Special Community Preview! The Membership Q&A Library PART 2: About the Shoemaker Protocol™ -Diagnosis; The Steps, Specific Cases & Resources
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PART 2: About the Shoemaker Protocol™
Diagnosis; The Steps, Specific Cases & Resources
INDEX:
SECTION 1: The Shoemaker Protocol’s™ 4 Initial Diagnostic Steps
SECTION 2: Q&As - Diagnosis, Specific Cases, Alternate Diagnostic Testing
SECTION 3: Q&As - Allergies vrs CIRS diagnosis
SECTION 4: Resources
(Also see PART 1: About the Shoemaker Protocol™ Q&A Category for more resources)
SUSPECT MOLD IS AFFECTING YOU? GET STARTED NOW.
The 4 Initial Diagnostic Steps
of the Shoemaker Protocol™
So many of the questions we see inquire about how to get started and how to treat each specific set of symptoms and the unique water-damaged circumstances.
While the set of symptoms and water-damaged building conditions can vary, the approach to diagnosing and treating each case remains consistent.
It always strictly follows the Shoemaker Protocol™ diagnostic and treatment pathway.
The get-started Shoemaker Protocol™ pathway:
STEP ONE: The first step is to locate the home or building that has a microbial problem related to the water intrusion that could be affecting you.
Obtain an ERMI/HERSTMI2 evaluation of any suspected Water Damaged Buildings (WDBs) in consideration (EnviroBiomics Labs offers more information and these dust sample testing kits).
STEP TWO: The next step is to confirm that you have a multi-system, multi-symptom illness.
This can be accomplished by checking, verifying, and documenting the symptoms you experience. You can check your symptoms below in the resources section. See the Quick-Look Symptom Roster or an expanded list in the downloadable Quick Start Guide.
STEP THREE: Next take an online Visual Contrast Screening (VCS) to obtain an initial pass/fail CIRS diagnosis within minutes.
You will receive a printable report to review with your physician and/or your Shoemaker Protocol™ Practitioner. It will also provide a base from which to continue tracking your recovery journey.
STEP FOUR: Establish care and continue the Shoemaker Protocol™ diagnostic pathway to confirm diagnosis specifics and treatment.
If you show you have a VCS deficit and multiple health symptoms then a Shoemaker Protocol™ practitioner or your local physician can assist you by ordering the subsequent labs needed to confirm your diagnosis as a chronic inflammatory response syndrome (CIRS).
“A full battery of labs should be done after your symptom roster is confirmed and compiled and a visual contrast sensitivity test (VCS) is performed.
If your VCS test is normal and you only have a couple symptoms, you probably are not going to be a person who has a CIRS.
If, however, you have a multi-symptom, multi-system illness with a VCS deficit (and the screening on the site will tell you) then I would recommend that you proceed with the protocol diagnosis pathway and have the next labs done. See the lab roster included on the Surviving Mold site for your practitioner to follow.
If you have questions on what to do, this would be an occasion where you would be well off to consult one of the practitioners trained in the Shoemaker Protocol™ listed on this site.” ~ Dr. Ritchie Shoemaker’s reply to a Membership Q&A
It’s highly advantageous to find a Shoemaker Protocol™ Practitioner or Proficiency Partner to work with you when dealing with this complex illness.
The next option would be to point your attending physician to the “physician resources” section and the testing and lab rosters available at survivingmold.com. Find a practitioner who will assist you in using the published, peer-reviewed and well-proven Shoemaker Protocol™.
SECTION 2: Q&As – Diagnosing Specific Cases, Alternate Diagnostic Testing
1/ Diagnosis after exposure; the step-by-step overview
QUESTION: I live on the top floor of an 8 story building in Florida, which unfortunately has had multiple roof leaks that have created moisture problems inside my apartment. I am having health problems. Can you help me?
ANSWER: On the Surviving Mold website is a wealth of information to help you get started in thinking about the possibility of having an illness acquired following the exposure to the interior environment of water-damaged buildings. The first step is to begin the process to confirm the diagnosis. It is not difficult to follow these initial steps. The diagnostic and treatment protocols I use have been peer-reviewed and published.
The first step is to confirm that there is a microbial problem related to the water intrusion.
