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If you have been sick for years without explanation, you are not alone — and you are not imagining it.

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Dr. April Vukelic, D.O. is a CIRS doctor and mold illness specialist based in Pittsburgh, treating patients in person and by telehealth across Pennsylvania.

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Chronic Inflammatory Response Syndrome (CIRS) is a disorder of the innate immune system most commonly caused by exposure to water-damaged buildings. About 25% of the population has a direct genetic vulnerability to biotoxins from these environments — meaning their bodies cannot clear the toxins on their own. Without the right treatment, they stay sick. Even after leaving the building, the immune system remains activated and the symptoms persist.

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CIRS is not a diagnosis most physicians know how to make. Patients are often told their labs are normal, that it's stress, or that nothing more can be done. Finding a CIRS doctor who understands this illness — and knows how to treat it — can feel impossible. That's why this practice exists.

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Developed by Dr. Ritchie Shoemaker, the Shoemaker Protocol is a step-by-step treatment approach for biotoxin illness. It is the only therapy for CIRS in which each step is supported by peer-reviewed research. Diagnosis and monitoring may include symptom review, visual contrast sensitivity testing (VCS), bloodwork, NeuroQuant MRI analysis, and genomic testing (GENIE) — which can reveal changes in genetic expression caused by CIRS and guide truly individualized treatment.

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Prescription Treatment

​Most mold-illness care available online stops at supplements. This practice prescribes.

Bile acid sequestrants — cholestyramine (CSM) and colesevelam (Welchol) bind mycotoxins for elimination. These are prescription medications and require a physician to order, dose, and monitor them.

Nasal protocols — compounded treatments for biofilm and MARCoNS, prescribed after culture confirms the finding.

Vasoactive Intestinal Peptide (VIP) — the final phase of the protocol, used once earlier steps are complete and specific lab criteria are met.

Supporting therapy — correction of the hormonal, immune, and inflammatory abnormalities that lab testing identifies over the course of treatment.

Treatment is sequenced. Each step is confirmed by lab work before the next begins, and steps are not skipped because a patient wants to move faster.

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Working with Dr. Vukelic

Dr. Vukelic's peer-reviewed research on CIRS appears in Annals of Medicine and Surgery (2024) and in Nutrition and Integrative Medicine for Clinicians (Routledge Press) — the world's largest textbook publisher — where she authored the chapter on central nervous system injury in CIRS and co-authored seven others alongside Dr. Shoemaker and other leading researchers. The volume devotes 16 of its 29 chapters to CIRS and water-damaged buildings. She is a certified Shoemaker Protocol physician and a founding member of the CIRS Academy.

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The initial consultation is typically two hours, covering your health history, environmental exposures, symptoms, and medical records. The depth of each appointment depends on the complexity of your case. The first follow-up, usually one hour, reviews your laboratory results and begins mapping out your treatment plan. From there, appointments are tailored to how your body responds.

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Most patients who find Dr. Vukelic have already spent years looking for answers. They have seen multiple doctors, tried multiple treatments, and been told there is nothing wrong. If that sounds familiar, you have found the right place.

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