EP235: Inside CIRS Lab and the Evolving Science of Biotoxin Illness - Christian Navarro-Torres, PhD
In a Nutshell
Dr. Christian Navarro-Torres, a CIRS patient and neuroscientist, details how his severe biotoxin illness progressed from mold exposure to high actinobacteria burden, Bartonella, Babesia, and parasitic colonization, requiring interventions beyond the standard Shoemaker protocol. Key findings include NeuroQuant showing brain atrophy patterns tied to actinobacteria and vascular stress, sinus biome testing revealing dominant actinobacteria like C. acnes correlating with low MSH and metabolic failure, and VIP plus Prodrome Glia as the most effective interventions for restoring brain volumes. Treatment success depends on prioritizing environmental removal, sinus actinobacteria clearance, and addressing endogenous infections and parasites in proper sequence, with HLA-DR and early trauma identified as severity predictors rather than direct causes.
These notes were generated by AI and may contain inaccuracies.
The Better Health Guy podcast explores complex chronic conditions and ways to build resilience, improve vitality, and achieve better health. Content is for informational purposes only and not intended to diagnose, treat, or cure any illness. Nothing discussed should be considered medical advice.
Episode 235 features Dr. Christian Navarro-Torres, a cognitive neuroscientist with formal training in cognitive psychology, neuroscience, language science, and applied data analysis. He earned his PhD in language science from the University of California, Irvine, a master's in cognitive psychology at Penn State, and a bachelor's in philosophy from the University of Puerto Rico. His research career included postdoctoral fellowships at Princeton University and Georgetown University, focusing on experience-dependent neuroplasticity and clinical assessment in patients with brain damage affecting language and cognition.
Dr. Navarro-Torres is co-founder of SIRS Lab, scientific director of the SIRS Research Foundation, and a research consultant for the Einstein Mission investigating erythromelalgia and SIRS. His recent scientific work extends into environmental health and immune dysregulation, including publications and presentations on biotoxin illness, its multi-system and multi-symptom pathology, and treatment outcomes, with particular interest in how SIRS-related brain changes may contribute to neurodegenerative processes.
Dr. Navarro-Torres is a complex, hypersensitive patient who endured serious microbial colonizations, tick-borne and protozoal co-infections. These overlapping comorbidities created a perplexing clinical profile that demanded self-advocacy. His scientific background became essential to navigating conflicting medical advice and fragmented care. He now provides training for physicians and clinicians on identifying, understanding, and treating those with complex, multi-layered presentations.
Through SIRS Lab, he provides consulting services and offers skills to bring new insights, interpretations, and actionable frameworks that can be implemented by patients working with their own practitioners.
Before becoming ill with SIRS, Dr. Navarro-Torres was studying as a PhD student the intersection of cognitive psychology, cognitive neuroscience, and language science. He was particularly interested in bilingualism and its potential neuroprotective influences on brain function and brain structure. Research found that bilingualism was consistently associated with a delay in the onset of Alzheimer's symptoms and dementia symptoms by about five years relative to monolingual speakers. These effects withstood the test of time in subsequent studies.
Dr. Navarro-Torres had a relatively functional life until his early thirties, when he began experiencing inexplicable symptoms, mostly digestive in nature. In 2019, he had a severe flare of unexplained GI symptoms paired with neuropathy-like activity and nerve pain, along with tearing at night for no reason. Multiple specialists could not determine the cause.
A gastroenterologist identified pancreatic enzyme insufficiency measured by low levels of elastase in stool, indicating fat malabsorption. He began enzyme replacement therapy with prescribed medication such as Creon. After abdominal imaging including CT scans and MRIs showed no structural problems such as tumors or visible inflammatory processes, he experienced dramatic improvement with significant energy restoration.
In March 2020, one week before the COVID pandemic was announced, while finishing his PhD at UC Irvine, he began experiencing inexplicable symptoms described as feeling like death. Digestive issues returned despite trying multiple diets. He developed severe anxiety that worsened incrementally, experiencing panic attacks at 2 a.m. with heart palpitations, depression, and cognitive dysfunction including memory difficulties and word retrieval difficulties.
