To add to what Hip has said, Shoemaker does not use urinary mycotoxin tests and is actually opposed to them, believing that the tests can not distinguish between recent dietary exposure and pathogenic mycotoxins (
ref). However, Brewer and many other mold exposure practitioners do advocate for the use of urinary mycotoxin testing, and I have even seen Shoemaker-trained docs use them. My feeling is that the skill of the practitioners adds a great deal of value to the interpretation of the test.
CIRS, however, can not be diagnosed by identifying mycotoxin exposure alone. It is the body's inappropriate inflammatory response and immunologic inability to clear the toxins, along with a history of exposure that defines a CIRS. I agree that a VCS test is an easy first step, although I wonder how many people with non-mold induced ME/CFS would pass the test.
To me, CIRS seems like ME/CFS but with biotoxins as the identified cause. It seems to also be heavy on the neurological symptoms (hence the positive VCS test). Below are symptom clusters taken from the
CIRS diagnostic consensus.