Marshall Protocol
…part 2 of Slowburn Treatment for Chronic Disease
UPDATE: Science-Based Medicine (no relation) has a nice balanced post on the Marshall Protocol in which it is pointed out that it has all the tell-tale trademarks of a SCAM (Spurious Complementary and Alternative Medicine):
The Marshall Protocol has all the characteristics of modern alternative therapy: a single discoverer, a hitherto undiscovered biology, an unproven therapeutic intervention and one of the most aggravating issues in SCAM’s: Taking a scientific truth the size of a molehill and transmogrifying it into a Cascade Range of exaggerated disease etiology and treatment. Unlike most SCAM’s, however, as best as I can tell Dr Marshall does not seem to be in the business of making a business from his discovery, although he does have patent applications for his protocol.
The Marshall Protocol was originally designed to treat sarcoidosis, an inflammatory condition, and utilised the drug Benicar, subsequent claims that it could also treat non-inflammatory conditions such as CFS and fibromyalgia, smack of the kind of reaching out for a panacea that is common in efforts to find cures for what conventional medicine considers incurable. Indeed, the list of diseases supposedly caused by L-form bacteria continues to grow and includes the spurious condition, mania.
One of the underlying principles of the Marshall Protocol is that patients must avoid vitamin D. Apparently, the patient’s immune system cannot kill L-form bacteria effectively until vitamin D is eliminated from their diet so they must also avoid sunlight as much as possible.
What we refer to as vitamin D is actually a steroid. Marshall argues that his molecular models show that the precursor form of vitamin D will actually inhibit the vitamin D Receptor and consequently the innate immune system. It is possible that any “feel good” effects are simply a result of L-form bacteria surviving and so no spewing out their toxins when they die. But, none of this has been tested or proven in vitro and certainly not in vivo.
A deficiency of vitamin D has been implicated recently as a causative agent in certain forms of cancer, then a treatment that perhaps reduces vitamin D levels below safe thresholds for long periods may indeed effect a resolution of chronic symptoms of one disease or another, but could concomitantly increase one’s cancer risk. That could be a red herring, however, it is thought that vitamin D will temporarily decrease a patient’s level of inflammation but only in the short-term. In the meantime those L-form bacteria could have a field day, if they actually exist.
There is certainly the feeling that long-term, low-level use of antibiotics among individuals with various non-specific disorders could be storing up real problems for the immune system by allowing low levels of real pathogenic bacteria to evolve resistance. And, that’s not to even mention probiotics, which millions of people imbibe on a daily basis in the belief that they will boost levels of so-called good bacteria.
A paper in the Lancet in February 2007, suggested that prescribing antibiotics in healthy volunteers is a very risky strategy. Macrolide [antibiotic] use is the single most important driver of the emergence of macrolide resistance, the researchers conclude, physicians prescribing antibiotics should take into account the striking ecological side-effects of such antibiotics.
Proponents of the Marshall Protocol point out that it uses carefully selected, extremely low-dose antibiotics. Particularly minocycline, which is used long-term for acne treatment and has not evolved resistance yet. Indeed, minocycline is actually one of the few antibiotics active against MRSA (multiple-resistant Staphylococcus aureus) that has not triggered resistance, although it is only weakly active.
Claims that go against the grain of conventional medicine often take years to filter through, especially if those claims suggest a simple answer to a wide range of illnesses. But, more often than not those claims turn out to be nothing more than a SCAM (spurious complementary alternative medicine). We have always sought a panacea, an elixir of life to cure all our ills. They don’t, unfortunately, exist. I suspect the Marshall Protocol, with its bizarre claims about naked bacteria and vitamin D will fall at the first hurdle when properly tested.
Back to the introduction.
66 Responses to “Marshall Protocol”
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July 25th, 2009 at 6:12 pm
Hi David,
Thanks for fishing out the better version of my post yesterday.
Looking back on my comment, I didn’t mean to imply that sick people can not recover by using the MP in it’s current state. I just wanted to stress the that MP is not a quick fix and for those people who have been ill for some time, decreasing bacterial load requires time and patience.
For example, I started the MP with a very serious case of CFS. It took me about four years to really get my life back and I dealt with some really difficult periods of IP. Then again if I hadn’t done the MP, I’d still have been sick during those years and I’d still be sick right now..and for the rest of my life.
However, my Mom started the MP right after a diagnosis of Sjogren’s syndrome, before she had taken any immunosuppressive medications or supplements. Although she experiences IP it is so mild that she can still work out for several hours and day, dances salsa, tango and is able to keep up her pre-MP life with only some harder days here and there. She’s doing very well and has not been on the MP for very long.
So the time scale needed to recover from the MP and the amount of IP one must experience to recover greatly differs from person to person. We cannot guarantee at all that everyone who starts the MP will be able (or willing) to tolerate their IP, although many of our sickest subjects have been able to improve and/or recover.
Of course, I still anticipate that what we now call the MP will evolve over time.
Best,
Amy
July 25th, 2009 at 8:42 am
Many thanks Amy. I fished out your comment from Akismet where it had been filtered initially (more than the standard links embedded, you see?)
