Introduction to the Marshall Protocol

The Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis., sometimes referred to as the MP, was developed by a team led by Trevor Marshall, PhD, as an antimicrobial treatment for chronic inflammatory diseases. Most diseases of unknown cause are chronic inflammatory diseases, and over 85% of patients with these diseases have responded to the treatment. On this site and others, chronic inflammatory diseases are sometimes referred to as the Th1 diseasesThe chronic inflammatory diseases caused by bacterial pathogens..

Treatment on the MP requires a number of years to complete, but the exact duration is determined by degree of illness and any unavoidable immune suppressants to which the patient is exposed.

At its essence, the MP involves five key elements, each of which is supported by the latest insights in molecular science. MP patients must:

1 take a minimum 40mg olmesartan (Benicar) every 4-6 hours;
2 avoid inter-personal stress and environmental immune suppression such as radio frequency radiation;   
3 avoid the consumption of vitamin D, as well as certain other immunosuppressive foods;  
4 wean off any immunosuppressive or potentially immunosuppressive therapies;
5 manage exposure to light, depending on blood levels of vitamin D and photosensitivity (if experienced)

Some MP patients also take varying combinations of pulsed, low doses of specific bacteriostatic antibiotics.

The objective of the MP is to safely activate a highly versatile defense, 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 strengthening the innate immune response, the MP targets the mix of microbes including bacteria, fungi, and viruses that play a role in chronic disease. As pathogens and infected human cells die, they generate 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. (sometimes called a “cytokineAny of various protein molecules secreted by cells of the immune system that serve to regulate the immune system. storm”) and release endotoxins into the body, resulting in a temporary increase in patients' original symptoms. This is known as 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. (generally abbreviated to IP).

The MP is to be administered only by a licensed physician competent in use of the Marshall Protocol. The available evidence for the treatment's effectiveness is described here.

Medications used

The document Marshall Protocol is a one-article summary of key issues related to the Marshall Protocol, especially those relevant to physicians. Many of the topics covered here are reviewed in greater depth throughout the Knowledge Base.

Without active participation of patients on MarshallProtocol.com site, Autoimmunity Research FoundationNon-profit foundation dedicated to exploring a pathogenesis and therapy for chronic disease. does not support or license the public use of this therapy.

Avoidance of vitamin D

Main article: Vitamin D in food

The vitamin D derived from supplements is converted into 25-hydroxyvitamin D (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.), the form of vitamin D which dysregulates 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.), to prevent the innate immune system from functioning properly. Olmesartan (Benicar)Medication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. can only restore the function of the innate immune system when it does not have to compete with 25-D at the VDR binding sites. A 25-D level of under 12 ng/ml provides the opportunity for 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. to work, and allows the immune system to return to proper function.

Patients on the Marshall Protocol (MP) are required to avoid all ingested forms of vitamin D. When the innate immune system returns to proper function, symptoms (immunopathy, or IP) may increase, but without this return to function, there cannot be cure.

A number of foods contain vitamin D, either naturally or because it has been added during processing. It is important to read labels. However, sometimes a label will not state that a food is supplemented with vitamin D.

The only objective way for a MP patient to determine if they have been successful at avoiding ingesting an excess of vitamin D is to periodically retest their serum 25-D to determine if the target of less than 12 ng/ml has been reached and maintained.

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Avoidance of environmental suppression

see Effects of EMF on the body

Immunopathology

Main article: Immunopathology

Immunopathology (often abbreviated to IP) is what patients experience when they fight an infection. In the context of the Marshall Protocol, immunopathology refers to an increase in one's present symptoms of inflammation, or a return of previous inflammatory symptoms. This is caused by cytokinesAny of various protein molecules secreted by cells of the immune system that serve to regulate the immune system. and endotoxins being released from dying bacteria. Occasionally, immunopathology will consist of a new symptom or abnormal lab value due to the occurrence of subclinical inflammation that has been revealed by the Marshall Protocol (MP). Immunopathology is a necessary part of recovery for most patients. The amount of immunopathology a patient experiences on the Marshall Protocol (MP) is correlated with disease severity. Patients who are less sick will have comparatively less strong immunopathology.

Immunopathology is sometimes used synonymously with “herx” or the “Jarisch-Herxheimer reaction.”

Note that three forms of immunopathology are particularly life-threatening and should be handled with an abundance of caution: cardiac immunopathologyAn exacerbation in symptoms of the heart muscle. Requires careful management by physicians., neurological immunopathologyA temporary exacerbation of neurological symptoms due to bacterial death. Requires careful management by physicians., and respiratory immunopathologyA temporary exacerbation in symptoms of the lungs due to bacterial death. Requires careful management by physicians..

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Duration of the Marshall Protocol

Main article: Duration of the Marshall Protocol

Related article: Spontaneous remission is a myth

The exact duration of the Marshall Protocol (MP) depends on any number of factors, including degree of illness, amount of fibrosis, ability of the kidneys to process and expel breakdown material, subclinical inflammation, exposure to unavoidable immune suppressants, and personal preference to remain on Olmesartan.

While someone who is very ill might expect the MP to take five or more years, there is no way to know for sure how long the treatment will take. Due to the nature of immunopathology, feelings of well-being and blood markers of disease tend to be variable in the short-term and improve over the long-term. Also owing to the nature of infection, different symptoms will improve at different rates.

So long as one is responding to olmesartan or olmesartan plus antibiotics with symptoms that wax and wane, there are still bacteria to be killed.

Note that there is no requirement for patients to use antibiotics in order to complete the Protocol. In many cases, patients can make considerable progress on olmesartan (Benicar) alone as the drug increases expression of the body's own antimicrobial peptidesBody’s naturally produced broad-spectrum antibacterials which target pathogens..

If choosing to use antibiotics there is no need to reach the maximum dosages for all antibiotics or do all antibiotic combinations. However, it is considered a good indication of patients' return to health if they no longer experience immunopathology from any antibiotic combination.

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