Related article: Length of the Marshall Protocol
Related article: Length of the Marshall Protocol
The Marshall Protocol (MP) is a curative medical treatment, which allows patients to make progress by activating the 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. by taking olmesartan (Benicar). In the process, this generates immunopathology. Patients will sometimes find it difficult to manage their immunopathology. Patients in later stages of treatment may find their immune response is relatively self-sustaining, and that it will take longer for the immunopathology to stabilize when making adjustments.
For those who have added antibiotics, they may find they need to discontinue the use of antibiotics when the immune response is too strong. The length of time it takes for antibiotics to no longer have an effect is variable. Determining factors include how long the antibiotics stay in one's system (often a month or more) as well as how self-sufficient the immune system is.
Patients are advised not to discontinue olmesartan (Benicar), as the drug is palliative and protects organs.
MP patients have cited the following reasons for taking a break from treatment:
Having improved morale is oh so important when you have to get through the difficult patches of recovery. A little bit of herx-holiday every few months is something I strongly suggest to the doctors who call me.
Trevor Marshall, PhD
Those considering or on a break from the Marshall Protocol are encouraged to post information about their plans as part of their regular updates in their own progress thread.
We are very interested in following the long term outcomes for all our members, including those that choose to discontinue the MP as we feel we are able to learn more this way.
That doesn't mean we agree with your interpretation of your response to the MP. However, we want to respect your personal healthcare choices and would like to continue to follow the outcome of those choices.
So, again, thank you, and do let us know how things are going from time to time.
p.s., our new MP knowledge base provides links to recent papers, publications, and presentations by our research team that you may find to be of interest… https://mpkb.org/home/publications
Joyful, MarshallProtocol.com
MP patients taking a break have the option to change the way they take their antibiotics, as follows:
Note that patients who discontinue antibiotics entirely are no longer benefiting from the mild anti-inflammatory effects that some of the MP antibiotics provide. Further, there is the distinct possibility that one's immune response can stay activated as the antibiotics are metabolized in the tissues. Paradoxically, taking a more frequent dose of antibiotics can actually modulate the immunopathology, making it more predictable.
For some, it may take a month or more for antibiotics to no longer have their effect.
For patients who take a break over more than a month, it may be best to start over with minocycline alone and only add a second antibiotic once the immunopathology indicates they are ready for additional immune stimulation.
Related article: Taking a break from the Marshall Protocol
Stopping olmesartan (Benicar) is not recommended. In its capacity as an angiotensin receptor blocker, olmesartan (Benicar) protects organs and is a potent anti-inflammatory, an effect which may be necessary to maintain tolerable symptoms.
Patients who consider taking a break because of their problem with light exposure should first try an increase in olmesartan (Benicar) dosing to 40mg every four hours or 20mg every two hours.
For those who must stop olmesartan (Benicar), it must be weaned gradually, preferably over the course of at least a couple weeks. This is especially true in emergency and critical care situations. Abrupt withdrawal of Benicar can provoke a strong inflammatory reaction and, if not done with care, have dire consequences. If there is ever any question, healthcare providers may call Trevor Marshall, PhD at any time.
An alternative to discontinuing olmesartan alone is to wean the patient across to another ARB, valsartan (Diovan), 80mg every 6 hrs (80 mg is one quarter of a 320mg Diovan tablet). Over a period of 2-3 days, the patient reduces the olmesartan dosage (e.g., from 40 mg to 20mg to 0) while simultaneously ramping the valsartan (e.g. 0 to 40mg to 80mg). The length of time the organ protection from the valsartan will be needed depends on how long it takes the immune system to slow again. This ARB does not activate the immune system, but does protect organs and provide a little palliation.
Irbesartan is a less-effective alternative which can be used if absolutely necessary (300 mg tablet – using 75 mg every 6 hours).
Patients who stop olmesartan are terminating their recovery.
MP patients must take adequate precautions to avoid an increase in symptoms related to light exposure. The return to getting “normal” levels of artificial and natural light is an individual experience. Stopping the MP medications will not decrease a patient's photosensitivity. The light sensitivity is part of the disease process and not due to the medications.
Those with cardiac symptoms should be particularly cautious in order to avoid a sudden severe cardiac event. Please be mindful that light exposure might cause a flare in cardiac inflammation and cardiac symptoms.
MP patients taking a break from treatment should continue to avoid all forms of ingested vitamin D during the break as symptom instability often results.
Sometimes it takes months for antibiotics to clear the body. Azithromycin (Zithromax), in particular, is metabolized rather slowly and has been known to have that kind of effect.
Also, there is the possibility that the MP has allowed to the immune response to become self-sustaining even in the absence of olmesartan (Benicar) or antibiotics.
These days, in all my presentations to physicians, I make a point of helping them to understand that it is the immune system which is doing the germ-killing in the MP, not the drugs. They tend to make the mistake of focusing on the drugs. The problem is that even after you stop taking the Benicar (and antibiotics), the immune system will keep killing the bacteria unmodulated for months.
Trevor Marshall, PhD
It is worth noting that “new” or stronger symptoms, which linger beyond an expected time frame are not “caused” by the MP, but merely revealed or unmasked.
Latent bacterial forms, except maybe the kind one sees in the rapidly degenerative disease ALS, are very slow-growing. Patients taking Benicar alone (olmesartan without antibiotics), but are continuing to experience some level of the symptoms of immunopathology, can expect that the intracellular bacteria are being dealt with and the patient is making progress towards recovery.
MP patients who have discontinued olmesartan (Benicar) during a break from the MP will want to restart regular dose olmesartan without additional antibiotics. Once symptoms have stabilized on olmesartan along, it will be easier to determine how strong their own immune response can be with the added support of olmesartan's immune stimulative properties.
Patients taking a break from antibiotics for just a few days or so usually find they can resume the antibiotics at the previous dose. However, patients taking a break from antibiotics for longer than a few days will need to restart their antibiotics at a lower dose to assess symptoms as tolerable, to avoid a strong immune system reaction.
The [antibiotic] break was very nice. When I am in the midst of herxing my emotions tell me that I have always been herxing, always will, with no end in sight. I know many of us have that psychological response. Taking this break has been a morale booster.
John McDonald, MarshallProtocol.com