CIRS / mold illness
Shoemaker repair-phase; no RCT. Sequence-dependent (after exposure removal + MARCoNS).
Decision support, not prescription. You decide.
Candidate agents
1 agent · tap to expand▶VIPLeadAnecdotalVasoactive intestinal polypeptide (usually intranasal) is the final, repair-phase step of the Shoemaker CIRS protocol, taken seriously only as a protocol-driven, sequence-gated intervention with no controlled efficacy data.expand
Vasoactive intestinal polypeptide (usually intranasal) is the final, repair-phase step of the Shoemaker CIRS protocol, taken seriously only as a protocol-driven, sequence-gated intervention with no controlled efficacy data.
▸Full clinical story
CIRS is framed as dysregulated innate immunity with low regulatory neuropeptides (VIP and alpha-MSH), elevated inflammatory markers (C4a, TGF-beta1, MMP-9, VEGF), and hormonal disruption; VIP is a proposed replacement of a deficient anti-inflammatory neuropeptide meant to down-regulate the residual inflammatory cascade and normalize pulmonary artery pressures once upstream drivers are removed. Its rationale is specifically as a repair-phase correction of a measured VIP deficiency, not a first-line anti-mold agent.
No RCT and no PubMed-indexed efficacy trial or case report exist for VIP as a treatment in CIRS. The nearest indexed literature is observational and biomarker-only: a retrospective CIRS-informed cohort (n=188, Front Endocrinol 2026) that tracked VIP alongside alpha-MSH and MMP-9 and found NO significant association between VIP trajectory and MARCoNS clearance (only the alpha-MSH signal was positive), and an earlier Shoemaker case/control study (chronic ciguatera, n=59/59) describing reduced VIP as a diagnostic marker of biotoxin illness. Both characterize VIP as a disturbed biomarker, not a validated treatment; the grade is honestly anecdotal, resting on the Shoemaker protocol and clinic-reported series in non-indexed outlets.
Anecdotal community signal only, not evidence: clinicians following Shoemaker sequencing prescribe compounded VIP nasal spray after exposure removal and MARCoNS eradication, and some patients report improved energy, cognition, and exercise tolerance while clinicians cite normalized VIP levels and VCS scores. These are uncontrolled self-reports circulating in CIRS practitioner networks and patient forums and should never be presented as efficacy proof.
Context, not a protocol: the commonly described regimen is compounded VIP nasal spray 50 mcg/spray, one spray up to four times daily, often started with a single test dose after confirming a normal repeat lipase and controlled biomarkers. Ranges and titration vary by compounding pharmacy and prescriber.
Strongly sequence-dependent: Shoemaker practice contraindicates starting VIP before ongoing water-damaged-building exposure is removed and MARCoNS is cleared, and before ancillary markers (e.g., MMP-9, TGF-beta1, VEGF) and lipase are addressed, as premature use is reported to be ineffective or provocative. VIP is a systemic vasodilator with pancreatic/GI activity; monitor lipase, and weigh hypotension risk. It is compounded and unapproved for this use.
VIP is the least-evidenced, last-in-sequence piece of a non-validated protocol: mechanistically coherent as neuropeptide replacement and reported helpful in uncontrolled clinic case series, but with zero controlled data and even the indexed biomarker cohort failing to link it to clinical clearance. Reasonable only as a late-stage, monitored, off-label trial after all upstream CIRS steps are genuinely completed.
- Clearance of multiple antibiotic-resistant coagulase-negative staphylococci is selectively associated with higher circulating alpha-melanocyte stimulating hormone in patients evaluated for chronic inflammatory response syndrome. ↗
- Defining the neurotoxin derived illness chronic ciguatera using markers of chronic systemic inflammatory disturbances: a case/control study. ↗
- Mixed12 corroboratinganecdotal
Dose: 200mcg · nasal · 2-4x daily · 3mo
Clearer vision, energy, mood/personality return; sequence-dependent
Side effects: worse before better, runny nose, fatigue, weight gain
sequence dependentr/CIRS - Adverse3 corroboratinganecdotal
Adverse crash (bedridden weeks) when taken during exposure or MARCoNS-positive
Side effects: severe crash
sequence ruler/CIRS
No peer data yet. Aggregates appear once ≥3 clinicians log an outcome.
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