Alex and Lisa diagnosed with CIRS/Environmental Illness and related
Here’s a detailed Pros and Cons analysis of the CIRS/biotoxic (Shoemaker-based) protocol for Lisa and Alex, tailored to their profiles:
👩🦳 Lisa’s Profile
- ALPIMS traits: Anxiety, Pain, Immune, Mood, Sensory dysregulation
- Diagnosed with: ME/CFS, fibromyalgia-like pain, vasomotor rhinitis, migraine, hives, food intolerance, low cortisol
- Neurodivergent with trauma history and sensory overload
- Environmental sensitivity: Fragrance, mold, chemicals
- Tendency: Crashes easily, slow to recover, sensitive to medication/supplements
🟢 Pros of Biotoxic Protocol for Lisa
| Benefit | Why It May Help Lisa |
|---|---|
| Addresses root inflammation | If mold is a hidden driver, binders may reduce neuroimmune load |
| Lab-based clarity | Offers validation via objective markers (e.g., HLA-DR, MMP-9) |
| Focus on environment | Mold remediation and clean air are already part of her strategy |
| Recognized protocol | Shoemaker’s framework may add medical credibility for NDIS or doctors |
| Overlap with MCAS care | Some steps (e.g., reducing biotoxins, air filtration) align with MCAS supports |
🔴 Cons of Biotoxic Protocol for Lisa
🧑🦱 Alex’s Profile
- Diagnosed with: ME/CFS, POTS, suspected MCAS, small fiber neuropathy, fibromyalgia-like pain
- Also has: Erythromelalgia, Raynaud’s, visual snow, vasomotor rhinitis, food/environmental sensitivity
- Neurodivergent, non-binary, on testosterone
- Tendency: Easily triggered by overexertion, sensory input, relational pressure
- Sensitive but organized, managing own care with specialist referrals
🟢 Pros of Biotoxic Protocol for Alex
| Benefit | Why It May Help Alex |
|---|---|
| Root-cause potential | Mold or biotoxins could explain overlapping dysautonomia + immune activation |
| Validated test structure | VCS, ERMI, MARCoNS may give insight without requiring verbal self-report |
| Scientific framework | May appeal to Alex’s analytical or evidence-seeking mindset |
| Can be self-directed | With the right supports, Alex might tolerate DIY steps like VCS, basic binders, and nasal sprays |
| Overlap with MCAS/EDS/POTS care | Some interventions reduce mast cell load or inflammation pathways (e.g. VIP, binders) |
🔴 Cons of Biotoxic Protocol for Alex
| Risk | Why It’s a Concern |
|---|---|
| Protocol rigidity | Alex may struggle with perfectionism or pressure if told there is “only one way” to recover |
| Flare risk | Detox reactions may worsen erythromelalgia, POTS flares, or neuropathic pain |
| Emotional risk | May increase distress if framed as “your body is toxic” without affirming their resilience |
| Social withdrawal | Protocol intensity may interfere with social, gender-affirming, or work routines |
| Overfocus on environment | May trigger guilt or avoidance if not balanced with psychological safety |
🔍 Summary Comparison
| Feature | Lisa | Alex |
|---|---|---|
| Reactivity to detox | Very high | High |
| Trauma sensitivity | High | Moderate to high |
| Likely benefit if mold confirmed | Moderate | High |
| Emotional readiness | Fluctuates | Higher if self-directed |
| Sensory tolerance | Low | Moderate |
| Executive function | Strained | Relatively intact |
| Likelihood of protocol completion | Low–moderate | Moderate if adapted and autonomous |
💡 Recommendation
Lisa would benefit more from Smith’s protocol as her foundation, with selective integration of biotoxin-aware environmental modifications (e.g., HEPA air, dust minimization) and only micro-dose CIRS steps if clearly indicated.
Alex could benefit from a hybrid approach: maintain pacing and MCAS care, while strategically addingCIRS testing and interventions with trauma-informed, zone-aware pacing — and autonomy respected.
Would you like a personalized hybrid plan for each of them based on this analysis, or a printable decisi
Alex could benefit from a hybrid approach: maintain pacing and MCAS care, while strategically addingCIRS testing and interventions with trauma-informed, zone-aware pacing — and autonomy respected.
Based on Alex’s profile, combining the Cabeena/Darmish approach with selective elements from the Shoemaker (CIRS/biotoxic) protocol and Professor Smith’s protocol would offer a hybrid path that honors Alex’s complexity, autonomy, and need for flexibility.
