- For Patients
- Introduction to the Marshall Protocol
- Length of the MP
- Immunopathology
- Managing immunopathology
- Food and drink
- Light restriction
- Vitamin D metabolite calculator - get feedback on vitamin D results
- Therapeutic probe - best method for determining MP suitability
- Starting the Marshall Protocol
- Resources for patients
- Marshall Protocol summary
- Palliative vs. curative treatments
- Patient interviews on Bacteriality
- Non-MP treatments
- Glossary
- The Protocol
- Marshall Protocol summary
- Publications and presentations
- Science behind immunopathology
- Science behind olmesartan (Benicar)
- Safety of olmesartan
- Resources for physicians
- Vitamin D metabolite calculator - get feedback on vitamin D results
- Therapeutic probe - best method for determining MP suitability
- Physicians' concerns about the MP
- Notice for emergency medical personnel
- The Pathogenesis
- Publications and presentations
- Science behind Marshall Pathogenesis
- Microbes in the human body
- Successive infection and variability in disease
- Autoimmune theory of disease
- Science behind vitamin D
- Metabolism of vitamin D and the VDR
- Th1 Spectrum Disorder - how chronic inflammatory diseases are related
- Transmission of bacteria and onset of chronic disease
- Evolutionary perspective on disease
- Incidence and prevalence of disease
- Evidence that chronic disease is caused by pathogens
- Diseases
- Foundation
- Related Sites
Table of Contents
Therapeutic probe
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Used in the context of the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP), a therapeutic probeA brief trial of the Marshall Protocol to see if it will generate an immunopathological response. The "gold standard" for testing whether a patient is a good candidate for the MP. refers to a brief trial of the MP, in which patients take regular doses of olmesartan (Benicar)Medication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. and restrict consumption of vitamin D. The presence of a positive treatment response is taken as an indication that a patient is sick with Th1 diseaseAny of the chronic inflammatory diseases caused by bacterial pathogens. and that the MP is a treatment option for that disease. Although there are other factors and variables, which can strongly suggest the presence of Th1 disease, the therapeutic probe is currently the best method for determining if the MP may be suitable for a patient.
In the context of the therapeutic probe, there are at least three responses or types of responses which indicate that continued treatment with the MP is warranted:
- photosensitivityAbnormal sensitivity to sunlight and bright lights. Also referred to as "sun flare" or "light flare." – Even if patients have never been light sensitive before, they may find lights to be too bright for comfort. Patients are cautioned that photosensitivity (and other symptoms) can occur in response to a withdrawal of typical levels of light exposure, even before the use of 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. is commenced.
- noticeable spike in symptoms – Replacing 'vitamin' D in the VDRThe Vitamin D Receptor. A nuclear receptor located throughout the body that plays a key role in the innate immune response., Benicar ensures reactivation of 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., allowing destruction of pathogenic bacteria and viruses. The effect of a strengthened immune system response is 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 feels bad because the killing of bacteria generates cytokinesAny of various protein molecules secreted by cells of the immune system that serve to regulate the immune system., endotoxins, and nitric oxide.
- noticeable relief in symptoms – As an ARBA drug which is an angiotensin receptor blocker. One of the ARBs is olmesartan (Benicar). Not all ARBs activate the Vitamin D Receptor., Benicar has profound anti-inflammatory effects, which manifest in a reduction in pain, fatigue, and other symptoms of Th1 disease.
Symptoms which wax and wane in tandem with an every-other-day administration of antibiotics are an especially strong indication of Th1 disease.
It is expected that the way a patient responds to the MP will change over time.
Instructions
Four to eight weeks is typically enough time to know if the therapeutic probe will show that a patient's immune system is responding to Olmesartan. In the interests of safety, members who commence a therapeutic probe should be presumed to have Th1 disease and should take all the precautions that anyone starting the treatment might take.