My suggestion to use ERMI or HERTSMI-2 dust sample testing kits (see EnviroBiomics Labs for more information and test kits). Whether you collect dust samples with a vacuum cleaner or with a Swiffer cloth will be dependent on whether there are rugs that you can vacuum or not. Once dust has been sent to a lab to sort out whether there is microbial amplification or not.
The next step is to confirm that you have a multi-system, multi-symptom illness. You can check your symptoms through the lists of common symptoms available on this site and in the resources section (see an overview symptom check list in the resource section below).
Next you can check symptoms and get an initial pass/fail by taking an online visual contrast sensitivity test (VCS, available on the Surviving Mold site)
If you show you have a VCS deficit and multiple health symptoms then a Shoemaker Protocol™ practitioner or your local physician can assist you by ordering the labs needed to confirm your diagnosis as a chronic inflammatory response syndrome (CIRS).
You can find a practitioner who will follow the treatment and diagnostic protocol (the Shoemaker Protocol™) outlined on the Surviving Mold site, along with the lists of labs that I have used routinely.
Differential diagnosis is next following the steps outlined in the Shoemaker Protocol™. You must rule out possible confounders that also contribute to CIRS. Once we have confirmed the diagnosis then the process of treatment continues through the multiple steps of the protocol.
It may be of benefit to you to read more information from the website (and the resources included in this document below).
2/ Diagnosis, minimum number of labs and tests
QUESTION: Our adult son has multiple complex health issues possibly related to his HLA DR and a mold exposure. His IgE is quite high and he has extreme eczema. What is the fewest number of tests needed to confirm presence of CIRS?
ANSWER: Understanding that diagnosis and treatment of CIRS is a process involving much more than just laboratory testing, for those who have the potential for exposure and a multi-system, multi-symptom illness, what we look for in laboratory studies includes HLA, MSH, TGF beta-1, C4a, MMP-9, VEGF and a T regulatory cell assay. I further will add ACTH/cortisol and ADH/osmolality if MSH is less than 35pg/ml.
Use of this testing should be done in close collaboration with your a Shoemaker Protocol™ Practitioner, or a physician who will follow the Protocol in sequential order.
The steps needed will depend how this illness is affecting your son, and to what degree. Only taking each step, one at a time, will reveal the number of tests needed.
Skipping steps in a complex diagnosed CIRS case is never a good idea. In the long run, committing to each step without taking shortcuts will be the most direct path back to health.
For those with longer duration illness without treatment, such as his possibly could be, the approach to therapy must include consideration of long-term correction of the genomic abnormalities that he is likely to have.
3/ Multiple symptoms, now disabled, without medical resolution – is it CIRS? And what to do.
QUESTION: Before my family bought our dream home I was super healthy. I ran marathons and would backpack at least one week every year. Shortly after moving into our home I developed multiple health symptoms with achy joints, headaches, rashes and more that resulted in two cervical fusion surgeries. Neither one helped me. My two daughters developed multiple health symptoms as well.
Two years after purchasing the home, a mold inspection confirmed presence of a water-damaged building. I was treated in Santa Barbara, California without benefit. I have since become disabled despite moving three times in six months. Please provide assistance.
ANSWER: This tragic history is so common in my practice. We have a published diagnostic and treatment protocol (the Shoemaker Protocol™) in peer-reviewed literature. I would strongly suggest that you have appropriate building testing, either by HERTSMI-2 or ERMI (see EnviroBiomics Labs for info and test kits) done in your current home to make sure this environment is safe.
You should also have the panel of labs that was supported by the internally peer-reviewed expert mold treating physicians consensus reported published on line in 2010. The labs are listed on this website. The treatment protocol is not simple anecdotes: it is based on decades of use.
VCS testing, available on this website, will help you confirm the potential of CIRS as well.
If you test positive for Chronic Inflammatory Response Syndrome (CIRS), it's highly beneficial to work with a practitioner trained in the Shoemaker Protocol™ to navigate the complexities of the condition. Discuss with your attending physician about starting the Protocol, and provide them with the relevant labs and information from this site. Alternatively, you can look for a practitioner who will adhere strictly to the Protocol. I strongly recommend avoiding therapies that have not undergone peer review.
(See a list of get-started resources below).
4/ Diagnosis and confirmation for his company
QUESTION: A flight attendant from the United Arabic Emirates writes he has been exposed in company accommodations for two years to indoor areas with evident microbial growth. The VCS is positive. He would like to be able to prove that the illness is making him ill.
