If you've been researching mold illness or CIRS (Chronic Inflammatory Response Syndrome), you've probably seen the term “Shoemaker Protocol.”
Developed by Dr. Ritchie Shoemaker, this evidence-based treatment roadmap has helped thousands of CIRS patients recover from mold and biotoxin exposure.
But what exactly is the Shoemaker Protocol — and how does it work?
In this article, we’ll break it down step-by-step so you can understand how certified doctors use it to guide recovery — from diagnosis to long-term stability.
What Is the Shoemaker Protocol?
The Shoemaker Protocol is a structured, science-backed treatment pathway created by Dr. Ritchie Shoemaker, one of the first physicians to recognize CIRS as a biotoxin-related illness.
It provides a clear, reproducible sequence of diagnostic tests and treatments to reduce inflammation, remove toxins, and restore normal immune function.
The protocol is widely used by Shoemaker-certified physicians, who are trained through the Surviving Mold Certification Program.
At its core, the Shoemaker Protocol is about:
- Identifying and removing biotoxin exposure
- Correcting immune and hormonal imbalances
- Repairing cellular communication and neurological damage caused by chronic inflammation
Step 1: Remove Exposure
The first and most critical step: get out of exposure.
If you remain in a mold-contaminated or biotoxin-exposed environment, recovery cannot begin.
Shoemaker doctors often use ERMI or HERTSMI-2 testing to assess the home or workplace. Patients may also work with environmental professionals to confirm safe air quality before continuing treatment.
Step 2: Bind and Remove Toxins
Once exposure is controlled, binders such as:
- Cholestyramine (CSM)
- Welchol (Colesevelam)
are prescribed to bind biotoxins in the gut and prevent reabsorption.
These medications are often taken away from food and supplements, and can be tapered once symptoms stabilize and labs improve.
Step 3: Treat MARCoNS (Resistant Nasal Bacteria)
Next, doctors test for MARCoNS (Multiple Antibiotic Resistant Coagulase Negative Staph) using a nasal swab.
If present, it’s treated with BEG spray or other prescribed nasal antimicrobials to reduce immune activation.
Step 4: Correct Hormonal and Inflammatory Imbalances
CIRS often disrupts critical biomarkers.
Shoemaker doctors use specific labs to track inflammation and hormonal balance, such as:
- MSH (Melanocyte Stimulating Hormone)
- VIP (Vasoactive Intestinal Peptide)
- C4a, TGF-β1, MMP-9, VEGF
- ADH/osmolality, ACTH/cortisol
Treatment may include VIP nasal spray (in later stages), adrenal support, or other targeted therapies based on lab data.
Step 5: Restore Neurological Function and Stability
As inflammation calms, cognitive and neurological symptoms like brain fog, fatigue, and anxiety often improve.
Some patients benefit from neuroplasticity training, exercise tolerance rebuilding, or functional neurology to support full recovery.
What Lab Tests Are Used in the Shoemaker Protocol?
Shoemaker-certified physicians use a standard set of diagnostic tests to confirm and monitor CIRS, including:
- HLA-DR genetic testing (to identify susceptibility)
- Visual Contrast Sensitivity (VCS) testing
- C4a, TGF-β1, and MMP-9 levels
- ACTH/cortisol
- VIP and MSH hormone levels
These labs help the doctor track each stage of recovery and determine when to move to the next step of the protocol.
How Long Does the Shoemaker Protocol Take?
There’s no one-size-fits-all timeline.
Mild cases can resolve in 6–9 months, while more complex cases may take 1–2 years of consistent treatment.
The pace depends on:
- How quickly exposure is removed
- Genetic factors (HLA type)
- Overall immune resilience
- Adherence to the treatment sequence
Patience and precision matter — skipping steps or self-prescribing binders can delay healing.
How to Find a Shoemaker-Certified Doctor
Not all “mold doctors” follow the Shoemaker Protocol.
To find an officially certified provider, visit the Find a CIRS Doctor directory and filter by:
- Shoemaker Certified
- Telemedicine Available
- State or Country
Many certified doctors offer virtual consultations, allowing patients to receive expert guidance without relocating.
Practical Tips for Success
- Track your symptoms: use a journal or app to document progress.
- Follow your doctor’s sequence exactly: steps are designed to build upon each other.
- Focus on environment first: clean air equals faster recovery.
- Don't self-treat with binders or sprays without medical supervision.
The Bottom Line
The Shoemaker Protocol is more than a treatment — it’s a map out of chronic illness.
By addressing the underlying immune and neurological dysfunctions caused by biotoxins, it helps restore stability, energy, and clarity.
If you’ve been struggling with CIRS, know this: recovery *is* possible — and the right doctor can guide you there.
🩺 Next Step: Find a Certified CIRS Doctor Near You
Browse trusted Shoemaker-certified doctors and practitioners who understand CIRS and mold illness.
