What Is CIRS?
Chronic Inflammatory Response Syndrome (CIRS) is a multi-system, multi-symptom illness first characterized by Dr. Ritchie Shoemaker. It affects individuals who carry specific HLA-DR genetic haplotypes, making them unable to properly clear biotoxins produced by mold and other organisms from their bodies. For these patients, even low-level mold exposure that wouldn’t affect most people can trigger a cascade of chronic inflammation affecting virtually every organ system.
Symptoms of CIRS include chronic fatigue, cognitive dysfunction (“brain fog”), joint pain, headaches, shortness of breath, light sensitivity, temperature dysregulation, and many others. Because the symptoms overlap with dozens of other conditions, CIRS often goes undiagnosed for years while patients cycle through specialists seeking answers.
Why Standard Mold Testing Isn’t Enough for CIRS Patients
Standard mold inspections typically rely on non-viable air sampling — collecting airborne spores over a short period and comparing indoor counts to outdoor baseline levels. While this approach works well for general mold concerns, it has significant limitations for CIRS patients:
- Snapshot limitation: Air sampling captures what’s airborne at that exact moment. Mold species like Stachybotrys, Chaetomium, and Wallemia — among the most dangerous for CIRS patients — produce heavy spores that don’t stay airborne long and are routinely missed by standard air tests.
- Genus vs. species: Standard air sampling identifies mold at the genus level (e.g., “Aspergillus/Penicillium”). CIRS physicians need species-level data to determine which specific organisms are present and at what concentrations.
- Threshold differences: What’s considered “normal” for a healthy person may be deeply problematic for someone with HLA-DR susceptibility. CIRS patients react to mold concentrations well below standard threshold levels.
This is why CIRS-literate physicians require ERMI and HERTSMI-2 testing — DNA-based analysis that detects mold species at far lower concentrations than traditional methods.
Already working with a CIRS physician? Call us at 940-240-6902 to discuss your testing protocol. We coordinate directly with your doctor to ensure the right tests are ordered.
Our CIRS-Specific Testing Protocol
Our inspectors are experienced with CIRS patients and understand the unique requirements of environmental assessment for biotoxin illness. Our CIRS testing protocol includes:
Comprehensive Visual Assessment
A thorough inspection of every room, including behind furniture, inside closets, utility areas, crawl spaces, and attic spaces. We look for visible growth, water staining, condensation, and past water intrusion that may harbor hidden mold reservoirs.
ERMI Dust Sampling
We collect composite dust samples from living areas using the EPA-developed protocol. These samples undergo MSQPCR (Mold Specific Quantitative Polymerase Chain Reaction) analysis to identify and quantify 36 species of mold via DNA, producing your ERMI score.
HERTSMI-2 Analysis
From the same ERMI data, we calculate your HERTSMI-2 score — focusing on the five species most dangerous to CIRS patients: Aspergillus penicillioides, Aspergillus versicolor, Chaetomium globosum, Stachybotrys chartarum, and Wallemia sebi. This score is what most CIRS-literate physicians use to determine if an environment is safe for habitation.
Targeted Air & Surface Sampling
In addition to ERMI, we collect air samples and surface samples from areas of concern to provide a complete picture of current airborne contamination and active growth locations.
Moisture Mapping
Using thermal imaging cameras and professional moisture meters, we map moisture intrusion throughout the home. Identifying and eliminating moisture sources is critical for CIRS patients because even successful remediation is temporary if the moisture source isn’t resolved.
Working With Your CIRS-Literate Physician
Environmental testing is one component of the Shoemaker Protocol for CIRS treatment. Our role is to provide the environmental data your physician needs to make treatment decisions. We do not provide medical advice — we provide scientifically rigorous environmental data.
Our reports are formatted to be directly compatible with the Shoemaker Protocol and include ERMI scores, HERTSMI-2 scores, species breakdowns with concentration levels, moisture findings, and specific remediation recommendations. With your authorization, our team can communicate directly with your treating physician to discuss methodology, findings, and follow-up testing needs.
We regularly work with functional medicine doctors, integrative health practitioners, and environmental medicine physicians throughout the DFW metroplex who treat CIRS patients.
Understanding HERTSMI-2 Scores
HERTSMI-2 Score Ranges:
Below 11: Generally considered safe for CIRS patients to occupy
11–15: Borderline — may require targeted remediation of specific species
Above 15: Unsafe for CIRS patients — professional remediation required before occupancy
Note: Individual physician recommendations may vary. Always follow your treating doctor’s guidance regarding safe environmental thresholds for your specific situation.
Post-Remediation Verification for CIRS Patients
After remediation is complete, CIRS patients need verification testing that goes beyond standard air quality clearance testing. We provide post-remediation ERMI and HERTSMI-2 testing to confirm the environment meets the stricter thresholds required for CIRS-safe habitation. Many CIRS physicians require a passing HERTSMI-2 score before allowing patients to return to a previously contaminated home.
Our full CIRS protocol page provides additional detail on our comprehensive approach to CIRS environmental assessment.
Fort Worth CIRS Resources
Fort Worth’s warm, humid climate — with annual humidity averaging 64–67% — makes mold exposure a persistent challenge for CIRS patients. The Trinity River watershed, aging housing stock in neighborhoods like Fairmount and Riverside, and seasonal weather patterns all contribute to elevated mold risk.
If you suspect you have CIRS but haven’t been diagnosed, we recommend seeking evaluation from a physician trained in the Shoemaker Protocol. While we cannot recommend specific doctors, resources like SurvivingMold.com maintain directories of CIRS-literate practitioners.