Integrative Approach to Chronic Inflammatory Response Syndrome (CIRS)

Chronic Inflammatory Response syndrome, or CIRS, is an internal response to invading pathogens or environmental triggers that release biotoxins into the body. The source of these pathogens is commonly found in damp-wet environments, carried by ticks, or can be due to other microbial exposures. In some individuals, these invaders in the body cause a dysregulation of the immune system, which sparks a cascade of inflammatory reactions, leading to debilitating signs and symptoms. Understanding Chronic Inflammatory Response Syndrome, how it manifests in the body, and how a comprehensive integrative healthcare approach can assist in managing and treating CIRS can help those who may be navigating this condition.

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What is Chronic Inflammatory Response Syndrome (CIRS)?

Chronic Inflammatory Response Syndrome (CIRS) has increasingly gained attention in functional medicine and holistic health. In clinical practice and the literature, CIRS is often interchangeable with Biotoxin Illness. CIRS is a complex and challenging condition, marked by a broad spectrum of symptoms and poorly understood causation. This challenge is that CIRS can occur from various routes and exposures. Dr. Ritchie Shoemaker coined the term Chronic Inflammatory Response Syndrome after his research and treatment of patients with odd symptom similarities across various debilitating states. After a Pfiesteria (single-cell flagella organism) outbreak in Maryland waterways in 1996 and a series of mycotoxins cases, Dr. Shoemaker began seeing a pattern of symptoms. He then went on to develop the CIRS diagnostic criteria, which include symptoms that are grouped into thirteen symptom clusters. Diagnosis of biotoxin illness, or CIRS, can be made when an individual meets eight of these thirteen categorized symptom clusters. Here are the thirteen categories:

1. Chronic Fatigue
2. Weakness decreased assimilation of knowledge, headaches, body aches, light sensitivity
3. Joint pain, especially early morning and with cramps
4. Metallic taste, watering eyes, and disorientation
5. Impaired memory or ability to find words
6. Skin sensitivity-numbness and pins and needles.
7. Shortness of breath and congested sinuses
8. Coughing, excessive thirst, confusion
9. Appetite shifts, Increased urinary frequency, difficulty regulating body temperatures
10. Blurred vision, red eyes, night sweats, mood swings, ice-pick pain
11. Abdominal pain, diarrhea, numbness
12. Static shocks and vertigo
13. Difficulty concentrating

Criteria for treating CIRS with the Dr. Shoemaker protocol include visual testing, genetic testing, physical examination, and a nasal swab for MARCoNS and other associated biomarkers.

Causes and Triggers of CIRS

Diagnosing CIRS requires an integrative diagnostic method. When an individual meets eight of the symptoms cluster criteria previously mentioned, then would then go on to further laboratory and diagnostic testing. This includes a visual contrast sensitivity (VCS) test to determine if there is a defect in their ability to detect visual patterns, genetic testing to look at HLA haplotypes, various CIRS-related blood markers, an MRI, and a deep nasal swab for Multiple Antibiotic Resistant Coagulase Negative Staphylococci (MARCoNS). Biomarkers include transforming growth factor beta (TGF-B1), Complement protein C4a, matrix metalloproteinase 9 (MMP-9), vascular endothelial growth factor (VEGF), vasoactive intestinal polypeptide (VIP), and alpha-melanocyte stimulating hormone (alpha-MSH). Many of these tests are available through LabCorp and Quest labs and referenced here as part of mold illness and CIRS testing. When diagnosing and treating CIRS, you should find a practitioner who specializes in CIRS or has been trained in the Dr. Shoemaker protocol.

Functional Medicine Strategies in CIRS Management

Functional medicine in CIRS management includes personalized treatment. The initial step is to identify the root cause in each case. Treating these underlying conditions, whether toxic mold exposure, Lyme disease, or biotoxin illness from other pathogens, is essential. A functional medicine treatment plan should include a dietary intervention, detoxification support, and lifestyle recommendations. This diet focuses on nutrient-dense, antioxidant-rich fruits and vegetables, whole grains, fiber-rich foods, high Omega-3 foods found in fresh fish and nuts, good quality meats, and legumes.

