Non-MP treatments

While there are notable exceptions, the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) should not be combined with any other protocols, treatments or supplements, especially those which are immunosuppressive or immunomodulatory. Using other treatments while on the MP can impede progress on the MP – or be dangerous to MP patients.

For intolerable symptoms, certain palliative medications such as sleep medication, pain medication, and antidepressants are acceptable. It is generally recommend that MP patients use the lowest dose of medication that is effective.

Non-MP medications, treatments, and supplements can be classified into one of three categories:

contraindicated - wean with the help of a physician
warning - therapy may be used under certain circumstances
okay - acceptable under all circumstances

MP patients are expected to be forthright about all non-MP supplements and medications they are taking when starting the MP. MP patients are also expected to wean or wean from those substances which are contraindicated. An extensive, but not complete, list is shown below. MP patients should consult with their physicians if they have questions.

Please note that there are instances where it is acceptable for MP patients to take certain palliative medicines or supplements. Supplements that give patients needed palliative relief for intolerable symptoms can be used. For example, if a patient has abdominal pain that is relieved by milk thistle, or if a supplement improves the quality of their sleep, then its use is permitted. Similarly, if a patient cannot obtain the RDA of a necessary nutrient, such as calcium, from diet alone, sometimes a supplement may be appropriate. (This does not apply to vitamin D.)

While the medications used on the MP have excellent safety profiles, it is not fully known how they might interact with all other medications. MP patients should ask their physician or pharmacist to review all of their non-MP medications with this in mind.

Growing evidence supports the contention that chronic diseases are caused by pathogens, not by a deficiency in some substance.

The body and the innate immune system represent a delicate balance between cells' nuclear receptorsIntracellular receptor proteins that bind to hydrophobic signal molecules (such as steroid and thyroid hormones) or intracellular metabolites and are thus activated to bind to specific DNA sequences which affect transcription. and the molecules that control numerous complex and intertwined feedback pathways. Any substance, including supplements and food, can bind key receptors and alter feedback pathways, potentially interfering with immune function or dysregulating a pathway that regulates important hormones.

Most of the body’s healing processes work better if they are left alone while you are on the MP. The concept that we should intervene in these diseases with supplements or therapies has not worked, and I deprecate it. I have seen this happen so often before…trying to Band-Aid the metabolite shifts [with supplements] will not help recovery and will often make the disease worse. They are almost always counter-productive.

Trevor Marshall, PhD

A broad array of substances can palliate symptoms at the expense of long-term health improvement. If patients with latent pathogens feel better after taking a supplement, it’s almost always because the substance is affecting a pathway that allows it to slow the activity of the immune system. By palliating the immune response, use of the substance temporarily decreases the inflammationThe complex biological response of vascular tissues to harmful stimuli such as pathogens or damaged cells. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. generated in response to the bacteria, causing a feeling of “wellness.” Yet, as in the case of vitamin D, this situation in which the immune system is depressed simply allows the bacteria to spread with greater ease.

We surgeons have been operating on the gut for literally thousands of years and the microbiotaThe bacterial community which causes chronic diseases - one which almost certainly includes multiple species and bacterial forms. has just been this extraordinary elephant in the room. We seem to have completely ignored the fact that we've co-evolved with thousands of bacteria over millions of years and that they somehow may be important to our health. As doctors, we routinely do terrible things to the microbiota and I'm sure this has implications for our health.

James Kinross, Imperial College of London at 2008 International Conference on Metagenomics

One of the abiding concerns with MP patients' use of over-the-counter supplements is that they contain occult vitamin D, even though it is not listed on the label. A number of supplements are immunomodulatory. Many lack evidence supporting their efficacy.

Name	Varieties	Recommendation	Rationale
aloe vera		wean	patient report of palliation
antacids		follow label directions; take at least 1 hour before or 2 hours after taking other meds	can interfere with absorption in GI tract
antioxidants	alpha lipoic acid, beta carotene, coenzyme Q10, glutathione, grape seed extract, green tea, melatonin, quercetin, selenium, vitamin C, vitamin E	wean supplements; exception: quercetin, which is only to be use to manage excessive 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.	immunomodulatory
baking soda	sodium bicarbonate, sodium hydrogen carbonate	may have adverse reaction	may help with shortness of breath
calcium		can be used if there's a deficiency; avoid if hypercalciuria or hypercalcemia; no more than RDA for sarcoidosis patients
chlorine dioxide	miracle mineral supplement, MMS solution	stop	non-MP antimicrobial exposes to danger of provoking runaway IP, does not restore innate immune function
colloidal silver		wean	unproven, turns skin grey
essential fatty acids (EFAs)	cod liver oil, fish oil, flax seed oil, hemp oil, omega-3 fatty acids, primrose oil, sunflower oil	wean	often contains vitamin D; may also be immunosuppressive through other mechanisms
enzymes	bromelain , serrapeptase	wean	immunomodulatory
glucosamine/chondroitin		wean	inhibits resolution of joint inflammation
guaifenesin	pills, syrup	acceptable in limited amounts; has skeletal muscle relaxant activity	mildly immunosuppressive
herbs, spices and other plants as supplements	cinnamon, curcumin, curry, garlic, ginkgo biloba, ginseng, hawthorn, milk thistle, mustard, rosemary, olive leaf extract, oregano oil, sage, turmeric	can be used in cooking; avoid supplemental forms	immunomodulatory
iron		avoid unless diagnosed with iron deficiency anemia	contributes to inflammation
magnesium		limited amounts can be used if not getting RDA
minerals	calcium, iodine, iron, magnesium, potassium
potassium		take only with MD approval and frequent testing	kidney disease could lead to renal resorption
probiotics	acidophilus	can be consumed if in food naturally; otherwise wean	some immunomodulatory, some are anticoagulants
propolis	bee propolis, caffeic acid phenethyl ester (CAPE), propolis resin, propolis wax	may be used infrequently, i.e., chewing gum; otherwise wean	antimicrobial, immunomodulatory, potent allergen and sensitizing agent
quercetin		not to be used when taking Warfarin; acceptable for occasional use in moderating intolerable immunopathology	anti-inflammatory
vitamins	folic acid and derivatives (Apo-Folic, Folate, Folvite, Novofolacid), vitamin A, vitamin B12 (cyanocobalamin), vitamin C (ascorbic acid), vitamin D, vitamin E	wean supplements	immunomodulatory
whey protein	naturally occurring can be consumed; avoid supplemental form	wean	may contain vitamin D; may be immunomodulatory