CIRS Recovery: Understanding the Shoemaker Protocol & Other Treatment Approaches

Hope for Healing: A Clear Path Forward

If you’ve been struggling with Chronic Inflammatory Response Syndrome (CIRS), you may feel like you’ve tried everything—only to be met with temporary relief or frustration. The good news is that CIRS is treatable, and recovery is possible when you follow a structured, science-backed approach.

Dr. Ritchie Shoemaker pioneered the Shoemaker Protocol, a proven multi-step treatment plan addressing biotoxin removal, immune rebalancing, and reducing inflammation. In addition to this protocol, many people benefit from integrative therapies that support detoxification, nervous system regulation, and whole-body healing.

This guide will walk you through how to recover from CIRS, step by step.

The Shoemaker Protocol: A Step-by-Step Guide to Healing

The Shoemaker Protocol is the most well-documented treatment framework for CIRS recovery. It is based on clinical research and biomarker testing to track progress. Each step must be completed in order for full recovery.

Step 1: Remove Exposure to Biotoxins

✅ Why? Biotoxin exposure (from mold, bacteria, or other environmental sources) triggers the chronic inflammatory response. Without eliminating exposure, the body remains stuck in an inflammatory cycle.
✅ How to do it:

• Test your home/workplace for mold and water damage (ERMI, HERTSMI-2, air sampling, etc.).

• If mold is found, remediate properly or relocate if necessary.

• Avoid areas with known biotoxin exposure (damp buildings, musty spaces, algae-filled waters, etc.).

Important: Some people do not improve until they completely remove themselves from exposure.

Step 2: Begin Biotoxin Removal with Binders

✅ Why? Binders help remove biotoxins from the body by binding to them in the digestive system and preventing reabsorption.
✅ Best binders for CIRS:

• Cholestyramine (CSM) – The most studied binder for mold-related illness.

• Welchol – A gentler alternative for those who cannot tolerate CSM.

• Activated Charcoal, Bentonite Clay, and Zeolite – Additional options for binding various toxins.

  
  How to use binders:

• Take away from food and medications.

• Stay well-hydrated and support detox pathways (saunas, lymphatic movement, sweating, etc.).

Step 3: Treat MARCoNS (if present)

✅ Why? MARCoNS (Multiple Antibiotic-Resistant Coagulase-Negative Staphylococci) is a resistant bacterial infection found in the sinuses of many CIRS patients. It prolongs inflammation and immune dysfunction.
✅ How to test for MARCoNS:

• A deep nasal swab culture performed by a functional medicine provider.
  
  How to treat MARCoNS:

• BEG Spray (Bactroban, Edetate Disodium, and Gentamicin) – A prescription nasal spray.

• Xylitol Nasal Spray to break down biofilms.

• Neti pot or saline rinse to clear nasal passages.

Step 4: Correct Hormonal & Immune Imbalances

✅ Why? CIRS disrupts hormone regulation, leading to imbalances in MSH, VIP, ADH, and cortisol levels, affecting sleep, energy, inflammation, and immune function.
✅ How to restore balance:

• Melanocyte-Stimulating Hormone (MSH) – Support sleep, pain, and immune function with adaptogens, omega-3s, and healthy fats.

• Vasoactive Intestinal Peptide (VIP) – VIP nasal spray can be prescribed in later recovery stages.

• Anti-Diuretic Hormone (ADH) – Maintain hydration and electrolyte balance (Himalayan salt, minerals).

• Cortisol & Adrenal Support – Balance stress response with adaptogens (ashwagandha, rhodiola, licorice root).

Step 5: Reduce Chronic Inflammation & Rebalance the Immune System

✅ Why? Chronic inflammation drives fatigue, pain, and brain fog in CIRS patients.
✅ How to reduce inflammation:

• Omega-3s (EPA/DHA) – Anti-inflammatory fats from fish oil.

• Curcumin & Resveratrol – Natural inflammation modulators.

• Low-Mold Diet – Reduce sugar, processed foods, and inflammatory triggers.

• Lymphatic Support – Dry brushing, movement, and hydration to flush out toxins.

Additional Integrative Therapies for CIRS Recovery

Many patients find additional relief by incorporating complementary therapies alongside the Shoemaker Protocol.

Nervous System Regulation & Brain Healing

• Limbic System Retraining (DNRS, Gupta Program) – Helps rewire the brain’s response to inflammation and stress.

• Vagus Nerve Stimulation (breathing, meditation, cold exposure) – Supports immune function and reduces overactive inflammation.

• Hyperbaric Oxygen Therapy (HBOT) – Improves oxygen delivery to tissues affected by inflammation.

Detoxification & Mitochondrial Support

• Infrared Saunas & Epsom Salt Baths – Helps remove stored toxins.

• Glutathione – A master antioxidant that enhances detoxification.

• CoQ10 & Magnesium – Supports mitochondrial energy production and cellular repair.

Environmental & Lifestyle Optimization

• EMF Reduction – Minimize exposure to electromagnetic fields that can exacerbate inflammation.

• Air Filtration – Use HEPA and carbon filters to improve indoor air quality.

• Grounding & Nature Exposure – Reconnect with natural elements to support immune resilience.

Final Thoughts: CIRS Recovery is Possible

Recovering from CIRS takes time, but with the right approach, targeted treatment, and environmental awareness, you can restore your health and vitality. The Shoemaker Protocol provides a clear roadmap, and integrative therapies can further support healing.

If you’ve been struggling with CIRS, know that you are not alone, your symptoms are real, and recovery is within reach. With the right tools, a supportive community, and a commitment to healing, you can take back control of your health.