Exploring the Role of Actinobacteria in CIRS, Immune Activation, and Environmental Illness

by Katie Driessens, RD, LDN, CDCES, CGN

When people talk about chronic inflammatory response syndrome (CIRS), the conversation often focuses on mold; it is crucial to address this biotoxin when it is present at levels that harm health. However, there are other potential contributors to environmentally acquired illness that often get overlooked and can also “hold you back” from getting better: enter actinobacteria.

Test Don’t Guess for Actinobacteria

In my work educating patients about CIRS and environmentally acquired illnesses, it is important “to rule out or rule in” actinobacteria sooner rather than later. If someone has made substantial efforts to address mold exposure, remediate, and heal their mold-related health problems but continues to struggle, we have to keep turning over other stones and consider excess actinobacteria as well.

Backstory: Actinobacteria (slang term you may hear: “actinos”) are another biotoxin that is from a large group of bacteria found naturally in soil, water, humans, and indoor environments. Many are harmless or even beneficial. But why I am bringing this up is that some species of actinobacteria have also been associated with inflammatory processes like CIRS, acne, respiratory illness, and MCAS – especially for those with certain HLA haplotypes (can self-order an HLA DR-DQ lab here to get drawn at Quest w/o a Physician order), which basically means genetically susceptible to getting “sick from biotoxins.”

Research on Actinobacteria

While literature on actinobacteria is developing, the proposed relationship between particular actinobacteria, CIRS, and specific treatment responses has not been established through large, independent prospective clinical trials. Nevertheless, we can’t ignore current data or reports of patients improving after addressing excess actinobacteria in the home and on the skin. Takeaway: this means actinobacteria can be considered as a potential additional exposure to evaluate—just not a universal explanation for persistent symptoms.

How Can Actinobacteria Contribute to Health Problems

When certain species of these bacteria overgrow on the skin in excess or are inhaled, they may be an additional source of inflammatory stress for susceptible individuals. The theory is that this ongoing immune activation may contribute to CIRS symptoms. Excessive actinobacterial colonization of the skin may shed cell wall fragments that the immune system recognizes as a threat. These bacterial components can activate immune receptors, triggering the release of inflammatory chemical messengers called cytokines.

Test for Excess Actinobacteria

If symptomatic or experiencing health-related problems that can be caused or exacerbated by excess actinobacteria, I recommend testing your skin (skin swab kit 21 linked here – coupon SAFEAIR15 for 15% off) to see if it’s elevated due to a former or current exposure to high levels of actinobacteria.

What To Look for on Actinobacteria Skin Swab Results

There is a lot of nuance to this, but to try to succinctly give some information, either Corynebacterium Tuberculostearicum and/or C. Acnes (formerly Propionibacterium Acnes) levels greater than 10,000 mean you likely need to do an Actinobacteria skin protocol, as these colonized levels on the skin are too high and can be one culprit to keep “triggering CIRS.” Please note that elevated levels alone do not diagnose CIRS – view it as one puzzle piece. If specific actinobacteria skin levels are elevated, then a low-risk, possibly high-reward intervention would be to follow an actinobacteria skin protocol.

General Education – Actinobacteria Skin Protocol Steps:

  1. Wash your whole body with gentle cleansing, mild, low-toxicity soap like Lume or Castille soap or EC3 Head to Toe Cleanser (coupon 10-HEAL at checkout), which each can reduce actinobacteria due to their formulations. Do not scrub soap hard into the skin, as you don’t want to irritate the skin barrier, which can cause actinobacteria to proliferate even more.
  2. Rinse skin thoroughly with filtered water; use a shower head filter and/or bathtub water filter if you don’t have whole home reverse osmosis. This is to help reduce contaminants and bacteria from the water supply.
  3. Use clean towels to dry skin. Make sure you wash towels and wash clothes after each use in hot water with laundry detergent. A laundry additive is a good idea too, like the EC3 Laundry Additive, which can help reduce odor-causing bacteria and general bacterial buildup on fabrics via its botanical and citrus-based ingredients.
  4. Use a moisturizer after bathing to help protect the skin barrier. Ideally, the moisturizer contains aloe (with Acemannan), as aloe has been shown to help reduce the proliferation of C. acnes in the skin microbiome. Alovea serum or the Stonybrook unscented moisturizer are two practical options to consider for maintaining the skin barrier that include aloe.
  5. Consider using a red-light therapy device over your skin for around 15 minutes daily if tolerated, which has been shown to also help reduce excess actinobacteria. This red-light device is a medically qualified device, and you can use an HSA/FSA card to purchase.

