Understanding Chronic Inflammatory Response Syndrome (CIRS)

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Chronic Inflammatory Response Syndrome, commonly known as CIRS, is a term used to describe a collection of symptoms that some practitioners associate with an ongoing inflammatory response following exposure to certain environmental substances.

CIRS is most commonly discussed in relation to exposure to water-damaged buildings and the mould, bacteria and other microbial contaminants that can be found within them.

People who have been diagnosed with, or are investigating, CIRS may experience a wide range of symptoms, which can vary considerably from person to person. These can include:

• Persistent fatigue and weakness
• Headaches
• Muscle and joint aches
• Difficulty concentrating or problems with memory
• Sinus congestion or respiratory symptoms
• Sensitivity to light
• Changes in mood
• Dizziness or vertigo
• Tingling or unusual skin sensations
• Sleep disturbance

These symptoms can have many different causes and experiencing them does not necessarily mean that you have CIRS. CIRS remains an evolving area of medicine and there is ongoing debate within the wider medical community about its diagnostic criteria, mechanisms and treatment.

If you are experiencing unexplained or persistent symptoms, it is important to discuss them with an appropriately qualified healthcare professional.

For people who have been diagnosed with CIRS, or whose healthcare practitioner suspects their environment may be contributing to their symptoms, understanding what is happening inside their home can be an important part of the wider investigation.

Water damage is not always obvious. Moisture and microbial growth can sometimes occur behind walls, beneath flooring, within roof spaces or in other areas that are difficult to see.

At Healthy Homes & Beyond IAQ, we do not diagnose or treat CIRS. Our role is to investigate the indoor environment and help identify potential issues that may need to be addressed.

Depending on the property and individual circumstances, this may include assessing:

• Damp and sources of excess moisture
• Visible and potentially hidden mould
• Ventilation and humidity
• Indoor air quality
• Dust and particulates
• Other potential environmental contaminants

Our Home Surveys & Advice and Air Quality Testing services can be tailored to the individual property and the needs of the people living there.

Finding mould or another indoor air quality issue does not automatically mean that it is responsible for someone's symptoms. However, identifying and properly addressing sources of damp, water damage and contamination is important for maintaining a healthy indoor environment.

Where problems are identified, we provide a detailed report explaining our findings and practical recommendations for addressing them.

For households where someone has particular health vulnerabilities, a standard approach to remediation may not always be appropriate. Our Medically Important Remediation guidance considers the needs of the individual alongside the requirements of the building.

Small Particle Cleaning may also be recommended in some circumstances as part of a wider remediation plan to reduce residual dust and fine particles within the indoor environment.

You may come across the Shoemaker Protocol when researching CIRS. Developed by US physician Dr Ritchie Shoemaker, it is a staged approach used by some clinicians to assess and treat people diagnosed with CIRS.

The approach can include identifying and avoiding potential environmental exposure, clinical testing and the use of prescription medication alongside ongoing monitoring.

It is important to understand that the Shoemaker Protocol is a medical treatment protocol. Healthy Homes & Beyond IAQ does not provide the protocol, diagnose CIRS or recommend medication. Anyone considering investigation or treatment for CIRS should discuss this with an appropriately qualified healthcare professional.

CIRS is a complex and developing area, and it can be difficult to know where to find reliable information.

CIRSx provides educational resources, research and professional education relating to CIRS and environmentally associated illness.

In the UK, there are also practitioners who work specifically with people investigating CIRS. Louise Carder is a Shoemaker Certified Practitioner and nutrition professional who works with clients experiencing chronic inflammatory conditions.You can watch a video of our founder Kristine chatting to Louise on our Resources page. 

We always encourage you to research practitioners carefully and involve your GP or wider healthcare team where appropriate.

If you have been diagnosed with CIRS, are working with a healthcare professional who has raised concerns about your indoor environment, or simply have concerns about damp, mould or air quality in your home, we can help you investigate the building itself.

Our approach is individual and supportive. We will listen to your concerns, discuss what is happening in your home and recommend an appropriate level of investigation rather than assuming that every property needs the same testing.

Explore our Home Surveys & Advice, Air Quality Testing and Useful Resources pages to find out more, or Contact Us to talk through your concerns.