Mold, CIRS & Chemical Sensitivity

What is established about damp buildings

Damp and moldy indoor environments are associated with respiratory symptoms, new and worsened asthma, allergic rhinitis, hypersensitivity pneumonitis and irritant effects; the World Health Organization’s 2009 guideline and a 2011 review of the epidemiology both reach that conclusion, and both recommend preventing and remediating dampness on that basis alone.¹² Those harms do not depend on any biotoxin model.

Water-damaged buildings, renovation and indoor VOC mixtures also recur in MCS onset and relapse histories, and small intervention studies show symptoms falling when exposure is reduced; the evidence, and its limits, are on the Evidence page linked above. None of that establishes that MCS is mold toxicity.

The CIRS model, as its originators propose it

Chronic Inflammatory Response Syndrome is the name the Shoemaker research group gives to a multi-system inflammatory illness it attributes to biotoxin exposure — from water-damaged buildings among other sources — in people carrying certain HLA-DR haplotypes proposed to prevent biotoxin clearance. The model defines the illness by a biomarker set (TGF-β1, MMP-9, C4a, VIP, MSH, VEGF and others), by HLA-DR/DQ genotype, and by a visual contrast sensitivity screen, and it is documented in that group’s case series, time-series and treatment-cohort papers.³⁴ The mechanism it proposes — failed immune tagging, enterohepatic recirculation, innate-immune activation, MSH depletion, MARCoNS — is set out on the biotoxin science page with its sources.

Where it stands

The model, its biomarker criteria and its treatment sequence have not been validated as a diagnosis in mainstream clinical guidelines and have not been reproduced by independent investigators; a 2019 review in a mainstream allergy journal argues that the mycotoxin-injury account is not supported by the toxicology.⁵ The originating group reports improvement in its own treated cohorts;³ those reports are the evidence for the protocol, and they are the group’s own. Hold both facts: a coherent model, and no independent confirmation.

The Shoemaker Protocol, named and not detailed

The originating group’s treatment is a prescription sequence that combines removal from exposure, a bile-acid sequestrant intended to interrupt the proposed recirculation, treatment of nasal colonization where found, and stepwise correction of its biomarkers, in an order that group sets and a trained clinician interprets from laboratory results. This site states no regimen, and the how-to material that once appeared on this page has been removed for that reason. The practitioner community maintains its own directories, through the International Society for Environmentally Acquired Illness among others; a listing there is the community’s, not this site’s.

What the literature and this site do not claim

This site does not state a proportion of the population carrying susceptible haplotypes, a proportion of MCS explained by CIRS, or a proportion of patients who recover on the protocol: each such figure traces only to the originating group’s own series or to no published source. Reports that chemical sensitivity improved after CIRS treatment exist as patient and practitioner reports, not as controlled evidence.

What to do about a building

Start with moisture, not testing. Visible mold or a persistent musty odor is reason enough to find the water source and remove contaminated material; CDC and EPA do not generally recommend routine air testing to decide whether a visible problem needs fixing, and there are no federal health-based airborne mold limits for homes. Stop the leak, dry wet material fast, remove what cannot be cleaned, isolate larger work, keep contaminated dust out of the HVAC, use qualified remediation for extensive or hidden problems, and do not substitute a biocide for removing the wet material. Testing choices, environmental indices such as ERMI and HERTSMI-2, and hiring a remediator are on the mold testing and remediation page.

If you are rebuilding or renovating after mold damage, material selection matters for anyone chemically sensitive; the Indoor Air Quality page covers it. Thinking about a hydroxyl or oxidant air device instead of remediation? See air-cleaning devices and MCS first.

Invasive mold disease is a different thing

The CDC’s 2026 surveillance report found invasive mold disease — fungus growing into lung, sinus, skin or brain tissue — undercounted and often fatal, almost entirely in transplant recipients, blood-cancer patients and the critically ill.⁶ It is a distinct illness from anything on this page, it was not linked to home exposure, and MCS was not studied in it; the CDC study page separates what it measured from what it did not.