The CIRS Protocol

Goal: Identify and eliminate all sources of biotoxin exposure.Remediate water-damaged buildings, HERTSMI-2 below 10, address endotoxins, and avoid re-exposure. Without removing the exposure source, subsequent treatments will be challenging or ineffective .

Goal: Bind circulating biotoxins in the intestinal tract. CSM (cholestyramine) is the most effective bile sequestrant ; Welchol is a more gentle bile sequestrant for those with sensitivities. Non prescription alternative use Mycobind.

Goal: MARCoNS colonize nasal passages in ~80% of CIRS patients, producing exotoxins that lower MSH. Treated with compounded BEG nasal spray (Bacitracin-EDTA-Gentamicin), or Biofilm Clear for 60 days. Confirm eradication with post-treatment nasal culture.

Goal: Elevated AGA indicates immune reactivity to gliadin driven by biotoxin-induced intestinal permeability. Typically requires a gluten-free diet for 3 months. If levels remain elevated, investigate for celiac disease or persistent gut inflammation.

Goal: Low MSH suppresses androgen production. Low testosterone and DHEA-S contribute to fatigue and cognitive issues. DHEA is often used when appropriate to support both pathways, while VIP at the final step may help normalize hormone signaling more broadly. HRT may also be considered when needed under physician supervision.

Goal: Correct low ADH and elevated Osmolality to restore balance. These can lead to excessive thirst, frequent urination, electrolyte imbalance, and static shocks. If needed additional treatment: DDAVP (desmopressin) nasal spray.

Goal: MMP-9 destroys connective tissue when elevated, contributing to neurological inflammation and blood-brain barrier compromise. Treatments: low-amylose diet, omega-3 fatty acids, VIP, Target below 332 ng/mL.

Goal: Low VEGF reduces capillary density and oxygen delivery, causing exercise intolerance and shortness of breath. VIP therapy and correcting MSH deficiency are key approaches. Exercise capacity improves as VEGF normalizes.

Goal: Elevated C3a indicates ongoing complement system activation. Associated with increased inflammatory cytokines and mast cell activation. C3a typically normalizes as overall CIRS treatment progresses. Target below 46 ng/mL.

Goal: C4a is the most sensitive blood test for active biotoxin illness (normal below 2830 ng/mL). It directly indicates complement activation from biotoxins. Normalizes with successful binder therapy, exposure removal, and VIP.

Goal: Elevated TGF-b1 promotes immune dysregulation and autoimmune tendencies. Binders often lower TGF-b1, but if additional treatment is needed, Losartan is the primary treatment. Requires physician oversight. Monitor GFR as a potential side effect.

Goal: VIP is the final and most powerful step. It normalizes MSH, VEGF, C4a, TGF-b1, and pulmonary arterial pressures. Only use after ALL prior steps are complete and patient is out of water-damaged building. Administered as intranasal spray 4x daily.