Ritchie Shoemaker, M.D. – Chronic Inflammatory Response Syndrome – Research Update

Air Date: 3-3-2017|Episode 450                                                                                Listen|Download

This week on IAQ Radio we welcome Ritchie C. Shoemaker, M.D. Dr. Shoemaker has been involved in the field of medical evaluation and treatment of patients sickened by exposure to the interior environment of water-damaged buildings for over 18 years…

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This week on IAQ Radio we welcome Ritchie C. Shoemaker, M.D. Dr. Shoemaker has been involved in the field of medical evaluation and treatment of patients sickened by exposure to the interior environment of water-damaged buildings for over 18 years. He has diagnosed and treated over 7000 patients; written and published multiple academic papers in peer reviewed literature; as well as three books, with the last published in 2014, State of the Art Answers to 500 Mold Questions, Volume 2. He lectures widely in the US and internationally. Since his medical retirement in January 2013 he has continued research into the basic genomics and brain inflammation effects of exposure.  Through his website, www.survivingmold.com, he has trained physicians to certify in his treatment protocols.

Dr. Shoemaker last joined us on 1-9-15 Episode 351. We discussed how things were going with his growing the network of doctors trained in his protocol, reviewed some of the foundational information underpinning what he and some colleagues have labeled Chronic Inflammatory Response Syndrome (CIRS) from Water Damaged Buildings (WDB). We also discussed his latest research and use of the NeuroQuant® technology.  Dr. Shoemaker and his colleagues have been using brain imaging combined with an FDA cleared software that correlates with symptoms and physiology. Try to listen to Episode 351 before today’s show it will help you follow the discussion which can get pretty technical.  Join us and LEARN MORE today at noon eastern on IAQ Radio!

