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Chronic Inflammatory Response Syndrome

AKA Mould Illness, Biotoxin Illness, Sick Building Syndrome

Chronic Inflammatory Response Syndrome (CIRS) is a multi-system, multi-symptom illness caused by inhaling the biotoxins and inflammagens produced by micro-organisms such as mould and bacteria in water-damaged buildings. When caused by a water-damaged building, CIRS is more commonly known as Mould/Biotoxin Illness.

In a water-damaged building, a phenomenon called amplification occurs whereby certain species of mould and other toxigenic microbial agents flourish and have the resources to produce significantly more biotoxins. When these biotoxins and other microbial by-products are inhaled over time, genetically susceptible individuals can become ill with CIRS. Such individuals are highly reactive to damp/mouldy environments, similar to an allergic reaction.

While allergies to mould do exist, CIRS is not technically an allergic response, nor is it a fungal infection. CIRS is instead characterised primarily by an overactive innate immune system. Inflammation is a natural part of the body’s response to pathogens and can be helpful in the short term, however when an individual’s immune system is able to detect but not remove biotoxins from the body, the body stays in an inflamed state that worsens over time and causes the chronic inflammatory response that CIRS is named for.


For more information about CIRS, including a great summary of the scientific evidence, please go to the

Toxic Mould Support Australia website.

Common CIRS Symptoms


Difficulty retaining information
Body aches
Light sensitivity

Memory impairment
Decreased word finding

Difficulty concentrating

Joint pain
AM stiffness


Unusual skin sensations or sensitivity
Unusual pain

Shortness of breath
Sinus issues

Abnormal thirst
Confusion/Difficulty thinking

Appetite changes
Difficulty regulating temperature
Increased urination

Red/irritated eyes
Blurred vision

Unexplained sweating
Mood swings
Ice-pick pain

Abdominal pain

Tearing/watery eyes
Disorientation/losing your bearings
Metallic taste

Static shocks

The above table represents research by Dr Ritchie Shoemaker, who found that 37 common symptoms could be categorised into 13 clusters. His clinical research suggests that if an adult possesses eight or more clusters of symptoms, the likelihood of CIRS exceeds 95%. 

The multitude and variety of symptoms is mostly due to the presence of the immune system throughout the entire body. In a healthy individual, biotoxins will be removed from the blood by the liver, broken down into harmless adducts and excreted. In those with a dysfunctional immune system, biotoxins can remain in the body indefinitely, continuing to trigger the innate immune system. This results in chaotic and ineffective inflammatory cascades, which only worsen with continuing exposure to water-damaged environments.

Want to know how many symptom clusters you possess?

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How Do I Know If It's Mould Illness/CIRS?

Unfortunately there is no single test that provides a diagnosis of CIRS/Mould Illness, but there is a step-by-step process that will provide clues:

1. Detailed history of symptoms and exposures

2. Symptom cluster analysis

3. Visual Constrast Sensitivity (VCS) test

4. HLA DR/DQ gene test for predisposition to CIRS

5. Various biotoxin markers and/or mycotoxin urine or serum antibody testing

7. Start treatment and monitor symptoms 

CIRS diagnosis framework

Working With The Clinic

Kate has personal experience with CIRS, having been through two significant exposures and their associated health consequences in the last few years. Kate is trained in both the Shoemaker Protocol and Dr Crista's Naturopathic approach, and has completed the following mould/biotoxin practitioner trainings:

- Surviving Mold Proficiency Partners Certification (Dr Ritchie Shoemaker)
- Mold Training for Medical Practitione
rs (Dr Jill Crista)
- Mold Illness Made Simple Course (Dr Sandeep Gupta)
- Advanced Precision Mold Master Class (Beth O'Hara)
- Advanced Mold-Immune Course (Drs Margaret Christensen & Dr Gail Clayton)


Surviving Mold Certificate
Dr Crista Certified
Mold Illness Made Simple
Advanced Mold Immune Course
Mast Cell 360 Mold Course

Once the initial consult has been completed, functional testing and relevant blood tests can be ordered via your GP or privately via NutriPath. Practitioner-grade supplements can then be onboarded to reduce inflammation, calm down an overactive immune system, optimize gut function and support detox pathways/remove mould. 

CIRS specific testing available:
- HLA DR/DQ test for mould sensitivity

- Mycotoxin urine analysis (RealTime or Great Plains)

- Mycotoxin serum antibody testing (MyMycoLab)

- Mould/Biotoxin markers (eg C4a, MSH, VEGF, TGF-b1, VIP)
- Blood biomarkers (eg Leptin, ADH/Osmolality, ACTH/Cortisol, AGA, ACLA)

- Indicators of inflammation & dysfunction (eg Liver/Kidney function, CBC, Lipid panel)

CIRS/Mould Illness Treatment Framework

CIRS framework
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