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Spontaneous remission is a myth

The chronic inflammatory diseases treated by the Marshall Protocol (MP) rarely go away on their own. It’s not that patients with Th1 diseaseAny of the chronic inflammatory diseases caused by bacterial pathogens. can’t and won’t go through periods where they might feel better. Unfortunately, these periods are usually a sign that the immune system has become severely compromised.

Whether temporary “remission” is driven by immunosuppressive drugs like corticosteroids, a high intake of vitamin D, excessive sun exposure, or simply the accumulation of a bacterial load that is so high that the VDR is almost completely shut down by bacterial ligands – these periods are times when the Th1 pathogens are alive and well, spreading, and surely infecting other tissues. This unchecked infection leads to illnesses that will only be discovered later in life such as arthritis, heart disease, decreasing kidney function, diabetes, cancer and the 'diseases of aging'. But during a “remission period,” when the immune system is not capable of killing the pathogens, there is no corresponding inflammatory response that would occur if the body was mounting a defense against the infection. This causes a patient to feel a sense of temporary relief during immune suppression that is often mistaken for “wellness.”

Relapsing/remitting nature of infection

One of the important factors in how symptoms of illness relapse and remit, is that infections relapse and remit. For example, Staphylococcus aureus is a major human pathogen which plays a role in deep tissue infections, osteomyelitis, and chronic lung infections.

A key characteristic of these infections is that relapse can occur months or years after an apparent cure. These relapses, Dr. Bettina Löffler and her team from the Institut für Medizinische Mikrobiologie in Münster, Germany, believe are due to phenotype switching, a change in the bacterial behaviour. After infection and invasion of the patient's host cells, the bacteria form small colony variants (SCVs), tiny bacterial subpopulations that can evade the immune system and many antibiotics and grow slowly.1)

Microbes ability to easily switch between forms explains both their persistence and the variability in patients' symptom presentation from one time point to another.

Research with insufficient follow up

As it happens, members of the medical community who put credence in spontaneous remissionTheory that diseases go away of their own accord. tend to base their information on studies that are notoriously poor at following subjects for long periods of time – periods of time that would allow researchers to take note of the declines that occur after bacteria have spread and any temporary periods of palliation have subsided. These studies would have to last for at least 5-10 years, with endpoints assessing systemic illness. Such studies would surely find that disease symptoms persist even in those people who had once experienced long periods of relief.

There has somehow been a misconception that remission could last a lifetime. In reality, remission is accompanied by recurrence and relapses.

Trevor Marshall, PhD

Sarcoidosis

Researchers at Jefferson Medical Center in Philadelphia found a 74% relapse rate in sarcoidosis patients with treatment-induced remission, while only 60% of patients identified as having a favorable prognosis actually sustained remission over 130 months.2)

Many argue that the most accurate study of sarcoidosis to date is the 2003 NIH ACCESS study, which followed 215 sarcoidosis patients for two years - a period during which it is sometimes mistakenly thought that the disease can go into remission. The study found that measures of sarcoidosis severity remain unchanged over the two-year period, despite the fact that many patients were using corticosteroids and other drugs.

In fact, in the NIH ACCESS study there were no documented cases of spontaneous remission. Even in the positive-sounding “improved” category for clinical markers, the percentages described were at best “improved”, not “substantially better” and certainly not “cured.” An indication of lack of substantial improvement in the improved group is the fact that there were essentially no change in use of corticosteroidA first-line treatment for a number of diseases. Corticosteroids work by slowing the innate immune response. This provides some patients with temporary symptom palliation but exacerbates the disease over the long-term by allowing chronic pathogens to proliferate. therapy during the two year period. The study also concluded that most patients with persistent sarcoidosis at two years were “unlikely to have resolution of the illness” and that “end-stage pulmonary sarcoidosis usually develops over one or two decades.”

In simple terms, the study found that not one patient recovered over a two year period, and that any patient to remain ill with sarcoidosis for two years is likely to die from the disease over the following ten to twenty years.

What is cure?

It has also been argued that there is a gap between how patients themselves and members of the medical community perceive success and improvement, as well as their concept of cure. The medical community has a tendency to be satisfied by results that show a patient has stabilized thanks to a particular medication, without taking into account systemic effects of disease, such as fatigue and pain, which are often excluded as endpoints.

A 2005 article on gene therapy described patients who had undergone treatment as “basically cured” – even though three had developed leukemia and one died.

The above example is a misuse of the word “cure.” For one thing, an actual cure results from a treatment that allows all participants to become well, including no long-term side effects or harm. Did the above study check in with its subjects a decade down the road in order to access their health years later? Probably not. But if they did, the subjects were probably symptomatic again, as gene therapy has not yet been adopted as an effective way to treat disease.