Working with a functional doctor on gut-related approaches produced a pattern of brief improvement followed by return to baseline. Activated charcoal was introduced as a binder along with chlorella. Vision became sharp initially, but within one to two weeks, frequent urination developed at a rate of 20 to 30 times per day regardless of water intake. He became unable to bear weight on his feet and used a wheelchair for several months. At approximately age 32 or 33, this was particularly difficult for someone who had been physically active with strength training throughout life.
The functional doctor suggested the presentation resembled chronic inflammatory response syndrome (SIRS). Dr. Navarro-Torres began researching Dr. Shoemaker's work on SIRS and biotoxin illness. This research became a coping mechanism. Hypersensitivity intensified to the point where clothing, touching surfaces, and different parts of rooms triggered neurological symptoms. Weight dropped to 95-98 pounds after losing approximately 50 pounds.
He had moved to Princeton, New Jersey for a postdoctoral fellowship at Princeton University and was living in a moldy apartment. A short-term medical leave was taken. He later attempted another postdoc at Georgetown University in the DC area but found the environment intolerable.
He began the Shoemaker Protocol with binding agents. Wellchol (cholestyramine), a cholesterol-sequestering medication, produced the first noticeable forward movement. He passed the VCS test after a couple of months. Improvement reached approximately 20 percent before plateauing. Marcons treatment was attempted in the sinuses despite negative testing.
The Georgetown postdoc was terminated prematurely after the first year due to environmental intolerances in the DC/Virginia area. He left academic career pursuits and started SIRS Lab initially as Instagram content creating short reels to capture nuances about the illness not being discussed even in established SIRS communities.
For three to four years, hundreds if not thousands of experiments were conducted to understand the interrelationship between his body and environmental influences. SIRS Lab gradually connected with the medical community. His background in research led to interest from others in collaborating on new research projects to build a new generation of research around biotoxin illness and move it into mainstream science.
He continues treating himself while working with practitioners both as a patient and collaborator. He serves as scientific director of the SIRS Research Foundation.
Both Dr. Navarro-Torres and the host express gratitude for Dr. Ritchie Shoemaker's work in bringing biotoxin illness to light. The host identifies Dr. Neil Nathan as another mentor who discusses sensitive patients extensively.
Supplements that logically should have helped, such as histamine-supporting supplements, instead increased reactivity. Opening a new bottle of Wellchol triggered a bodily reaction. The tablet was crushed and diluted in water, with only the tiniest sip taken. This produced an intense reaction within approximately 10 seconds, nearly causing blackout. It took about eight weeks to reach one tablet. The typical maximum dose for Wellchol in biotoxin illness protocols is six tablets daily, either two tablets three times per day or three tablets twice per day.
After the initial microdose, sleep patterns, bowel movements, and blood flow dynamics shifted. New supplement intolerances developed, including curcumin causing passing out and bruising, suggesting possible coagulation issues such as microclotting or microbleeding characteristic of SIRS patients.
Eight air purifiers were used in a one-bedroom apartment. Intense cleaning was performed. IQAir air purifiers were identified as the most effective choice. Initial negative reactions to IQAir occurred but were recognized as part of a necessary notification process related to bipolar ionization.
Microdosing, extensive purification, and careful cleaning formed the basic approach during the first year of Shoemaker/SIRS treatment.
Modalities including nervous system regulation, limbic system retraining, and vagal tonification are considered important in chronic illnesses like SIRS. Prior to SIRS diagnosis, mindfulness, chiropractic care, therapy, EMDR, and other approaches were attempted. An EMDR practitioner noted after three sessions that the presentation resembled PTSD but did not fit typical criteria exactly.