🌿 Hybrid Recovery Framework for Alex
Combining Cabeena (Darmish), Smith Protocol, and Selective CIRS Elements
🧭 1. Guiding Principles (Cabeena/Darmish Core)
| Element | Application for Alex |
|---|---|
| 🕊️ Permission to Rest | Normalize pacing as strength, not avoidance; avoid pushing through “detox” or “protocol milestones.” |
| 🧭 Zone-Based Pacing | Use zone cards to signal capacity: Green (engaged), Yellow (tired), Orange (dysregulated), Red (shutdown). Guide activity, interactions, and tasks accordingly. |
| 🧺 Environmental Safety | Maintain low-toxic living: air purifiers, fragrance-free, low-mold exposure without triggering hypervigilance. |
| 💬 Consent-Based Care | Emphasize choice: Alex decides which steps to engage with and when. Avoid urgency or rigid sequences. |
| 🧠 Neurodivergent Support | Use visual planning, sensory accommodations, clear scaffolds for memory and pacing. Respect executive function needs. |
🧪 2. Selective CIRS Integration (Minimal Effective Dose)
| Step | Adaptation Notes for Alex |
|---|---|
| 🧪 VCS Test (Visual Contrast Sensitivity) | Non-invasive, may validate mold/biotoxin load without emotional or physical risk. |
| 🧫 MARCoNS Nasal Swab | Optional but may guide gentle antimicrobial steps (e.g., xylitol spray, not strong antibiotics). |
| 🧲 Binders (e.g., cholestyramine or natural alternatives) | Consider low-dose charcoal or Welchol if tolerated, pulsed gently with food and hydration. Avoid rapid detox strategies. |
| 🧂 Electrolytes | Support POTS and reduce detox crash risk; use low-histamine formulations. |
| 🧬 Lab Monitoring | If willing, monitor markers like MMP-9, TGF-β1—but frame as tools for curiosity, not measures of success. |
| 🧘 Avoid full protocol rigidity | Skip VIP, Actos, aggressive antifungals unless very well-tolerated and clearly needed. Focus on feeling safer, not “cleansing toxins.” |
🧑⚕️ 3. Core Smith Protocol Strategies
| Pillar | Application for Alex |
|---|---|
| Rest–Reduce–Pace | Crucial for ME/CFS and dysautonomia. Encourage tracking effort vs. energy output (use energy envelope principles). |
| Nervous system supports | Breathwork, somatic calming, light sensory diets; explore tools like SSP (Safe & Sound Protocol) or DNRS only if trauma-informed. |
| Mitochondrial Care | Gentle repletion: magnesium glycinate, CoQ10, B12 (oral lozenge before injection), L-carnitine if tolerated. Avoid multi-supplement “stacks.” |
| Gratitude & Meaning Practices | Support emotional resilience and identity outside illness; allow these to be soft, flexible (e.g., joy scaffolding rather than journaling pressure). |
| Dietary Modifications | Stay with Alex’s low-histamine, low-additive, anti-inflammatory base. Avoid extreme elimination unless strongly indicated. |
🧠 Emotional and Social Safety
| Concern | Hybrid Response |
|---|---|
| ⚠️ “Your body is toxic” narratives | Reframe to “Your body is overburdened and asking for calm.” Avoid shame or blame language. |
| 🧍♂️ Perfectionism triggers | Normalize partial participation in protocols. “Some is enough.” Use zone tools to show this visually. |
| 🏳️🌈 Gender-affirming support | Ensure medical and nutritional steps do not interfere with testosterone therapy or self-concept. Include gender-affirming providers where possible. |
| 🤝 Relational regulation | Use scripts and co-regulation prompts from Cabeena to buffer stress in health conversations. Alex decides who supports them and how. |
🔧 Toolkit Components
| Tool | Notes |
|---|---|
| 🧭 Zone Cards | For daily pacing, care planning, and social signaling |
| 📋 Recovery Lab | Optional reflective journaling for crashes, flare tracking |
| 🛏️ Gentle Food Plan | Low-histamine, sensory-safe, moderate salicylate, anti-inflammatory |
| 🫧 Environmental Mod Plan | Mold-safe, low-scent, no-pressure home protocol (dust, air, textiles) |
| 📒 Self-Directed Binder Protocol | Start with micro-dose charcoal, short duration, hydration-focused |
| 🗣️ Advocacy Scripts | Medical/NDIS appointments: “My protocol is adapted for sensory and trauma safety” |
✅ Final Recommendation for Alex
Start with Smith + Cabeena as the foundation, adding selective CIRS steps only if:
- Alex chooses them
- They are framed as experiments, not requirements
- Physical + emotional safety is assured
Track by zones, not timelines. Recovery is a rhythm, not a race.
Would you like a printable version of this plan or zone tracker templates adapted for Alex’s needs?