The public often isn’t satisfied with the medical community’s perception of a “cure,” which is why so many patients have left mainstream medicine – searching for solutions among doctors that practice alternative medicine or even among psychotherapists.

Unfortunately, for chronically ill patients, commercial interests and the media have combined to progressively define down what “better” means—so much so that assessing the significance of any new “breakthrough” becomes difficult, at best.

How is the Marshall Protocol different?

The MP is different. It is an attempt to address the underlying cause of Th1 disease – failure of the innate immune system to control bacteria which caused the symptoms in the first place. Unless these bacteria are targeted and killed, Th1 diseasesThe chronic inflammatory diseases caused by bacterial pathogens. do not go away. Indeed, if they went away on their own, why would there be hundreds of forums on the Internet where people with chronic disease discuss what it’s like to live a life full of relapses and pain?

Common misperceptions

(the protocol is continued for 3-5 years) In actuality, the impact of Th1 disease is different for each individual. Patients themselves vary in personality, physiological reactions, environmental conditions, degree of impact that social attitudes make to their morale. Stress is an important factor interfering with recovery, it often contributed to collapse of innate immunity.

A majority of patients have chosen to continue the therapy for as long as they experience improvement; this has been known to continue for ten years. Minimally for as long as it takes to bring 1,25 D into the healthy range and maintain this over one year of testing (if available). Often for at least as long as it takes to experience continuing improvement.

(patients must wear wrap-around NoIR sunglassesSpecial sunglasses worn by Marshall Protocol patients to block light. at all times, including inside) Those people who already wear sunglasses have been known to find the wrap-around NoIRSpecial sunglasses worn by Marshall Protocol patients to block light. give superior comfort. Actually some patients never wear NoIR because not photosensitiveAbnormal sensitivity to sunlight and bright lights. Also referred to as "sun flare" or "light flare.", for others it hits hard and fast. A few have been obliged to postpone the MP journey because they could no longer practice their profession effectively while photosensitive.

(Protocol relies on massive amounts of pharmaceutical drugs) Not massive amounts, and only one drug, to cure problems which may have been caused by previous use of pharmaceutical drugs (penicillin type drugs). Any MP compatible Abx used while on MP is optional and used in minimal doses.

(MP gives you one reason for pain. 'Too much vitamin D') The MP explains most pain as caused by microbial die-back producing cytokines as the immune system begins to work normally. Other pain may be caused by irreversible damage. This type of pain can be controlled by judicious use of opiates. Patients and doctors who desire only reduction of pain may be advised to avoid the MP. Patients who desire roll-back leading to cure of immune problems must look to developments in immune protection, restoration and support.

(MP could be dangerous?) Young children and pregnant women are warned they must postpone this therapy, as a precaution. Olmesartan is one of the safest medications known. It is far safer than many drugs available without prescription, such as aspirin..

(MP recommends the opposite of natural practitioners, seems all that MP does is shut down bodily ability to heal) Olmesartan does the opposite, when dose is taken frequently, enables recovery of innate immunity, including healing where damage is not irreversible. Patients are encouraged to find a natural whole foods diet which is suited to their individual digestive process. Moderate exercise appropriate to the individual is encouraged, going all out is not.

(MP staff are not open-minded) I do not understand this reaction. IMO patients must be pretty open minded to stick with MP long enough to be nominated as support staff. They welcome discussion of the experience of all participants, learn from failure and success as does any competent scientific study.

===== Notes and comments =====

Sallie Q 10.21.2018 draft infill for common misconceptions:-

the protocol is continued for 3-5 years In actuality, the impact of Th1 disease is different for each individual. Patients themselves vary in personality, physiological reactions, environmental conditions, degree of impact that social attitudes make to their morale. Stress is an important factor interfering with recovery, it often contributed to collapse of innate immunity.

A majority of patients have chosen to continue the therapy for as long as they experience improvement; this has been known to continue for ten years. Usually for as long as it takes to bring 1,25 D into the healthy range and maintain this over one year of testing (if available). Minimally for at least as long as it takes to be able to get enough sleep, when healing is most active.

patients must wear wrap-around NoIR sunglasses at all times, including inside. Those people who already wear sunglasses have been known to find the wrap-around NoIR give superior comfort. Actually some patients never wear NoIR because not photosensitive, for others it hits hard and fast. A few have been obliged to postpone the MP journey because they could no longer practice their profession effectively while photosensitive.

