VIP peptide for CIRS and long COVID: what the evidence actually shows

What did @ask.yvette actually say?

The creator claims that after nine years of abnormal "Shoemaker labs" and failed treatments, she reversed her CIRS markers within one month of starting VIP (vasoactive intestinal peptide) nasal spray, four times daily. She also says it allowed her to reduce mast cell stabilizers "for the first time in five years" because VIP works "upstream of mast cell activation syndrome." She recommends viewers with long COVID or CIRS contact PD Labs to find a prescribing provider, and frames VIP as more effective and more accessible than Trudose, a systemic PRP treatment she describes costing up to $16,800.

To her credit, she admits upfront: "I don't actually know if this will work" for others. That caveat matters. This is a personal testimonial from someone who identifies as a CIRS patient, not a clinical recommendation. But the video has reach, and the claims deserve scrutiny regardless.

Does the science back this up?

There is real science behind VIP as a signaling molecule. The evidence for exogenous VIP administration in CIRS specifically is thin, comes almost entirely from one researcher's work, and has never been validated in a randomized controlled trial.

VIP is a 28-amino acid neuropeptide with well-documented anti-inflammatory properties in preclinical and in vitro studies. Abad et al. (2010, Current Pharmaceutical Design) reviewed its immunomodulatory roles extensively. The CIRS-specific application, however, originates almost entirely from the work of Ritchie Shoemaker, whose protocol includes intranasal VIP as a late-stage intervention. Shoemaker's own published data (Shoemaker et al., 2013, Internal Medicine Review) reports improvements in inflammatory markers and symptoms, but this research is observational, uncontrolled, and conducted by the same physician who developed and commercializes the protocol. Independent replication is essentially absent. The "Shoemaker labs" the creator references, including MSH, VEGF, TGF-beta, and MMP-9, are real biomarkers, but their use as a CIRS diagnostic panel is not validated by mainstream clinical guidelines. Long COVID overlapping with CIRS is a hypothesis, not an established diagnosis, though researchers like Heyman have proposed the connection in conference settings.

What did they get wrong (or right)?

She got the pharmacology directionally right. VIP does have documented effects on mast cell activity. Tunçel et al. (2006, Regulatory Peptides) and subsequent work confirm VIP receptors are expressed on mast cells and that VIP signaling can modulate degranulation. Calling it upstream of mast cell activation is a reasonable, if simplified, description of the mechanism.

Where things get shakier: the creator uses "SIRS" and "CIRS" interchangeably, but they are not the same thing. SIRS is systemic inflammatory response syndrome, a well-defined critical care term. CIRS is Shoemaker's chronic inflammatory response syndrome, a contested diagnosis not recognized by the CDC, NIH, or any major specialty society. Conflating them gives the impression that CIRS has broader clinical legitimacy than it currently does.

Her mispronunciation of "vasoactive" as "Basso active" is a small tell that the transcript catches, and it does not affect the substance of her claims. More importantly, she does not describe which specific lab values improved, by how much, or whether she changed anything else during that month. A single-patient, uncontrolled n-of-1 experience is not evidence that VIP will work for anyone else.

What should you actually know?

VIP is a compounded prescription peptide, not an FDA-approved drug for any indication. That means no standardized manufacturing oversight, no approved dosing regimen, and no phase III trial data. PD Labs, which she specifically recommends contacting, is a compounding pharmacy. Compounded peptides vary in purity and concentration between batches and between pharmacies. The FDA has issued warnings about unapproved compounded peptides broadly, and VIP is not on the FDA's approved drug list.

The cost she cites, roughly $230 to $250 per month, is real-world pricing for compounded intranasal VIP. That is significantly cheaper than Trudose or extended functional medicine workups, but it is still an out-of-pocket expense for a product with limited trial data in humans.

If you have long COVID or suspect CIRS, the existence of this testimonial is not a reason to self-diagnose or self-prescribe. It is a reason to ask a knowledgeable clinician, one familiar with the Shoemaker literature and its limitations, whether your specific lab picture warrants a conversation about this.