Nutritional and Detox Interventions for CIRS

Nutrition for CIRS management heavily focuses on reducing inflammation in the body. Dietary strategies for Chronic Inflammatory Response Syndrome are similar to treating mold toxicity and Lyme disease. You want to decrease inflammation in the body and provide it with nutrient-dense foods. While there is no specific diet in the literature for treating CIRS, an Anti-inflammatory nutrition plan would significantly help reduce the total toxin body burden. This diet excludes processed foods, added sugars, refined carbohydrates, alcohol consumption, and harmful food additives. Regarding immune system regulation, excretion of toxins, and lowering of inflammation in the body, gut health should be heavily supported. Eating foods to support your gut microbiome, the balanced microbes in your intestinal tract, can assist in reducing the impact of chronic inflammation. The gut microbiome can also assist in reducing pathogens in the body by creating an undesirable habitat for invaders and having a solid protective intestinal lining barrier. Lastly, a robust immune system starts with a vital gut flora. A microbiome diet is more specific, and an elimination diet involves four phases. The key features are eliminating foods that feed pathogenic microbes while reinoculating the gut with probiotics and fibrous-rich foods. Implementing a restrictive diet can be challenging and should be done under the guidance of a practitioner. 

During nutritional adjustment, implementing supplements to support detoxification is critical. One component that is widely used for CIRS and gut detox protocol is binders. Binders attach to biotoxins and pathogens and help excrete them out of the body. A commonly used binder that can be utilized by prescription only is Cholestyramine. Most notability used to assist with high cholesterol, this highly effective binder is often used in a CIRS protocol. Many supplements can assist with killing mycotoxins, addressing Lyme disease, and aiding in detoxification in these conditions. When working with a functional medicine practitioner, your detox protocol should be focused on eradicating the specific root cause.

Mind-Body Therapies in CIRS Treatment

Chronic Inflammatory Response Syndrome is a complex and systematic condition that takes a whole-person approach to address fully. The suffering that many endure before evening getting a diagnosis can be long and daunting. Holistic treatment for Chronic Inflammatory Response Syndrome should include mind-body support that provides support in stress management and mental health. Statistics show that individuals with chronic illness have an increased risk of developing mental health conditions like depression. Research also shows that depression can be associated with inflammatory states and immune system dysfunction. 

Incorporating mind-body therapies like yoga, breath work, and meditation are beneficial avenues for supporting those with chronic illnesses. A systemic review of yoga found that this practice decreased inflammation across various inflammatory-based conditions. Incorporating yoga as a daily or weekly routine can support mental health and inflammation. Breath work and meditation can both reduce stress and anxiety that may be sparked due to the ongoing mental toll of living with a chronic condition.

Conventional and Complementary Medicine Integration

Integrative and functional medicine practitioners are leading the way in medicine when it comes to diagnosing and treating CIRS. While conventional Western medicine does not fully recognize CIRS, it does acknowledge Sick Building Syndrome (SBS), a mycotoxin illness culprit. In terms of treating SBS, mainstream medicine recommends avoidance of the building that induced the symptoms and provides symptom control in the form of antidepressants, anti-anxiolytics, and sleep medications. Holistic health practitioners take a root-cause approach by examining genetics, blood biomarkers, visual testing, and brain imaging. In a holistic approach to CIRS treatment, doctors can get a clearer picture of the root cause and have a targeted treatment plan to address the issues rather than just treating the symptoms. Advancements in research and conventional medicine approaches would greatly benefit those suffering from the condition but have limited resources.

Challenges and Considerations in Managing CIRS

The complexity of CIRS makes it challenging to have a one-size-fits-all approach. Cases of CIRS present a diverse range of symptoms within the thirteen categories. The diverse range of symptoms can impact multiple organ symptoms, making determining the root cause challenging. A comprehensive investigation into each suspected CIRS case is necessary to assist patients in an individualized approach. Practitioners should base their treatment protocol based on diagnostic results, clinical presentation, and with a thorough plan. These patients also need consistent and continuous monitoring to evaluate or modify their progression.

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Chronic Inflammatory Response Syndrome (CIRS): Key Takeaways

Chronic Inflammatory Response Syndrome is a debilitating condition As mentioned throughout this article, an integrative approach to CIRS includes investigation for the root cause, whether that be mycotoxins, tick-borne infections, or other pathogens. Extensive testing methods and an individualized treatment protocol will help these patients get on a path toward health. Understanding the criteria, reviewing symptom presentation, and getting a deep dive intake regarding concerns for CIRS is essential. While conventional medicine is not where it should be in diagnosing and treating this condition, seeking an integrative doctor who understands it is a viable option.