Paradigm Shift
Exploring the Impact of Mold & CIRS on Medicine
Dr. Aaron Hartman
July 24, 2024
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It would be difficult to overstate how dramatically my medical practice has been influenced by Chronic Inflammatory Response Syndrome (CIRS) over the past decade—not because I decided to specialize in mold or biotoxin illness. Instead, I just kept seeing it in my patients.
For the past several weeks, I’ve had the opportunity to compare clinical notes and stories with my colleague, Dr. Christian Jenski. We explore the paradigm shift that CIRS has forced upon our own medical practice, and that is reshaping healthcare far more broadly. You can follow the entire conversation on YouTube.
If you’re new to Mold or CIRS and don’t know where to begin, this article is for you. I’ll provide a brief summary of each of our conversations, and link back to earlier articles covering similar topics. I’ll also highlight some of the insights our conversations uncovered that we haven’t previously covered.
Let’s get started.
Episode 1
In our first episode, Dr. Jenski and I introduce the complexity of CIRS.
Chronic Inflammatory Response Syndrome is a complex, multi-system disease resulting from biotoxin exposure, such as mold in water-damaged buildings (WDBs). Interestingly, mold is a relatively minor player in CIRS, contributing only about 16% of cases, while other factors like actinomycetes and endotoxins are more prevalent. Understanding the genetic predisposition, specifically the HLA-DR, -DQ gene, which affects about 20–23% of the population, is crucial. We explored how CIRS mimics various conditions such as chronic fatigue, fibromyalgia, and even long COVID, making diagnosis challenging but essential for effective treatment. Importantly, the episode highlighted the intricate steps required for treatment, from removing exposure and using binders like cholestyramine, to innovative lipid therapies and anti-inflammatory strategies.
Related Articles
New Insights
- One of the fascinating insights from our conversation is that homes, much like our gut, can have “dysbiosis,” leading to toxic imbalances in indoor environments.
- Our discussion of lipid therapy as a newer kind of detox method represents an evolving approach to treating this multifaceted syndrome.
- Lastly, we emphasized the importance of genetic predisposition and how having susceptibility to one biotoxin group essentially means susceptibility to all, broadening the scope of who might be at risk.
Episode 2
In Episode 2, Dr. Jenski and I focused on the detailed process of diagnosing Chronic Inflammatory Response Syndrome (CIRS).
We covered the significance of understanding one’s biotoxin exposure history, highlighting how various sources such as water-damaged buildings, dental issues, and even car interiors can contribute. A key diagnostic tool discussed was the Visual Contrast Sensitivity (VCS) test, which can indicate neurologic impairment from biotoxins.
We also examined the importance of a thorough physical exam to identify subtle signs and symptoms like fine tremors and abnormalities in reflexes, which can suggest neuroinflammation. Lab tests play a critical role in confirming the diagnosis with markers like C4A, MMP9, and HLA-DR genes, amongst others.
We also touched on the multifaceted nature of CIRS, linking to conditions like long COVID and Mast Cell Activation Syndrome (MCAS). We emphasized the importance of a comprehensive approach and longitudinal patient care to navigate and manage this complex condition.
Related Articles
New Insights
- Dr. Jenski and I discussed the utility of the VCS test for patients to self-monitor post-exposure—a tool for maintaining ongoing vigilance and managing re-exposures.
- We elaborated on novel markers like VEGF, explaining their role in understanding hypoperfusion and fatigue in CIRS patients.
- Our discussion around mitochondrial dysfunction, particularly the “cell danger response,” provides new context for understanding patient symptoms on a cellular level.
Episode 3
In this episode, Dr. Jenski and I broke down the intricate biotoxin pathway that characterizes Chronic Inflammatory Response Syndrome (CIRS).
We explored how biotoxins from various sources (e.g., mold, bacteria, Lyme) initiate a cascade of immune responses, particularly when the individual has the HLA-DR/DQ genetic mutation that hampers the body’s ability to detoxify efficiently. This pathway involves several complex processes, including leptin resistance, suppression of melanocyte-stimulating hormone (MSH), and the presence of MARCoNS (a drug-resistant staph colonization). We also delved into how these disruptions lead to multisystem symptoms and chronic inflammation. Central to the pathway are markers like C4a, MMP9, and VEGF, which can indicate the state of immune response and tissue hypoxia. Additionally, we touched on some advanced anti-inflammatory treatments such as Specialized Pro-Resolving Mediators (SPMs) and their roles in mitigating inflammation and promoting resolution.
Related Articles
New Insights
- New insights in this episode include the deeper dive into how leptin resistance caused by the regulatory system in the hypothalamus can lead to multi-system dysregulation, affecting neuropeptides like MSH and VIP.
- Understanding MARCoNS as a chronic, multi-drug resistant staph colonization unique to CIRS patients is critical as it further suppresses MSH and perpetuates inflammation.
- We also discussed the role of SPMs and phospholipid therapy as innovative approaches to manage inflammation better—a shift from traditional therapies to more targeted treatments in calming the cytokine storm and supporting immune function.
Episode 4
In this episode, Dr. Jenski and I detailed the comprehensive treatment approach of the Shoemaker Protocol for Chronic Inflammatory Response Syndrome (CIRS).