These modalities provided limited initial relief but did not prevent the ongoing cascade. The body was perceived as having taken over and dictating processes until root issues could be addressed. Once endogenous components including potential chronic infection burden and colonization burden were addressed, modalities such as therapy and relaxation practices became more accessible again.
Strong clinical suspicion exists, supported by indirect markers rather than traditional test confirmations, for significant burden from Bartonella and parasites. Fungal issues were present with rashes initially. Actinobacteria later emerged as a significant factor. These represent burden independent from environmental exposure.
Early childhood trauma is recognized by some CIRS practitioners through specific questionnaires. Clinical observations indicate that trauma severity measured by these tools appears highly predictive of CIRS severity, including hypersensitivity. While this is not yet supported by published research in the biotoxin illness context, it is considered one of several significant potential contributors to illness severity. A large longitudinal dataset combining trauma questionnaires with biotoxin illness severity measures would likely identify early childhood trauma as a statistically significant predictor of outcomes.
HLA-DR types are viewed as creating general inefficiencies in antigen presentation and antigen processing rather than conferring mold-specific susceptibility. The types reflect broader vulnerabilities where the immune system may struggle to properly introduce certain microbial organisms into innate-adaptive immune communication. HLA-DR is considered a risk factor rather than a direct determinant of illness severity; other conditions must be present for susceptibility to manifest.
Mycotoxins are metabolites excreted by molds and are not the primary targets of HLA antigen recognition, which focuses on DNA fragments from microbial organisms. Therefore, HLA types are not directly tied to mycotoxin handling. The same HLA vulnerabilities that increase susceptibility to mold exposure also extend to actinobacteria, endotoxins, beta-glucans, and mycotoxins rather than being limited to one category.
Actinobacteria is considered a late-stage problematic organism rather than a priming event. It tends to emerge after prolonged immune exhaustion, metabolic dysregulation, brain atrophy, and loss of resilience, typically appearing years after CIRS has been triggered. It arises as a byproduct of downstream dysbiosis. In contrast, mold exposure is viewed as a more likely priming event.
Fungal ribotoxins are highlighted as uniquely capable of disrupting RNA sequencing and ancient loops such as the Sarsen Bryson loop. This disruption is proposed as a mechanistic precursor that sets the stage for subsequent CIRS development, including HLA-related susceptibility.
Inability to efficiently excrete mycotoxins in CIRS patients is linked to chronic innate immune activation rather than a direct genetic predisposition. Once chronic innate immune activation is established, downstream effects impair bile release from the liver, rendering biosequestration and detoxification severely dysfunctional. Mitochondrial shifts move cells into a defensive state with reduced energy production and cooperation, sometimes deliberately altering detoxification pathways as a protective mechanism, including retention of heavy metals against potential microbial threats.
GENIE is treated as one tool within a broader inventory rather than a standalone diagnostic. Multiple data sources are required to determine causation, including NeuroQuant, blood work, symptom history, VCS patterns, and living situation. GENIE can generate inferences about biotoxin exposure and metabolic status but is most useful when integrated with other findings.
GENIE frequently shows upregulation of MAP kinases and TGF-beta-1 receptors correlating with actinobacteria burden. Toll receptor patterns, particularly Toll receptor 2, require careful interpretation because C. acnes (formerly P. acnes) is a known strong stimulator. CD14 elevations may initially suggest endotoxin involvement. Metabolic gene expression patterns appear frequently. Gene expression signatures can shift during treatment from environmental to more endogenous sources, so patterns such as MAP kinases or toll receptors cannot be assumed to reflect only external exposures. Upregulated toll receptors may also indicate endotoxemia from gut leakage.
These markers do not independently identify specific causation; they must be interpreted within the full clinical pattern. Chronically elevated values in long-term CIRS patients are generally indicative of ongoing innate immune activation tied to biotoxin exposure.
C4a testing has become less informative due to methodological issues outside specialized labs such as National Jewish Hospital. TGF-beta-1 values above 10,000 are widely recognized in the scientific literature as indicating unusually elevated inflammatory activity. MSH is considered an underappreciated central hormone in the Shoemaker biotoxin illness pathway, with downstream effects across multiple systems; a recent paper was published to further examine MSH deficiency and recovery.