ANSWER: You will first need to confirm diagnosis of CIRS by following the published, peer-reviewed, and well-proven protocols (Shoemaker Protocol™) I’ve laid out in many of the Q&As and resources on this site. Survivingmold.com offers extensive research papers and informational resources on the discussion of diagnosis of a CIRS acquired following exposure to the interior environment of water-damaged buildings.
What you will need to do is confirm that the substance you see is microbial growth and not soot or something else in the building of concern; you will need to record symptoms together with performance of a visual contrast sensitivity (VCS) test.
You will also need to have laboratory studies done (use the physician order sheet found on this website) that satisfy the lab abnormalities identified in 1829 mold patients compared to 500 controls (please refer to the paper published in Health in 2013 also on the website, link below). Your last task to confirm this diagnosis is to have improvement with the Protocol treatment.
These criteria are based on the 2008 USGAO report and echoed by the 2010 Expert Treating Physicians and Consensus report. (See the resources below for links.)
5/ CIRS-WDB diagnosis pathway (with a physician who will check for CIRS)
QUESTION: I have had ongoing exposure to the basement of my work site. There is evidence of water intrusion and musty smells in the building. I have been to countless physicians who have been unable to help me figure out where my symptoms come from. I have received at least 15 diagnoses, none of which are supported.
I found a physician who actually listened to me and found my C4a was getting close to getting out of range. What should I do?
ANSWER: Your brief history sounds pretty typical of those that I worked with as a treating physician over the years. The answer for your case follows the Shoemaker Protocol™ pathway that I’ve used for each client I’ve treated before you.
First, a proper exposure to a water-damaged building history needs to be done. Proper identification (speciation) using ERMI or HERTSMI-2 building testing needs to be done confirming which fungi are present in settled dust in buildings to which you are exposed.
Please do not assume that just your work place is making you ill. It may be an obvious WDB, but you must also be sure that schools, churches, homes, grandparent’s homes and other buildings that you are commonly exposed to are normal by actual testing. Be prepared to spend some money for proper diagnostic testing understanding that HERTSMI-2 costs about $125 and ERMI $300. If you are as ill as it sounds then it is more likely than not that occult re-exposure will be your greatest enemy. (See EnviroBiomics Labs for more information and test kits).
A full battery of labs should be done after your symptom roster is completed and the online visual contrast sensitivity test (VCS) is performed. If your VCS is normal and you only have a few symptoms, you probably are not going to be a person who has a CIRS.
If, however, you have a multisymptom, multisystem illness with a VCS deficit (and the computer on the site will tell you) then I would recommend that you have the labs done. If you have questions on what to do, this would be an occasion where you would be well off to consult one of the credentialed physicians listed on this site.
6/ Diagnosis; longer duration illness
QUESTION: I was exposed to a water-damaged building for 5 months. I now have asthma symptoms and fatigue. I am looking for testing to show me where I am in this illness and what kinds of treatments are available.
ANSWER: This question remains one of the most common ones that we receive on the website. The method of diagnosis of CIRS is published in peer-reviewed literature that is free to users on this site. What patients need to be able to show is that they truly do have exposure to water-damaged buildings as is shown either by presence of visible mold, musty smells or evidence of speciated microbes. Air sampling will not accomplish either of these three
different elements.
Patients will also need to be shown to have a multi-system, multi-symptom illness as represented in published peer reviewed literature. Having asthma symptoms and fatigue are commonly seen in patients with CIRS, but true CIRS patients have far more than just two symptoms.
Having laboratory testing done to confirm presence of innate immune abnormalities is also required. These lab abnormalities need to be consistent with what has been published in peer-reviewed literature.
7/ Diagnosis, prolonged symptoms after exposure; new building construction
QUESTION: I moved out of a house that had major water damaged 6 years ago. I was ill then as was my son, but we have not improved with removal from exposure. The house was brand new. Could this long-term mold exposure be contributing to my illness?
ANSWER: For those with HLA-based susceptibility, and in the rest of the question you wondered if you had one of the haplotypes that confer such susceptibility, there will not be resolution of illness with removal from exposure. Chronic inflammatory response syndromes are initiated by response to antigens, which certainly would have been the case with your exposure several years ago, but are perpetuated by differential gene activation.
