What Causes CIRS?

Chronic Inflammatory Response Syndrome (CIRS) develops when the body is exposed to biotoxins that cannot be effectively cleared, leading to ongoing inflammation. These biotoxins are often produced by mold in water-damaged buildings, which release fragments and toxic byproducts that trigger illness. In addition to mold, infections such as Lyme disease, Bartonella, and Ehrlichia have also been identified as triggers. Certain types of algae, like cyanobacteria, as well as dinoflagellates responsible for red tide or ciguatera fish poisoning, are also known sources. Even spider bites from species such as the brown recluse can introduce biotoxins capable of setting off this cascade.

Not every individual exposed to these biotoxins will develop CIRS, which makes susceptibility an important factor. Those with genetic differences that impair the body’s ability to detoxify are at higher risk. In these cases, the toxins remain in circulation rather than being cleared, creating a prolonged inflammatory response. Over time, this inflammation spreads across multiple systems of the body, producing symptoms that may not immediately appear connected to one another. CIRS has been described as a multi-system illness because the body does not mount a simple localized reaction. Instead, immune pathways are chronically activated, which eventually leads to dysfunction in the nervous system, the endocrine system, and even vascular function. Specialists at The Center for Occupational and Environmental Medicine (COEM) take this broad picture into account when investigating possible causes of CIRS.

The symptoms of CIRS are wide-ranging and can affect nearly every part of the body. Many patients report unrelenting fatigue, weakness, or flu-like feelings that never seem to resolve. Cognitive issues such as brain fog, poor memory, and trouble concentrating are also common, creating challenges for daily functioning. Sleep disturbances, sensitivity to environmental triggers, and shifts in mood often develop as the illness progresses, leaving individuals with a sense that their entire system is out of balance. Beyond these general symptoms, patients frequently experience specific disturbances in the eyes, ears, nose, and throat. This can include light sensitivity, blurred vision, tinnitus, hearing changes, or chronic sinus congestion. Musculoskeletal pain is also a frequent complaint, sometimes presenting as joint stiffness, muscle cramps, or unusual nerve-related sensations. Digestive problems may surface as well, ranging from nausea and reflux to alternating diarrhea and constipation.

Respiratory issues like shortness of breath, cardiac symptoms such as palpitations, or skin problems including rashes and itching often overlap in one individual. Patients can also experience neurological shifts that mimic other disorders, making it difficult to distinguish CIRS without careful evaluation. The specialists at COEM consider the full scope of symptoms, which allows them to identify patterns often overlooked elsewhere.

While anyone can develop CIRS following significant exposure, not all individuals carry the same level of risk. Some individuals have genetic variants that reduce their ability to process and eliminate biotoxins. For these individuals, exposure that might only trigger a temporary illness in someone else can lead to a long-term inflammatory condition. This genetic predisposition makes them far more vulnerable to developing chronic illness when encountering mold, tick-borne infections, or other biotoxin sources. Susceptibility also rises when the immune system is already compromised. Patients with weakened immunity, impaired detoxification pathways, or underlying chronic illnesses may struggle to cope with toxin exposure. Environmental stressors can compound the problem, whether that means living in a damp building, repeated insect bites, or ongoing contact with contaminated water. The more prolonged and intense the exposure, the greater the likelihood that the illness will progress. CIRS also does not present evenly across all patients. Some may develop symptoms primarily affecting cognition and mood, while others may notice stronger respiratory or musculoskeletal involvement.

Diagnosing CIRS requires a comprehensive approach since there is no single test that can definitively confirm the illness. A patient’s history of exposure is an important starting point, such as documented water damage in a home or workplace, or symptoms following exposure to contaminated water. When these factors are present alongside persistent, multi-system symptoms, suspicion for CIRS increases. Specialized testing is often used to establish a diagnosis. One commonly used tool is Visual Contrast Sensitivity testing, which measures the eye’s ability to distinguish patterns of light and dark. Laboratory assessments may also be ordered to evaluate inflammatory markers, immune responses, and genetic factors, such as a Total Toxicity Test, looking for long-term exposure to biotoxins. Testing can include hair, blood, stool, and saliva samples. These results, while not diagnostic on their own, provide important clues that support the overall evaluation. Due to the fact that CIRS can mimic so many other disorders, diagnosis is typically a process of ruling out alternative explanations while identifying patterns consistent with biotoxin illness. Improvement with targeted treatment can also confirm that the underlying cause has been addressed.

Chronic Inflammatory Response Syndrome (CIRS) treatment is available at The Center for Occupational and Environmental Medicine (COEM). For more information, contact us today or book an appointment online. We are conveniently located at 7510 North Forest Drive North Charleston, SC 29420. We serve patients from Charleston SC, Mount Pleasant SC, Summerville SC, North Charleston SC, Goose Creek SC, Ladson SC, Hanahan SC, James Island SC, John’s Island SC, Daniel Island SC, West Ashley SC, Moncks Corner SC, Sullivans Island SC, Folly Beach SC, Isle of Palms SC and all of South Carolina, Nationally, and Internationally. Patients routinely fly into Charleston to be evaluated by COEM and to enjoy this beautiful city, which is a Condé Nast and Travel and Leisure Top Domestic and International Tourist Destination.