CIRS Lab holds a NeuroQuant license and provides report generation plus consultation services to help interpret findings. Two primary pathways exist for obtaining NeuroQuant: sending scanner settings to an MRI facility and forwarding raw DICOM files, or obtaining a physician-ordered MRI that includes NeuroQuant processing.
Older NeuroQuant software versions used conventional segmentation methods that align with historical Shoemaker criteria. Newer AI-based segmentation produces incompatible results, requiring a specific license compatible with the morphometry report used for the Surviving Mold NeuroQuant analysis. The Triage Brain Atrophy Report provides high-resolution ranking of approximately 47 brain regions against age- and gender-matched healthy controls.
Common early-stage findings include enlargement or elevation of white matter tracks, interpreted as potentially reflecting microglia activation within the chronic innate immune profile. Atrophy of the pallidum is observed with moderate frequency; because this structure is highly metabolically sensitive, its involvement raises consideration of molecular hypometabolism and possible actinobacteria burden. Later-stage presentations show widespread cortical atrophy, possible pallidum involvement, and shrinkage of limbic structures.
NeuroQuant is also used to screen for traumatic brain injury history, which is frequently identified in CIRS patients even when remote events (such as childhood injuries) are not initially reported. Patterns consistent with water-damage-building exposure have been documented in published work by Shoemaker and McMahon, with ongoing preliminary research exploring additional fingerprints on the Triage Brain Atrophy Report.
When analyzing NeuroQuant results, patterns connected to chronic infection are considered, though these remain more speculative without strong scientific consensus on how chronic infections like Lyme impact the brain. One observed pattern is atrophy of the white matter tracks, with Bartonella suspected when other explanations have been ruled out. White matter tracks are among the first brain structures affected by poor blood flow or vascular issues, and Bartonella is known to create significant endothelial stress on the vascular system.
For patients in treatment, NeuroQuant is reasonably repeated every six months to capture meaningful, sustained changes in brain volumes, though some do intervals between six and twelve months. Changes can sometimes appear in as little as three to four months depending on whether meaningful interventions are being used to restore brain volumes and normalize them. Every six months is considered a safe interval for follow-up.
The two interventions that stand out most for normalizing brain volumes as measured by NeuroQuant are VIP at high dosages and Prodrome Glia from Prodrome Sciences and Dr. Day and Goodenow's work. This combination has produced significant improvements, including cases with widespread bad atrophy documented in the triage brain atrophy report where patients were neurologically very limited in function. Within an 18-month period, some have normalized percentiles to the point where they are indistinguishable from healthy individuals on assessment.
Prodrome Glia is particularly valuable for white matter abnormalities or white matter atrophy. While other interventions may promote neuroplasticity, VIP and Prodrome Glia are considered foundational for restoring brain volumes.
Phosphatidylcholine and other lipids are considered, with animal-based choline and phosphatidylcholine ranking at the top. However, significant intolerance to these interventions is observed when patients are still very sick and dealing with high infection burden. These tend to work better in later stages of healing from CIRS or biotoxin illness.
Animal-based formulations appear more impactful for brain-related issues, while plant-based formulations tend to work better for detoxification, supporting liver function, and peripheral organs. Animal sources include egg yolk and caviar. Prodrome PC Plus, which contains animal choline from egg yolk, is noted as an expensive product. When unavailable, some use caviar regularly as a high-concentrated dose of animal-based choline.
The Prodrome scan or bio scan is used quite a bit, though not always. When used alongside Genie and NeuroQuant, these three form what is described as a holy trinity, especially during optimization phases. The Prodrome scan adds value in later stages when trying to optimize and identify what's left over, such as when the plasmalogen pool is not deficient but the body appears to be compensating by attempting to make plasmalogens without adequate supply. It is also valuable for patients with confirmed or suspected high risk of neurodegeneration.
