Week of May 29, 2023
1/ When do you begin CIRS testing after exposure?
QUESTION:
I went camping this past weekend at Camp Woodlands in Annapolis. Shortly after we turned in for the night, one of my friends developed a significant cough, headache and congestion. Another friend had a flare of her pre-existing asthma. We left after one hour. Should we seek medical care?
ANSWER:
Exposure to any number of environments can cause the acute onset of respiratory symptoms without necessarily being an inflammatory response syndrome caused by
exposure to a water-damaged building.
Classic chronic inflammatory response syndrome is present for over a month; we cannot say that applies to an exposure of less than 3 hours associated with an illness of less than 3 days. You mentioned that you are beginning to feel better now several days after your exposure. If you are not experiencing multiple symptoms through multiple body systems, it would make sense to observe and not initiate treatment.
Having said that, if you are concerned with ongoing symptoms, having a VCS test done now provides a reasonable basis to look back 2 weeks from now to see whether this is developing into an ongoing syndrome. If the visual contrast sensitivity (VCS) test is positive at this date, the likelihood that this finding will resolve is quite low.
Having a VCS test done now provides a reasonable basis to look back 2 weeks from now to see whether this is developing into an ongoing syndrome.
I do not object to you having baseline labs done, including C4a and TGF beta-1, together with MMP-9, as the acute exposure is not likely to have enough time to lower MSH and VIP but did have enough time to drive up inflammatory responses.
2/ VIP, preventing re-exposure
QUESTION: Does the use of VIP mean I can go into buildings that I know are water-damaged and that have high ERMI scores without suffering ill effects or is it still necessary to avoid exposures?
ANSWER:
Use of VIP is confined solely to people who have followed the strict treatment and VIP use protocols. These protocols are available in the VIP module (on this site) but to summarize, patients must have followed the first 10 steps of the sequential treatment intervention; they must not have exposure to buildings with ERMI >2 or HERTSMI >10; they must have negative nasal cultures and VCS must no longer be positive. VIP is not a replacement for any of the prior 10 steps in the protocol. VIP is helping people return to normal life but as long as they are genetically susceptible and/or low MSH, they must be careful to avoid re-exposures. Should such exposure occur, VIP use would markedly decrease the reactivity of patients and will essentially eliminate “sicker, quicker,” but we can not say the patient has been
cured.
The use of the term “cure” is always in quotes and needs to be recognized that patients are returning to normal functioning with symptoms equal to controls, labs equal to controls and genomics equal to controls. What we have not done is proven that patients with prior illness can ever let down their vigilance regarding prevention of re-exposure.
CSM is often used proactively for limited time periods when patients are trying out new buildings that appear safe after initial inspection.
For more detailed information on CSM or VIP use, you may be interested in the Shoemaker Protocol™ medication learning modules available on the site.
3/ VIP, availability
QUESTION: Is it possible for individuals to purchase VIP?
ANSWER: Pharmacies can purchase VIP in bulk for compounding in the U.S. As your question appears to be coming from Sweden I do not know what the regulations are for your country. VIP is available by prescription to private patients.
4/ MTHFR
QUESTION: If someone is MTHFR positive will mold remediation and treatment protocol remain the same?
ANSWER: Yes. This is a commonly observed finding, seen in about 80% of our patients. The vast majority of patients are heterozygous. There is no need to adjust treatment for this common genetic change.
5/ 23andMe, allergy, and urine testing
QUESTION: I don’t know if I have a mold problem or not. I did the 23andme gene test and I am positive for the HLDA mold gene. I took my VCS test and that is normal. My antidiuretic hormone level is elevated and I have a high urine osmolality test. I drink one glass of water a day. I have no mold exposure that I know of but I had a
skin allergy test that showed environmental allergies. My serum iron and ferritin are both normal but are at the bottom of the normal range. Could this be due to mold exposure?
ANSWER: You have raised many significant issues that are best answered in a private consultation or with any of the Shoemaker Protocol™ Practitioners, and not just a short answer for frequently asked questions. I will try, however.
I am unfamiliar with the documentation from 23andme regarding adverse effects of the HLDA mold gene. I am happy to read such information. Please forward at your earliest convenience.
We do not look at urine osmolality; we look at plasma osmolality. The relationship of antiduretic hormone to simultaneously measured osmolality is often disrupted in CIRS, independent of whether an exposure to a water-damaged building is the cause or not. Urine testing does not provide any conclusive information in diagnosing CIRS.
Allergy testing will look at acquired immune responses and not innate immune responses. The skin allergy test has no relationship to the CIRS symptoms derived from exposure to water-damaged buildings.
With normal serum iron and ferritin, even though those numbers might be low normal, there is no diagnosis that can be made. If there were problems with hemoglobin, hemolysins, transferrins, or intestinal malabsorption of iron, those would be important elements to know to assist you with your concerns about iron.
6/ 23AndMe
QUESTION: I had my genes tested by 23AndMe with an opinion rendered by Livewello. The latter makes sense of the raw data from 23AndMe. Can you show me what the rsID numbers are for the gene markers mentioned on Survivingmold.com?
ANSWER: I am not familiar with Livewello but would be happy to take a look at your report. Please forward that to the site and I will be glad to review. Remember the simple presence of a gene does not tell us anything regarding gene activation and will not reveal levels of regulatory control. Further testing is necessary.
