The Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) is based on the Marshall PathogenesisA description for how chronic inflammatory diseases originate and develop., which posits that chronic diseases (termed Th1 illnesses), are the result of infection by an intraphagocytic, metagenomic microbiota of chronic microbial forms that we often refer to as the Th1 pathogensThe community of bacterial pathogens which cause chronic inflammatory disease - one which almost certainly includes multiple species and bacterial forms..
Patients on the MP take higher than typical doses of a medication called 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. (called Benicar in the United States), which is able to bind and activate the Vitamin D ReceptorA nuclear receptor located throughout the body that plays a key role in the innate immune response. (VDRThe Vitamin D Receptor. A nuclear receptor located throughout the body that plays a key role in the innate immune response.) by pushing 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. and bacterial proteins out of the receptor.
Patients also lower levels of 25-D in the body by avoiding the kinds of vitamin D present in various foods. These measures renew the body’s ability to turn on the innate immune response and produce antimicrobial peptidesBody’s naturally produced broad-spectrum antibacterials which target pathogens.. The immune system is then able to kill the Th1 pathogens and is once again able to manage viral and other co-infections.
Main article: Science behind immunopathology
Related articles: Managing immunopathology, Immunopathology
When patients on the MP kill bacterial pathogens they experience a reaction called 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.. Immunopathology is an increase in one's present symptoms of Th1 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., or a return of previous Th1 inflammatory symptoms, that is caused largely by cytokinesAny of various protein molecules secreted by cells of the immune system that serve to regulate the immune system. generated by the immune response and endotoxins released from dying bacteria. Occasionally, immunopathology will result in a new symptom or abnormal laboratory value (e.g., elevated creatinine, elevated liver enzymes, low white blood count, etc.). The occurrence of subclinical bacterial 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. is due to 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. 's activation of the immune system. Immunopathology appears to be a necessary part of recovery. The amount of immunopathology a patient experiences on the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) tends to correlate with disease severity and bacterial load. Patients who are less sick will have comparatively less-strong immunopathology.
Immunopathology is sometimes used synonymously with the “Jarisch-Herxheimer reaction” or “herx.”
Many MP patients who have experienced prolonged periods of immunopathology have reached stages of significant improvement or remission. This supports the conclusion that immunopathology is a necessary result of chronic bacterial death, and a precursor to disease reversal. The MP is not unique in this regard. A number of other diseases and/or therapies generate immunopathological or immunopathological-like reactions.1) 2) 3)
Lab work and patient reports can be used to track clinical signs of immunopathology.
NOTE: Antibiotics are no longer considered a necessary part of the Marshall protocol.
Main article: Science behind olmesartan
Related article: Health maintenance and Olmesartan
Patients on the Marshall Protocol (MP) take olmesartan (Benicar)Medication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor., a drug whose actions are well known, every six hours. In general, olmesartan tends to be prescribed for its antihypertensive properties due to the fact that is an angiotensin receptor blocker. A growing body of research supports the use of olmesartan as a part of a curative therapy for chronic disease.
For the purposes of the MP, olmesartan has two primary actions: it reduces inflammation by blocking the Nuclear Factor-kappaB cytokine pathway and it is an agonist of the Vitamin D Receptor (VDR). As a VDR 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 uniquely activates the innate immune response. Research supports the safety of the doses used by MP patients.
Olmesartan has minimal interactions with other drugs and is one of the safest drugs on the market.
Main article: Safety of olmesartan
Related article: Recent research into Celiac disease
Some patients and healthcare providers have expressed concerns about the safety of higher than typical doses of olmesartan (Benicar).
Ample research supports the fact that olmesartan is one of the safest and has the most gentle side effects profiles of almost any drug on the market – as opposed to Benicar HCT, which contains a thiazide and is harmful.
I feel there are simply no adverse reactions or negative side effects that I need to worry about while taking the Marshall Protocol medications. It is an extremely safe approach. Personally, I believe overtreating this condition is preferable than undertreating as the side effects of both antibiotics and Benicar are so minimal compared to the risk of [disease] recurrence.
Greg Blaney, M.D.
For those with gastric issues, it is recommended that the pill be crushed and mixed with applesauce or similar to reduce impact on gastric lining.
Main article: Olmesartan and kidney disease
As a matter of course, markers of kidney function including blood urea nitrogen (BUN) and creatinine will fluctuate while a patient is on the Marshall Protocol (MP).
There is a tendency for some physicians to become alarmed by these fluctuations, particularly if a patient has kidney disease. However, for the vast majority of patients these test results are an expected part of the healing process. In fact, a wide range of research shows that olmesartan is therapeutic for kidney disease.
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At the same time, MP patients take pulsed, low-dose antibiotics. Antibiotics taken in this manner are much more effective against bacteria in biofilms and are able to greatly weaken the Th1 pathogens so that the patient’s own immune system is then able to destroy them. Most of the different MP antibiotics weaken the bacteria by blocking their ribosomes, which they need to produce proteins that help them survive and reproduce. It’s important to understand that when the Th1 pathogens die, there is a temporary change in a patient’s immunopathology.
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. refers to the changes in the immune system that result from bacterial death (another term sometimes used is the Jarisch-Herxheimer or “Herx” reaction). Dying bacteria release toxins into the bloodstream, stimulate the production of inflammatory cytokinesAny of various protein molecules secreted by cells of the immune system that serve to regulate the immune system., and generate temporary hormonal imbalances. This means that once a patient begins the MP, each dose of antibiotic will cause them to feel bad for the period of time it takes their immune system to deal with the consequences of bacterial die-off.
Before starting the MP, many patients may feel that they have improved through consuming vitamin D and taking steroids such as prednisone. In reality, these compounds inactivate the VDR, preventing the immune system from effectively killing the Th1 pathogens. Since it is the death of these forms of microbes that generates an increase in painful symptoms, people may experience short-term relief when using vitamin D or prednisone as their immune system shuts down and less microbes are killed. However, in reality, this situation allows the microbes to spread more easily.
Patients on the MP have dozens of different medical conditions. As evidenced by members’ reported progress on the marshallprotocol.com website, nearly all experience a powerful 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. after taking a dose of antibiotics.
Many patients report great improvement, while some are approaching complete recovery.
Some of the diseases patients are currently using the MP to treat include (but are not limited to):
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