If you have been sick for months or even years, you have probably collected more than a few diagnoses along the way. Perhaps you have been told you have chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, autoimmune disease, anxiety, migraines, or hormone imbalance. While those labels may describe what you are experiencing, they often do not answer the most important question. Why did those symptoms develop in the first place?
At the Restorative Medicine Center, I encourage patients to think differently about chronic illness. Rather than chasing each new symptom as it appears, we dig deeper to understand what is driving immune dysfunction beneath the surface. One concept that helps explain why some people remain chronically ill is IACIRS, a framework for understanding persistent immune activation that may help connect symptoms that otherwise seem unrelated.
What Is IACIRS?
IACIRS is a term used to describe a state of persistent immune activation and chronic inflammatory dysfunction. Instead of responding to a threat and then returning to normal, the immune system remains stuck in an ongoing inflammatory state.
This does not mean the immune system is simply "too strong" or "too weak." Rather, it has become dysregulated. It may overreact in some situations while failing to respond appropriately in others.
For many people, this ongoing immune imbalance contributes to a wide range of chronic symptoms, including:
- Fatigue
- Brain fog
- Joint and muscle pain
- Digestive problems
- Allergies and sensitivities
- Autoimmune conditions
- Anxiety and mood changes
- Hormone imbalances
- Chronic infections
- Poor exercise tolerance
Why Doesn't the Body Simply Recover?
Under normal circumstances, your immune system responds to an infection or injury and then settles back into balance. That is exactly how it is supposed to work.
Unfortunately, some people never make that transition. Instead, the immune system continues receiving signals that something is wrong. Those signals can persist for months or years, creating chronic inflammation and a growing list of seemingly unrelated symptoms.
This helps explain why some patients never feel like they fully recover after:
- A significant infection
- Tick borne illness
- Mold exposure
- Long periods of stress
- Environmental toxin exposure
- Multiple health challenges occurring at the same time
Looking Beyond the Diagnosis
One of the biggest frustrations I hear from patients is that every specialist focuses on a different diagnosis. A rheumatologist may diagnose autoimmune disease. A neurologist may diagnose migraines. A gastroenterologist may diagnose IBS. Another physician may identify thyroid disease or anxiety.
None of these diagnoses are necessarily wrong. They simply describe different pieces of the same puzzle. I often explain that these labels are descriptive diagnoses. They describe what is happening but not necessarily why it is happening.
That is why my approach focuses on asking different questions.
Instead of asking:
- What should we call your illness?
I ask:
- Why is your immune system behaving this way?
- What is preventing it from returning to balance?
- What root causes are keeping this process going?
The Root Cause Triad: A Different Way to Understand Chronic Illness
Over the years, my clinical experience has led me to organize chronic illness around what I call the Root Cause Triad. Rather than viewing symptoms as isolated diseases, I look for three major categories that frequently work together to drive immune dysfunction.
Microbes
Persistent infections can continue stimulating the immune system long after the initial illness appears to have passed.
These may include:
- Borrelia species
- Bartonella
- Babesia
- Viral infections
- Fungal overgrowth
- Other stealth pathogens
Toxins
Not all toxins come from industrial chemicals. Some of the most significant immune disrupting toxins are actually biotoxins, substances produced by living organisms.
Examples include:
- Mold exposure from water damaged buildings
- Microbial toxins
- Environmental toxic exposures
- Internal fungal toxins
Stress Response
Many people think of stress as simply feeling overwhelmed. The stress response I am referring to is much broader.
When the body remains trapped in a prolonged fight or flight state, healing becomes much more difficult. The nervous system, immune system, hormones, and metabolism all become interconnected.
Common Triggers That Can Keep the Immune System Activated
Chronic or Stealth Infections
Many microbes are capable of remaining in the body for extended periods. These infections may produce subtle symptoms that change over time, making them difficult to recognize.
Examples include:
- Lyme disease
- Bartonella
- Babesia
- Mycoplasma
- Chronic viral infections
Mold and Biotoxin Exposure
Living or working in a water damaged building can expose people to mold and microbial toxins. Even after leaving the environment, some individuals continue experiencing symptoms because the immune system remains activated.
