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.

Conventional Treatment of Biotoxin Illness

Since Biotoxin Illness/CIRS is not a recognized condition in conventional medicine, treatment is focused on treating the symptoms of this condition, which may include the following medications:

  • Anxiety medications.  Since many people who have CIRS have anxiety, these patients are often treated with anti-anxiety medications.
  • Antidepressants. Since many people who have CIRS are also depressed, antidepressants are commonly used in these patients. Low doses of some antidepressants can also help improve sleep and relieve pain.
  • Sleeping pills. Since many people with CIRS have sleeping problems, various prescription sleep aids are often used.

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
Functional Medicine seeks to restore normal body Function


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