CIRS in the UK: Hidden Illness Without a Diagnosis

Chronic fatigue? Muscle aches? Brain fog? Sensitivity to light, sound, or chemicals? Pain? Memory issues? Sleep disturbances? Thirst? Increased urination? Skin irritation?

For many people, these symptoms occur all together, and persist for years without a clear explanation. They may be told their blood tests are “normal,” or that their symptoms are stress-related. But for some, the real issue is something called Chronic Inflammatory Response Syndrome (CIRS) – an illness triggered by exposure to biotoxins such as mould, Lyme or exposure to algael blooms.

What is CIRS?

CIRS is a chronic, multi-system illness caused by the body’s inability to clear toxins effectively after exposure to mould, water-damaged buildings, Lyme disease, or other biotoxins¹.

In genetically susceptible individuals, the immune system does not “switch off” after exposure. Instead, it remains activated, driving chronic inflammation that can affect the brain, lungs, gut, hormones, and immune system² ³.

The Challenge in the UK

Unlike in the USA, where CIRS is increasingly recognised and there is a clear diagnostic framework, in the UK the situation is far more difficult:

• No official diagnosis – CIRS is not acknowledged within the NHS, so patients are often mislabelled with ME/CFS, fibromyalgia, or psychosomatic illness⁴.
• Testing barriers – key markers such as C4a, TGF-β1, MMP-9, VIP, and HLA-DR haplotypes are rarely available on the NHS⁵, and are difficult to access privately in the UK.
• Prescription challenges – binders such as cholestyramine, shown to reduce biotoxin burden⁶, are not routinely prescribed for this purpose in the UK.
• Lack of awareness – many clinicians have never heard of CIRS, despite an expanding body of research linking water-damaged buildings and biotoxin exposure with chronic inflammatory illness⁷.

This leaves patients feeling dismissed and without hope.

Why the Shoemaker Protocol Matters

Dr Ritchie Shoemaker pioneered the recognition of CIRS and developed a structured 12-step protocol to help people recover. This approach includes:

• Removing exposure to the biotoxin (e.g., remediating mould in the home)
• Using binders to clear toxins from the body⁶
• Correcting hormonal, immune, and inflammatory imbalances step by step⁸
• Rebuilding resilience and restoring normal physiology

The protocol is supported by multiple peer-reviewed publications showing measurable changes in inflammatory markers, brain imaging, and patient outcomes² ⁸ ⁹.

Although not yet widely available in the UK, this framework has given thousands worldwide a path to recovery when nothing else worked.

A Story of Hope

One client I worked with had been unwell for over a decade. She had been diagnosed with chronic fatigue syndrome and fibromyalgia, but none of the treatments helped. She experienced constant brain fog, pain, and exhaustion.

When we explored her history, we found she had lived in a water-damaged property for many years. Simple tests identified that there was a 98.5% probability that CIRS was at the root of her issues. Once she began following the Shoemaker Protocol, combined with remediating her home, her symptoms gradually lifted. Within months, her energy improved, her brain fog cleared, and she felt she finally had her life back.

Stories like this remind us that CIRS is not a dead end, there is a way forward.

Complete the Cluster Questionnaire here.

If you have select more than one symptom in more than 8/13 cluster groups (6/13 for children), there is a 95% probability that CIRS is part of your picture.

If you want to know more book in for a CIRS Exploratory Call

References

1. Shoemaker RC, et al. Possible estuarine-related illness: symptoms, vision, and treatment. Environ Health Perspect. 2001;109(5):539–545.
2. Shoemaker RC, House DE. Sick building syndrome in water-damaged buildings: results of 2003–2004 testing. Neurotoxicol Teratol. 2006;28(5):573–588.
3. Shoemaker RC, Hudnell HK. Neurotoxicity, inflammation, and chronic biotoxin-associated illness. Toxins. 2011;3(8):1261–1273.
4. Hope J. A review of the mechanism of injury and treatment approaches for illness resulting from exposure to water-damaged buildings, mold, and mycotoxins. Scientific World Journal. 2013;2013:767482.
5. Shoemaker RC, Schaller JL. Lab testing in biotoxin illness. Surviving Mold Reports. 2010.
6. Shoemaker RC, House DE. A time-series of illness symptoms in sick building syndrome: Correlation with cholestyramine therapy. Neurotoxicol Teratol. 2006;28(5):573–588.
7. Brewer JH, et al. Detection of mycotoxins in patients with chronic fatigue syndrome. Toxins. 2013;5(4):605–617.
8. Shoemaker RC, et al. Structural brain abnormalities in patients with inflammatory illness acquired following exposure to water-damaged buildings: a volumetric MRI study. Neurotoxicol Teratol. 2014;45:18–26.
9. Shoemaker RC, Maizel MS. Innate immune responses and biotoxin-associated illness. Toxins. 2011;3(10):1345–1357.