July 25th, 2009 at 8:40 am
That’s excellent to know Frans, Joyce.
July 25th, 2009 at 3:00 am
Hi All,
Sorry that this comment originally got posted to the wrong place (I think!)….
Is the MP a panacea? A better initial question might be, “what kind of evidence is growing to support as Marshall hypothesizes that chronic pathogens are the driving force behind nearly every chronic inflammatory condition?”
Such evidence is indeed growing as the Human Microbiome Project and independent organizations like the Venter Institute continue to use new molecular technology to sequence an ever-greater number of previously unknown bacterial species that reside in the human body – bacteria with pathogenic characteristics. Areas of the body once considered to be completely sterile have been shown to harbor these microbes.
For example, Stanford researchers recently discovered 18 different taxa in the amniotic fluid of women who give birth prematurely. Furthermore, the Marshall Protocol is based largely on the hypothesis that many of these bacteria survive by dysregulating the VDR, a type I nuclear receptor that controls the bulk of the body’s antimicrobial peptides and subsequently the innate immune response.
When David wrote this article, Marshall had identified a group of biofilm bacteria with these properties. But, just over the last few months, research has shown that HIV, Borellia, EBV, and M. Tb all dysregulate the VDR, providing increasing strength for Marshall’s hypothesis.
I encourage you to read more about this topic in a paper, we (I am part of Dr. Marshall’s research team) recently published in Autoimmunity Reviews.
http://autoimmunityresearch.org/transcripts/AR-Proal-Metagenome.pdf
But back to the panacea question. The Marshall Protocol is based on the hypothesis that these different bacteria whose presence overlaps in different chronic disease states have similar properties that allow them to be targeted in the same manner, namely the use of a potent VDR agonist to prime the immune system itself with the help of biofilm-targeted subinhibitory antibiotics to target a wide range of chronic bacteria.
This is plausible. For example, penicillin is one drug but can be used for a multitude of conditions. Is that a panacea? Not really. It has broad applicability.
If you want data on recovery rates, Tom Perez presented data at the 2008 International Congress on Autoimmunity:
http://autoimmunityresearch.org/transcripts/ICA2008_Transcript_TomPerez.pdf
But if you want more definitive data, you’ll have to wait a bit longer. Phase III trials of the Marshall Protocol are commencing shortly at West China Hospital, the largest clinical center in the world and the center for the Cochrane Collaboration:
http://www.eurekalert.org/pub_releases/2009-07/arf-sat072109.php
The first results will hopefully presented at Ljubljana, Slovenia in 2010.
http://www2.kenes.com/autoimmunity2010/Pages/Home.aspx
Remember though that I personally believe the Marshall Protocol can help people recover from a wide range of diseases, the word panacea conveys the idea that the treatment is easy like popping a pill. On the contrary, seriously ill patients are generally on the MP for years before they experience improvement, and as they they progress they must deal with difficult rises in inflammation caused by bacterial death. Some patients simply have too high a bacterial load to deal with these bacterial die-off reactions (called immunopathology). So, the MP in its current state cannot work for them.
Therefore, the primary goal of our non-profit foundation and our colleagues at West China Hospital is to figure out ways to mitigate immunopathology with compromising the immune response. Also, we continue to stress that the MP should be used as early as possible after diagnosis or even as a preventative. Immunopathology reactions are barely a problem if people start the MP sooner rather than later before their bacterial loads have escalated out of control and their illness level mirrors that of someone with end-stage cancer.
Hope this helps,
Amy
July 25th, 2009 at 1:27 am
As you can see here: http://www.cochrane.org/contact/centres.htm , West China hospital is officially enrolled in the prestigious evidence-based Cochrane Collaboration.
At the above site’s home page, I am sure you can read all about what that entails.
It is not something they are claiming without a basis, clearly.
You use the rather pejorative term, panacea, which seems to prejudge it. I don’t know if you intend to do that. Many of us have seen evidence of effects on numerous illnesses and conditions. But of course, establishing how many conditions it will work on, to the satisfaction of the scientific community will take time and a lot of funding.
It may seem too good to be true, but if chronic persistent bacterial infections have been largely missed or ignored, it makes sense that they may underlie a large proportion of the unexplained common chronic diseases. I think of biofilm and cell wall deficient bacteria as analogous to a new class of organism — evolved to persist, often in a latent form. To me, it makes a lot of sense that they could explain many diseases and this is supported by people’s responses to the Marshall Protocol.
I feel a bit like those people must have felt who first discovered viruses. They thought most things must be caused by them. But when it comes to many chronic diseases, viral causes have been studied for decades and yielded very little. A growing minority of scientists think bacterial causation revealed by more advanced methodology will end up as the answer.
Joyce
July 25th, 2009 at 1:01 am
David,
On this page at Cochrane.org (scroll down a bit), you will find this exact text:
Chinese Cochrane Centre
Mingming Zhang
Chinese Cochrane Center
West China Hospital
Sichuan University
- http://www.cochrane.org/contact/centres.htm
I Hope Cochrane doesn’t take offense to their own title ;-)
Sincerely, Frans