Chronic Inflammatory Response Syndrome
Dr. Tichauer is an active member of the International Society for Environmentally Acquired Illness (ISEAI.com) and well experienced in the treatment of biotoxin related medical problems.
Mold illness is a medical condition that is very serious and often misdiagnosed. When a genetically susceptible individual is exposed to toxic mold spores in a water damaged building, an inflammatory cascade occurs due to the body’s inability to remove the mycotoxins. This can result in a complex multi-system illness, coined “Chronic Inflammatory Response Syndrome, (CIRS),” by Ritchie Shoemaker, MD. Symptoms of CIRS may include fatigue, weakness, muscle pain, headaches, sinus issues, dizziness, abdominal pain, joint pain, difficulty concentrating, and insomnia.
CIRS represents a constellation of symptoms that collectively encompasses Biotoxin Illness. Originally thought to be caused only by mold exposure, it has been found that exposure to other fat soluble toxins as well as numerous bacteria, fungal and viral infections can lead to Chronic Inflammatory Response Syndrome. Some auto-immune disorders as well as post-treatment Lyme syndrome is actually the manifestation of immune dysregulation resulting in regional and/or systemic chronic inflammation.
Due to the complexity and severity of symptoms in this condition, a systematic approach needs to be taken to evaluate and treat mold and biotoxin illness. With no well-established consensus in the medical community regarding this issue, the doctors at BCNC make an effort to utilize the best of each evidence-based approach to optimize outcomes. For diagnosis, this commonly includes some combination of the following:
- Direct testing for mycotoxins utilizing Real Time Labs or Great Plains Laboratory
- Performing a swab of the sinuses for culture and/or PCR testing to determine if there is fungal presence or certain bacteria (MARCONS) which are characteristic of ongoing mold exposure.
- Visual Contrast Sensitivity – this test is a very inexpensive and effective method for understanding the severity of mold illness as well as tracking the effectiveness of therapy.
- Indirect testing to ensure no particular mold/biotoxin was missed as well as to determine the severity of illness and how best to initiate and progress through treatment. This testing can include markers such as MSH, VIP, TGF-b1, ADH with osmolality, testosterone, DHEA, VEGF, MMP-9 and cortisol.
Once the diagnosis of mold/biotoxin illness has been made, a similarly integrative approach is used to help eliminate toxin from the body. Depending on the individual diagnosis, this includes some combination of the following:
- The first and most essential starting point is ensuring that the patient is no longer being exposed to a sick/water-damaged building. Testing for mold spores (and toxin levels) using an ERMI, EMMA, HERTSMI, canister test or other method is critical, as ongoing exposure will surely sabotage recovery. Until you clean or move out of the toxic environment, it’s a bit like using a bucket to bail out a leaking boat.
- Binders to sequester toxins and promote elimination, primarily through stool. These medications are chosen based on the specific toxins identified as well as gauging which substances are most likely to be individually tolerated. Common binders include cholystyramine, charcoal, clay, chlorella, propolmannan and modified citrus pectin. Cholagogues to stimulate bile flow are often utilized prior to taking these binders and can be provided either orally or intravenously.
- Nasal-sinus sprays or washes to eliminate abnormal fungi/bacteria associated with mold illness. This can range from prescription antibiotics and antifungals to essential oil formulas or patented colloidal silver sprays with EDTA.
- Mobilizers to promote elimination of mycotoxins/biotoxins from fatty tissues such as cell membranes. This ‘lipid-exchange’ method can be done orally or, if needed, intravenously and involves the use of true phosphatidlycholine, fatty acids in a specific ratio, folinic acid, glutathione and other nutrients needed for cell membrane and mitochondrial membrane repair and remodeling.
- Medications, either naturally or pharmaceutically, to help repair the damaged systems in the body. This is done in a very targeted and systematic way as established by Dr. Shoemaker. Commonly the goal is to eventually use VIP (vasoactive intestinal peptide) spray to repair atrophied neuroendocrine regions of the brain.
In certain cases of CIRS, the offending biotoxin comes from an implanted material or a resident commensal or opportunistic organism living in the body. This could be virtually any organism that has found a way to survive in the human body including herpes, Candida, Klebsiella, Strep, Epstein-barr, a dental filler or implant, a stool parasite or a tick-borne infection such as Borrelia (the organism that causes Lyme). In these cases, since it is not always possible to eliminate the source of inflammation, the goal is to re-establish immune tolerance. This is commonly done using thymic peptide injections, immune based therapies and/or Low Dose Immunotherapy.