CIRS and Re-Exposures

Dealing with Chronic Inflammatory Response Syndrome (CIRS) and managing re-exposures can seem overwhelming for many individuals. Whether you are currently undergoing active treatment or have transitioned to maintenance mode, understanding how to handle re-exposures is crucial for your recovery and long-term health.

 

Since CIRS is a lifelong condition, having the right mind-body tools can be just as important to make sure re-exposures don’t cause any nervous system dysfunction. Along with the right essentials and preventative tools, having an informed, prepared approach can help minimize the stress around these situations.

 

We will provide valuable insights into the complexities of re-exposures during different stages of treatment, offering guidance on how to identify common initial symptoms and implement effective supports. We will explore these nuances and share best practices in order to help empower you with the knowledge and tools needed to effectively manage re-exposures.

 

Let’s take a closer look at how to best support yourself after you experience a re-exposure.

 

What Is CIRS?

 

 

Chronic Inflammatory Response Syndrome (CIRS) is a multifaceted condition affecting various bodily systems, resulting in a wide range of symptoms. This condition arises from significant inflammation triggered by an overactive immune response. As a medically acknowledged disorder, diagnosing CIRS requires extensive lab tests and an in-depth review of the patient’s medical history.

 

The diverse symptoms associated with CIRS frequently lead to misdiagnoses or insufficient treatment. Unlike typical immune disorders marked by abnormal adaptive immune responses, CIRS remains undetectable through standard autoimmune blood tests. Consequently, a specialized and comprehensive diagnostic approach is essential for the proper identification and effective management of CIRS.

 

 

What leads to the heightened immune response and extensive inflammation characteristic of CIRS? The primary culprits are biotoxins, which are naturally occurring toxic substances that trigger and exacerbate CIRS. These biotoxins originate from various sources:

 

• Water-Damaged Buildings: Around 80% of CIRS cases are associated with exposure to water-damaged environments. These settings harbor mold mycotoxins, bacteria, and chemical irritants that provoke inflammatory responses in susceptible individuals. Both living and dead mold components contribute significantly to inflammation in the body and brain.

 

• Insect Bites: Certain insect bites, such as those from ticks and spiders, can lead to chronic conditions such as Lyme disease. Pathogens such as Borrelia burgdorferi and Babesia microti, along with venom from recluse spider bites, can cause long-term health issues.

 

• Seafood Consumption: Consuming tropical reef fish contaminated with ciguatera toxin, often linked to Pfiesteria and harmful algae blooms such as cyanobacteria (blue-green algae), can result in biotoxin-related illnesses. This toxin accumulates in larger reef fish that consume smaller fish which have ingested dinoflagellates.

 

• Contaminated Water Contact: Exposure to or inhalation of water tainted with toxic algae blooms, including Pfiesteria and cyanobacteria, can trigger inflammatory responses related to CIRS.

 

• Other Biotoxin Sources: Additional triggers for CIRS include certain vaccines, viruses, volatile organic compounds (VOCs), endotoxins, and actinomycetes. These elements can contribute to the onset and exacerbation of the syndrome.

 

 

 

Biotoxins are minute molecules that can penetrate cell membranes, making them challenging to detect with standard blood tests. These toxins usually enter the body through inhalation but can also be introduced via ingestion, insect bites, and contact with contaminated water.

 

Not everyone exposed to biotoxins, such as mold, will develop CIRS. Genetic predispositions and life stressors play significant roles in susceptibility to biotoxin-related conditions. Factors like severe illnesses, surgeries, high fevers, pregnancies, substantial biotoxin exposure, and other traumatic events can trigger a cytokine storm. This activation may initiate the CIRS gene in genetically predisposed individuals, particularly those with HLA-DR genes, indicating that CIRS can manifest at any stage of life. It’s important to note that a lack of symptoms does not equate to immunity, and genetic testing can provide valuable insights for prevention.

 

While biotoxins might cause immediate illness, most people’s immune systems can identify and eliminate these toxins effectively. However, individuals genetically predisposed to CIRS have immune systems that fail to recognize and clear these toxins, allowing them to persist in the body. This results in a chronic, severe immune reaction and widespread inflammation, leading to a variety of symptoms and long-term health issues.

 

For a more detailed understanding of CIRS, click here.

 

Pro-Tip: If you think you’re suffering from CIRS, start with our White Glove Service for comprehensive care.

 

What Is the Shoemaker Protocol?