As I see your case now, however, it will be necessary to approach you as an unknown. We would need to make sure that you have no other exposures to water-damaged buildings that were ongoing; we would need symptom rosters; together with visual contrast sensitivity testing (the VCS on this site is adequate to help you get started); and if you have exposure, symptoms and positive VCS test results I would recommend the battery of tests that are listed in the Physicians’ Resources section of this website.
For those with longer duration illness without treatment, such as yours possibly could be, the approach to therapy must include consideration of long-term correction of the genomic abnormalities.
A word about new buildings. Water intrusion has nothing to do with age. Newer
structures can be put up quickly (and that can mean skipping steps or using shoddy methods), have not had passed the test of time to show absence of construction defects.
There is a developing series of data that also show that older structures, built before 1970, are less likely to be contaminated by some of the many species of mutated fungi that we see since that time that now are major sources of inflammagens in an interior environment.
8/ Diagnosis; why some family members are ill, some not.
QUESTION: Can some members of the same household develop CIRS while others do not?
ANSWER: Of course. The mechanism by which patients lose regulation of inflammation begins with genetic susceptibility and exposure. There is no guarantee that siblings will have the same genetic makeup in that they have one copy of the immune response genes (out of two), with one from Mom and one from Dad. It is quite possible that one child will have two copies of a gene that increases susceptibility for CIRS while others will have none.
There is also no guarantee from using proteomic evaluations that we can tell when an individual is developing a CIRS before the full syndrome develops. While some patients develop full-blown CIRS later in life, some experience it in childhood. Genomics, however, is a different story. Here we feel strongly that our genomic data will give us an indication of who is developing CIRS even before the syndrome is full blown. What this would mean is that treatment could be instituted effectively early on when there are less complicating factors from longer duration illness.
9/ Diagnosis, trying alternative therapies without recovery
QUESTION: I am a practicing physician with an interest in CIRS-WDB. I am concerned my office makes me ill. I have been using a variety of interventions that I do not see listed on your website. I have been using saunas, Toxin Absorbmax, EC3 products, Amphotericin B nebulizers and glutathione. I am no better at all. My C4a is 4,587.8 and my TGF beta-1 is not reported. I have become sensitized from my laptop computer. I am considering evaluation at the Environmental Health Center in Dallas.
ANSWER: What I don’t see here is a properly obtained database that would let you use peer-reviewed published protocols. The interventions that you’ve mentioned are prescribed by a variety of physicians without any documentation in published, evidence-based, peer-reviewed literature showing any benefit. The fact that you do not have before and after results that would show benefit or lack of from these interventions does cause concern. CIRS is an incredibly complex illness and guessing at therapies without any assessment and without any baseline or change in baseline with therapy is not logical.
As an aside, C4a should never been done at LabCorp as yours obviously was.
If your chemical sensitivity is progressing rapidly then the work that Dr. Rea does is the state of the art in my opinion.
First, I recommend taking the steps to confirm the initial CIRS diagnosis (see the steps outlined above in this document).
For more information about CIRS, I hope you will be able to review the resources on the Surviving Mold site (and below), and it may also benefit you to review the Certified Shoemaker Protocol™ Practitioner essays, written by Protocol-trained expert treating physicians, to become more familiar with the steps for conclusive diagnosis and treatment.
10/ Confused about diagnosis, mixed results; 23andme; Urine analysis
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 consultation and not just a short answer for frequently asked questions. I will try, however.
The VCS results can be relied upon in well over 90% of tests when performed accurately. False reads can happen in specific instances, which you can learn more about on the VCS information page on this site. This is the only test I know of in your list that gives us reliable information as it is extremely helpful looking for inflammatory responses from biotoxins.
If you have multiple persistent symptoms commonly found in CIRS cases and yet you pass the VCS, then it is reasonable to obtain the labs listed in the diagnosis section of this website. (See resources below.)
There must also be confirmation of the exposure, with documentation of water intrusion and microbial growth. HERTSMI-2 and ERMI test kits can provide you with this information.
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. Urine analysis does not give conclusive information in detecting CIRS/mold illness. The relationship of antidiuretic 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.
Allergy testing will look at acquired immune responses and not innate immune responses. The skin allergy test has no relationship to the CIRS from water-damaged buildings.
With normal serum iron and ferritin, even though those numbers might be below normal, there is no diagnosis that can be made. If there were problems with hemoglobin, hemolysins, transferrins, or intestinal mal-absorption of iron, those would be important elements to know to assist you with your concerns about iron.
