What Is CIRS?

When people ask us what we do, we respond that we specialize in mold inspections for hypersensitive individuals. The diagnostic term for the illness that this segment of the population deals with is called CIRS, otherwise known as Chronic Inflammatory Response Syndrome. That’s a mouthful! Of course, the next natural question is, “What is CIRS?” 

CIRS is not a term that is commonly known to the general public. Unfortunately, it is not until someone deals with severe toxic exposure, often from a water-damaged building (WDB), that they must seek a CIRS diagnosis. Other common names for CIRS are biotoxin illness, mold sickness, or sick building syndrome. 

It is essential to understand that CIRS is not equivalent to a mold allergy. While a person with CIRS can also be allergic to mold, the body’s response in cases of CIRS is much more complex than that of an allergy. The body is responding to the mycotoxins created by mold. These mycotoxins cause the deregulation of the immune system, hormonal imbalances, and neurological dysfunction. 

3d Illustration virus, bacteria, cell infected organism, virus abstract background. Hepatitis viruses in infected organism.

To make matters worse, most people who suffer from CIRS have a specific gene that makes it impossible for them to create antibodies against the mycotoxin that makes them sick. Therefore, to get relief from symptoms and be able to detox the toxins, the most crucial first step is to get out of the building that is harboring mycotoxins. As you can see, this is why our work is so important to us: A healthy house is pivotal for those recovering from CIRS. 

Mold is not the cause of all cases of CIRS, but the individuals affected by mold are our focus. Often, those who are hypersensitive to mold are dealing with CIRS. This subset of patients who get sick from the building in which they live is diagnosed with CIRS-WDB. Certified Mold Assessments specializes in testing the homes of such hypersensitive individuals. 


Dr. Ritchie Shoemaker’s research, which he began in 1997, pioneered the foundation of our understanding of CIRS today. When practicing family medicine in Maryland, he witnessed a trend with many of the patients he treated. He linked a set of symptoms to a fish-killing toxin in the Chesapeake Bay known as Pfiesteria. Over time, Dr. Shoemaker linked a similar illness caused by toxins produced in water-damaged buildings and tick-borne microbes. 

Dr. Shoemaker has devoted his practice to clinical research on the topic and training doctors to treat CIRS. Others such as Dr. Andrew Heyman and Dr. Neil Nathan have continued research and used their clinical experience to publish books on mold illness. Dr. Shoemaker’s popular site survivingmold.com is a one-stop resource for many struggling with CIRS. 


Like any complex illness, researchers are still working to understand the causes of CIRS. Currently, the triggers fall into four main categories: 

  1. Inhalation of air from a water-damaged building (WDB): A WDB is often a breeding ground for more than just mold. A person affected by the mix of chemicals, VOCs, bacteria, viruses, fungi, and the mycotoxins and endotoxins they create, is not reacting to any “one” thing.  
  2. Ingestion of food contaminated with mycotoxins or endotoxins such as eating reef fish contaminated with dinoflagellate algae (this alga produces the Ciguatera toxin).
  3. Tick or spider bite: these insects carry hundreds of known bacteria, viruses, and fungi such as Lyme disease. There is still much to be discovered in this area. 
  4. Contact with contaminated water: swimming, bathing, or ingesting water contaminated with a toxin such as Cyanobacteria.

This knowledge of the trigger’s complexity is one reason hiring a mold testing company specializing in CIRS is so important. With our understanding of CIRS, we can keep up with new testing developments, such as the latest available endotoxin and mycotoxin testing. There are many layers to assessing the total picture, and this requires more than air testing. In some cases, getting the most precise idea of what toxin variety is present in a WDB can help you understand what you are currently reacting to and might react to in the future. 

What Patients Experience 

Because of the wide range of symptoms a CIRS patient experiences, no two cases are alike. However, researchers have been able to isolate a set of symptoms that are unique and common to cases of CIRS. If you are experiencing some of the symptoms below, it is possible your home or office building is water-damaged and has hidden mycotoxins. 

