If you’re suffering from unexplained fatigue, brain fog, chronic pain, strange neurological symptoms, or worsening sensitivities, and have been told “everything looks normal,” you’re not alone. These kinds of symptoms are often labeled as “idiopathic” — a medical term that simply means “we don’t know why it’s happening.” But at Restorative Medicine Center, we believe there is always a reason — and when it comes to complex, chronic illness, Biotoxin Illness is often that reason.
What Is Biotoxin Illness (CIRS)?
Biotoxin Illness is also known as Chronic Inflammatory Response Syndrome (CIRS) — a complex, multi-system condition triggered by exposure to biotoxins, or biologically-produced toxins that disrupt immune regulation and create widespread inflammation in the body.
This is not a simple mold allergy or minor exposure issue. CIRS is a true, immune-mediated illness where the body becomes unable to effectively eliminate certain toxins, which then act like ongoing fuel for inflammation, keeping the immune system in overdrive and causing damage across multiple organ systems — including the brain, lungs, gut, muscles, and endocrine system.
The Shoemaker Protocol and the Evolution of CIRS Awareness
The term CIRS was coined by Dr. Ritchie Shoemaker, a pioneer in understanding how mold exposure and biotoxin-producing microbes can cause serious chronic illness. Through years of research, Dr. Shoemaker established a detailed diagnostic framework that includes symptom clusters, visual contrast testing, genetic markers, and key inflammatory biomarkers like C4a, MMP-9, and TGF-β1.
While his work was groundbreaking, it was also met with skepticism — partly because traditional medicine has long focused on symptom management rather than root causes, and partly because biotoxin illness can mimic so many other conditions. As a result, patients with CIRS are often misdiagnosed with chronic fatigue syndrome, fibromyalgia, depression, autoimmune disorders, or even dismissed entirely.
Why Is Biotoxin Illness So Often Overlooked or Misdiagnosed?
Biotoxin illness doesn’t fit neatly into conventional diagnostic boxes. Standard labs often appear “normal,” and symptoms can fluctuate wildly. Many patients are told “it’s all in your head” or are prescribed medications to suppress symptoms rather than investigate their cause.
Because CIRS can manifest with such a broad range of symptoms — from memory issues and air hunger to joint pain and chronic GI problems — it often leads people down a long and exhausting journey from specialist to specialist, without ever receiving a unifying diagnosis.
To complicate matters, most doctors aren’t trained to recognize or treat biotoxin illness, let alone connect environmental exposures (like mold) or stealth infections (like Lyme or Bartonella) to long-term immune dysfunction.
Dr. Teresa Birkmeier-Fredal: One of Michigan’s Only Biotoxin Illness Specialists
Dr. Teresa Birkmeier-Fredal stands apart in this field. As one of the only physicians in Michigan openly diagnosing and treating Biotoxin Illness, she brings together years of clinical experience in integrative and functional medicine, along with deep training in microbial and environmental root causes of chronic disease.
What makes her approach unique is her use of the Root Cause Triad — a paradigm that identifies the interconnected role of:
- Microbes (including mold-related and vector-borne infections)
- Toxins (especially biotoxins and toxicants)
- Stress response dysregulation
At Restorative Medicine Center in Rochester Hills, Dr. Teresa doesn’t stop at labeling symptoms — she digs deeper. Patients come here not just for relief, but for answers, and for a clear, comprehensive path forward based on what’s actually causing their immune system to remain in dysfunction.
How Restorative Medicine Center Diagnoses Biotoxin Illness
It Starts With a Full Functional Medicine Intake
Every patient begins with a comprehensive functional medicine evaluation — not a 10-minute appointment, but a deep dive into your history, exposures, symptoms, and story.
We look at:
- Environmental history (Have you lived or worked in water-damaged buildings?)
- Travel history (Have you visited Lyme-endemic areas or had tick bites?)
- Chronic symptom patterns over time
- Past diagnoses that may actually be labels for unrecognized immune dysfunction (e.g. fibromyalgia, IBS, ME/CFS, chronic sinusitis)
Validated Screening Tools: MSIDS & CIRS Criteria
We utilize well-established tools to assess the likelihood of biotoxin illness:
- MSIDS Questionnaire (developed by Dr. Richard Horowitz): A broad-spectrum assessment tool that screens for vector-borne infections and chronic immune dysregulation.
- CIRS Symptom Cluster Criteria (from the Shoemaker Protocol): If you meet criteria in multiple symptom clusters — especially alongside exposure history — the suspicion for CIRS is high.
Advanced Lab Testing for Biotoxin Illness
While many patients come to us with a stack of “normal” labs, these often lack the specific immune and inflammatory markers that reveal biotoxin-driven disease.
At Restorative Medicine Center, we assess:
- C4a: An inflammatory marker elevated in response to mold exposure and biotoxin-related immune activation.
- MMP-9: Indicates leaky blood-brain barrier and tissue remodeling from chronic inflammation.