Urine mycotoxin testing, mycotoxin antibody testing in blood, and organic acids testing are not generally used. While mycotoxin urine testing could have value for understanding exposure components and correlating with detoxification fluctuations, these are not go-to tests in this clinical context.
Proper remediation is considered foundational and incredibly important given current building and construction practices. For hypersensitive patients, the broader ecosystem should be considered beyond just the house itself. Thresholds exist where the body signals enough exposure has occurred, and these can come from outdoor sources such as water treatment plants with high endotoxins, lakes with high cyanobacteria, or areas prone to historic flooding.
Environmental tests brought in by clients are treated as proxies rather than absolutes. A HERTSMI-2 is considered useful as a starting point. Scores of 14, 15, or 16, or even gray zone scores of 12 or 13, prompt further investigation into species and potential active water intrusion versus residual issues. When actinobacteria appears to be a significant problem based on symptoms and patterns, actinobacteria testing may be recommended, including environmental, skin, or sinus testing.
CIRS is viewed primarily as an immune dysregulation problem rather than traditional immune compromise. The immune system functions like an attention system that should know what to pay attention to, when, and how. In CIRS, there is a breakdown of this attention system with chronic elevated innate immune activation while adaptive immunity may initially be underwhelming or too silent. Over time, this creates an imbalance where the immune system shifts attention outward to the environment and disregards what is happening inside the body.
While not immunocompromised in the traditional sense like an HIV patient or someone on chemotherapy, there can be an element of immune compromise in long-term CIRS patients due to resource depletion. This may manifest as metabolic issues, brain atrophy, plasmalogen deficiencies, increased infection burden or colonizations, and systemic permeability issues. The immune system may show signs of fatiguing or giving up in parts.
Autoimmunity occurs on the adaptive immune side as an inflammatory response with genetic susceptibility factors. Some patients are more likely to have autoimmunity as the forefront of chronic illness, and there is a subtype of CIRS patients who are CIRS autoimmunity dominant. One hypothesis is that the adaptive immune system attempts to address breaches from colonizers and chronic infections in tissues by participating in attacks, even if that means attacking the body's own tissues.
Addressing environmental factors allows the body to respond more appropriately to microbial overgrowths, while addressing microbial overgrowths reduces burden on the immune system. Starting with the environment is considered the place to begin. Treating suspected infections without addressing the environment often results in an endless loop where issues keep returning. Lowering environmental signals allows the immune system to shift attention inward.
Actinobacteria treatment can serve as a middle step after environmental work but before addressing deeper problematic organisms like tick-borne infections and parasites.
A paper published in Frontiers in Endocrinology with Dr. Peg DiTullio titled "Clearance of Multiple Antibiotic-Resistant Coagulase-Negative Staphylococci is Selectively Associated with Higher Circulating Alpha-Melanocyte Stimulating Hormone in Patients Evaluating for Chronic Inflammatory Response Syndrome" examined 188 CIRS patients who tested positive for MARCoNS at baseline. Assessments included MSH, MMP9, and VIP levels. Follow-up assessments occurred after MARCoNS treatment interventions lasting at least six weeks, with treatment protocols varying by patient and including combinations of silver, EDTA, and xylitol.
Significant changes in MMP9, VIP, and MSH were observed regardless of whether patients had cleared MARCoNS at follow-up. MMP9 showed a remarkable average drop from approximately 800 to 350 across nearly 200 cases. However, only MSH showed an interaction between MARCoNS presence or absence and recovery, with those who cleared MARCoNS showing higher MSH levels than those who remained positive. The paper documents a statistically robust correlation but does not make definitive claims about causation.
The finding that sinus microbial activity correlates with modulations of neuroendocrine activity in the pituitary hypothalamic region is considered novel in mainstream science. Increases in MSH occurred for everyone regardless of MARCoNS clearance, suggesting factors beyond MARCoNS as currently measured contribute to MSH recovery.