Patients frequently report:
- Fatigue
- Sinus problems
- Brain fog
- Headaches
- Muscle pain
- Increased chemical sensitivities
Chronic Stress Physiology
Emotional stress, poor sleep, trauma, chronic illness, and ongoing inflammation can all contribute to prolonged activation of the body's stress response. When this system remains overactive, recovery often slows. Patients sometimes notice they feel stuck in survival mode, even when life has become less stressful.
Multiple Triggers Often Exist Together
One of the biggest misconceptions in medicine is that every illness must have a single cause. That is rarely what I see.
A patient may have:
- Tick borne infections
- Mold exposure
- Nutrient deficiencies
- Chronic stress physiology
- Sleep disruption
Why Symptoms Can Look So Different From Person to Person
No two immune systems respond exactly the same way. Two patients with similar underlying immune dysfunction may have completely different symptom patterns.
One person may develop autoimmune thyroid disease. Another may struggle with migraines and brain fog. Someone else may experience digestive symptoms, allergies, and chronic fatigue.
Common downstream symptoms include:
- Fatigue
- Memory problems
- Difficulty concentrating
- Joint pain
- Muscle pain
- Headaches
- Anxiety
- Depression
- Digestive issues
- Food sensitivities
- Hormone imbalance
- Recurrent infections
How Is IACIRS Evaluated?
There is no single blood test that confirms IACIRS. Instead, evaluation requires looking at the entire clinical picture.
That includes carefully reviewing:
- Medical history
- Symptom patterns
- Previous illnesses
- Environmental exposures
- Family history
- Physical examination
- Laboratory findings
Depending on the individual patient, laboratory evaluation may include inflammatory and immune biomarkers such as:
- VEGF
- MMP-9
- C4a
- TGF-β1
- hsCRP
- Cortisol
- Vitamin D ratio
- Immunoglobulin levels
- Autoimmune markers
These results are never interpreted in isolation. Laboratory testing is one tool that helps us understand what the immune system may be doing, but it must always be considered alongside the patient's history and symptoms.
Why Simply Treating Symptoms Often Is Not Enough
There is certainly a role for treatments that improve symptoms. Reducing pain, improving sleep, or controlling inflammation can make daily life much more manageable. The problem arises when treatment stops there.
If the underlying immune dysfunction remains unchanged, new symptoms often appear over time. Many patients tell me they feel like they spend years moving from one diagnosis to another.
That pattern often suggests it is time to step back and ask whether something deeper is driving the entire process. Rather than continually treating the downstream mess, I believe we should spend equal effort identifying and addressing the factors that created it.
What Does Treatment Typically Focus On?
Every patient is unique, so treatment should never follow a one size fits all protocol. Instead, treatment is built around identifying each person's specific root causes.
Depending on the situation, treatment may focus on:
- Reducing microbial burden
- Identifying and eliminating toxin exposure
- Supporting detoxification pathways
- Restoring immune balance
- Improving sleep quality
- Supporting healthy nutrition
- Correcting nutrient deficiencies
- Calming an overactive stress response
- Optimizing hormone function when appropriate
One principle I emphasize with every patient is that treatment should move at a pace the body can tolerate. Healing is rarely a straight line. Sometimes slowing down allows the body to make more meaningful long term progress than pushing too aggressively.
Healing Starts by Asking Better Questions
If you have been sick for years, it is easy to feel discouraged. Many patients begin to believe that accumulating more diagnoses simply means they have to live with chronic illness forever.
In many cases, there is another way to look at the problem. IACIRS provides a framework for understanding how persistent immune dysfunction may connect symptoms that appear unrelated. Instead of focusing only on disease labels, we can begin asking what is keeping the immune system from returning to balance.
Let's Dig Deeper Together
At the Restorative Medicine Center, my goal is not simply to manage symptoms. It is to identify the root causes contributing to immune dysfunction and develop a personalized treatment strategy that supports long term healing. We dig deeper because lasting health often depends on understanding why your symptoms developed in the first place.
Restorative Medicine Center
Dr. Teresa Birkmeier-Fredal, MD
705 Barclay Circle, Suite 115
Rochester Hills, MI 48307
Phone: (248) 289-6349
Fax: (248) 289-6923