 

 

The Shoemaker Protocol is a comprehensive, evidence-based treatment developed by Dr. Ritchie Shoemaker to address CIRS and other biotoxin-related illnesses. As the only peer-reviewed, clinically replicable treatment for biotoxin illnesses, including mold-related conditions, the Shoemaker Protocol is grounded in rigorous scientific research and clinical trials, ensuring effectiveness and reliability for treating CIRS patients.

 

A crucial element of the Shoemaker Protocol is minimizing biotoxin exposure, which is foundational to the healing process. Continuous exposure to biotoxins can trigger ongoing inflammation, hindering treatment progress. Patients must thoroughly remediate their living environments, relocate to biotoxin-free homes, or create designated sanctuary spaces within or outside their current residences.

 

Additionally, CIRS patients must be mindful of other environments as potential points of exposure, such as work, school, and travel. These spaces can harbor biotoxins, requiring either remediation or continuous monitoring and management to ensure a safe environment that supports the healing process. Minimizing exposures can be really helpful during treatment. While it is impossible to avoid all exposures during the entirety of treatment, practicing preventative measures can significantly reduce the impact and aid in the healing process.

 

Re-exposures during treatment and after treatment are unavoidable. CIRS patients will need to learn how to properly prepare to address each re-exposure both during active treatment and while in remission or maintenance mode. Proper planning and preventive measures are essential for managing re-exposures and maintaining health.

 

The Shoemaker Protocol provides a structured approach that includes specific medications and therapies to reduce inflammation, correct hormonal imbalances, and restore proper immune function. Each step is carefully designed to address various aspects of CIRS, ensuring a holistic approach to treatment. Patients following this protocol can achieve significant improvements in their health, often leading to complete remission of symptoms.

 

CIRS and Non-Home Environments

Re-exposure to a compromised building can impact a person within 15-30 minutes, with some individuals reacting immediately upon entry. This rapid response, known as the “quicker sicker effect,” is particularly common in CIRS patients undergoing active treatment. The quicker sicker effect describes a swift and severe worsening of symptoms when re-exposed to environmental triggers like water-damaged buildings. The immune system overreacts, leading to a quick, intense flare-up of symptoms.

 

For individuals who have completed the Shoemaker Protocol and are in maintenance mode, their C4a levels will measurably rise in the blood four hours after just 15 minutes of exposure to a building with an Environmental Relative Moldiness Index (ERMI) greater than two. C4a, a component of the complement system, is a crucial inflammatory marker for diagnosing and monitoring CIRS. It reflects the innate immune response in individuals exposed to water-damaged environments.

 

CIRS Re-Exposure Symptoms

Trust your symptoms to determine if you are experiencing exposure. Using the Visual Contrast Sensitivity (VCS) test as a baseline before going out and retaking it afterward can help identify any changes in your results.

 

Common immediate exposure symptoms include:

 

• Respiratory issues: coughing, difficulty breathing, nasal congestion, asthma
• Skin reactions: rash, itching, redness
• Allergic/histamine reactions: sneezing, runny or stuffy nose, itchy eyes, itchy nose/throat, watery eyes
• Cognitive issues: difficulty concentrating, confusion, memory problems
• Throat irritation
• Headaches
• Fatigue
• Odor sensitivity
• Difficulty sleeping or poor sleep following exposure

 

Monitoring these symptoms and using tools such as the VCS test can help you effectively identify and manage re-exposure.

 

Pro-Tip: Anecdotally, many individuals report experiencing having different symptoms from re-exposures in different environments. We theorize that this could be due to differing mold species and building microbiomes, which could in turn, manifest in different symptoms.

 

CIRS Tips for Entering Commercial Buildings

The Environmental Protection Agency (EPA) estimates that up to 85% of commercial buildings in the US have water damage so it’s highly likely you’ll encounter exposure when you enter any non-home environment. It’s estimated that about 50% of homes are water-damaged as well.

 

We recommend finding the right combination of personal protection equipment (PPE) and air filtration for entering any possibly contaminated buildings.

 

Personal Protection Equipment

Here are some general recommendations to explore:

• Fully-Sealed N95: Find the right N95 option that fully seals for your face shape. N95s filter out 95% of airborne particles larger than 0.3 microns. It’s ideal to find something with this level of filtration or better such as a N99.
• Aus Air: Reusable masks with disposable filters that filter down to at least 0.3 microns as well are another option to explore. AusAir filters out >99% of airborne particles down to 0.1 microns, offering better protection than N95s.
• Nose Filters: Nose filters are another option to explore. They don’t offer the same level of protection as the three options above but may be ideal for speaking arrangements and events where a mask or respirator may not be the most effective option. Similar to masks, it’s important to find an option that properly seals within the nasal cavity.