The study did not consider whether subjects' MARCoNS were producing polycyclic ether toxins, as this information is currently only obtainable through Genie testing. Existing MARCoNS tests do not yet differentiate between those who should treat versus those who should not treat based on toxin production.
Published clinical observations exist from practitioners, but more literature is needed to understand the mechanisms. Limitations in current studies include not considering patterns of antibiotic resistance and using strict criteria cutoffs where two or more patterns of antibiotic resistance define positivity. Additional factors like biofilm activities and other organisms present in ecosystems should be considered.
The MicroGen DX Sinus Key test is a DNA-based test that quantifies relative abundance of organisms and speciates the nasal biome more broadly. It detects fungal organisms, gram-positive bacteria, and gram-negative bacteria beyond just Staph. This testing emerged from collaboration with practitioners Dr. Andrea Jordheim, Dr. Lacey Venanci, and Dr. Lauren Sparks, who recognized there is more to the sinuses than previously measured.
Testing reveals actinobacteria species including C. acnes (also called P. acnes) as dominant, Corynebacterium tuberculostericum as second, and rare Cootie bacterium species in low levels, alongside Staph epidermidis. These findings are particularly relevant in patients with low MSH who have fatiguing metabolic issues and are stalled despite treatments. Actinobacteria emerge as primary suspects when too abundant in the sinus biome, specifically C. acnes and C. tuberculostericum.
Fungal DNA traces sometimes appear, occasionally from environmental spores that clear with rinsing protocols, and sometimes suggesting potential colonization. When fungal colonization profiles appear, high actinobacteria activity is also commonly observed in Sinus Key testing, showing an interesting correlation between the two.
Genie testing indicates endotoxins at 42% and actinobacteria at 28% of CIRS causation. Mold and mycotoxins remain more primary at 7% despite Genie data. Actinobacteria tend to appear later in the process in more compromised individuals.
Actinobacteria treatment can be a necessary prerequisite for some patients before addressing chronic infections, parasites, and benefiting from VIP. It is also a misunderstood organism. Human actinobacteria like C. acnes are commensals on skin but become opportunistic with immune dysregulation and permeability breaches, targeting immune-tolerant body parts.
High actinobacteria burden correlates with metabolic issues and dreaded zombification symptoms including very low energy, fatiguing, cognitive fatigue, physical fatigue, and zombie-like frozen brain and body. These persistent symptoms during CIRS treatment typically indicate an actinobacteria component. Improvement requires addressing actinobacteria in sinuses, skin, or combination environments, potentially including the gut.
Actinobacteria are considered the prime candidate for creating ADHD immune confusion or immune dysregulation profiles. Unlike endotoxins that can trigger sepsis or fungal exposures that are very inflammatory, actinobacteria operate more on the metabolic side. Not all actinobacteria should be eliminated, as bifidobacteria is an actinobacteria, and antimicrobials targeting pathobiome organisms may negatively impact beneficial microbes.
Actinobacteria are opportunistic human species like C. acnes and Corynebacterium species. Treatment focuses less on killing and more on shifting ecosystems that disrupt their opportunistic ability. In CIRS patients with high actinobacteria, excessive alkalinity is often seen in mucosal tissues including skin barrier, sinuses, gut, and vaginal areas, creating favorable environments for these organisms.
CIRS patients tend to show acidification in blood, potentially contributing to fatiguing and metabolic issues, while mucosal tissues show the opposite shift from normal acidity to excessive alkalinity. Lipophilic activity is another factor, as organisms like C. acnes thrive in lipid-rich ecosystems under the skin and epithelium.
Horopito, a New Zealand herb touted as antifungal, disrupts lipid-rich ecosystems by dissolving them to expose organisms to the immune system. It also helps acidify skin. A topical version is available. The product discussed is from KOLOREX (KOLOREX.com), with soft gel form recommended over capsules. Additional products like Lume body wash with low pH properties may help but may not be sufficient alone.
