What is CIRS? A closer look at the immune syndrome that sidelined Jonathan Toews

Medical Watch

CHICAGO — Blackhawks captain and center Jonathan Toews stepped away from the game last year after revealing his immune system was struggling and unable to handle any bodily stress.

He sought a diagnosis for the unexplained symptoms and Tuesday he said he now knows he was suffering with Chronic Immune or Inflammatory Response Syndrome, also called CIRS.

Dr. Greg Sharon is part of the allergy/immunology department at AMITA Health.

“It is a response where your immune system overreacts,” he said.

Always looking strong on the ice, Toews was not feeling in top form.

“My immune system was reacting to everything that I did,” he said on Twitter. “Any kind of stress, anything I would do throughout the day, there was always some kind of stress response.”

What triggered the syndrome? It is often associated with exposure to toxins and mold.

“He was probably exposed to mold his whole life,” Sharon said. “(And) genetically, the more athletic, the more flexible you are, the more likely you are to develop some of these immune reactions. That stress combined with lack of sleep can lead to mold sensitivity. When you overreact you get tired, fatigued, joint aches and pains, difficulty with your belly and interestingly, this affects your brain.”

Brain injury like a concussion can also leave people more susceptible to CIRS.

“Often times we hear this gets worse after a motor vehicle accident or after a fall or after a stroke, after a baby is born” Sharon said. “Something that has led to a change in your blood brain barrier. It is very common trigger for triggering this off.”

If left unchecked, the disorder can be debilitating. People experience fatigue, executive function loss as well as memory problems and mood disorders. Because it involves many body systems with varying symptoms it is often misdiagnosed as Parkinson’s Disease, Chronic Fatigue Syndrome, fibromyalgia and even Alzheimer’s disease.

“It took some time and that was the frustrating part not knowing when or how we were going to get over the hump,” Toews said in his video.

CIRS is associated with COVID-19. Toews admits he may be a long hauler. Inflammation can be triggered by the virus.

“CIRS is usually from an infection, bacterial viral fungal, like Covid, where you overreact,” Sharon said. “So that is a form of Chronic Inflammatory Response because about a third of people have chronic symptoms after Covid. So they have had the disease but it has triggered the immune response.”

Blood tests can determine susceptibility to certain genetic triggers but CIRS is mainly diagnosed after ruling out other health problems.

And once doctors know what it is, they offer counseling for changes in behavior and drugs to tamp down the immune response and the inflammation.

“One (suggestion) is that you would change your lifestyle, try to improve your sleep, your rest and treat any mental illness,” Sharon said. “Because the more stressed out you are, the more this is a trigger. You would look at your environment. You would avoid allergens as much as possible so molds, damp areas things like that.”

By heading back into the game that has the potential to trigger the immune response once again, exposed to mold and stress, Sharon said it will be a challenge to stay healthy. Toews will have to work on that as much as the physical skills of hockey.

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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