What We Learned at CIRSx

One of the greatest lessons we've learned from serving the autoimmune community is that healing rarely follows a straight line.

For some people, removing inflammatory foods is enough to dramatically reduce symptoms. Others may discover lingering infections, gut imbalances, hormone dysfunction, nutrient deficiencies, or environmental triggers that continue to keep the immune system activated.

Sometimes, digging deeper into those root causes uncovers something many people have never heard of: Chronic Inflammatory Response Syndrome (CIRS).

Recently, Urban AIP had the privilege of sponsoring CIRSx, a conference dedicated to educating both practitioners and patients about CIRS, mold-related illness, and the growing body of research surrounding chronic biotoxin exposure. It was inspiring to meet so many physicians, researchers, and individuals committed to helping people find answers after years of unexplained illness.

What Is CIRS?

Chronic Inflammatory Response Syndrome (CIRS) is a complex inflammatory condition that can develop after exposure to certain biotoxins, most commonly from water-damaged buildings.

Not everyone exposed to mold develops CIRS, but some individuals appear to have more difficulty clearing these biotoxins, resulting in a persistent inflammatory response.

Because inflammation affects virtually every system in the body, CIRS symptoms can be incredibly diverse and often overlap with autoimmune diseases and other chronic illnesses.

Some people experience chronic fatigue, brain fog, joint or muscle pain, headaches, digestive issues, sinus congestion, shortness of breath, light sensitivity, temperature regulation problems, sleep disturbances, anxiety, or mood changes.

These symptoms are not unique to CIRS, which is one reason diagnosis can be challenging. Many people spend years searching for answers before environmental illness is ever considered.

Why This Matters for the Autoimmune Community

At Urban AIP, we often say that food is foundational—but it isn't always the entire story.

The Autoimmune Protocol helps reduce one of the biggest sources of inflammation for many people: food. Creating a nutrient-dense, anti-inflammatory foundation gives your body the resources it needs to heal.

But if symptoms continue despite consistently following an AIP lifestyle, it may be worth working with a knowledgeable practitioner to investigate additional root causes. Environmental exposures—including mold and water-damaged buildings—may be one piece of that puzzle for some individuals.

This doesn't mean everyone with autoimmune disease has CIRS, nor does everyone with mold exposure develop chronic illness. Rather, it's a reminder to keep an open mind and continue asking thoughtful questions when progress stalls.

Why Doesn't Mold Affect Everyone the Same Way?

One of the most fascinating concepts discussed throughout CIRSx is that exposure alone does not tell the whole story.

According to the work of Dr. Ritchie Shoemaker and the Shoemaker Protocol, approximately 24% of the population carries certain HLA-DR genetic variations that may make it more difficult for the immune system to recognize and eliminate biotoxins efficiently.

Rather than clearing these toxins after exposure, these individuals may experience a persistent inflammatory response that continues long after leaving the water-damaged environment.

This doesn't mean someone is destined to develop CIRS simply because they carry one of these gene variants. Genetics are just one piece of the puzzle. The amount and duration of exposure, overall health, immune function, and many other factors also influence whether illness develops.

Understanding this concept can be incredibly validating for people who have wondered why everyone in their family lived in the same house, yet only one person became chronically ill.

The Shoemaker Protocol: A Stepwise Approach

One of the most recognized clinical frameworks for evaluating and treating CIRS is the Shoemaker Protocol.

Rather than relying on a single laboratory test, the protocol combines several pieces of information, including a history of exposure to water-damaged buildings or other biotoxin sources, a characteristic symptom cluster, Visual Contrast Sensitivity testing, HLA-DR genetic testing, inflammatory biomarkers, and environmental assessment of the home or workplace.

Treatment is also sequential. The first priority is reducing ongoing exposure before moving through additional steps that may include binders, treatment of secondary issues, correction of inflammatory markers, and other targeted therapies under the guidance of a trained practitioner.

This is important because CIRS is complex. It is not something most people can accurately identify or treat on their own with a single supplement, binder, or detox protocol. For those who suspect CIRS may be part of their story, working with a practitioner trained in this area can make the process safer, clearer, and more effective.

A Helpful Place to Start: The Symptom Cluster Chart

One of the tools frequently used by practitioners familiar with CIRS is the Symptom Cluster Chart developed as part of the Shoemaker Protocol.

Rather than focusing on a single symptom, it looks for patterns across multiple body systems. While the chart is not a diagnostic tool, it can help identify whether a conversation with a knowledgeable healthcare provider may be worthwhile.

If you're curious, you can review the symptom cluster chart here:

Symptom Cluster Chart: Surviving Mold Symptom Cluster

Another Screening Tool: The Visual Contrast Sensitivity Test

Another commonly used screening tool is the Visual Contrast Sensitivity test, often called the VCS test.

Unlike a standard eye exam, the VCS test measures your ability to distinguish subtle differences in contrast. Research has shown that contrast sensitivity can be affected in people experiencing certain neurotoxic or biotoxin-related illnesses, making it a useful screening tool within the broader CIRS evaluation process.

It is important to remember that the VCS test alone cannot diagnose CIRS and should always be interpreted alongside symptoms, medical history, and additional testing by a qualified practitioner.

If you'd like to learn more or take the screening test, you can find it here:

Visual Contrast Sensitivity Screening: Surviving Mold VCS Test

Learning From Leaders in the Field

One of the highlights of attending CIRSx was meeting practitioners who have dedicated their careers to helping patients recover from complex chronic illness.

We especially appreciated reconnecting with our friends at Roots & Branches Integrative Healthcare in Colorado. Their work caring for patients with CIRS reflects something we deeply believe at Urban AIP: healing requires looking at the whole person.

Rather than asking, "How do we suppress this symptom?" they ask, "Why is the body still stuck in an inflammatory state?"

That philosophy aligns beautifully with our own mission.

At Urban AIP, we often say that food is one of the foundations of healing—but it isn't always the entire story. Sometimes supporting recovery means looking beyond nutrition to uncover hidden drivers of inflammation, whether that involves gut health, chronic infections, environmental exposures, or other root causes.

CIRS reminds us that healing is rarely about finding one magic answer. It's about continuing to ask better questions until the missing pieces begin to come together.

Healing Often Means Looking Beyond Food

We firmly believe that nourishing your body with real, nutrient-dense food creates an incredible foundation for healing.

At the same time, we also recognize that true healing often requires looking at the bigger picture. Nutrition, sleep, stress, infections, hormones, gut health, environmental exposures, and toxin burden can all play important roles in an individual's recovery journey.

Our experience at CIRSx reinforced something we've believed from the beginning: every healing journey is unique.

If you've been doing "everything right" and still aren't feeling like yourself, don't lose hope. Sometimes the next step isn't trying another supplement or stricter diet—it's simply asking a different question.

Healing isn't always about working harder. Sometimes it's about uncovering the missing piece.

Frequently Asked Questions

Can mold exposure make autoimmune symptoms worse?

Mold exposure does not affect everyone the same way, but for some people, exposure to water-damaged buildings and biotoxins may contribute to ongoing inflammation. Since many CIRS symptoms overlap with autoimmune symptoms, people who are still struggling despite diet and lifestyle changes may want to discuss environmental triggers with a qualified practitioner.

What is CIRS and how is it connected to inflammation?

Chronic Inflammatory Response Syndrome, or CIRS, is a complex inflammatory condition that may develop after exposure to certain biotoxins, often from water-damaged buildings. In people who have difficulty clearing those biotoxins, the immune system may stay activated, leading to symptoms such as fatigue, brain fog, pain, headaches, digestive issues, sinus problems, sleep disturbances, and mood changes.