battle the condition alone, usually resulting in the worsening of its symptoms.

If you have a genetic susceptibility, the progression of the condition follows a specific path. Understanding this progression can help you seek the right kind of help. The earlier on you can interfere, the better the outcome.

The progression can be broken down into the following four phases:

Phase 1 – Exposure

As noted above, the different types of biotoxin exposure that can lead to CIRS. Most commonly, it’s through water-damaged buildings.

Phase 2 – Immune System Response

An image of biotoxins in the blood streamFor those without a genetic susceptibility, their immune system is able to identify and get rid of the biotoxins, as well as any microbes or irritants that released the biotoxin into the system in the first place. However, even for such people, this may not be the easiest phase, since biotoxins can be quite taxing on the body, and the process of eliminating them can really put pressure on the immune system and the NEM in general. They may end up feeling weak or even getting adrenal fatigue.

For those with a genetic susceptibility, the biotoxin travels through their system undetected by the adaptive immune system. And, technically, these biotoxins can stay in the system indefinitely. As they circulate in your body, going from cell to cell, they will damage these cells and cause many unpleasant symptoms. They can even start invading immune system cells. And this will lead to phase 3.

Phase 3 – Immune Dysfunction

Just like how these biotoxins cause harm to the cells they travel through, they can also damage your immune system cells. Immune system damage is an entire issue in its own right. It can open you up to many other conditions, and in some cases, it can even lead to dysfunctions such as autoimmunity. This can then put even more pressure on your adrenal glands, leading to AFS and NEM dysregulation. And, this immune system damage is also what leads to the chronic inflammation that is the central issue in CIRS.

Phase 4 – The Spread of Inflammation and The Worsening of Symptoms

When your immune system is damaged and is being attacked, it begins to react in harmful ways. It can create a type of inflammation that doesn’t subside. And this inflammation can spread to different parts of the body. This is the same in CIRS as it is in any chronic inflammatory response.

Inflammation that spreads to the joints will cause joint pain. If the inflammation spreads to the brain and nervous system, it can cause neurological and psychiatric issues. Inflammation that spreads to the skin will create problems there. And inflammation that spreads throughout the GI tract can cause digestive problems.

This is why you can see so many varied and seemingly unrelated symptoms in CIRS. This is also what leads to sufferers being misdiagnosed with one or several other conditions.

How CIRS Can Lead to Adrenal Fatigue

An image of kidneys and their adrenal glands next to a stethoscopeCortisol is your body’s main anti-stress hormone. It is responsible for many important functions, including:

  • Raising your blood sugar levels in order to provide your body with extra fuel for the fight or flight response.
  • Suppressing the immune system once its job is done. This is important so that your immune system isn’t switched on all the time.
  • Neutralizing inflammation when its job is done, in relation to the immune response.

There are other functions it is involved in, such as regulating blood pressure and maintaining the heart and blood vessels. But these are some of the most important. If cortisol is too high or too low, you can get problems in all of these functions. And that's exactly why you see these issues in AFS.

In the beginning stages of AFS, your cortisol levels are increasing, which brings its own set of symptoms. But once your adrenals are exhausted and their cortisol output drops, that brings on another set of symptoms.

Now, imagine that these biotoxins are attacking your immune system, causing damage to your body, and your body is unable to get rid of them. This is a form of stress that is continuous. So your adrenals have to keep secreting more and more cortisol to fight that stress. They're trying to make sure your body can win this battle, neutralize the inflammation that is spreading all over, and get your system back to homeostasis. But to no avail. So at some point, your adrenals become exhausted and can’t produce cortisol anymore. Leaving your body even more defenseless against the spread of the inflammation.

Is There Any Way to Test for CIRS?

Although blood work won’t help much, since these biotoxins can travel from cell to cell without entering the bloodstream, there are a few other tests that can help determine if you have CIRS.

But the most important thing is that you actually get looked at by someone who has experience in this condition, as well as in AFS and NEM dysregulation. Otherwise, you might end up going through the very frustrating cycle of getting misdiagnosed and being given the wrong treatment. Or being told there’s nothing wrong with you, and it’s all in your head.

Once you have the right kind of professional support, the process of testing should involve the following:

  • Your full medical history and symptom list.
  • A check to see if your immune system does have the vulnerability we mentioned. This can be done through HLA testing.
  • A test to check if you have neurotoxicity, as biotoxins can travel to your nervous system and cause damage there. Visual contrast sensitivity is a good test for this, as are certain types of MRIs, and these can be done online very easily as a good screening tool.
  • Immune system biomarker testing, including ones such as TGF beta-1 and C4a.
  • Testing for inflammatory markers, as well as associated biomarkers. For example, MMP-9 is involved in the breakdown of cell membranes that can then allow inflammatory substances into the cells and tissues.
  • Testing for stress hormones, such as cortisol and ACTH.
  • Testing for the actual producers of biotoxins, for example parasites, mold, and spirochetes, etc.