 

Personal Air Filtration

Here are some general personal air filtration options to explore:

• AirTamer: The personal ion device is best used when stationary but should offer additional protection when on the move. It’s ideal to combine this with PPE.
• Dyson Zone: This air-filtration and noise-canceling headphone combination offers the ability to take calls and listen to headphones while it supplies continuous purified air through a detachable visor.
• Portable Cordless HEPA Mini Filter: The rechargeable and cordless option offers another layer of protection for those who frequently move around at work or school. It’s often best when combined with a personal device such as AirTamer or Dyson Zone and PPE.

 

Vintage and Second-Hand Items Considerations

During active treatment for CIRS, patients are more sensitive to biotoxin exposure. One common source of contamination is vintage or second-hand items, which are often cross-contaminated with mold and other harmful substances. These items can introduce new biotoxins into your living environment, exacerbating symptoms and hindering your healing process. Therefore, it is generally best to avoid purchasing any second-hand goods during this time.

 

If you are adamant about buying vintage or second-hand items, make sure it can undergo proper small particle cleaning. Avoid purchasing porous cloth furniture, unsealed wood furniture, or any items that you cannot confidently launder or clean properly. Hard, non-porous items that can be effectively cleaned with appropriate solutions may be safer options.

 

Purchasing New Item Considerations

When purchasing new items, here are a few things to consider. One effective strategy is to wash all new clothing, bedding, and any cloth items before introducing them into your home. This practice helps remove any residual chemicals, dust, or potential contaminants that might be present on these items, ensuring a safer and cleaner environment for your recovery.

 

For non-cloth items, consider using an air compressor to blow off dust and small particles outside or using a HEPA vacuum before bringing them indoors if needed. When purchasing new furniture, be mindful of off-gassing volatile organic compounds (VOCs). New furniture often releases VOCs, which can exacerbate symptoms in sensitive individuals.

 

If possible, off-gas your new furniture in the garage or an outdoor space before moving it inside. Additionally, opt for non-toxic, organic, and natural furniture options to further reduce your exposure to harmful substances. Taking these precautions can help you create a healthier living space that supports your healing journey and minimizes the risk of re-exposure to cross-contamination.

 

CIRS Tips After Visiting Unknown Environments

These special considerations are generally only needed during active treatment until you’re able to improve your resiliency through the Shoemaker Protocol. Having a designated decontamination area in your home helps make the process more efficient and minimize any cross-contaminiation.

 

Creating a Mold Decontamination Area for Your Home

Keeping your home safe from cross-contamination by creating a mold decontamination area is important. Streamlining this process and having a protocol and space in place can help prevent cross-contamination from unideal environments. This is usually a temporary protocol while you’re healing but varies based on your individual sensitivity levels. 

 

Here are some general examples of mold decontamination areas that you can implement in your home:

 

• Garage Decontamination Area: Run an air filter in your garage and another high-quality air filter at the entrance of your home, particularly if the garage is attached. You can opt for a cheaper HEPA air filter for the garage if finances are prohibiting. Create a space with a small table or shelving that can keep items off of the ground. Use a sealed plastic bin or covered hamper to store all clothes when coming back from an unknown or water-damaged property. You can keep some cleaning supplies here too for opening packages and quickly air compressing and/or wiping down items coming into your home.    

 

• Patio or Outdoor Decontamination Area: Run a high-quality air filter inside the entrance to your patio or outdoor decontamination area. Create a space with a table or a small table or shelving that can keep items off of the ground. Use a sealed plastic bin or covered hamper to store all clothes when coming back from an unknown or water-damaged property. You can keep some cleaning supplies here too for opening packages and quickly air compressing and/or wiping down items coming into your home. 

 

• Mudroom, Entrance Area, or Bathroom: Run a high-quality air filter in whatever space you choose as your decontamination area. If you have a small bathroom available close to the entrance of your home with ventilation, this can also be a suitable option. Use a sealed plastic bin for all your clothing worn out to minimize any cross-contamination. It’s best to open packages outside so having a cleaning caddy of your supplies that you can quickly bring outside with you can help make this process more efficient. 

 

Pro-Tip: For handbags, backpacks, suitcases, and other items that you frequently take outside of your home into questionable environments, you can store these in a sealed plastin bin inside your garage, decontamination area outside if it’s safe, or inside your home. Find what works best for you but make sure these are properly stored in a sealed plastic bin. 