- TGF-β1: A powerful cytokine that contributes to fibrosis, brain fog, and immune dysregulation when elevated.
- VEGF: Involved in blood vessel formation. Low levels can indicate poor oxygen delivery to tissues.
- VIP (Vasoactive Intestinal Peptide): Often suppressed in CIRS. Critical for neurological, immune, and hormonal function.
- Cortisol + VDR Ratio: Assesses adrenal status and vitamin D receptor sensitivity, both of which are impacted in chronic illness.
HLA Genetic Testing: Do You Have the Biotoxin Susceptibility Genes?
Roughly 25% of the population has HLA-DR gene patterns that impair the ability to recognize and eliminate biotoxins. If you carry these genes, you may become a “canary in the coal mine” — experiencing severe symptoms from exposures that others tolerate.
This doesn’t mean you’re doomed. But it does mean your detox and recovery process will need to be more strategic — and that avoiding future exposures is essential.
Environmental Exposure Assessments
Because you can’t heal in the same environment that made you sick, part of our diagnosis includes assessing where and how you may be getting exposed to biotoxins.
This includes:
- Identifying water-damaged buildings (your home, school, workplace)
- Air quality testing recommendations
- Home mold inspection referrals
- Education on using ERMI or HERTSMI-2 testing to evaluate indoor mold burden
The Restorative Medicine Treatment Approach
The Root Cause Triad™ in Action
Every treatment strategy is built around the three pillars that underlie chronic immune dysfunction:
- Microbes – stealth infections, vector-borne pathogens, gut imbalances
- Toxins – biotoxins from mold, microbes, or the environment
- Stress Response – nervous system dysregulation that perpetuates inflammation
What Might Your Treatment Plan Include?
Because biotoxin illness presents differently in every individual, treatment plans are never one-size-fits-all. That said, here are some of the core tools we may use depending on your labs, symptoms, and current resilience level:
Biotoxin Binders
Targeted binders such as:
- Cholestyramine or Welchol (Rx options)
- Activated charcoal, bentonite clay, or GI detox binders (natural options)
Nutritional & Detox Support
When your body is under constant immune assault, nutrients become depleted quickly.
We support:
- Methylation and glutathione pathways (to support detox and repair)
- Mineral repletion (especially magnesium, zinc, selenium)
- Targeted mitochondrial support for fatigue, brain fog, and poor recovery
Antimicrobial Therapy (When Infections Are Driving the Process)
For patients whose biotoxin burden stems from unresolved infections — like Borrelia, Bartonella, Babesia, or Candida — we carefully introduce:
- Botanical antimicrobials
- Targeted pharmaceuticals (when appropriate)
- Gut and immune system rebalancing alongside pathogen reduction
Reducing Environmental Exposure
You cannot heal if you’re still being exposed.
We’ll walk you through how to:
- Test your home or workplace for mold
- Remediate safely and correctly (or relocate, when necessary)
- Use air purifiers and create clean air sanctuaries in sleeping areas
- Filter your drinking water and reduce chemical exposures in the home
Limbic Retraining & Vagal Nerve Regulation
The longer your body has been in a state of fight-or-flight, the more your brain gets stuck in survival mode. Healing the nervous system is essential.
We may recommend:
- Limbic retraining programs (e.g., DNRS or Gupta Program)
- Vagal nerve stimulation practices – including breathwork, cold exposure, and light movement
- Somatic therapies or trauma-informed strategies (as needed)
Supportive Therapies That Amplify Healing
We often integrate gentle, non-invasive therapies to boost detox and immune regulation:
- Far Infrared Sauna – supports detox through sweat, reduces pain and inflammation
- Red Light / Near Infrared Therapy – improves mitochondrial function and mood
- Methylene Blue – a powerful mitochondrial and neuroprotective agent when used correctly
You Don’t Have to Stay Stuck
If you’ve been living with chronic, confusing, or debilitating symptoms — and no one can give you a real answer — biotoxin illness may be the missing piece.
It’s not “in your head.” You’re not lazy, dramatic, or broken. Your immune system is trying to protect you — it just needs help recalibrating. And that’s exactly what we specialize in here.
At Restorative Medicine Center, we don’t chase symptoms or rely on generic protocols. We dig deep, ask the right questions, and build treatment plans based on your root causes — not someone else’s checklist.
Dr. Teresa Birkmeier-Fredal has helped countless patients like you uncover the truth behind their illness and finally start to heal. If you're ready to move past surviving and into thriving, we are here to guide your next step.
Contact Us Today
📍 Restorative Medicine Center
705 Barclay Circle, Suite #115
Rochester Hills, MI 48307
📞 Phone: 248.289.6349
📠 Fax: 248.289.6923
🕘 Office Hours: Monday – Thursday: 9:00 AM – 5:00 PM | Friday: Closed
🌐 Website: www.restorativemedcenter.com
📩 Email: drbirkmeier@gmail.com