Protocol relies on massive amounts of pharmaceutical drugs Not massive amounts, and only one drug, to cure problems which may have been caused by previous use of pharmaceutical drugs (penicillin type drugs). Any MP compatible Abx used while on MP is optional

MP gives you one reason for pain. 'Too much vitamin D'. The MP explains much pain as caused by microbial die-back producing cytokines when the immune system is working normally. Other pain may be caused by irreversible damage. This type of pain can be controlled by judicious use of opiates. Patients and doctors who desire only reduction of pain may be advised to avoid the MP. Patients who desire roll-back leading to cure of immune problems must look to developments in immune protection, restoration and support.

MP could be dangerous? Young children and pregnant women are warned they must postpone this therapy, as a precaution.

MP recommends the opposite of natural practitioners, seems all that MP does is shut down bodily ability to heal. Olmesartan, when taken frequently, enables recovery of innate immunity, followed by healing where damage is not irreversible. Patients are encouraged to find a natural whole foods diet which is suited to their individual digestive process. Moderate exercise appropriate to the individual is encouraged, going all out is not.

MP staff are not open-minded. I do not understand this comment. IMO patients must be pretty open minded to stick with MP long enough to be nominated as support staff. They welcome discussion of the experience of all participants, learn from failure and success as does any competent scientific study.

Sallie Q 06.12.2017 proposed addition 'common misconceptions about MP' patients must wear wrap-around NoIR sunglasses at all times, including inside the protocol is continued for 3-5 years Marshall believes, if you don't feel bad, it's not working. [1/2 truth] his approach reveals a lack of appreciation of the complexity and variation of the human system. “he is doing a lot of harm to people who desperately seek help for their pain.” None of these ( diet and nutritional type, exercise, sleep, stress, psychological factors, environmental toxins, and …)is mentioned, that I can find, in the Marshall Protocol. Taking antibiotics for years, (is) directed by the MP …best strategy is to get your immune system into shape by addressing the things I mentioned above, none of which are addressed by the Marshall Protocol. Benicar has many documented side effects at much smaller doses than what the MP calls for, including headaches, chest pain, muscle pain, and coughing. The lower your levels (of v.D), the higher your risk (of cancer) patients might experience a recurrence of symptoms once the meds are discontinued. there are much better ways to increase your melatonin level than by sacrificing sunlight and valuable vitamin D! Marshall is placing people's health at risk by having them participate in a clinical trial via the Internet It would seem that the only indication for MP would be sarcoidosis. Marshall's theories seriously. They are poorly substantiated and lack corroborating evidence. Health comes from getting back to the basics…nutrition, exercise, restorative sleep-

Patients that 'fail' on the MP are told that the either a) were doing it wrong b) did not try hard enough You can speak no evil on the site or you get banned. many of these alternative med drs are nothing more than high priced hookers. it is a unsupervised cult , not a treatment. one such ex-MP patient, having been on it for almost 2 years in an attempt to recover from CFS. I am now virtually a cripple What he cannot and should not do is devise drug regiemes, make baseless claims of a cure and test his theories on desperate patients before …testing in a lab and then on animal models. it makes no sense from an evolutionary standpoint. lacking any sound scientific evidence. the MP study site does not allow for discussion of the falilures. reliance on massive amounts of pharmaceutical drugs? by sunbathing, using no vitamin D foods at all, and my 1,25-D stayed in the normal range, which according to the theory should not be possible. MP gives you one - albeit totally illogical - reason for your pain. Too much vitamin D. the MP can be dangerous to some people,… MP staff refuses to be open-minded he (TM) often implies a strong medical background a the MP involves the use of various antibiotics. MP works in directly the opposite way natural practitioners advocate. Instead of working with the body's ability to heal itself, it looks that everything MP recommends tend to shut down body's ability to heal/resist The Marshall protocol is one of the most drug-dependent therapies available for anything.

Giftbearer Posted On 2/9/2015 6:15:54 PM Whattodo Posted On 1/28/2012 4:50:40 AM Abra51 Posted On 3/27/2009 1:56:29 PM semia1234 Posted On 3/17/2009 1:55:46 AM

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===== References =====

1)
Tuchscherr L, Medina E, Hussain M, Völker W, Heitmann V, Niemann S, Holzinger D, Roth J, Proctor RA, Becker K, Peters G, Löffler B. Staphylococcus aureus phenotype switching: an effective bacterial strategy to escape host immune response and establish a chronic infection. EMBO Mol Med. 2011 Mar;3(3):129-41. doi: 10.1002/emmm.201000115. Epub 2011 Jan 26.
[PMID: 21268281] [PMCID: 3395110] [DOI: 10.1002/emmm.201000115]
2)
Gottlieb JE, Israel HL, Steiner RM, Triolo J, Patrick H. Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy. Chest. 1997 Mar;111(3):623-31. doi: 10.1378/chest.111.3.623.
[PMID: 9118698] [DOI: 10.1378/chest.111.3.623]
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