Laboratory tests

Before and during treatment using the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis., there are some specific lab tests that may be helpful in assessing each patient's potential and actual response to the protocol.

Of course, doctors will need to evaluate the results of testing within the clinical context for each individual patient. In addition to the reference range, doctors will consider other factors when interpreting test results. These factors include personal and family medical history, results from a physical exam, and other test results. Doctors may also consider things that might cause an incorrect test result such as improper sample collection or handling or improper patient preparation.

For many patients, some of these tests could be considered non-essential, however, a periodic assessment of the patient's 25-DThe vitamin D metabolite widely (and erroneously) considered best indicator of vitamin D "deficiency." Inactivates the Vitamin D Nuclear Receptor. Produced by hydroxylation of vitamin D3 in the liver. levels is strongly recommended. A doctor and patient should discuss the decision to perform these tests based on the individual patient's clinical picture and any economic concerns.

During treatment, the presence of the immune reactions confirms the continuing efficacy of treatment without the need for frequent testing. However, symptom resolution along with an absence of immune reactions and normal blood work do indicate recovery for the patient.

Apart from the symptoms or diagnosis being indicative, the way to find out if the Marshall Protocol may be applicable to any person or their disease is to test the D Metabolites.

Baseline D Metabolite tests are ordered prior to introducing Benicar. This is because once the Benicar is taken, the results of these tests would reflect the profound changes that occur upon taking the Benicar and will not be an accurate measure of any pre-treatment D Metabolite dysregulation.

Before getting tested, carefully review these instructions: D Metabolite Test Instructions

Take note that not all lab handling procedures are the same! Follow these D Metabolite Test Instructions carefully to assure that results obtained are worth the money spent to obtain them.

After getting tested, to understand more about the results of your tests, see the: D Metabolites Calculator

Baseline inflammatory marker tests are also ordered prior to introducing Benicar to provide the best possible measure of chronic inflammation in the patient prior to treatment. For best coverage, a doctor may chose to order a complete blood count (CBC) along with a comprehensive metabolic panel (CMP).

Repeating some of these tests during the protocol may be valuable as some organs, including the liver and kidneys, often have subclinical chronic inflammation, that may or may not be detectable from tests done prior to the patient starting the Marshall Protocol.

A Complement C3a assay and Soluble Interleukin 2 Receptor (sIL2R) may also be used to measure inflammatory activity. They can help to confirm possible errors in the 1,25-DPrimary biologically active vitamin D hormone. Activates the vitamin D nuclear receptor. Produced by hydroxylation of 25-D. Also known as 1,25-dihydroxycholecalciferol, 1,25-hydroxyvitamin D and calcitirol. assay or to confirm that inflammation is not so widespread but it is usually not necessary to do these tests.

Coverage of IL2R will vary by insurance company. Here is a paper showing it as an effective diagnostic tool for sarcoidosis. A doctor might take the position that she or he is trying to rule out sarcoidosis.

Doctors find it helpful to track (every 2-3 months) the level of the D Metabolite, 25-D, for patients on the protocol. This allows the doctor and the patient to be aware of when the 25-D level is starting to get low enough that the patient's innate immune responseThe body's first line of defense against intracellular and other pathogens. According to the Marshall Pathogenesis the innate immune system becomes disabled as patients develop chronic disease. begins to return. This is a critical point to discern so that any strong increase in immunopathologyA temporary increase in disease symptoms experienced by Marshall Protocol patients that results from the release of cytokines and endotoxins as disease-causing bacteria are killed. (IP) can be quickly addressed with appropriate measures.

[Frequency of 25-D testing] depends on the level. If your 25-D consistently tests below 8 ng/ml then every 3-6 months should be OK, but if you are hovering in the teens, I would think every month or two to track the changes you are making to your diet.

Trevor Marshall, PhD

Prior to the start of Phase 2 of the Marshall Protocol, doctors often find it helpful to retest the CBC with differential along with the inflammatory markers: CRP, ALP, creatinine, BUN, and triglycerides, to compare against the patient's pre-treatment baseline. This provides objective measures to assist the doctor in discerning how the patient is responding to the current pace of treatment.

Some doctors find that their Marshall Protocol patients are unable to identify when the immunopathology from a particular antibiotic dosage level has outpaced their body's ability to process and recover.

What ever the cause, transient decrease in Hgb and hematocrit are common in the early phases of the MP. My use of lab tests is to help determine pace of therapy especially if degree of Herx reaction is difficult for patient to interpret.

With chronically ill patients, it is common to disassociate from one's feelings and therefore can be difficult to determine the sometimes subtle shifts associated with Herx reactions. As the old saying goes “I've been down so long, it is beginning to look like up.”

Greg Blaney, MD

Many organs that have had subclinical chronic inflammation will show diminished function in blood test results even while that inflammation is being cleared during the Marshall Protocol. This is an unavoidable result of the immune system reaction but it can be controlled by slowing down immunopathology.

Again, testing CBC with differential along with CRP, ALP, creatinine, BUN, and triglycerides, will provide objective measures to assist the doctor in discerning how the patient is responding to the current pace of treatment.

Many doctors using the Marshall Protocol to treat their patients have other tests they are familiar with using to assess their patients status. Many of these tests could be considered elective and would only be worth the expense if the patient finds that the possible peace of mind offered offsets the economic benefit of deferring testing. Other tests are invasive and may be counter-productive to the goal of minimizing setbacks to recovery.

Ask your doctor if the results of the proposed imaging will change the treatment plan. Some doctors are accustomed to repeat testing to monitor disease progression but may not inform their patients that these tests do nothing to change the course of treatment. Periodic monitoring of inflammatory markers is usually all that is necessary to gauge your progress.

C Reactive Protein is an inflammatory marker which, if elevated, return to baseline along with Triglycerides, Alkaline Phosphatase and 1,25D as the MP does its job. These markers typically start to drop after about 6-12 months.

SED rate will (hopefully) go way up in the early stages of the Marshall Protocol indicating that bacteria are being killed, and the body's immune system is dealing with them. Later on (at 12 months or so) the SED rate will remain closer to normal, as fewer organisms are being killed. Eventually it returns to baseline.

I regard the ANA tests as largely irrelevant. They are not specific enough to be useful as Th1 disease markers. Indeed, ANA disappear as the infection progresses. Many of the sarcies have had ANA disappear over the years, to be replaced by biopsy-verifiable granuloma.

Trevor Marshall, PhD

As a patient, you are the most important member of your health care team. Making sure you know what is in your medical records means that you are able to follow-up on questions and in some cases, verify accuracy. Your doctor's office personnel can read you the exact numbers with measurements over the phone but we recommend you get a printed copy of all lab results.

You may need to sign a release of information form. Call your clinic's “Release of Information Office” or Medical Records to find out what their procedure is to obtain medical records. You should be able to do this all via the phone and mail. Once your release form is on file, you can just call them and have them mail you copies of the doctor's clinic note and test results after each visit.

It is best to always ask for copies of your lab reports, x-rays reports, clinic notes, etc.
A proactive patient knows exactly what is in his/her medical record.