What "Benched" Jonathan Toews?

September 14, 2021

By Barret Procyshyn, Pharmacist at Dauphin Clinic Pharmacy

With hockey season starting to get going it got me thinking about one of my favorite players. Jonathan Toews is a household name across the country and especially in Manitoba. The native of Winnipeg has won just about every trophy in hockey you can win. He has his name on the Stanley cup three times, has five world championship medals, has won two Olympic gold medals for Team Canada, and is considered a leader in the dressing room in addition to "wearing the C" for Chicago. This guy once landed in Dauphin in a helicopter and toured around Dauphin in a community parade to highlight our city's community spirit. So, what makes a young and extremely fit hockey player so sick he cannot put on a pair of skates, never mind lead his NHL team out on the ice. For those of you who are unaware, he missed the whole 2020-2021 season.

After a long period of keeping his issues private, Jonathan Toews reveals he was suffering from a condition called Chronic Immune Response Syndrome (CIRS). Toews is quoted as saying "I just think there's a lot of things that just kind of piled up where my body just fell apart," Likely Jonathan did not come out and explain why he was away from the game from the start, because he did not know what was wrong. It is an extremely difficult condition to diagnose and it's a condition that causes further complications in the body. CIRS in frequently complicated by failure of one or more organs or organ systems.

We do not have a full understanding of how CIRS develops and its difficult to pinpoint the cause. We do know the cause can be from infectious or non-infectious sources. The most common causes appear to be from mold exposure, and it is often referred to as a biotoxin illness. Bacterial infections, viral infections (such as COVID-19) and serious fungal infections are also potential causes.

Symptoms can be wide ranging and again difficult to pinpoint to CIRS. It can overlap and can mimic symptoms associated with other conditions such as Lyme Disease and some Auto Immune Disorders. CIRS may often be misdiagnosed, or under diagnosed. Symptoms include low or feverishly high body temperature, rapid heart rate over 90 beats per minute, high respiratory rate. Blood work showing abnormal white blood cell counts are also an indicator. Basically, your body is under increased metabolic stress. The illness often appears as fatigue, weakness, flu-like symptoms, exhaustion, insomnia, sensitivity to environment, which explains why a hockey player cannot get up and go to work in the morning.

Believe it or not a special vision test is one of the most common tools used for diagnosis. Visual Contrast Testing developed as a visual assessment for jet fighter pilots measures the ability to see details at variable contrast levels of grey. It is found to possess a high degree of accuracy and sensitivity for biotoxin exposure in the person with the symptoms. If you know you were exposed to a mold and are symptomatic it will help with a diagnosis.

Visual contrast ability is impaired in most CIRS sufferers whereby over 90% of them fail a simple VCS test. VCS testing provides an initial indication of whether CIRS is a likely diagnosis, although it cannot confirm or rule out CIRS.

Treatment of the disease usually focuses on first identifying the cause and then trying to get rid of it. Often steroids to decrease the immune response and allergy medications are used as well. Antioxidant treatment and vitamin supplementation also have some place, but solid data is still required to determine their uses. CIRS is obviously a complex illness, and we have a long way to go to learn to how to better diagnose and treat the disease. The latest reports ahead of training camp are that Jonathan looks great on the ice. Hopefully he has a great season, just not when he is playing against the jets.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist, or other health care professional.

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