Z-mans Blog
“Doing the best we can, with what we’ve got.”
Ritchie C. Shoemaker, MD has been involved in the field of medical evaluation and treatment of patients sickened by exposure to the interior environment of water-damaged buildings for over 21 years. He has diagnosed and treated thousands of patients, written and published multiple academic papers in peer reviewed literature; as well as 11 books. He lectures widely throughout the US and internationally. Since his medical retirement in January of 2013 he has continued research into the basic genomics and brain inflammation effects of exposure. Through his website, www.survivingmold.com, he has trained physicians to certify in his treatment protocols.
Nuggets mined from today’s interview:
Physician certification in his protocol involves: written examination, written essays, a review of literature and an oral examination. 25 doctors have completed the certification and are using his protocol. 100 more are in preparation. For uniformity, a society of certified physicians is being formed.
  • Medically sound remediation addresses multiple causes in buildings.
  • Specific causation has disappeared from water damage related court cases.
  • The first report of gene activation and suppression was published in 2009.
  • Mycotoxins role in building related illness is likely only 1%.
Actinomycetes- are a specific group as bacteria. Morphologically they resemble fungi because of their elongated cells that branch into filaments or hyphae.
Ribosomes- are a minute particle consisting of RNA and associated proteins, found in large numbers in the cytoplasm of living cells. They bind messenger RNA and transfer RNA to synthesize polypeptides and proteins.
Ribotoxins- Any of a class of toxic ribonucleases.
Dinoflagellates are a large group of flagellate eukaryotes that constitute the Phylum Dinoflagellata.  Most are marine plankton, and they are common in freshwater habitats as well.
David Lark opened a lab in Texas to study nonfungal members.
Protein elongation disruption is a warfare situation among amoebas, ribosomes, and eukaryotes.
1 Quattuordecillion = 10 to the 45th power.  Patient ribosomal mRNA gene count before treatment dramatically reduced after treatment.
RNA (ribonucleic acid) is not only functional as a messenger between DNA and protein but also is thought to be involved in the regulation of genome organization and gene expression..
Organisms respond on the cellular level in seconds. Our body turns genes on/off. There is can be no definition of a normal person as gene change is constant.
Will a normal person have DNA disruption? Patients in his protocol serve as their own control.
VIP (vasoactive intestinal peptide) is a regulatory peptide he first used in 2008. VIP may be legally compounded in compounding pharmacies. It’s been his observation that his patients felt better, corrected and cleared inflammation, plus beneficial genomic and CNS effects as shown in grey matter nuclei.
Mitochondria- an organelle found in large numbers in most cells, in which the biochemical processes of respiration and energy production occur. It has a double membrane, the inner layer being folded inward to form layers (cristae). It generates the bulk of cellular energy by turning glucose fragments into CO2 and water. The disruption of electron transport chain functions by disruption of nuclear encoded mitochondrial genes is a new concept shown to be vitally linked to innate immune activation.
Mitochondrial DNA (mtDNA or mDNA) is the DNA located in mitochondria, cellular organelles within eukaryotic cells that convert chemical energy from food into a form that cells can use, adenosine triphosphate (ATP).
Trauma leads to inflammatory response: Mitochondrial genes in our own genome may be at root of dangerous complications from injury.
When cell VIP receptors are turned on, protein and energy correction occurs and damaged cells regrow fixing movement and grey matter (sub-cortical) nuclear atrophy. Fixing brain tissue and giving patients their brains back.
MCS isn’t just air fresheners, ETS and diesel fuel; it can also be triggered by foods. Common thread among his 500 MCS patients was that they all were injured by a WDB before developing MCS.
NeuroQuant investigation is useful, FDA approved and has been used in court cases.
IEPs- important to keep in mind the evolution of our understanding of the disease mechanism. People argued against the validity of sick buildings, correct objective parameters.
Genomic evolution- while everyone doesn’t manifest injury, genomic injury can occur and be overlooked, need the mechanism for determining injury or not, genetic markers. SNPs of no help: it is gene expression that counts.
IEPs and remediation contractors may suffer brain injury from exposure to inflammagens.
Too much emphasis of fungi and mycotoxins, insufficient emphasis of fragments from fungal cell walls and actinomycetes. Humans have adequate protection against mycotoxin ingestion.
VOCs may remain in body fat for 6 months.
Air sampling has evolved from ERMI to QPCR to HERTSMI 2. Doing the best we can, with what we’ve got.
Need more focus on bacteria in wet buildings.
Coagulase negative staphs make ribotoxins. Can’t separate what made me sick.
Specific causation is elusive. Must measure to know. You can spend all your money on measuring and not have the answer, Measure what you can afford! The only measurement that works is human health before and after remediation.
Genomics versus genetics. Genetics is the study of single genes and their role in the way traits or conditions are passed from one generation to the next. Genomics is a term that describes the study of all parts of an organism’s genes.
The building can be a snake pit for some and livable for others.
Remediators must remediate to make safe for the most vulnerable occupant.
Remediation is a biological science, can’t decontaminate 100%.
Contaminated reservoirs include air, walls, ceilings & floors, and contents. Remediate the entire home and eliminate dust. Vacuum, remove small particulate, abate moisture sources, measure what’s going on the air.
Dust is vibrant and living, grows everyday.
Biological situation has the potential for biological disruption.
Remediation is a political issue; how can the insurance industry exclude water damage from hurricane coverage claims?
According to Dr. Shoemaker, the Medicare Medicaid building had a HERTSMI-2 score of 50!
Other areas of study and research interest:
Interstitial lung disease is another area of study, Inhibition of TGF beta 1 shows disease reversal.
Is there an immunologic explanation for chronic pain? A study in Norway gave a drug to remove lymphocytes which alleviated pain.
Brown fat. Beige fat is the adrenergically inducible cell type that is dispersed throughout adipose tissue. It has greater variability in lipid droplet size, and a greater proportion of lipid droplets to mitochondria giving it a lighter brown appearance.
Weight loss and Type 2 diabetes. An OTC drug can unlock direct fat burning, helping the obese and Type 2 diabetics. Early in research process.
Genomes, brain injury and repair is his next project.

Z-Man signing off

 

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