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This breakthrough peer reviewed publication outlines the Chronic Inflammatory Response Syndrome (CIRS), an evidence‐based model of assessment and treatment of Chronic Fatigue utilizing objective biomarkers, structural Brain MRI and transcriptomics, and moves medicine away from a ‘symptom only’ approach to managing the fatigued patient. CIRS is a neuroregulatory‐inflammatory disease process found in genetically susceptible patients (20% of US population),initiated by exposure to a biotoxin(s) such as a water damaged building, Lyme disease, ciguatera, pfistera and many more.
A final common pathway of immune dysfunction ensues, including abnormal findings such as Transforming Growth Factor Beta (TGFb), Vasoactive Intestinal Peptide (VIP), Melanocyte Stimulating Hormone (MSH), split products of complement activation, Matrix Metalloproteinase (MMP9) and others now available for use as clinical diagnostics. In cases of cognitive decline, new technology for brain MRI analysis, NeuroQuant, can pick up small changes in brain structures consistently shown in CIRS.