 

Post-Exposure Hygiene

While in active treatment, it’s ideal to take immediate steps to mitigate exposure to biotoxins after visiting contaminated or unknown environments. One effective measure is to change clothes and shower as soon as you get home. This practice helps to prevent the spread of contaminants into your living space, thereby reducing the risk of exacerbating your symptoms.

 

Place your worn clothing in a sealed plastic bin, a sealed laundry hamper, or directly in the washing machine for immediate laundering. This ensures that any biotoxins or contaminants are contained and can be thoroughly cleaned. Additionally, showering immediately helps remove any biotoxins from your hair and skin, providing an extra layer of protection.

 

What Do I Do After a Re-Exposure?

 

 

If your symptoms and/or VCS test results are indicating a re-exposure, here’s what you’ll need to do:

 

During Treatment

If you experience re-exposure during active treatment for CIRS, it’s essential to take immediate action to minimize the impact. Make sure to take the full daily dose of Cholestyramine (CSM) or Welchol as prescribed. If you are using Vasoactive Intestinal Peptide (VIP) nasal spray, continue with it as it offers protection during exposure.

 

Supplements such as high dose omega-3 fatty acids can help manage the inflammatory response as well.

 

However, be cautious not to overdo the detox process. Avoid adding additional natural binders (unless you are already taking them) and only take detox supports such as glutathione if you’re already tolerating them. Allow CSM or Welchol to work effectively on their own so you’re not putting additional stress on drainage pathways during this stage of treatment.

 

After Treatment

Post-treatment, your response to re-exposure should be tailored to your individual needs and the extent of the exposure. Typically, it’s helpful to take a small dose of CSM before potential exposure and then continue with up to the full dose of CSM for up to two weeks to aid in detoxification. Most individuals take modified dosing of CSM or Welchol while some opt for a gentle, yet less-effective option called MycoBind. VIP spray can also be used both during and after exposure for added protection.

 

Support Your Drainage Pathways

Supporting your drainage pathways can really help whether you’re in active treatment or remission. Consider incorporating practices such as using a sauna, applying castor oil packs, dry brushing, acupuncture, cupping, and lymphatic massage. Supplements that aid in drainage can also be beneficial but should only be considered under the care of your trusted practitioner during active treatment. Post-treatment, feel free to take your preferred drainage pathway supplement supports.

 

Mental Health Toolbox

 

 

A common symptom of re-exposure is impacted mental health. Prepare a toolbox of strategies that can help manage symptoms. Understand which mind-body tools are effective at different stages of dysregulation. For instance, there may be times when you are too dysregulated to engage in certain exercises due to mental resistance. Having a variety of approaches ready can help you navigate these challenges more effectively.

 

Re-Exposure and CIRS Labs

The following inflammatory markers used in tracking CIRS treatment progress that can become directly abnormal after an exposure:

• C4a
• Leptin
• MMP-9
• VEGF
• TGFBeta-1

 

There are other reasons why some of these markers can become abnormal as well, making it essential to work with your trusted practitioner to determine what your lab results mean within the scope of your case.

 

Pro-Tip: For the remainder of this content, please join our CIRS Support Group.

 

Closing Thoughts on CIRS Re-Exposures

Re-exposures are an inevitable part of life when dealing with CIRS. It’s crucial to prepare yourself and not let these occurrences dysregulate you or your progress. While this process may seem overwhelming at first, with time and practice, these precautions will become second nature.

 

Remember, the beauty of effective CIRS treatment lies in the fact that you will never become as sick as you once were. Practicing proper detox methods and minimizing exposures by using PPE are essential steps. However, it’s equally important to continue living your life and not let fear dictate your actions.

 

Empower yourself with knowledge and tools, and approach each day with confidence. Know that each step you take towards managing re-exposures is a step towards a healthier, more resilient you. Stay connected with your support system, and take things one day at a time. Your journey with CIRS may have its challenges, but with patience and persistence, you will navigate through them.

 

 

Pro-Tip: Are you looking for more in-depth practitioner resources and a like-minded community to support you through your CIRS journey? Join our exclusive CIRS Support Group for the latest research, step-by-step protocol tools, and support to successfully achieve root-cause healing.

 

Work With Our Trusted CIRS Practitioners

The Nutrition with Judy practice is honored to be a trusted CIRS practitioner support serving clients from around the globe. We’re passionate about helping our clients achieve root-cause healing in order to lead the best quality of life possible that’s nearly symptom-free. Our team is dedicated to finding the answers our patients need. We welcome you to explore our free resources and are always available to support you through personalized protocols. If you’re interested in working one-on-one with our CIRS nutritional therapy team to support you through your journey, our CIRS Support Package delivers the support and accountability for achieving root-cause healing.