11/ Diagnosis, labs for a complex case
How can I be sure that I am suffering from mold illness based on my lab results showing mold susceptible HLA; MSH too low at 18; TGF slightly elevated at 2920 and normal VEGF? I was given hydrocortisone for a putative diagnosis of adrenal insufficiency and I have not been able to wean off.
ANSWER: The diagnosis of CIRS is based on satisfying multiple elements before we get to the lab part of the diagnosis.
Specifically, we look for the potential for exposure to an indoor moldy environment; presence of multiple typical symptoms as found in patients reported in peer-reviewed literature (see the resources above and free information guides available on this site); positive VCS (showing a deficit) and differential diagnosis showing no other explanation.
Lab findings typically will include:
(1) Evidence of lack of regulation of inflammation in a given person with HLA susceptibility.
(2) Evidence of out of control inflammatory markers.
Your labs are consistent with a diagnosis of CIRS; I would suggest looking for a deep nasal culture; C4a (not done at LabCorp); ADH and osmolality; and ACTH and cortisol.
Given the apparent complexity of your case, these additional studies are not ones that can be skipped.
12/ Diagnosis; A variety of symptoms after moving
QUESTION: My son and I have been ill since we moved into our apartment from our prior home. We were well when we moved in. Apparently, there have been floods in the apartment in part due to the foundation structure of the home. I have a variety of health symptoms possibly related to low thyroid. What should I do?
ANSWER: Getting started in the journey to diagnose and to successfully treat chronic inflammatory response syndrome (CIRS) acquired after exposure to the interior environment of water-damaged buildings, can be complex and confusing if there is not a organized approach. The Shoemaker Protocol™ diagnosis pathway is included in the information section in the Surviving Mold website (plus see the info and resources included in this document) and includes testing the home or suspected buildings with an environmental dust sample testing kit.
There is a lot of information published and available here to help you see if you meet the criteria needed to show that you do have CIRS.
You don’t have to guess what to do. The materials you need are published, proven, and documented for you and your attending physician. If you discover you do have CIRS, I recommend working with a Shoemaker Protocol™ trained practitioner to best handle the nuances and particulars of this complex illness.
13/ Diagnosing symptoms
QUESTION: I have developed frequent health issues since a washing machine has been flooding our kitchen. The manufacturer is investigating; I have an attorney hired to look at damages. I have metallic taste and multiple health symptoms. I am short of breath and light headed with memory loss and dry eyes. I am an LPN. What do you recommend?
ANSWER: While you have mentioned a few of the symptoms common to CIRS-mold illness, conclusive diagnosis is your next step and begins with the initial steps you’ll need to do before making an appointment with a Shoemaker Protocol™ Practitioner, or your attending physician.
Please see the many diagnosis-related member Q&As and Surviving Mold resources where I cover these initial steps (also see the introduction section above in this document and resources below).
There are also videos that may be of benefit for you that are posted on YouTube. You need the diagnosis; you need the tools to make diagnosis (including ERMI testing) and you need to understand how to prove that your house has a microbial problem or not.
You will need to prove that you have the potential for exposure; symptoms typical of those seen in published peer-reviewed literature with CIRS caused by exposure to water- damaged buildings; same for labs and finally response to treatment.
SECTION 3: Allergies versus CIRS diagnosis
1/ Allergy testing proves clear
QUESTION: I have been tested for mold RAST and IgE. These proved to be clear. Would it still be advisable to have a CIRS work-up?
ANSWER: Yes, CIRS does not involve allergies and while you have ruled-out significant allergic responses, you have not ruled-out CIRS.
2/ Diagnosis underway; common symptoms; checking for allergies
QUESTION: We have found Stachybotrys in our home, especially in the shower and crawl space. I am seeking assistance and have been to see an allergist in Denver.
ANSWER: If you truly have an inflammatory response syndrome caused by an interior environment of a water-damaged building, no allergist would be of any benefit to you as the illness has nothing to do with allergy. You might be surprised to see what the past history of some allergists/OccMeds at NJC has done in mold cases.
A confirmed case of CIRS is due to innate immune inflammatory events. You mention your daughter has diarrhea but it is important to remember that illnesses caused by exposure to moldy homes will be multi-system, multi-symptom and not just diarrhea. Your multiple symptoms as described in your note of headaches, respiratory issues, sinus congestion, abdominal pain, aching and fatigue sound very typical of what CIRS-WDB patients have.
