The Marshall Protocol is an experimental medical treatment being used by a number of doctors throughout the world to treat a variety of chronic inflammatory and autoimmune diseases including chronic fatigue syndrome (ME/CFS), fibromyalgia, multiple chemical sensitivity (MCS), chronic Lyme disease, psoriasis, Crohn’s disease, rheumatoid arthritis, and sarcoidosis. The protocol aims to correct the underlying cause of these conditions rather than simply suppressing or treating individual symptoms.
The Marshall Protocol is a phase II community-based internet study that is monitored by the Food and Drug Administration (FDA) of the United States. The study is supported by the Autoimmunity Research Foundation; a non-profit organization. The Foundation is working with the FDA to make the Marshall Protocol available to patients with a wide range of diagnoses which proponents believe would derive benefit from the treatment.
Patients can visit the Marshall Protocol website and sign up to be part of the ongoing study into the treatment as long as they are under the care of a doctor familiar with the treatment. Those developing the protocol advise against patients undertaking it unsupervised.
Who Developed The Marshall Protocol?
The protocol was developed by researcher Trever Marshall, Ph.D. Marshall has a background in electrical engineering but moved into the medical field working on medical treatment devices as part of his doctoral work. Marshall developed sarcoidosis in the 1970s and pursued research in biomedical engineering to understand the disease. After developing sarcoidosis, a systemic autoimmune disease, which affects lung function as well as negatively impacting lymph nodes and other organs, Marshall began researching the underlying causes of the disease and looking for a potential cure (there is currently no curative treatment available for sarcoidosis). As a result in 2004 he published the paper “Sarcoidosis Succumbs to Antibiotics” in the medical journal Autoimmunity Reviews.
The Theory Behind The Marshall Protocol
The Marshall Protocol is based on the hypothesis that many chronic diseases, termed Th1 illnesses because of how they affect the immune system, are the result of infection by specific types of bacteria that are able to evade the patient's immune system and infect the cells of the body, even cells of the immune system such as macrophages which ordinarily are the first line of defence against infection. The specific bacteria in question are referred to by a number of different names:
Introphagocytic Bacteria - Refers to their ability to remain alive and proliferate undetected by the immune system inside the cells they infect.
L-form Bacteria - Refers to bacteria which are in a particular phase of their life cycle in which they lose their cell wall. The hypothesis with Th1 diseases is that under certain conditions the bactria remain chronically in this L-form. Because they lack a cell wall, many antibiotics are unable to kill L-form bacteria directly and they cannot be detected by standard laboratory tests.
Th1 Pathogens - Simply refers to any pathogens involved with causing chronic diseases according to Marshall's theory.
As well as potentially interfering with the functioning of a patient's cells directly through their presence the Th1 pathogens cause the body's own cells to release inflammatory cytokines (immune chemicals) which cause fatigue, pain, inflammation, and the other symptoms associated with Th1 illnesses.
The reason these Th1 pathogens are able to infect and proliferate in the patient according to Marshall is a result of abnormalities in vitamin D metabolism and specifically the inactivation of the vitamin D receptor (VDR) which switches on the innate immune system and protects us from infection. Activation of the VDR also increases production of antimicrobial peptides which kill pathogens such as viruses, bacteria and fungi. In those infected with TH1 pathogens it is thought that substances they produce block the VDR and cause the innate immune systm to be switched off. This allows the Th1 pathogens to proliferate and also allows other infections to occur; childhood viruses are reactivated, Candida infections become common, and mycoplasma are able to infect the patient; a common pattern in chronic fatigue syndrome and other Th1 illnesses. Importantly, and perhaps surprisingly, the inactive form of vitamin D (25-D) also inactivates the VDR and leads to this immune system malfunction so vitamin D consumption in foods and supplements by those with TH1 illnesses can actually worsen their condition according to Marshall's theory.
In healthy individuals, the active form of vitamin D (1,25-D), in contrast to 25-D binds to and activates the VDR thus switching on the innate immune response and protecting us from infection. Unfortunately in those with Th1 illnesses who have 25-D and bacterial proteins blocking the VDR, 1,25-D is forced out of the receptor and into the surrounding tissues.The end result is that 1,25-D levels rise to an abnormally high level. At these levels 1,25-D begins to bind with other receptors, displacing the substances that are supposed to bind them, and causing dysfunction in many body systems. Interestingly the receptors affected are those for adrenal (cortisol, DHEA), thyroid (T3), and sex hormones. Problems with the functioning of these hormones are well established in chronic fatigue syndrome, fibromyalgia and other Th1 illnesses and result in symptoms such as fatigue, inability to deal with stress, sleep problems, and body temperature dysregulation.
So, in summary, Th1 illnesses result from infection with Th1 pathogens due to vitamin D abnormalities and the inactivation of the innate immune system due to blockage of the VDR. In patient's with TH1 illnesses 25-D appears low on lab tests which prompts doctors to assume vitamin D deficiency when in fact there is an excess of the active form of vitamin D. 1,25-D is often not tested for but if it were levels would be found to be abnormally high according to Marshall and proponents of his research.
The Marshall Protocol Treatment
The aim of the Marshall Protocol is to correct the dysfunction in vitamin D metabolism, reactivate the innate immune system, and eradicate both the TH1 pathogens and secondary infections such as viruses, common bacteria (with a cell wall) and fungi. This is achieved in the following ways:
Olmesartan (Benicar) - Patients take this drug which is known as an 'angiotensin II receptor antagonist' and is commonly used to treat high blood pressure. It is used in the Marshall Protocol because it is able to bind and activate the VDR by pushing 25-D and bacterial proteins out of the receptor.
Avoid Foods Rich in Vitamin D - Levels of 25-D in the body are lowered by avoiding the kinds of vitamin D present in various foods. Foods high in vitamin D include fish, seafood and various plant seeds including sunflower and pumpkin. Patient's must also avoid nutritional supplements that contain vitamin D such as fish oil supplements.
These two measures are aimed at reactivating the innate immune system and allowing the body to produce the anti microbial peptides. The immune system is then able to kill the Th1 pathogens and is once again able to manage viral and other secondary infections.
Pulsed, Low-Dose Antibiotics - Used in this way antibiotic drugs are able to greatly weaken the Th1 pathogens so that the patient’s own immune system is then able to destroy them (after being activated by the two measures above).
Sun/Bright Light Avoidance - Since vitamin D is made in the skin when exposed to sunlight and also to a lesser extent in the eyes exposed to bright light patient's must also avoid these. If they do not their 1,25-D levels will rise, intefering with the other parts of the protocol and causing symptoms to worsen due to hormonal effects.