Biotoxin illness / Chronic Inflammatory Response Syndrome (CIRS)

Biotoxin illness or Chronic Inflammatory Response Syndrome (CIRS) is a chronic inflammatory condition involving primarily the innate immune system which results from exposure to a biotoxin (ie: mycotoxins from mold or toxins produced by bacteria such as Borrelia burgdorferi from Lyme disease).  Chronic Inflammatory Response Syndrome was a description coined by Ritchie Shoemaker, MD, to describe a subset of individuals who appeared to have a chronic inflammatory response to certain biotoxins (toxins produced by other organisms).  Some individuals are more susceptible to mycotoxin illness than others.  According to Dr. Shoemaker’s research, approximately ¼ of the U.S. population has specific genes that make them susceptible to this condition.  Normally, these biotoxins are removed from the body via detoxification pathways.  However, in these individuals, the biotoxin is not recognized by the adaptive immune system and therefore is not removed from the body.  

There is no single test to confirm a diagnosis of biotoxin illness/CIRS.  You may need a variety of medical tests to rule out other health problems that have similar symptoms.  However, there are a number of biomarkers associated with biotoxin illness that can be ordered via conventional labs and specialized lab testing that help in identifying this condition.  Assessing for levels of mycotoxins excreted in the urine and Lyme-associated infections and co-infections is also important.

Biotoxins may pass from cell to cell creating cell damage and causing immune system dysfunction which leads to systemic inflammation.  This chronic inflammation affects multiple organ systems causing widespread symptoms, frequently leading to misdiagnoses and failed treatment.  

Biotoxin illness or CIRS is often confused with these conditions or can lead to the following diagnoses:

  • Fibromyalgia 
  • Chronic Fatigue Syndrome 
  • Chronic pain 
  • MCAS (Mast Cell Activation Syndrome) 
  • HPA Axis Dysfunction 
  • Depression 
  • Anxiety 
  • Post-traumatic stress disorder (PTSD)  
  • Alzheimer’s 
  • Parkinsonism 
  • Breast implant illness 
  • Allergy
  • Sinus infections

Symptoms associated with biotoxin illness include:

  • Fatigue 
  • Weakness
  • Muscle and joint pain
  • Headaches
  • Weight Gain (rapid) 
  • Light sensitivity 
  • Memory impairment
  • Brain fog
  • Shortness of breath
  • Chest pain
  • Cough
  • Dizziness
  • Poor vision
  • Irregular heart rhythm
  • Abdominal pain
  • Diarrhea
  • Sinus congestion

Functional medicine management of Biotoxin Illness

A comprehensive approach to the management of complex conditions such as CIRS must take into consideration many aspects of health, including gut barrier integrity and imbalances of gut flora, liver detoxification capacity, oxidative stress, chronic inflammation and toxic burden. 

There are several areas of management of CIRS in the Functional Medicine approach:

  • Dampening activation of the innate immune system and decreasing inflammation
  • Restoring normal gut barrier integrity, digestion and gut microbial balance 
  • Supporting bile production and elimination of mycotoxins
  • Decreasing oxidative stress with antioxidants and supporting antioxidant enzymes
  • Supporting energy production by the mitochondria, the “power-houses” of the body’s cells
  • Restoring healthy levels of nutrients in cases of nutritional deficiencies

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