I would recommend that you do the visual contrast sensitivity (VCS) test on this site and if you have a problem passing that test then I would strongly recommend that you have the labs done by your doctors as described in the diagnosis section of this site. (See also the symptom checker and 4 Quick-Start Steps included in this document).
SECTION 4: Shoemaker Protocol™ Resources
THE QUICK-LOOK SYMPTOM CHECKER
Because CIRS affects multiple systems in the body, patients will exhibit several of these common symptoms:
♦Fatigue ♦Weakness ♦Aches ♦Muscle Cramps ♦Unusual Pain ♦Ice Pick Pain ♦Headache ♦Light Sensitivity ♦Red Eyes ♦Blurred Vision ♦Tearing ♦Sinus Problems ♦Cough ♦Shortness of Breath ♦Abdominal Pain ♦Diarrhea ♦Joint Pain ♦Morning Stiffness ♦Memory Issues ♦Focus/Concentration Issues ♦Word Recollection Issues ♦Decreased Learning of New Knowledge ♦Confusion ♦Disorientation ♦Skin Sensitivity ♦Mood Swings ♦Appetite Swings ♦Sweats (especially night sweats) ♦Temperature Regulation Problems ♦Excessive Thirst ♦Increased Urination ♦Static Shocks ♦Numbness ♦Tingling ♦Vertigo ♦Metallic Taste ♦Tremors
THE NEXT STEP: TAKE THE ONLINE VCS TEST
LEARN MORE & GET STARTED >
If you are experiencing several of the above symptoms without resolve, you could be suffering from mold illness. The next step is to take the online Visual Contrast Sensitivity (VCS) test.
If you take the VCS and show a visual deficit together with the presence of multiple health symptoms, in less than 5 minutes you can determine with your VCS printout whether or not to proceed with the Shoemaker Protocol™ lab-testing pathway for conclusive diagnosis and treatment specifics.
Shoemaker Protocol™ Resource List
Below you’ll find a compilation of some of the most recommended and popular Surviving Mold resources for guiding you, your care team, and your attending practitioner as you recover
(For a more comprehensive list of resources see Membership Q&As, PART 1: About the Shoemaker Protocol™ in this series).
A short introduction and summary of each step of the Shoemaker Protocol™
This short guide explains and takes you through the initial Shoemaker Protocol™ diagnostic steps. Get started right now, and get answers, no doctor appointment required.
Dr. Shoemaker has trained hundreds of practitioners in the Shoemaker Protocol™, and that number continues to grow worldwide. Choose from Certified Protocol Physicians or the Proficiency Partners to find one who can manage your case. Telemedicine options are now widely available.
Our “Physician’s Resources” tab on the Surviving Mold Home Page has the necessary resources for your attending physician to guide you through recovery with the Shoemaker Protocol™ (includes the Shoemaker Protocol™ Lab Roster).
The Surviving Mold Site is full of Shoemaker Protocol-based information and resources, including a Patient Resources section, Group Support offerings, and a Search Bar feature that is very helpful, too.
One of the Shoemaker Protocol’s initial diagnostic steps includes appropriate building testing, either by HERTSMI-2 or ERMI done in your current home and/or other frequently visited buildings, to determine what building is affecting you. This report will also identify which specific types of biotoxins are present, and to what level. You will have information that will inform your recovery and maintenance journey ahead.
Protocol-Related Published Papers & Information
EXPERT TREATING PHYSICIANS CONSENSUS OF 2010 >
One of Dr. Shoemaker’s most-referenced papers provides evidence to support a cause-effect relationship between exposure to the air and dust in water-damaged buildings (WDBs) and a chronic inflammatory response syndrome (CIRS) that is linked to certain genetic HLA haplotypes.
“VIP CORRECTS CIRS…” PUBLISHED PAPER, 2013 >
Review the paper published on use of VIP to learn of its revolutionary effects on the illness, and more. This paper has labs and p-values (statistics) for 1829 mold patients together with nearly 500 controls.
CONSENSUS STATEMENT FOR MICROBIAL REMEDIATION 2020
This document is a consensus statement that expands on existing professional society recommendations by including guidelines for remediation of buildings to be occupied by known, sickened patients.
WHO GUIDELINES FOR INDOOR AIR QUALITY >
RESPIRATORY AFFECTS OF MOLD EXPOSURE – INST. OF MEDICINE >