Endotoxins from gram-negative bacteria may become significant amplifiers once CIRS is primed, particularly with fungal burden and ribotoxin injury, rather than serving as priming events themselves. Endotoxins can be endogenously created in microbiomes, not only from external environments. Permeability is the key issue, as compromised barriers allow endotoxins to cross into bloodstream, triggering aggressive innate immune responses.
Natural binders tend to be negatively charged while cholestyramine and cholecevalam have positive charge. Binding involves more than polarity, including the level of analysis where cholestyramine and cholecevalam bind at the bioasset level while natural binders may operate differently. Bentonite clay has been shown to bind lipopolysaccharides. Natural binders are complementary rather than equivalent to pharmaceutical binders.
Cholecevalam has emerged as potentially better than cholestyramine in the CIRS community, moving the needle with fewer side effects despite earlier views that it was 20% as effective. Personal experience shows better tolerance profile with cholecevalam. Order of binder use is important, as starting with charcoal and chlorella may open cascades of problems if the body is not ready.
Approximately eight out of ten clients show actinobacteria components that appear primarily endogenous in the body. Selection bias exists as clients seeking consultation are more likely to have these problems. About half of actinobacteria cases involve clear water intrusion issues. Actinobacteria fingerprint includes getting sick several days after entering clean environments.
Lyme and co-infections can trigger CIRS, though historically Lyme has not been a major focus. Testing limitations create many false negatives for Borrelia, Bartonella, Babesia, and parasites, forcing practitioners to rely on symptom patterns and do-no-harm botanical interventions. Prevalence of chronic infections in the CIRS population is likely much higher than acknowledged, potentially affecting half or more of patients. Dr. Shoemaker presented excitement about using herbs for Lyme based on Dr. Jody Deshoor's publication.
If patients have been working on mold and mycotoxins without improvement, exploring different microbial burdens becomes important. Bartonella is considered possibly the most significant of the three Bs—Borrelia, Bartonella, and Babesia—though some practitioners are shifting toward viewing Babesia as more prominent while others maintain Borrelia as the kingpin. When any one of these three is present, there is a high probability that at least a second player is significantly contributing. Dr. Bob Moziani has noted that when Bartonella is present, Babesia is almost always there, and when Babesia is present, Bartonella is almost always there.
In the CIRS population, the signal that stands out most clinically is Bartonella. Cases with Bartonella often show elevated VEGF instead of low VEGF as a blood marker for CIRS, with chronic elevation on one marker. One personal example involved VEGF levels over 400, which began decreasing after starting botanicals targeted for Bartonella. Bartonella patients tend to present with more neuropsychiatric issues, while people with more Lyme-like presentations tend to have chronic moving pain and flu-like feelings. The combination of Bartonella and Babesia is seen quite frequently.
Before experiencing CIRS, viruses could serve as a priming event by adding stress or amplifying the priming signal in combination with something like water damage exposure. Once CIRS has been turned on, viral reactivity issues are not typically seen as clearly necessary to address for recovery. In some cases, viral issues self-correct with other treatments like addressing chronic infections. However, some patients experience very aggressive viral activation leading to structural issues in the spine or discs. Viruses are viewed more as secondary contributors once CIRS has been activated, though they can contribute to burden.
In hypersensitive CIRS patients, there is likely a massive parasitical burden. Parasites are hypothesized to be the big enablers—once they start taking over, other things come downstream, potentially including actinobacteria. Parasites can influence the immune system and affect markers in the GENIE test. Testing is notoriously bad, though one useful test is the CSA test from ParasiteTesting.com, a culture-based test that cultures parasites, fungal issues, and actinobacteria. Dr. Lacey Venanti often uses a timing method involving collections two days prior to the full moon and one day after.
Tinctures in the category of black walnut, wormwood, and clove form an effective combination. For CIRS patients with significant burden, considering rounds of ivermectin and albendazole (or mebendazole) under medical supervision can lead to significant healing moments when done in the right order. Dr. Rafael D'Angelo with Para Wellness Research is another referenced tool for parasite work.
