Week of May 6, 2024

Week of May 6, 2024

1/ VCS, false fails


Q: Why does my VCS results show that I failed? I missed one before row 6 but then got one right after. I have all but one correct in both Columns of C in D I have six correct with both eyes. But it is still not showing that I passed.


A: The computer is programed to fail anyone who cannot see 7 in row C and 6 in row D. If there is a miss on C or D, and the test is being done in person, seeing a correct image in C and D can be credited by the examiner. 


In your test, you missed 6 in row D in the left eye and 5 in row D in the right eye. But you saw 7 in row D in the left eye correctly and 6 in row D in the right eye. This creates what we call a false fail. The computer cannot correct false fails but your test is a false fail, which is also a passing score. Column E is not involved in scoring. 


2/ Treatment for those without genetic susceptibility


Q: If I passed the online VCS, I guess that means I probably do not have mold gene, is that right? Is the treatment the same if you have the mold gene or not?


A: You cannot conclude genetics through the VCS. The online eye test has an 8% false positive rate. If you are questioning the results and your symptoms check out, you can follow up with a Shoemaker Protocol™ Practitioner and a handheld VCS test in office, and begin the next diagnostic tests and labs in the Protocol which will confirm if you are experiencing the effects of CIRS, or not.


People without the gene can get sick from repeated exposure to heavily water-damaged building interiors. Yes, the testing pathway and, if necessary, the treatment steps will follow the Shoemaker Protocol™ with our without genetic susceptibility. Mold genes are part of an immune response that dominates discussion about children and parents, both of patients with susceptibility.


3/ Absence of HLA susceptibility and illness


Q: Is it possible to become ill and stay ill without one of the HLA haplotypes associated with susceptibility?


A: Yes, we see approximately 95% of cases having one of the six HLA haplotypes that in turn comprise 24% of the normal population. That means 5% of ill people (cases) do not have HLA-driven susceptibility. The good statistical news is that for those 5% their

prognosis is much better than those of the other 95% of cases. Treatment is still necessary for the non-HLA susceptible individuals. Even though they don’t have the HLA we are accustomed in seeing in cases, they will not self-heal. The standard response

to the predictable response of “how does HLA alone determine susceptibility” that I have used in the past is that “biology is never 100% and HLA research is in its infancy.” That statement is still correct. In order to perform the research needed to show how defective antigen presentation is occurring, we would need a very large prospective study to be done on a multi-site basis.

Don’t forget, once MSH falls to below 35, additional susceptibilities to inflammatory illness develop.


4/ Absence of HLA susceptibility and illness due to MARCoNs.


Q: If a non-susceptible individual acquires an CIRS illness, could that condition solely be due to colonization for MARCoNs with its own genomic affects?


A: This is an interesting question from a reader from Australia. Specifically we are still counting on fingers on one hand the number of people with true MARCoNs without MSH deficiency. If MSH deficiency is the mechanism for MARCoNs colonization (please don’t say infection; it is not an infection) then we can restate your



5/ MSH deficiency


Q: Is there a mechanism to get sick solely due to MSH deficiency?


A: That answer is yes. What we don’t see are people ill just from MARCoNs and without low MSH. What this means is that treatment with the Protocol medications alone will not take care of an inflammatory illness acquired following exposure to an interior environment of water-damaged buildings. Use of cholestyramine and subsequent protocols will not eradicate the MARCoNs. That treatment is specific for this biofilm-forming commensal.

Please note that researchers from Newcastle University in Australia were among the first to note the importance of MARCoNS first in facial pain first and then in Chronic Fatigue Syndrome. As I recall Dr. Timothy Roberts and Dr. Butts were early and prolific researchers in this field. It has been nearly 10 years since I have spoken with that group and hope that they have adopted use of MSH profiling as part of their susceptibility rosters for acquisition of MARCoNS. We hope to be publishing soon the genomic results of the MARCoNS biofilms study we completed not long ago.


