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What is Chronic Inflammatory Response Syndrome?

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Chronic Inflammatory Response Syndrome (CIRS)

Chronic Inflammatory Response Syndrome (CIRS) is a multi-system, multi-symptom illness triggered by exposure AND accumulation of biotoxins most often from mold and tick-borne infections. While anyone can get ill from this kind of exposure, about 22% of the population is genetically susceptible to CIRS because they are unable to properly excrete or destroy these toxins. The toxins then remain in the body and cause a hyperactive, pro-inflammatory, and destructive immune response. A series of events will also cause neurological dysfunction, neuro-endocrine system alterations, imbalance in the gut microbiome, and much more. CIRS is called a “multi-system” illness because it can affect virtually ANY organ system of the body and if left untreated becomes debilitating. The most common symptoms are chronic fatigue, brain fog, chronic pain, IBS, diarrhea, autoimmunity, mast cell activation syndrome, difficulty sleeping, neuropathy, and sinus infections. At Aspen Integrative Medical Center, Dr. Paul Despres specializes in the management of CIRS. The treatment of CIRS can be quite complex and overwhelming, so please give us a call to establish care with Dr. Despres to receive the right guidance on your road to recovery. 

What causes CIRS?

80% of CIRS is caused by exposure to toxic mold in water damaged buildings. Mold toxicity can be caused by the mold itself, mold spore fragments, mycotoxins, volatile organic compounds, Actinomyces, and/or Mycobacteria. It is estimated that as high as 50% of all water structures have a water problem.

20% of CIRS is caused by Lyme disease, Ciguatera, Pfiesteria, and Cyanobacteria. 

Other contributing factors include other environmental toxins, diet, epigenetics, trauma, and PTSD. Often see the patient went through a traumatic event or changes 1-2 years prior to CIRS starting (divorce, serious financial issues, car accident).

Who is susceptible to CIRS?

22% of the population is at higher risk of having CIRS because they carry HLA alleles that prevent formation of antibodies and excretion of the biotoxins. These individuals get progressively sicker as biotoxins accumulate in their body. That means an estimated 40 million people in the US is vulnerable to CIRS. Potential vulnerability increases If exposed to other environmental toxins or have a history of trauma.  

What are the symptoms of CIRS?

Because the illness affects multiple systems in the body, CIRS can present with numerous symptoms. If you are experiencing several of these symptoms, you could be suffering from CIRS.

Remember there are other conditions that are far more likely statistically to cause these symptoms, especially for children. For example, children get frequent upper respiratory infections (nasal congestion, fatigue, etc.) and their bowel habits can fluctuate. The list of symptoms is more concerning if they can’t be explained by another cause, they won’t go away, they keep returning, and/or they come in a group. 

The following symptoms are unique to CIRS and is CIRS until proven otherwise: 

    • Severe fatigue, cognitive impairment, intense anxiety, depression
    • “Buzzing” or “tremor” sensation in the body
    • Ice pick or lightning bolt sensation
    • Electric-like painful sensations
    • Unusual areas of numbness and tingling
    • Odd tics and spasms (dykinesias)
    • Seizure like events
    • Disequilibrium and dizziness that can’t be diagnosed neurologically
    • Fibromyalgia
    • “Atypical” MS, Parkinson’s Disease, Alzheimer’s Disease
    • “Atypical” rheumatological condition

Comprehensive list of acute and chronic symptoms by system:

    • Constitutional: headache, brain fog, migraines, fatigue, frequent static shocks, weight gain, sweats, temperature dysregulation
    • Respiratory: nasal bronchospasm, cough, chest pain, asthma like acute respiratory syndrome, shortness of breath, air hunger, sinusitis, pulmonary hypertension
    • Cardiovascular: palpitations, hypotension
    • Mouth: taste changes, metallic taste in mouth, excessive thirst
    • Gastrointestinal: appetite swings/changes, abdominal pain, bloating, nausea, diarrhea, constipation, leaky gut, gall bladder removal, gastroparesis
    • Musculoskeletal: joint pain w/ morning stiffness, joint swelling, stiffness, muscle weakness, fibromyalgia, cramps, spasms
    • Eyes/Sinuses: conjunctivitis, sensitivity to light, nasal polyps, redness, blurred vision, tearing, chronic sinus congestion
    • Genitourinary: polyuria, nocturia, excessive thirst
    • Skin: skin rash, stretch marks, pruritis, skin sensitive to light touch
    • Immune system: multiple chemical sensitivity, mast cell activation syndrome, frequent infections
    • Hormonal: temperature dysregulation, adrenal fatigue, excessive thirst
    • Psychiatric: PTSD, mood swings/changes, depression, difficulty concentrating, memory loss, cognitive impairment, loss of executive function, insomnia, irritable/angry, word assimilation, confusion, disorientation
    • Neurological: unusual pains “ice pick” or “lightening bolt”, vertigo, tremor, numbness, tingling, dysautonomia, POTS, electric like shocks, unusually under skin feelings (crawling, clawing, sharp), seizures
    • Gynecological: impotence, infertility, menorrhagia, frequent cysts

How is CIRS diagnosed?

There is no one diagnostic test or marker for CIRS. Diagnosis is often based on the following factors:  

  1. Positive exposure to biotoxin(s) or testing
    1. Visualized mold, musty smell, prior known leak, lyme/tick bite/travel/rash, brown recluse spider bite, started with eating fish (ciguatoxin), started after exposure to certain bodies of water (pfiesteria), etc.
    2. Positive test for either mycotoxins in urine, lyme disease, etc.
  2. Other potential causes have been ruled out
  3. Present with 8 or more (if adult) or 6 or more (if child) of 13 clusters of symptoms:
    1. Fatigue
    2. Weakness, decreased assimilation of new knowledge, aching, headache, light sensitivity
    3. Memory impairment, decreased word finding
    4. Concentration difficulty
    5. Joint pain, morning stiffness, muscle cramps
    6. Unusual skin sensitivity, tingling
    7. Shortness of breath, sinus congestion
    8. Cough, excessive thirst, confusion
    9. Appetite swings, difficulty regulating body temperature, increased urinary frequency
    10. Red eyes, blurry vision, night sweats, mood swings, unusual pain/ice-pick pains
    11. Abdominal pain, diarrhea, numbness
    12. Static shocks, vertigo
    13. Tearing, disorientation, metallic taste
  4. Abnormal lab testing:
    1. Failed Vision Contrast Study (VCS)
    2. Presence of HLA-DR
    3. Elevated MMP-9
    4. ACTH/Cortisol Imbalance
    5. ADH/Osmolarity Imbalance
    6. Low MSH
    7. Elevated C4a
  5. Experience symptomatic and lab value improvement with therapy.

How do you treat CIRS?

Treatment is individualized for each patient. It frequently includes:

  • Elimination of further biotoxin exposure
  • Resetting nervous system
  • Setting foundations of health
  • Choosing the right binder(s)
  • Opening detox and lymphatic pathways
  • Healing the gut
  • Healing the sinuses including MARCONs
  • Calming mast cell activation syndrome (if needed)
  • Prescribing antifungals medications and herbs
  • Correcting abnormal lab values – sex hormones, ADH/osmolarity, MMP9, VEGF, C3a, C4a, TGF B-1, VIP
  • Addressing tickborne infections (if needed)

Schematic Created by Dr. Paul Despres – Illustrating the Cascade of Events With Chronic Inflammatory Response Syndrome That Lead to Severe Symptoms

If you suspect you have Chronic Inflammatory Response Syndrome, call us to schedule an appointment today.