CIRS (Chronic Inflammatory Response Syndrome) and related mold issues
Updated: Oct 18
This topic hits home for me. One of my best friends suffered the worst effects of CIRS, and seeing firsthand what it did to her broke my heart over and over again. The right doctor did finally help her, but before then, it was watching someone I love suffer. It was awful. After my own treatments, I had random mold exposures that felt like being hit by a truck. I always felt those exposures were what she felt daily.
Here is what CIRS is, what the tests can and can't tell you, and what the mold doctors I trust are saying now, in simple terms.
Looking for things that may help? My Mold Possible Solutions post has ideas and the products I recommend at 25% off:
A quick-view graphic with the key points is at the bottom of this post.
WHAT CIRS IS
- CIRS stands for Chronic Inflammatory Response Syndrome. It describes a body stuck in a strong, ongoing inflammatory reaction, most often linked to mold exposure.
- Mold illness and Lyme share many of the same symptoms, so mold can be missed when someone with Lyme isn't getting better.
- Dr. Tania Dempsey sees CIRS and mast cell activation (MCAS) as basically the same inflammatory response. She explains that genes can make some people more likely to react, but genes alone don't cause the illness.
MOLD ILLNESS VS CIRS: WHAT IS THE DIFFERENCE?
MOLD ILLNESS
- Also called mold toxicity or mycotoxin illness. The focus is on the mold toxins (mycotoxins) that build up in the body.
- Dr. Neil Nathan finds mycotoxins are the main problem for most of his mold patients. A urine mycotoxin test shows which ones are there.
CIRS
- Dr. Ritchie Shoemaker's Surviving Mold describes CIRS as a whole-body inflammatory reaction after time spent inside a water-damaged building.
- It explains CIRS isn't only from mold. Bacteria (like actinomycetes), endotoxins and other inflammatory substances that grow in water damage can play a part too.
- CIRS is usually measured with blood markers rather than a urine mycotoxin test.
HOW THEY OVERLAP
- Bay Area Lyme Foundation describes CIRS as an illness that can be triggered by long-term mold exposure, so the two often go together.
- A simple way to think about it: mold illness looks at the toxins, and CIRS looks at the body's inflammatory reaction to a water-damaged building. Both start with getting out of the exposure.
THE BLOOD MARKERS
- Doctors who test for CIRS often check a group of inflammation and hormone markers, such as C4a, TGF-beta 1, MMP-9, VEGF, VIP and MSH.
- Dr. Marty Ross explains that these markers are indirect tests. They can be off from chronic tick-borne infections too.
- Dr. Neil Nathan used these markers often in his early years. He now sees them as a general sign of inflammation, because they can also be high with Lyme and Bartonella. They are helpful, but they don't prove mold.
- Your doctor's lab will list its own normal ranges for each marker.
OLDER NUMBERS FROM DR. RAJ PATEL (2017)
In a 2017 talk summarized by LymeDisease.org, Dr. Raj Patel shared these numbers. They are older, and your own lab's ranges may be different:
- VIP: low if under 23 (Lyme and/or mold)
- MSH: low if under 35 (Lyme and/or mold)
- VEGF: low if under 31 (Lyme and/or mold)
- TGF-beta 1: high if over 7,000 (Lyme and/or mold)
- MMP-9: high if over 500 (Lyme and/or mold)
- C4a: over 2,800 but under 10,000 suggested Lyme without mold
- C4a: over 10,000 suggested Lyme and mold
- Learn more about one of these markers here:
OTHER TESTS YOU MAY HEAR ABOUT
- Visual contrast test (VCS): a screening test for how well you see contrast. Dr. Ross notes it is not perfect, and Dr. Nathan shares it can also be affected by Lyme and mercury.
- HLA-DR gene test: Dr. Ross explains it only shows if you may be more likely to react, not that you have mold illness.
- NeuroQuant MRI: a brain MRI that measures the size of different brain areas. Learn more here:
THE DIRECT TEST
- Dr. Neil Nathan and Dr. Marty Ross both rely on the urine mycotoxin test to see which mold toxins are actually in your body. More on testing is in my Mold education post:
WHAT THIS MEANS FOR YOU
- If your CIRS markers are off, it's worth asking your doctor about mold, Lyme and co-infections.
- Work with a mold literate doctor on your own plan:
MY OWN LAB SUCCESS
I shared my own lab success here:
For support, I recommend one group that focuses on recovery:
RELATED POSTS
Lab Tests on Various Topics:
Mast Cell Solutions:
Histamine Intolerance:
ALL MOLD AND CIRS POSTS
Mold Directory:
Mold (education):
Mold - Possible Solutions:
Steps to Overcome Mold:
Mold and Lyme Treatment Order:
Find a Mold Literate Doctor:
EC3 Micro Balance for Mold:
Binders:
Cholestyramine (CSM):
MMP-9:
NeuroQuant MRI:
SOURCES
LymeDisease.org, Dealing with Lyme Disease and Mold Illness at the Same Time, with Dr. Raj Patel (2017):
Dr. Ritchie Shoemaker, Surviving Mold, Diagnosis and the definition of CIRS
Dr. Neil Nathan, Two Perspectives, One Mission: Advancing the Conversation on Mold Illness and CIRS (2026)
Bay Area Lyme Foundation, The Connection Between Mold Illness and Lyme Disease (2020):
Dr. Neil Nathan with Dr. Jill Carnahan, Toxic Mold Revisited: Mold and the Highly Sensitive Patient (2026)
Dr. Marty Ross, Mold Toxin Illness in Tick-Borne Diseases (updated 2026)
Dr. Tania Dempsey, Mold/Mycotoxin Illness, Mast Cell Matters (2024)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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