CIRS, MCAS or Autoimmunity? What's Really Driving Your Symptoms
CIRS, MCAS, and autoimmunity can look almost identical. Fatigue, brain fog, joint pain, water retention, gut flares, food reactions. Because the symptoms overlap so much, many people get labeled with one condition when something else (or several things) is driving their illness. The fix isn't guessing harder. It's testing deeper and healing in the right order.
If you've been told you have CIRS, you've remediated your house twice, and you're still sick, this one's for you.
Key takeaways
- CIRS, autoimmune disease, MCAS, anemia, and blood sugar problems share many of the same symptoms.
- Some labs move in opposite directions in CIRS vs. autoimmunity, which helps tell them apart.
- Dr. Stadler sees MCAS as one of the most misdiagnosed chronic conditions.
- Most food reactions come from your immune system making histamine, not the histamine in the food.
- There's a biochemical order to healing. Skip a step (like anemia) and you plateau.
Meet Dr. Stadler
Dr. Stadler is the head physician for Dr. Josh Redd's Red River clinics. He trains the other doctors, and he now leads Red River Orem, the clinic that used to be Provo Health. It's now a CIRS-focused clinic that looks at everything happening in your body, not just mold.
I've been waiting months to get him on the podcast. Every time this man opens his mouth, I'm floored.
🎧 Listen to the full episode: CIRS, MCAS & Autoimmunity
Why do CIRS and autoimmunity get confused?
Because the symptoms are nearly the same, and many lab markers move the same way. Both create chronic immune activation and chronic inflammation.
Dr. Stadler put it bluntly: if you had to tell apart anemia, Hashimoto's, Sjögren's, CIRS, and reactivated Epstein-Barr from symptoms alone, "it would be a complete roll of the dice." Two sisters with the same diagnosis can look totally different.
That's why testing matters so much.
Which labs help tell CIRS from autoimmunity?
A few examples Dr. Stadler shared:
- C4a: can go up or down with autoimmunity, but almost only goes up with CIRS. A low C4a points away from CIRS.
- MMP-9: if it isn't elevated, CIRS becomes less likely.
- ANA and thyroid antibodies (like Hashimoto's antibodies): these don't typically turn positive from CIRS alone. Something autoimmune is going on underneath.
- MSH: almost always suppressed in CIRS, but it can vary with autoimmunity. And 10 to 15% of people have genetically low MSH with no symptoms at all. HLA testing helps sort that out.
My own story: I went in thinking I still had active CIRS. My labs said no. What I actually had was Hashimoto's thyroiditis and nerve damage left over from years of inflammation. No CIRS doctor had looked at my thyroid. I could have spent years chasing mold I didn't have.
Is it really MCAS?
Dr. Stadler says MCAS is the most misdiagnosed chronic condition he sees. When he runs a 24-hour N-methylhistamine urine test on patients told they have MCAS, most don't show even moderate elevations.
They still have a histamine problem. But it's usually something else:
- Overactive immune cells (like eosinophils) making histamine faster than the body clears it
- Immune triggers that haven't been found yet, like very low vitamin D plus food sensitivities
The good news: when those triggers are managed, he often sees 70 to 90% symptom improvement. True MCAS tends to plateau lower.
Is the histamine in my food the problem?
Usually not. The histamine in the food is "a drop in the bucket." The bigger problem is when a food triggers your immune system and your own mast cells make 100 times more histamine than the food ever had.
So obsessing over low-histamine lists often doesn't move the needle.
Why do I suddenly react to so many foods?
When your gut lining can't regenerate properly, proteins leak through and your immune system starts making antibodies to them. Dr. Stadler sees this most with anything that slows cell regeneration: low thyroid, poor T3 conversion, certain birth control pills that raise binding proteins, and unmanaged low blood sugar.
When my body blew up, my food sensitivity test was the second worst that clinic had ever seen. I knew in my bones: it's not the food. It's my immune system.
Dr. Stadler's approach: fix what's making the gut leak first, then use a quality IgG food sensitivity test (he likes ImmunoLabs) to narrow things down. He says a good test catches about 80% of sensitivities. Cutting 60 foods on your own isn't the answer.
Wondering where your body broke down first? Your symptoms are clues, not a life sentence. 👉 Take the free Root Causes Quiz and find out what to support first.
How do stress, cortisol, and blood sugar affect autoimmunity?
Cortisol is your body's natural anti-inflammatory. It's the same reason doctors prescribe steroids for flares.
When stress stays high for too long (life stress, internal chemical stress, plus over-exercising "to fix your fatigue"), your body can't keep making enough cortisol. Without that brake, the immune system goes into overdrive and starts reacting to everything leaking through the gut.
Blood sugar plays in too. When your blood sugar drops and you don't eat, your brain signals your adrenals to make cortisol so your liver can release stored sugar. If cortisol can't keep up, your body uses adrenaline instead. That can feel like anxiety. Dr. Stadler sees a lot of people told "it's just anxiety" who really have unmanaged low blood sugar.
That was me. When I'm stressed, I stop eating. And my tremors and brain fog get worse.
For your nerves, the three non-negotiables are oxygen, glucose, and stimulation. Anemia starves the brain of oxygen. Blood sugar dips starve it of fuel.
What order should you heal in?
There's a biochemical order to healing. Each step sets up the next. If someone feels 30% better for a month and then crashes back, that's often a sign the order is off.
Some of the first things Dr. Stadler checks:
- Anemia. If this isn't fixed first, almost nothing else will help much.
- Blood sugar and cortisol balance
- Vitamin D
- Chronic allergies (yes, even to your own dog)
- Gut permeability and food sensitivities
His other rule: don't guess more, test more. Then retest and track symptoms to make sure the plan is working.
Why are so many people sick right now?
Dr. Stadler named a few big drivers: chronic stress (including social media comparison), endocrine disruptors in our environment, and sedentary lifestyles. His tip: schedule exercise like a meeting you can't move.
And here's what I love most. Instead of "just reduce your stress" (which feels hopeless when life is hard), he focuses on the stressors you can control, like managing blood sugar every day. That gives you your power back.
Frequently asked questions
Can you have CIRS and autoimmune disease at the same time?
Yes. Many people have CIRS on top of autoimmunity, infections, anemia, or blood sugar issues. If only the CIRS is treated, they often plateau.
What test confirms MCAS?
Dr. Stadler uses a 24-hour N-methylhistamine urine test to check histamine clearance. Many people diagnosed with MCAS don't show elevations on it.
Are food sensitivities and food allergies the same thing?
No. Allergies are usually IgE-driven and release histamine. Sensitivities are IgG-driven and cytokine-mediated. Both can keep your immune system revved up.
Why do I feel worse when I skip meals?
If you have low blood sugar and low cortisol, your body may rely on adrenaline to bring your blood sugar back up. That can cause shakiness, anxiety, and worse brain fog.
Where do you start?
You're not a diagnosis. You're a person whose body got out of balance, and there's an order to bringing it back.
That's exactly what the Order of Healing™ maps out: 8 steps, starting with mindset and mitochondria and working up to the brain. Because you're not broken. You're out of order.
👉 Download the free Order of Healing™ Guide and find your starting point.
🎧 Listen to the full episode on the Gutsy Health Podcast.
Want to work with Dr. Stadler? Call Red River Orem at 801-691-1765 to schedule a consultation.
This post is for education only and isn't medical advice. Talk with a qualified provider before changing your treatment.