6/ Exposure from camping


Q: 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?


A: 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 the interior environment of a water-damaged building. During your 3 hours, did you spend time in a building that had signs or smells of water damage? Campers could be home to a water-damaged environment, or even tents could be a trigger. The first step of the Shoemaker Protocol™ is to pinpoint the environment that affected you, as well as remove yourself from that environment.


Then, it’s important to note your symptoms as well as duration. CIRS/mold illness includes multiple symptoms through multiple systems of the body. Classic chronic inflammatory response syndrome presents 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.


The Shoemaker Protocol™ Quick Start Guide can help you check your symptoms and help you determine if the diagnostic VCS online screening is your next step.


You mentioned that you are beginning to feel better now several days after your exposure. If you do not have lasting multisystem, multiple symptoms it would make sense to observe and not initiate further treatment. Having said that, if the visual contrast sensitivity (VCS) test is positive at this date, the likelihood that this finding will resolve without treatment 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.


If you fail the VCS test, I do not object to you having baseline Shoemaker Protocol™ 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. You need to have the labs present to secure the diagnosis and initiate treatment.


You can point your attending physician to the Protocol lab order sheet and testing pathway on this site.


7/ Lake home


QUESTION: We live on a lake. Could this be contributing to our CIRS?


ANSWER: If you are a lake resident cyanbacteria and wind-blown aerosols can create adverse health effects, that may not be CIRS-related. It is primarily indoor exposure to water damaged environments that specifically causes CIRS symptoms and “mold illness.”


Also note, if you have a property on a lake and it is closed up over the winter, as often is the case, moisture in the basement can equally be a problem for microbial growth.

See the above question for more information or read The Shoemaker Protocol™ Quick Start guide to check your symptoms and begin the diagnostic pathway today.


8/ Multiple symptoms after exposure


Q: My Mom’s house flooded when she was away and it sat soaking for weeks. I went in for six hours scrubbing mold from walls in the home. I now am ill with sinus problems, sore throat and lung congestion. I now am irritable and moody with red eyes and temperature intolerance. Is this serious?


A: Certainly you have met the requirement for the potential for exposure and you have multiple health systems represented with multiple health symptoms. I would suggest that you take a look at the visual contrast sensitivity (VCS) test to gain a better idea of what

all symptoms you might actually have and then to correlate those symptoms with an objective screening test. At some time it would make sense for your physician to evaluate you with the labs that we look at routinely as represented on the physician order sheet in

the diagnosis section of this website. You need to have the labs present to secure the diagnosis and initiate treatment. Do not ignore your illness. I think that you have made a good start by contacting us. I hope you will follow through.


9/ Well water:


Q: My well water has a strong musty smell and I feel unwell after changing the water filter. I assume this is from Actinobacteria. Should I have the water tested and do I need to worry about contaminants in the water spreading to the house?


A: I have not seen contamination of Actinobacteria in well water. Testing makes sense. To date, we have not seen a spread of Actinobacteria from well water.


10/ 23andme


Q: I have 23andme genetic testing but can’t find a way to understand HLA SNPs vs. the specific tests recommended. Also, I have been told I have protomyxzoa rheumatica infection. Please help.


A: The future of medicine will include accurate genomic testing. I have little knowledge of the basis for the use of 23andme testing in clinical medicine. I am happy to review any data that you have that supports specificity and sensitivity of these tests underlying clinical illness.


It is my opinion that use of SNP testing is fraught with a significant possibility of error as mere presence of an SNP has nothing to do with gene activation/suppression. Presence of a SNP tells us nothing about regulation of the entire gene by microRNA. I have never been able to confirm a diagnosis of protomyxzoa infection though I have

seen a number of patients who have had testing done by Dr. Fry’s lab in Arizona.


I am happy to review any data that you have to confirm this diagnosis with a particular eye to objective proteomic findings separate from findings on peripheral smear. Please forward these findings to the website so that I may be of assistance to you.