Home

Dosage and administration of Marshall Protocol antibiotics

The Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) is distinguished from other antibacterial treatments in at least two key respects. For one, MP patients take regular doses of the Vitamin D Receptor agonistA substance such as olmesartan (Benicar) or 1,25-D which activates the Vitamin D Receptor and transcribes the genes necessary for a proper innate immune response., olmesartan (Benicar)Medication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor.. Also significant is the use of pulsed low dosesAdministration of an antibiotic periodically such as every 48 hours and in amounts small enough that the immunosuppressive effects of the antibiotics are minimized. of specific antibiotics; pulsed dose allow plasma concentrations of a medication to wane between doses. Used in conjunction, these two interventions generate an immunopathological reactionA temporary increase in disease symptoms experiences by Marshall Protocol patients that results from the release of cytokines and endotoxins as disease-causing bacteria are killed.. Patient feedback suggests that in the absence of regular doses of olmesartanMedication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. Also known by the trade name Benicar. , patients can only generate a fraction of the 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. they do on the MP.

The Phase One and the Phase Two/Three guidelines specify a series of steps for moving from one dose and combination of antibiotics to the next. Understanding the rationale behind these instructions and knowing when to vary them can help keep a patient safe and experiencing tolerable immunopathologyA state in which a patient has maintained an acceptable intensity of bacterial die-off reaction. The primary goal of the Marshall Protocol.. As always, MP patients are encouraged to work closely with their physician.

Administration of antibiotics

Antibiotics may be taken with or without olmesartan, and with or without food. However, some patients have found that taking antibiotics without food leads to gastric upset.

Taking minocyclineBacteriostatic antibiotic used by Marshall Protocol patients. with dairy products or calcium may alter its absorption. Patients should take this into consideration only if they need to eliminate any variable that might be affecting immunopathology. In that case, take the minocycline dose one hour before or two hours after consuming dairy products or other foods high in calcium. Otherwise, it is okay to take minocycline with food.

In the hours after taking minocycline, when concentrations of the antibiotic are relatively high, the body is immunosuppressed. This leads to feelings of temporary symptom relief and well-being.

Pulsed dosing of antibiotics

As per the Phase One and Two/Three instructions, MP patients begin taking an antibiotic at the minimum dose, which varies for each antibiotic, and increase it gradually, sometimes over the course of months.

All of the different MP antibiotics have a time-concentration curve similar to minocycline (see figure). When an antibiotic is first ingested, levels of the antibiotic spike. This results in temporary immunosuppression. The window of feeling symptomatic relief following consumption of an antibiotic is about hours two to four for minocycline, clindamycinBacteriostatic antibiotic used by patients on the Marshall Protocol. , Bactrim DSSulfa antibiotic used by patients on the Marshall Protocol. Combination of sulfamethoxazole and trimethoprim. Works by blocking bacterial folic acid synthesis., and demeclocyclineBacteriostatic antibiotic used by patients on the Marshall Protocol.. On the other hand, azithromycin (Zithromax)Bacteriostatic antibiotic used by Marshall Protocol patients. Has relatively long half-life. typically results in feelings of temporary well-being on days two to four following administration.

Unlike treatments which employ high doses of antibiotics, the MP has patients take antibiotics only every two days. This limits the time during which a patient's immune system is suppressed and extends the time during which it kills bacteria. To prevent extended immunosuppression, patients should take note of the upper limits on the amount of antibiotic to be taken at one time.

The constantly variable plasma concentration of an antibiotic means that the MP can be forgiving of small errors of dose or interval. Provided a patient is experiencing tolerable immunopathology, the exact amount of antibiotic is taken is somewhat immaterial. It may help to think that it's not the antibiotic killing the bacteria but the immune system.

Time of administration

While it's probably a good idea to take one's antibiotics at the same time of day on days they are to be taken, there is no preferred time. The question of when to take one's antibiotics has as much to do with when a patient wishes to benefit from the temporary immunosuppression. Some patients prefer to take their antibiotics before bedtime to sleep through some of the immunopathology. Others figure taking them in the morning will mean they sleep through the worst immune system reaction on the second night. Still others take an increased dose just before their days off from work because they can tolerate more immunopathology when they are not working.

Altering dosing and frequency of antibiotics

The choice to increase or vary antibiotics taken is one that should be made in conjunction with a patient's physician and according to the Phase One and Phase Two/Three guidelines. The time spent on each phase varies between patients but some data has been collected.

Unlike, olmesartan, which should not be ramped, antibiotics should be increased incrementally and over time, to ensure both safety and efficacy of the treatment. To do so, patients may need to divide their medications.

One of the strategies for managing immunopathology is to increase the frequency with which one takes minocycline. When necessary, taking frequent doses of minocycline is a perfectly acceptable way to mitigate a robust immune response.

Read more:

Notes and comments

EDIT

  • Should we also be able to stop mino if on MZ or MZC if one doesn't find mino palliative and one needs to – I don't know if you have a similar type statement somewhere? –JCW
    • reduce the dose first (lowest dose is 25mg)
    • extend the schedule to every third or fourth day
    • take an extra dose of 25mg (or 50mg if used to a higher dose)
    • discontinue until symptoms settle
    • take a low dose more often (25mg every 6 hours or 50mg every 12 hours or a daily dose of 25-50mg)
    • Use past experience in Phase One to decide which option might work best now. When uncertain what to do when trying to reduce symptoms, it is best to first try reducing the Mino dose and/or delaying the next dose before trying an extra dose or frequent Mino dosing.
  • IMO, this would/should go in the managing IP page. Being explicit is good, but I worry about the possibility of confusing people. –PA
  • Okay. –JCW
Last modified: 06.02.2010
© 2010, Autoimmunity Research Foundation. All Rights Reserved.