Light restriction

Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) patients who are photosensitiveAbnormal sensitivity to sunlight and bright lights. Also referred to as "sun flare" or "light flare." are advised to limit their exposure to light. This article summarizes information related to light restriction for MP patients. In later stages of the MP and/or when the treatment is complete, veterans of the MP may choose to expose their eyes and skin to increasing amounts of light.

1. Differentiate between symptoms due to light exposure and immune system reaction symptoms. When in doubt, patients should assume their symptoms are due to light exposure and reduce light exposure if symptoms are serious, i.e., cardiac in nature.
2. High risk patients should be more cautious about exposing themselves to light. MP patients with pre-MP levels of 1,25-DPrimary biologically active vitamin D hormone. Activates the vitamin D nuclear receptor. Produced by hydroxylation of 25-D. Also known as 1,25-dihydroxycholecalciferol, 1,25-hydroxyvitamin D and calcitirol. higher than 45pg/ml, those who have osteoporosis or may be at risk for osteoporosis, and those who did not assess their 1,25-D pre-MP should consider that light exposure may increase 1,25-D to levels that promote bone resorption. They should weigh the risk/benefit ratio of light exposure vs. their need or desire to expose themselves to light.
3. Experimentation with sun exposure, is encouraged during all phases of the MP but should be done cautiously, and extra caution should be used if one's illness is severe. The symptoms and timing of a photosensitivityAbnormal sensitivity to sunlight and bright lights. Also referred to as "sun flare" or "light flare." reaction may change over time on the MP, and this should be taken into account. For example, a patient might have more of a delayed and longer-lasting response later in the MP than they did early in the MP. It must be remembered that all cremes applied to the skin, including Zinc Oxide 'screens', may be (partly) absorbed, and have a systemic effect on the body.
4. Being on the MP is more important than 100% compliance. A less-than-ideal compliance with light avoidance may be better than no MP at all for many individuals who cannot or will not change their lifestyle to avoid light exposure.
5. Take intolerable symptoms of light exposure seriously. Intolerable symptoms resulting from light exposure should be treated using the guidelines for cardiac immunopathologyAn exacerbation in symptoms of the heart muscle. Requires careful management by physicians. and/or the runaway immune system reaction.

MP patients who are photosensitive must protect their eyes from exposure to both natural and bright artificial light by using NoIRsSpecial sunglasses worn by Marshall Protocol patients to block light. or the equivalent sunglasses that prevent all types of radiation from reaching the eyes. Most kinds of glasses are not appropriate for use outdoors on the MP as they do not protect against infrared light.

Of the NoIR sunglasses, there are three options.

• 2% amber (outdoor)
• 10% amber (indoor)
• 40% amber (low lighting situations)

Patients who would rather not wear NoIRs have the option to use certain kinds of stylish frames and prescription sunglasses.

Unless it obstructs vision while driving, photosensitive MP patients should wear eye protection (including at night, due to the effect of oncoming car headlights).

It is recommended that patients starting the Protocol buy and wear any of the recommended glasses for two weeks to be safe and to learn if light affects their symptoms in unanticipated ways.

Because of the effect of light on the skin, Marshall Protocol (MP) patients who exhibit photosensitivity must protect their skin from exposure to natural light. This involves covering windows of indoor spaces to block outside light. When outdoors, it means wearing dark, tightly-woven clothing or multiple layers of clothing, covering most of the body. Sunscreens containing a high percentage of zinc oxide (greater than 15%) may be useful in some circumstances but are not a substitute for other measures. Many MP patients wear hats and gloves as well.

• Natural light falling on skin may cause an excess production of 1,25-D in persons with Th1 diseaseAny of the chronic inflammatory diseases caused by bacterial pathogens..
• Natural light exposure will not stop bacterial killing while on the MP, but progress may be slowed if either 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. or 1,25-D are elevated by light exposure enough to inhibit immune function.
• Natural light is defined as outside light from dawn to dusk, even on cloudy days, including reflected light, light coming into a building or through tinted car windows.
• Dawn and dusk approximate the recommended low artificial lighting of 30 lux and may be safe.
• Light intensity, as it relates to production of 1,25-D, is the same in northern latitudes as it is at the equator.
• Individuals with darker skin are no less susceptible to the effects of light on the skin than are individuals with lighter skin.

MP patients need not cover their skin indoors if all natural light is blocked. If natural light has not been blocked from their house, they will need to cover their skin and eyes at all times. If natural light has been blocked but artificial lighting exceeds 30 lux, wear appropriate eye protection only. If all natural light has been blocked from the area, and artificial lighting has been reduced to no more than 30 lux, no precautions are needed.

• Fluorescent lighting – MP patients must wear appropriate eye protection and a cap with a bill. Many stores, doctor's offices and other commercial establishments have fluorescent lighting, so adequate eye protection is needed there.
• Incandescent light – Incandescent light must not be too bright or direct to eyes. MP patients must wear appropriate eye protection or dim to 30 lux.
• Halogen light – To protect against halogen light, MP patients must wear appropriate eye protection and a cap with a bill.
• Televisions and computer monitors – MP patients must limit their exposure to light from televisions and computer monitors by lowering the brightness on these devices and/or wear sunglasses.

Both the visible wave lengths and the invisible ultraviolet and infrared wave lengths of light can provide enough energy to create 1,25-D. MP patients must limit their exposure to ultraviolet and infrared radiation.