The therapeutic probe consists of three elements:
- Restriction of vitamin D – Limit consumption of foods and supplements which contain vitamin D. Restrict skin and eye exposure to light. The level of 25-hydroxyvitamin-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. in the bloodstream should be below 20ng/ml before initiating the therapeutic probe. If higher levels are present, please seek suggestions from the community at the MP websites. Note that discontinuing vitamin D may cause a patient to temporarily feel more symptomatic due to a withdrawal effect.
- Regular doses of olmesartan medoxomil (Benicar) – Take 40mg of Benicar every six hours. If the response to treatment is especially strong, the patient and may need four hourly dosing for palliation. When Benicar is first taken, the body may rebalance hormones. This symptom often diminishes after a few days, but a period longer than two weeks may be required with some individuals. Members who decide to remain on Olmesartan because of an immunopathology response may need to quickly buy or borrow a pair of NoIRSpecial sunglasses worn by Marshall Protocol patients to block light. glasses, which block all infrared light, something most sunglasses do not.
- Only if necessary to elicit a response, add pulsed low doses of minocycline - Begin with 25mg every other day and ramp by 25mg increments up to a maximum of 100mg every other day.
Absence of a response in healthy people
In healthy people, the therapeutic probe will have a minimal effect, if any. Benicar is more commonly used as a hypotensive medication, and it is a mild one at that, typically reducing blood pressure by 12mm Hg. Minocycline is widely prescribed as an anti-acne medication and generally has few side effects in those without preexisting Th1 disease.
Challenge of diagnosis
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As any clinician who treats chronic disease will probably agree, it is often very difficult to diagnose chronic illness with absolute certainty. While chronic diseases share a single underlying pathology, there is yet to be a test, which measures a patient's general pathogenic bacterial load.
The vitamin D metabolites may offer one indication of disease. Patients sick with Th1 disease often have a low 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. coupled with a high 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.. However, this is not always the case. A variety of factors could skew these results. A patient could be consuming high levels of 25-D or the D metabolites test could be mishandled, which is more common than one might initially suppose.
The practice of treating a disease in order to diagnose it may seem counterintuitive, but it is actually quite common in medicine. If someone has pain in his big toe but blood tests are inconclusive, the doctor may have the patient take a medication for gout. If the pain goes away, the patient is presumed to have gout and the medication is continued to prevent future episodes. When a patient who complains of symptoms suggestive of a bladder infection is given an antibiotic without preliminary urinalysis and culture, that antibiotic acts as a therapeutic probe. If the bladder symptoms are relieved, the patient is said to have had cystitis caused by bacteria susceptible to that antibiotic.
The time-honored therapeutic probe is the most effective “acid test” for Th1 diseasesThe chronic inflammatory diseases caused by bacterial pathogens.. Any other diagnostic tool will have both false positives and false negatives. If the patient starts the MP, and experiences immunopathology for themselves, then not only is it confirmation that the problem was/is occult bacteria, but also proof positive to the patient that they are on the correct track. That is why we tend to suggest the MP even when the D data is uncertain.
Your physician makes a risk-benefit analysis - evaluating the risk of the ARB and antibiotics (effectively zero to healthy individuals) with the degree of disability you are experiencing from your illness, and his or her expectation of whether the illness will get worse or better if left alone.
Trevor Marshall, PhD
Other versions of the therapeutic probe
Patients whose physicians are unwilling or reluctant to prescribe the medications necessary for a therapeutic probe can try a “mini-probe,” one without Benicar or antibiotics. A mini-probe involves avoiding all sources of vitamin D including sun exposure. A change in symptom severity can strongly suggest a Th1 disease process at work.
Note that patients whose physicians are ultimately unwilling to prescribe the MP can request a list of other physicians in their area.
25-D and other confounding variables
Patients whose level of the vitamin D metabolite, 25-D is above a certain threshold, 25ng/mL, may not be able to kill pathogenic bacteria even with the help of antibiotics. For this reason, patients may want to measure 25-D prior to the start of the therapeutic probe as a potential confounding factor.
Patients taking corticosteroids and other immunosuppressants may find their immune response to be muted. Typically, any patient with a condition for which corticosteroidsA 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. are prescribed is an ideal candidate for the MP.
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