  • Respiratory (asthma, sinus issues, earaches)
  • Anxiety and depression
  • Irritability, “mold rage.” 
  • Ice pick pain 
  • Light sensitivity
  • Blurred vision 
  • Red eyes 
  • Tearing
  • Cough
  • Shortness of breath
  • Abdominal pain 
  • Short term memory loss 
  • Morning stiffness 
  • Muscle cramps 
  • Heart palpitations 
  • Slow wound healing 
  • Sweats, especially night sweats
  • Trouble regulating temperature 
  • Ringworm and other fungal rashes 
  • Problems with eyesight 
  • Dark circles under eyes 
  • Food sensitivities 
  • Migraines and other headaches 
  • Nightmares 
  • Insomnia 
  • Hair loss 
  • Decreased learning of new knowledge
  • Confusion 
  • Disorientation 
  • Word-recollection issues 
  • Skin sensitivity
  • Mood swings
  • Appetite swings 
  • Excess thirst 

We have seen clients dealing with everything from asthma to insomnia, anxiety, nightmares, and weight gain. CIRS can mimic symptoms of MS or Alzheimer’s, among many other things. The longer one stays in a WDB, the worse the symptoms can get. As mentioned, the best first step is to get out of a water-damaged building and into a safe home. Only then can a client affected by CIRS begin to have relief. 

How We Can Help 

A CIRS diagnosis poses a unique challenge for patients in that to recover from mold illness, one must not only treat their body but their home or workplace as well. There is an advantage to having a mold-testing company with a thorough understanding of the challenges a CIRS patient must face. Certified Mold Assessments will not only look for the source of the water intrusion. We can also offer air testing, various surface testing methods, ERMI/HERTSTMI, mycotoxin, endotoxin testing, actinomycetes, and even VOC tests to see if the mold is actively growing! 

Resources for CIRS Patients 

The magnitude of a CIRS diagnosis can be overwhelming. We recently published an article, “Mold Sick? Now What?” that can help those newly diagnosed with mold illness to navigate the many issues they must address. 

Thankfully, many knowledgeable people are doing great work and sharing valuable information in books, websites, podcasts. For a deep dive into CIRS and the issues associated, we recommend the following books and podcasts: 

For more tips, or if you are interested in learning how to prevent future mold issues or address current ones, please follow us on Instagram and Facebook. If you have any questions or comments, feel free to leave them in the comments below or on our social media. 

And of course, please book your inspection today! We look forward to continuing the conversation. 


1. Mold Illness & the Surviving Mold Official Book | Dr. Ritchie Shoemaker. Survivingmold.com. https://www.survivingmold.com/. Published 2021. Accessed April 9, 2021.

2. Shoemaker R, V N, A H, Westhuizen M v, S M, D L. Newer Molecular Methods Bring New Insights into Human- And Building-Health Risk Assessments from Water-Damaged Buildings: Defining Exposure and Reactivity, the Two Sides of Causation of CIRS-WDB Illness. Med Res Arch. 2021;9(3). doi:10.18103/mra.v9i3.2358

3. Dr. Andrew Heyman | Integrative Medicine Doctor Aldie VA. Virginia Center for Health & Wellness. https://www.vc4hw.com/staff/dr-andrew-heyman.html. Published 2021. Accessed April 15, 2021.

DISCLAIMER: CMA and CMA staff are not medical doctors, dieticians, nor nutritionists. We do not hold degrees in medicine, dietetics, or nutrition. We make no claims to any specialized medical training, nor do we dispense medical advice or prescriptions. This content is not intended to diagnose or treat any diseases. It is designed to be provided for informational, educational, and self-empowerment purposes ONLY. Please consult with your doctor or wellness team if you have any questions regarding any of the information provided here, and then make your own well-informed decisions based upon what is best for your unique genetics, culture, conditions, and stage of life.