CIRS Shoemaker Protocol Step #2
As we covered in the last blog… you’ve caught onto the idea that chronic inflammatory response syndrome (CIRS) and erythromelalgia (EM) are related. You’ve learned that the first step in recovery from CIRS and therefore EM is removal from exposure. Let’s continue to walk through the steps of CIRS treatment together. Don’t forget that Dr. Shoemaker’s brilliant protocol that treats CIRS involves a great deal of information and many new words to learn. This is the ‘alphabet soup’ of CIRS. Don’t be hard on yourself if you don’t ‘download’ it all in the first go at it. I’m a medical provider, and it has stretched me to understand CIRS treatment. The good news is that it is the job of your CIRS savvy medical provider to walk you through the steps. Nonetheless, it helps to understand the ‘why’ behind the wonky things you are being asked to do.
So, you failed the VCS test and were worked up for CIRS. Your positive blood markers resulted in a diagnosis. Now treatment will involve taking the CIRS protocol step-by-step. The first step is removal from exposure. The next step is to start a binder.
Step #2- ADMINISTRATION OF CHOLESTYRAMINE OR WELCHOL (AKA- a ‘binder’)
The second step of the protocol involves prescription of a non-absorbable bile acid sequestrant– either cholestyramine (CSM) or colesevelam (Welchol). Your medical provider will consider your past medical history as well as current clinical presentation to determine which medication may be right for you. Regardless of which medication is chosen, the medication’s positively charged anion exchange resin is able to bind to negatively charged anions like bile salts where toxins are stored [2]. In essence, these medications bind the toxins. While the average person’s immune system can see and therefore remove toxins, those with certain HLA haplotypes associated with CIRS need the help of a prescription binder to remove the toxins. Overtime with frequent dosing, the toxins are excreted each time you have a bowel movement.
While we are on the subject of binders, let me share some hard-won wisdom on the topic-
First, binders are constipating. Be sure to drink plenty of water daily while on binders. Be sure you are pooping daily! If you are having a bowel movement each day, you are reabsorbing the toxins which defeats the purpose of binding. Luckily, the supplement magnesium citrate or glycinate can do the trick, and those with co-existing EM tend to do well with magnesium. Adjust the dose to be sure you are pooping at least once daily. If you don’t tolerate magnesium, talk to your CIRS savvy medical provider about other options.
Second, a detox reaction can occur when using binders. Basically, you are detoxing faster than your body can keep up. This is why we start low and go slow with binders. If a significant detox reaction is anticipated due to the severity of illness, your medical provider may ask you to take a 5-day course of high dose omega 3 fatty acids (EPA 2.4 grams/ DHA 1.8 grams) before starting binders and to continue with this dose of EPA/DHA for five additional days after the start of binders. If you notice detox symptoms such as increased fatigue, dark thoughts, heavy limbs, or any other changes, notify your medical provider so they can direct you. Binding shouldn’t be making you feel worse.
Lastly, binders are a marathon and not a sprint. Expect to bind for a year or longer. Given the fact that you accumulated the toxic load you carry over many years, it’s quite remarkable that our body can make a full recover in a few years’ time! Binding frequently is more important than binding with a large dose. For example, it would be more important to take 1/8 tablet 3x daily than to take 1 tablet 1x daily. Once in a safe space, the slow and steady removal of toxins that have been driving inflammation and illness is the ticket to health!
Happy binding!
You can read about CIRS Shoemaker Protocol Step #1 here.
You can read more about my journey as a medical provider hellbent on healing her own erythromelalgia here.
Read about healing my chronic inflammatory response syndrome (CIRS) and how that connects to EM here.
Interested in receiving my blogs in your inbox? Simply click here lauren@untamediona.com to shoot me an email and be added to the mailing list.
Think I may be a good fit for your needs? You’ve explored my offerings but still have a few burning questions specific to the one and only Y-O-U… Book a 15-minute connection call at a rate of $60 plus tax to explore your concerns. Let’s find ways forward together.