Gauging Progress:

You should see results in your health and on your skin, assuming you are no longer exposed to high levels of actinobacteria in your home. You can re-swab the skin to gauge progress to get objective data too. Goal to get levels of C.T. and C.A to less than 10,000 on your skin. Remember, some actinobacteria is normal, as we don’t want the skin sterile, but the big picture is to get excess managed and, of course, prevent exposure to excess levels indoors to stop the cycle. Consider working with a Physician for individualized advice, as this is not medical advice.

But What About Actinobacteria in the Home?

Keeping actinobacteria and other biotoxins at bay can be done through regular cleaning, assuming there isn’t indoor water damage, AND by addressing colonized areas on the skin using the information above.

If you are working with an IEP (indoor environmental professional), their individualized recommendations for your home supersede the information provided here as general education. View this information below as a starting point and general guidelines if you do not have an IEP or a healthcare practitioner you are working with one-on-one.

Biotoxin/Actinobacteria Maintenance Home Cleaning Protocol – *For Post Remediation

As we established, some actinobacteria in a building is “normal” to some extent, but if the levels are elevated per testing, then the root issues need to be found & addressed; excess actinobacteria can stem from water/moisture/humidity damage/plumbing issues or from soil, pets & we self-generate some. People who are sensitive to biotoxins can develop health problems from them.

To see if indoor levels are elevated, self-order an Actino dust swab test (actino Swiffer dust kit 13 here use code SAFEAIR15 for 15% off). If levels are elevated, specifically C. tuberculostearicum or C. acnes >10k (formerly P. Acnes) from your home dust, then I would recommend hiring an IEP (Indoor Environmental Professional) to find the water damage IF it exists, remediate IF needed & then do a whole home small particle clean. However, you can have elevated levels of actinos in the home that are not from water damage – from not doing the right cleaning often enough as the short answer.

**This information below is not small particle cleaning recommendations which occur as the last step after remediation from water damage. Actino cleaning protocols are regular maintenance cleaning to keep “normal amounts” from building up in the home.

General Education Actino Cleaning Protocol:

These details are for someone who has had CIRS, is at risk of developing it again, or has been labeled with acne; this is the recommended cleaning to consistently reduce your exposure to “normal” amounts of actinobacteria so it doesn’t build up around the home over time. The “big stuff” from old or new water damage needs to be professionally identified and addressed, but if you have already done that, this is merely the ongoing cleaning recommendations to keep biotoxin levels at bay.

Cleaning Supplies to Keep Actinobacteria & Other Biotoxin Levels at Bay

Necessary supplies all linked here on Amazon Prime

  1. HEPA vacuum cleaner (& HEPA filters – to replace monthly)
  2. Disposable microfiber cloths for wet wiping. There is more than one way that will work, but you can do: Branch Basics Concentrate at 5 drops per quart of water + 1 TBSP vinegar. (If the surface can’t handle vinegar, consider hypochlorous acid OR hydrogen peroxide products instead). You can also consider the EC3 Enzyme Cleaner Concentrate: mix 4 ounces with 1 gallon of water, then use microfiber cloths to wet-wipe.
  3. Laundry detergent
  4. Air purifiers
  5. Dehumidifier
  6. Swiffer mop plus dust cloths

Cleaning Steps to Keep Actinobacteria & Other Biotoxins Levels at Bay:

Regularly Dusting to Keep Dust at Bay – (where Actinobacteria settles)

  1. Wet wiping: (ideally weekly) move from top to bottom (from the fans, light fixtures to walls to furniture to trinkets to flooring). Wet dust all surfaces using an “S” cleaning pattern. Can attach a wet microfiber cloth to the Swiffer mop for walls, or use disposable wipes.
  2. Then dry dust with either dry microfiber or Swiffer cloths
  3. Use a HEPA vacuum cleaner at least 2-3x per week around the home (floors, furniture). If you don’t have a bagged system like the Miele, just make sure you empty the vacuum canister outside into the trash. Don’t open the vacuum canister inside the home to empty into an indoor trash can (the particles disperse into the air then).
  4. Use alcohol wipes periodically to clean the vacuum and canister.

Ongoing Air Filtration to Help Minimize Dust and Contaminants

  1. Run HEPA air purifier(s) that cover sq. footage of the home.
  2. Make sure you change filters often per manufacturer.

Regular HVAC Maintenance & Ventilation

  1. Replace HVAC filters every 1-2 months and ensure the HVAC system is appropriately sized for the home, as this is a top root cause of mold if the unit is over- or undersized.
  2. Run a dehumidifier to keep humidity below 50% to prevent microbial growth. This typically needs to be run in a basement year-round. It definitely needs to run in a crawlspace year-round. You may need a professional-sized one, depending on square footage, or multiple dehumidifiers. Change the dehumidifier filters often so the machine doesn’t prematurely burn out.