Gut issues are very prominent in CIRS, especially in hypersensitive, high actinobacteria patients. High actinobacteria, C. acnes, or Cutibacterium burden with low MSH in the sinuses indicates significant gut work needed, often accompanied by parasites, food intolerances, and histamine issues connected to mast cell activity. The gut, sinuses, and brain are highly interconnected ecosystems. Using a nasal spray with eucalyptus and propolis (Beekeepers Max) for sinus actinobacteria burden led to approximately 60% improvement in histamine gut issues within two weeks, demonstrating the interconnected nature of these systems. Working on the sinuses first and then moving downward tends to be an effective order of operations.
DNA testing using shotgun or 16S methods provides better sensitivity for biome distribution in the gut. Recommended tests include Ombre, Tiny Health, and Nirvana Biome. These are more equipped to detect distribution compared to other tests where signal and sensitivity can be inconsistent.
There are documented cases of CIRS patients feeling significant improvement with antifungal medications. Concerns exist around antifungals due to metabolic issues and potential worsening of preexisting atrophy. However, antifungals are not just tackling fungi—they can disrupt lipid-rich ecosystems where organisms like P. acnes thrive and hide. Some patients had fungal issues that resolved over time with other treatments like binders. The approach remains agnostic regarding whether treatment is exclusively targeting fungi or working at a systems level.
COVID appears more likely to act as a priming event rather than a biotoxin, creating immune dysregulation that makes people sensitive to previously tolerated exposures. This dysregulation opens the door for latent infections like Bartonella or EBV to become activated and allows various imbalances to emerge. One personal case involved likely COVID exposure on campus without testing positive or experiencing classic symptoms, which served as the final priming event that triggered CIRS.
Coagulation is a big player in terms of illness severity and symptom burden. Presentation can include unexplained bruising after minimal activity. Long-term microclotting increases risk for clotting-related vascular disease, dementia, neurodegeneration, and strokes. Testing options include prothrombin fragment 1 and 2, thrombin-antithrombin complexes, Von Willebrand's panel, and cardiolipin. The GENIE can provide information around coagulation. If basic CIRS treatment does not address coagulation issues, underlying drivers like Bartonella or Babesia—which put massive stress on the endothelial system—should be investigated. Heavy metals are also recognized as triggers for coagulation.
Mast cell activation syndrome and histamine intolerance play significant roles. One personal experience involved multiple ER visits for anaphylactic-like reactions, which were less about specific foods and more about the environment where consumption occurred. Histamine support was necessary, and MSH and MMP9 are markers correlated with histamine response modulation. Data presented at CIRSx showed correlations between aggressive histamine treatment and improved MSH recovery with lower MMP9 levels. If getting out of exposure does not correct histamine issues, underlying infection or colonization burden should be considered.
Almost everyone worked with requires expanding beyond the 12-step Shoemaker protocol for full recovery. The protocol remains valid as an entry point and foundational framework with critical sequencing, but hypersensitive and complex patients often need additional work. The three items that most frequently stand out are high actinobacteria burden, chronic infection (most often Bartonella), and parasitical issues, with parasites tending to be addressed later in the process.
The third step of the Shoemaker protocol—addressing the sinuses—is critical. Whether dealing with MARCoNS, actinobacteria, or other contributors to MSH, the sinuses are the most privileged and important body part in a CIRS patient because they generate multi-system problems through brain signaling. Winning the sinus battle allows regaining control over everything else. Bringing in VIP makes sense after foundational work for repair and healing.
Daily practices include SIRS-conscious living with weekly cleaning routines, traveling with an iAdapt Air, and using an AirTamer ionizer in public places. Ongoing treatments include parasite protocols, binding, and gut work. Intentional reintegration into life is emphasized as a critical component—introducing corrective experiences while lowering signals from parasites, colonizers, and infections, and staying out of exposure. This completes the healing cycle in its entirety.
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