How Is CRS Diagnosed?
Patients with CIRS are often misdiagnosed as having depression, anxiety, post-traumatic stress disorder, and somatization; as well as Alzheimer’s, Parkinsonism, allergy, fibromyalgia, and chronic fatigue syndrome, among others.
Treating patients for these seemingly diverse conditions do not improve their symptoms of CIRS, although effective therapies for CIRS exist.
CIRS is an activation of the innate immune system, making a proper diagnosis difficult since common parameters of inflammation are generally negative upon laboratory evaluation.
There is a genetic component that can be tested. CIRS is a brain on fire. A dominant clinical feature of CIRS is the common cognitive complaints by patients, including memory loss, mood disorders, brain fog, loss of executive function, and fatigue. This is not a surprise considering that this is a key component of the innate immune response.
There are multiple markers to measure the innate response and measure the presence of inflammation in the brain.
Testing For CIRS
If chronic inflammatory response syndrome is suspected, we would conduct a blood test to check for the genes HLA-DR and HLA-DQ which indicate CIRS susceptibility.
At Sponaugle Wellness, we also test for high amounts of cytokine in your blood and marked differences in levels of the following hormones and antibodies:
- Vasoactive intestinal peptide – Responsible for regulating the absorption of water and electrolytes in your gut. Also responsible for some heart and vascular functions. Low levels can cause watery diarrhea and indicate CIRS.
- Transforming growth factor Beta 1 – A specific type of cytokine, responsible for cell division and death. Large numbers indicate CIRS and may be linked to your symptom of shortness of breath.
- Melanocyte stimulating hormone – Otherwise known as MSH, this hormone controls the pigment of your skin but it also regulates how much cytokine your body makes. Low levels indicate CIRS, as your body is unable to shut down the production of cytokine.
- C4A – Part of the complement group, these are a group of proteins that work with your immune system. They are responsible for activating your neutrophil cells, which can worsen inflammation. Large numbers can indicate CIRS.
- Adrenocorticotropic hormone (ACTH) – This hormone normally regulates your cortisol levels. Your ACTH levels may initially be high and then can drop when symptoms are more prevalent.
- Cortisol – This hormone has many different functions in the body but is released in great quantities when you are stressed or your immune system requires backup. Cortisol levels may be high initially but then drop over time.
- Anti-gliadin antibodies (AGA) IgA/IgE – These antibodies are produced in response to gliadin. Often triggered if you have a gluten sensitivity, but they are also affected by mold biotoxins.
- VEGF – Vascular Endothelial Growth Factor stimulates blood vessel formulation. CIRS patients usually show a deficiency in VEGF.
- Leptin – This hormone helps regulate fat storage in the body. High levels of leptin result in quick, easy weight gain, another signifier of chronic inflammatory response syndrome.
- Anti-cardiolipin antibodies (ACLA) IgA/IgG/IgM – These antibodies are often seen in patients with autoimmune disorders. Heightened numbers usually indicate that your body is dealing with high levels of inflammation. In fact, your antibodies are often attacking your healthy tissues instead of the biotoxins.
- Antidiuretic hormone – This hormone is responsible for the regulation and balance of water in your body, your blood pressure, and concentration of urine being made in your kidneys. Reduced levels of ADH for a CIRS patient means that you suffer from dehydration, increased thirst, and frequent urination.
- MMP-9 – This enzyme is responsible for many different bodily processes from memory and wound healing, to blood vessel formation. Increased levels are a sign of chronic inflammatory response syndrome.
We also take a full history – not only of your health but also of your environment. We need to establish if the mold exposure is ongoing, due to an infestation in your living or working environment, or whether your symptoms were triggered in the past. Only by establishing these facts can we then treat you effectively.
Why is CIRS often misdiagnosed?
Many times, patients present with so many bizarre symptoms that practitioners (or even family members) believe it’s all “in their head.”
Other times, practitioners misdiagnose mold illness. In a 2013 study of 112 patients with chronic fatigue syndrome, 104 (93%) tested positive for at least one mycotoxin.
When compared to healthy control subjects, researchers found that mycotoxin levels were significantly elevated in patients with chronic fatigue syndrome (6). When looking for a root cause in complex patient cases, it’s very important to consider mold.
Like the patients with chronic fatigue syndrome, patients are often given various diagnoses that are either incorrect or if they are correct, they often improve once they are treated for mold. These diagnoses include:
Chronic Fatigue Syndrome
Post Traumatic Stress Disorder
Irritable Bowel Syndrome
Attention Deficit Disorder
Recently, there has been some more concrete evidence for neurological difficulties associated with mold illness. In a 2014 study, 17 patients who presented with CIRS showed structural brain abnormalities when compared to a medical control group.
These abnormalities included atrophy of the caudate nucleus and enlargement of the pallidum. They also included enlargement of the left amygdala and right forebrain.
There is also research to support the inflammatory cytokine response that mold and mycotoxins induce. These inflammatory cytokines are also present in neurological conditions, such as major depression, which is more reason to test for mold as one of the root causes of neurological issues.