Regular Laundering of Material/Cloth Based Items

  1. Wash bedding at MINIMUM weekly with hot water, laundry detergent plus & EC3 Laundry Additive.
  2. HEPA vacuum mattresses weekly while sheets are in the wash.
  3. Ideally, most dirty clothes are washed after being worn via hot water or the hottest temperature the fabric can manage.

Regular Bathroom Cleaning & Maintenance

  1. Keep bathroom fans running for at least 30 minutes post-shower to reduce moisture.
  2. Wet wipe toilet, shower, surfaces weekly too. Add vinegar OR hydrogen peroxide product (don’t mix!) to toilet bowl & scrub. Replace the toilet brush every 6 months, as it can be a source of biotoxins.
  3. Wipe shower dry after each shower with microfiber.
  4. Ideally, bathroom towels are used once, then laundered in hot water.

Regular Kitchen Cleaning

  1. Clean kitchen sink weekly (either vinegar, hypochlorous acid, or hydrogen peroxide). Bleach may be needed periodically for true disinfecting.
  2. Replace dishcloths daily.
  3. Wet wipe counter surface after cooking and/or meal prep.
  4. Wipe down appliances weekly – inside and out.

Regular Floor & Furniture Cleaning

  1. Steam clean carpets annually OR consider replacing them with hard flooring (tile, hardwood, or vinyl plank, which is a better option for those with CIRS or CIRS-susceptible).
  2. Mop weekly at a minimum with diluted Branch basics/water/vinegar mixture or with diluted EC3 Enzyme Cleaner Concentrate.

Periodic Deep Cleaning and Assessment

  1. Have sensors under sinks to detect leaks ASAP
  2. Check for Hidden Moisture: Use a moisture meter to find leaks behind walls, under sinks, or in crawl spaces.
  3. Declutter & Minimize Fabric-Based Items: Actinobacteria thrive in dust—limit stuffed animals, excessive books, or porous decor items.
  4. Ducts and the HVAC system need to be cleaned about every 3 years or sooner per your IEP’s recommendations

Summary

My central message is simple: do not guess when you can investigate; then you can implement interventions specific to what is actually going on. If excess actinobacteria are a plausible concern, consider the skin and the home and address both when needed. Practical hygiene and cleaning measures can really help support health.

The goal is not perfection. It is to identify meaningful problems, correct what can be corrected, and make informed decisions that support a person’s overall health without adding unnecessary expense or burden.

References and further reading:
  1. Shoemaker RC, et al. Exposure to Actinobacteria Resident in Water-Damaged Buildings and Resultant Immune Injury in Chronic Inflammatory Response Syndrome. Medical Research Archives. 2021. Full text.
  2. Rintala H. Actinobacteria in indoor environments: exposures and respiratory health effects. Frontiers in Bioscience (Scholar Edition). 2011; 3:1273–1284. PubMed.
  3. Ahmed N, et al. Genomic characterization of the C. tuberculostearicum species complex, a ubiquitous member of the human skin microbiome. mSystems. 2023. PubMed.
  4. Microbial succession in an inflated lunar/Mars analog habitat during a 30-day human occupation. PubMed.

Educational disclaimer: This article discusses an emerging CIRS-related environmental hypothesis and is not a substitute for medical evaluation, building inspection, or individualized treatment advice. The presence of an organism or an abnormal environmental test result does not, by itself, establish the cause of a person’s symptoms.

 About the Author:

Hi, I’m Katie Driessens, RD, LDN, CDCES, CGN —a Functional Medicine-aligned Registered Dietitian, plus a rare insurance accepting Dr. Shoemaker CIRS Proficiency Partner, and Dr. Jill Crista-trained practitioner specializing in root-cause wellness.
My passion for helping others heal stems from my own journey. As a CIRS survivor who lost approximately 75% of my hair due to toxic indoor mold exposure, I experienced firsthand how mold can contribute to chronic bodily dysfunction that often goes overlooked in conventional healthcare. That experience ultimately led me to create an online, self-paced Mold Recovery Program and to also dedicate my practice to helping others 1-on-1 uncover and address the root causes of their health symptoms and concerns.
Today, I help patients navigate complex chronic health issues through advanced functional testing, precision nutrition, targeted supplementation, and practical lifestyle strategies. As one of the few functional medicine-aligned practitioners who accepts insurance, my mission is to make root-cause healthcare more accessible while maintaining an integrative stance (understanding the pros and limitations of both western and functional care).
Whether you’re dealing with mold illness, CIRS, unexplained hair loss, gut dysfunction, or chronic “your labs are normal everything is fine” but no one has been able to connect the dots on, I’m here to help you stop guessing, start getting answers, and pursue evidenced based interventions that are individualized.
Website: Dietetics with Driessens
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Questions? Comments? Write to us below or join us on Thursday, November 5 at 1 PM CST with Katie to discuss this topic and to answer your questions LIVE!

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