We emphasized foundational steps such as identifying and removing sources of biotoxin exposure, which is critical to halt ongoing inflammatory responses. Binders like cholestyramine (CSM) and Welchol (colesevelam) are pivotal in eliminating biotoxins stored in the body. We further discussed the nuances of using additional natural binders such as activated charcoal and the role of dietary interventions. Treatment also involves addressing MARCoNS (multi-drug resistant staph), correcting hormonal imbalances, adjusting ADH/osmolality, and ultimately, utilizing Vasoactive Intestinal Peptide (VIP) as a powerful neuropeptide that can reset genetic abnormalities and restore health. VIP, in my personal and observed experience, has demonstrated remarkable capacity to “switch on” a patient’s vitality and cognitive functions, making it a transformative component in advanced stages of CIRS treatment.
Related Articles
New Insights
In this episode, we delved deeply into the practical application of the Shoemaker Protocol and shared several new strategies and insights not previously discussed:
- Updated treatments for MARCoNS now include using EDTA with colloidal silver instead of the traditional BEG spray to avoid ototoxicity, enhancing patient safety.
- I also shared personalized anecdotes about the transformative effects of VIP therapy, emphasizing how it restored cognitive and physical functions for patients, including myself.
- We highlighted the role of various supportive binders and dietary practices in enhancing patient responses and managing Herxheimer reactions during detoxification, providing a more nuanced and integrative approach to CIRS treatment.
Episode 5
In this episode, Dr. Jenski and I addressed how Chronic Inflammatory Response Syndrome (CIRS) redefines our understanding of numerous chronic diseases.
We explored how CIRS underlies many conditions previously considered idiopathic or multifactorial, such as chronic fatigue syndrome, fibromyalgia, IBS, and certain neuropsychiatric disorders. Central to this paradigm shift is recognizing that water-damaged buildings contribute significantly to CIRS, but that mold itself accounts for only about 16% of these cases. Misleading beliefs about mold being the primary culprit obscure the broader range of biotoxin exposures that can trigger CIRS, including sources like dental infections, breast implants, and even head trauma. Additionally, we reinforced the importance of an integrated treatment approach involving diet, stress management, and environmental control to support lasting recovery and prevent relapse.
Related Articles
New Insights
This episode introduced several new insights and expanded on existing concepts:
- Comprehensive Approach to Diet: Patients should focus on consuming real, whole foods. We discussed the benefits of fiber in detoxification and the negative impact of processed foods and unhealthy oils, suggesting more nuanced dietary strategies to manage CIRS.
- Stress and Trauma Management: We highlighted the use of various techniques such as breathwork, flotation therapy, and massage to manage chronic stress and trauma, which are crucial in preventing relapse and supporting recovery. Specifically, the role of psychoneuroimmunology and the idea of maintaining a “rest and repair” state were emphasized as critical for long-term health.
Episode 6
In this episode, Dr. Jenski and I dove headlong into some of the most contentious myths and misconceptions surrounding mold & CIRS.
Notably, we dissected the ongoing debate between urine and blood testing. While urine testing for mycotoxins is common, it mainly reflects dietary exposure rather than environmental, and doesn’t indicate immune system response. Blood testing, however, provides robust insights into immune dysregulation and is crucial for diagnosing CIRS accurately. Furthermore, we talked about the limitations and benefits of different environmental tests like ERMI and HERTSMI-2, and the necessity of involving certified Indoor Environmental Professionals (IEPs) for thorough home inspections. We also dove into lipid therapies and dietary adjustments that can support detoxification and mitigate symptoms.
Related Articles
New Insights
- Chewable VIP: This is an exciting development. Dr. Jenski mentions, “There is a chewable version of VIP now that PD Labs offers… it’s a nanitized, lipophilized version of VIP that you chew” which could be a game-changer in terms of administration and compliance.
- Clarifications on Environment Testing and Mold Sensitivity: There was a detailed discussion about how ERMI and HERTSMI-2 tests can sometimes be too sensitive and why it’s crucial to bring in professionals who can evaluate issues like incorrect wrapping (missing Tyvek) or chemical vapors from garages.
- Vagal Nerve Dysfunction in MCS: We elaborated on the complex interplay between past exposures, limbic dysfunction, and extreme sensitivities in some patients. This is essential for understanding why some patients might have severe reactions to minimal exposures and how vagal nerve reprogramming can help.
Conclusion
As we wrap up this journey through Chronic Inflammatory Response Syndrome (CIRS) and its far-reaching implications, it’s clear that understanding and addressing this complex condition requires a paradigm shift in our approach to health. Through our conversations, Dr. Jenski and I have explored the intricacies of CIRS, from its diagnostic challenges to innovative treatment protocols that offer hope and healing. Whether you’re just beginning to uncover the layers of CIRS or you’re seeking deeper insights, our ongoing discussions aim to empower you with science-backed solutions and a clear roadmap to whole-person health. Take the next step towards reclaiming your health by subscribing to our YouTube channel for more in-depth episodes, or visit our blog for a wealth of related articles and resources. Together, let’s harness the power of functional medicine to restore health and vitality—because you were made for health.
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