This page contains educational material about diagnosing Chronic Inflammatory Response Syndrome due to water damaged building (CIRS). This is a biotoxin illness that is caused by mold and the interaction between mold, bacteria and chemicals used in building materials. Other biotoxin illnesses have similar signs and symptoms. They are also treated similarly. Some of them are discussed on this site. This information is for educational purposes only. Nothing in this text is intended to serve as medical advice. All medical decisions should be made only with the guidance of your own personal medical authority. I am doing my best to get this data up quickly and correctly. If you find errors in this data, please let me know.
Identify if the person has a past history of exposure to mold and a precipitating incident. Were they exposed to mold/water damaged buildings or other biotoxins. Do they remember some type of stressful incident that precipitated their illness. Many of these folks remember a specific incident such as a car wreck or acute illness or some type of emotional event.
Identify signs and symptoms of mold or other biotoxins.
A look at the full toxin load, not just biotoxins is necessary as biotoxins are just one type of toxin category. All toxins together create a toxic load level that the body may or may not be able to handle.
Identify if the person has any heavy metal issues, microbial, parasite or viral issues that can add to the drain on their health. Additionally, look at their home/work/school environment to see if they are around any toxic chemicals that could add to their toxin load. Examine their daily habits including what they eat and drink, as well as the prescription and non-prescription drugs. These are all possible layers of toxicity. Realize that stress adds to this load, so you need to examine all sources of mental, emotional and physical stress.
Besides knowing what their toxin load is, it is important to know how they are able to biotransform these toxins. It is important to examine their biotransformational capability.
While examining all the things that are not working in their life, be sure to identify what is working well in their life and what makes them happy and feel better.
A full examination of all body systems is necessary and a full physical exam can be helpful. All of these people have "leaky gut" due to gut inflammation leading to inflammation all over the body. Keep this in mind.
Test for identifying biomarkers that are altered in CIRS - due to water damaged buildings.
Genomic Analysis is a necessity to help most folks deal with inadequate biotransformational/detoxification systems. Nutrigenomics can be used to assist these people.
The physician will usually use a list of signs and symptoms that they look for. They will also ask the patient if they have been exposed to a water damaged building at home, work or school etc. Additionally they will see if the patient has been exposed to poisoned seafood, spider/scorpion bites, may have or had Lyme Borreliosis, may have been exposed to blue green algae or other cyanobacteria. Most patients will also have some sort of precipitating incident that starts their illness off. They may have been living in a moldy environment and it was not noticeably bothering them until some big stressor effected them. I am talking about major life stressors such as a car accident. If a patient has any of these exposures and if the patient has signs and symptoms that are seen with biotoxin disease, they may suspect CIRS. The most common type of biotoxin illness seen is that due to water damaged buildings (mold).
Next they may ask the patient to use a Visual Contrast Sensitivity test. Many physicians that treat patients for mold exposure or other biotoxin illness use the Visual Contrast Sensitivity test as an easy to take test that helps them screen their patients. If positive, more tests are undertaken. There are a variety of places patients can take this test on line or you can purchase the test to use in office. One place that offers on-lines tests is survivingmold.com They also sell a kit for your office. Dr. Ritchie Shoemaker who is the owner of the Surviving Mold website has done tremendous research on mold related illness. He has greatly contributed to the knowledge of biotoxin illness. His website is worth while to visit.
If the Visual Contrast Sensitivity test is positive, there are a variety of additional tests that can be run depending on the signs and symptoms the patient is displaying.
If the patient has a past history of exposure to a biotoxin, has signs and symptoms of biotoxin illness and tests positive for a number of lab tests used to identify CIRS patients, the physician at that point will move forward with the diagnosis. The most common biotoxin illness is CIRS - due to water damaged buildings (mold).
In 2008 the following list of diagnositc procedures were made available at the Government Accountability Office by Dr. Shoemaker.
Tier 1 - exposure; see it, smell it, measure it. Need to have sufficient symptoms in 4 of 8 body systems.
Tier 3 - improvement. Symptoms and VCS should improve with treatment. Labs should improve.
For more information on symptoms and clusters of symptoms, see this article by Dr. Shoemaker.
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