Personalised Support for Mould Illness & Chronic Inflammatory Response Syndrome (CIRS)
Chronic Inflammatory Response Syndrome . Mould Illness . Tick Borne Infections . Long COVID . Laboratory Testing . FAQs
At the Autoimmune Clinic, we specialise in mould illness and chronic inflammatory response syndrome (CIRS), through a functional medicine approach.
Mould illness and Chronic Inflammatory Response Syndrome (CIRS) are complex, multi-system conditions that can lead to fatigue, brain fog, pain, and heightened sensitivity to foods, chemicals, or smells.
We understand that mould exposure can affect people in many different ways — from allergy and delayed sensitivities to chronic immune dysregulation.
Our approach goes beyond symptom management to uncover root causes, reduce exposure, calm inflammation, and support you with a personalised plan that addresses both your health and your environment.
Have you heard of Chronic Inflammatory Response Syndrome (CIRS) ?
IN SIMPLE TERMS, 25% OF THE POPULATION CANNOT EFFECTIVELY MOUNT AN EFFECTIVE RESPONSE TO MOULD TOXINS TO CLEAR THEM FROM THE BODY.
​Chronic Inflammatory Response Syndrome (CIRS) is a multifaceted condition first identified and elaborated by Dr. Ritchie Shoemaker in the late 1990s. It is also called mould biotoxin illness.
Currently, there are over 1,700 scientific articles discussing this syndrome.
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CIRS is characterised as a multi-symptom illness triggered by exposure to biotoxins or neurotoxins from biological sources. 80% of CIRS cases are mould illness cases. ​
Because of the inadequate response of the immune system, it continuously produce cytokines in an attempt to eliminate these toxins.
This persistent but inefficient response leads to chronic inflammation and tissue damage over time. Whilst approximately 25% of the population is genetically predisposed to developing Chronic Inflammatory Response Syndrome (CIRS) when exposed to significant amounts of biotoxins, as estimated 2% of people have genes that make them highly susceptible to severe symptoms from prolonged or recurrent biotoxin exposure.
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The problem sadly for these individuals with CIRS is that their bodies become severely compromised and weakened from the vicious cycle of invading biotoxins, immune response, and inflammation.​
What about the remaining 75% of the population you ask?
These individuals' immune system, when exposed to mould toxins, respond by binding with the invading poison that allows its cells to filter the biotoxins through the liver, kidneys, and other organs. No ongoing symptoms persist and the inflammatory process returns to normal.
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"The difficulties arise due to a significant gap between practitioner understanding and published literature regarding mould exposure and its management."
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People facing mould-related illness often encounter significant challenges within the healthcare system.
One of the biggest challenges faced by people sick from mould is the fact that doctors, friends, and family members dismiss their symptoms simply because they do not get sick when exposed to mould.
Many victims of mould sickness are labelled as hypochondriacs which is so sad as these people have no control over their sickness because their bodies have a genetic predisposition to mould illness.
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UNDERSTANDING THE BASICS OF MOULD IS CRUCIAL.
Mould thrives in damp environments, commonly found in buildings with water damage and high humidity. Individuals with chronic illnesses often report feeling worse in specific environments, such as their homes, where they experience symptoms that improve when they are away.
Other known triggers for CIRS include:
Beside mould and water-damaged buildings, other well-established triggers of CIRS include:
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Tick‑borne infections
Borrelia (Lyme), Babesia, Anaplasma, Ehrlichia and Bartonella can act as biotoxin triggers, leading to the persistent inflammatory response characteristic of CIRS
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Spider bites
These too may release toxins that provoke a CIRS reaction
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Ciguatera poisoning
Consumption of reef fish contaminated with biotoxins can induce CIRS via ciguatoxins
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Harmful algal blooms
(cyanobacteria) – Exposure to toxins from blue‑green algae is also implicated
CIRS and Long COVID
In recent years, COVID-19 has emerged as a major trigger for persistent, multisystem illness. A growing body of research and clinical observation suggests that many individuals experiencing Long COVID share striking symptom overlap with Chronic Inflammatory Response Syndrome (CIRS).
These include:
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Profound fatigue and post-exertional malaise
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Cognitive dysfunction or “brain fog”
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Breathlessness and chest tightness
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Autonomic disturbances such as dizziness, palpitations, and temperature dysregulation
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Heightened sensitivity to chemicals, smells, and even foods
We know realise that Long COVID may share the same underlying mechanisms as CIRS, a sustained inflammatory response triggered by the body’s inability to fully clear toxins produced by viral antigens. This becomes particularly relevant when symptoms persist for many months, despite no evidence of ongoing infection.
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For individuals with a history of mould illness or other biotoxin exposure, COVID-19 can act as a tipping point. Clients often report a significant worsening of symptoms following acute infection or vaccination. This may reflect an already compromised immune surveillance system now burdened by additional inflammatory stress.
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The Role of the Innate Immune System
In both CIRS and Long COVID, dysregulation of the innate immune response is a central feature. Inflammatory cytokines, impaired detoxification, and disrupted neuroimmune signalling contribute to a complex web of symptoms that can be difficult to unravel without a structured, root-cause approach.
We work closely with clients to assess for underlying biotoxin exposure, immune markers, and susceptibility patterns (e.g., HLA genotypes), while also supporting key areas such as mitochondrial health, neurological recovery, and limbic system retraining.
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Each case is unique, and no single protocol works for everyone. Some individuals benefit from targeted detoxification and binders (such as cholestyramine), others may require antiviral or antifungal support, vagus nerve stimulation, or work to re-regulate the hypothalamic-pituitary-adrenal (HPA) axis.