There are many other tests that can be done to check. But, actually, like with adrenal fatigue, lab tests are not the cornerstone of diagnosis and recovery. The skill and knowledge of an experienced health professional will enable her to understand what’s going on.

A Note On Your Gut and Microbiome

An image of the gut, liver and stomachBefore we get into the CIRS recovery protocol, we need to emphasize the importance of your gut and microbiome. First of all, the reason they are integral to your immune system is because about a third of your immune system cells come from there. They are called Gut-Associated Lymphoid Tissue (GALT). That’s why keeping your gut and microbiome in optimal shape is one of the best ways you can enhance your immunity. And this is one of the most important steps in the recovery process.

Diet is also the central focus of adrenal fatigue recovery. And that has to do with the fact that a lot of times, an unhealthy diet is the main stressor your body is facing. Plus, when you have adrenal fatigue, your nutrition and energy stores are depleted. That’s why you have so much fatigue. And you need to replenish these stores.

The good news is that the adrenal fatigue diet also helps a lot with CIRS recovery.

The CIRS Recovery Protocol

Recovering from something as debilitating and confusing as chronic inflammatory response syndrome is a long-term process, just as it is with adrenal fatigue. You will do it in several steps, each one building upon the one before it. It also needs to be adjusted as you go along, because each person’s response to the recovery process is different.

Step One

The first and most important step is to remove yourself from exposure to the biotoxins. There’s no point trying to get better when you’re constantly inhaling or ingesting biotoxins. This could mean identifying the source, and potentially moving or changing jobs. Likewise, with AFS you need to eliminate the stressors before the adrenal glands can regain their strength.

Step Two

You need to have the biotoxins that are already in your system removed. This is a detoxification process, and different practitioners will do it differently. It will also depend on the state of your Detoxification circuit and your adrenal glands. If you are very weak, this process needs to be done very gently. Some health professionals will use certain medications to support this process, specifically in the case of CIRS biotoxins. These can include cholestyramine or Welchol.

Step Three

You need to address any other sensitivities you have, especially gluten sensitivity. That’s because if you remove the biotoxins but your system is still reacting to other substances, the problem will keep going. With gluten, the inflammation in the gut will become chronic and spread elsewhere. And, as we mentioned, your gut and microbiome need to be strong in order to rebuild your immunity and fight off inflammation. This will also be very helpful for adrenal fatigue. In fact, the adrenal fatigue diet is gluten-free for this reason.

Step Four

Any issues created by the presence of biotoxins or chronic inflammation need to be dealt with. For example, those with CIRS can sometimes suffer from androgen-based hormone imbalances. In such cases, DHEA supplements might help. CIRS can also cause certain hormone imbalances that affect blood sugar levels, so a low-glycemic index diet might be a good idea. Again, with the adrenal fatigue diet, we don’t include any simple sugars, only complex carbohydrates.

Step Five

Finally, add in any extra supplements or specific foods that can help rebuild the gut and microbiome, and fill in any nutritional gaps. This will help strengthen your overall health.

In Conclusion

Chronic inflammatory response syndrome can be a serious condition. And it’s difficult to know what to do about it because it can resemble other conditions whose treatments are entirely different. The first and most important step you can take here is to get the right kind of guidance.

Depending on your specific situation and needs, an experienced health professional will devise a recovery plan that will allow you to get the biotoxins out of your system and also rebuild your immune health. This process will take some time and may need to be adjusted along the way.

If you have adrenal fatigue as well, you will have to be extra careful so that this recovery process doesn’t put more pressure on your adrenals. More pressure can lead to adrenal crashes, making recovery even more difficult and long.

But the good news is that, by addressing this issue, you will also be helping your adrenal fatigue as well as your overall health. You may end up discovering you have other sensitivities you didn’t know about that you can now avoid. This will all lead to much greater health and a better quality of life down the line.

Your Next Steps

If you have questions about CIRS and adrenal fatigue recovery, you can contact the Dr. Lam Coaching team. We can offer you a free** no-obligation phone consultation at +1-626-571-1234 where we will privately discuss your symptoms and what your options are. You can also send us a question through our Ask The Doctor system by clicking here.

© Copyright 2021 Michael Lam, M.D. All Rights Reserved.

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CIRS is a chronic inflammatory response syndrome that results from the exposure to certain biotoxins. Sometimes continuously. And if you have the genetic susceptibility, your immune system can’t fight it on its own. You need guidance and support. Here’s what you need to know.

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