By integrating principles from both CIRS and post-viral illness recovery, we aim to provide a structured, science-informed path forward for those affected by Long COVID — particularly when conventional approaches have yielded few answers.
Tick-Borne Illnesses & Chronic Lyme disease
Ticks can carry multiple pathogens including Borrelia burgdorferi (Lyme disease), Babesia, Anaplasma, Ehrlichia, Bartonella, and Rickettsia. Many individuals are co-infected with more than one of these organisms, which complicates diagnosis and increases the likelihood of persistent, multi-system symptoms.
Importantly, not all of these infections are transmitted solely by ticks: Bartonella species can also be spread via fleas and animal scratches, while Babesia and Rickettsia have been reported in some regions to be transmitted by mosquitoes and other biting insects. This broader range of vectors increases the potential for unnoticed exposure, especially in individuals with outdoor lifestyles or frequent animal contact.
Although the term “chronic Lyme” is debated in conventional medicine, a significant number of patients report long-lasting symptoms following acute infection, including fatigue, brain fog, pain, and autonomic dysfunction. In many of these cases, it may not be the active infection driving symptoms, but instead an ongoing inflammatory response—hallmarks of Chronic Inflammatory Response Syndrome (CIRS). This is especially relevant for those with genetic susceptibility (HLA-DR haplotypes).
Why is it important to address CIRS in chronic tick-borne infections?
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When managing chronic infections such as Lyme disease and its co-infections, it is essential to recognise that the immune system—not just the pathogen—often drives ongoing symptoms. Chronic immune dysregulation and biotoxin accumulation can persist even after microbial load has been reduced. This is where CIRS (Chronic Inflammatory Response Syndrome) becomes clinically relevant.
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For long-term recovery, it is crucial to address both the infection and any other contributing biotoxin exposures—such as mould in the home or workplace. Regulating the immune system through targeted interventions, alongside binders to support detoxification and avoidance of ongoing exposure, forms the foundation of successful treatment for many complex cases.
Helpful Screening Tools
WHERE TO START IF YOU SUSPECT YOU MAY HAVE CIRS
The 37 Symptom Cluster Questionnaire
Here are the 37 symptoms associated with CIRS. Most people with CIRS, especially when being exposed to mould or with repeated exposures will typically present with some of these symptoms:
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The VCS Test
VISUAL CONTRAST SENSITIVITY TEST
CIRS can have devastating effects on different systems throughout the body, including neurological functions.
The visual contrast sensitivity test (VCS test) indicates how certain biotoxins, such as mould, affect the brain and retinal artery blood flow. This interferes with the ability to discriminate between white and gray contrast as seen in the test. If you have a multi-symptom, multi-system illness and a failed VCS test, the likelihood that you have CIRS is 98.5%.
See here an example of what the VCS test looks like.​
We ask for you to complete a VCS test before you initial appointment. You are also welcome to share your results during your pre-intake call.
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Testing for CIRS
LABORATORY TESTING
It's likely that no one has looked at markers directly associated with CIRS. Conventional doctors might test for mould allergies if you suspect mould is causing your illness, and many functional medicine practitioners mistakenly use urinary mycotoxin tests to investigate mould illnesses. However, none of these tests look at on the innate immune system, which is where the core issue lies.
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Tests for CIRS specifically look at how your innate immune system is responding to a biotoxin and the biological changes that take place with this immune activation
When It Is Not Mould Illness Caused by CIRS
Not everyone who feels worse in a mouldy environment has CIRS. Some people are dealing primarily with allergy, delayed sensitivities, or nervous system hypervigilance. Others have unrelated conditions — thyroid, autoimmune, or metabolic issues — that need ruling out.
Starting with a general health MOT and, where relevant, allergy testing or a symptom questionnaire can clarify what is driving symptoms. Taking this broader view helps ensure the right plan is created for you, rather than relying on a single protocol that may not fit your situation.
Mould Allergy (IgE-Mediated)
Some people respond to mould exposure with a classic allergic reaction. This IgE-mediated pathway can cause sneezing, congestion, itchy eyes, cough, wheeze, rashes, or hives — sometimes within minutes of exposure. Fatigue or brain fog can appear suddenly and lift after leaving the environment.
If you suspect a mould allergy, it is worth asking your GP about specific IgE and total IgE testing. Improving ventilation, reducing dampness, and using medical treatments when appropriate can all help. We combine these measures with functional medicine support to reduce background inflammation and help you feel more resilient.
Mould Sensitivity (Non-IgE)
Mould sensitivity is different from allergy. Symptoms may build over time — for example, after a few days in a damp building you might notice more fatigue, pain, poor sleep, or cognitive slowing. These reactions are driven by other branches of the immune system and are often missed on standard allergy testing.
Taking a careful history and, where relevant, running mould sensitivity (IgG) testing can help connect the dots. The focus is usually on reducing exposure, calming immune activation, and supporting recovery at a sustainable pace.
Total Body Burden
Mould is one part of a bigger picture. Stress, poor sleep, chemicals, infections, and other chronic health challenges all add to the body’s total load. When the “bucket” is full, even small exposures can tip you into symptoms.
Lightening this load — improving indoor air quality, reducing chemical exposures, prioritising sleep and nervous system balance, supporting regular bowel movements and gentle detoxification — can make a significant difference in how your body responds.
CIRS
Frequently Asked Questions
We understand that starting your journey to better health can raise many questions. Below are answers to some of the most common questions we receive about managing CIRS at the Autoimmune Clinic.
