UUSI HOITOMUOTO? KUUMA PUHEENAIHE

[Bb]

Lähettäjä: Soijuv Lähetetty: 28.4.2004 10:49

Tämän hetken "kuumin" puheeaihe borreliarintamalla on tulehduksellisten prosessien estäminen Benicar-lääkkeellä (alunperin verenpainelääke). Marshall-niminen lääkäri on havainnut sillä olleen merkittäviä vaikutuksia sarkoidoosia sairastaville. Sarkoidoosissa ja borrelioosissa on paljon samankaltaisuuksia, joten jotkut borrelioosia sairastavat ovat olleet yhteydessä Marshalliin ja aloittaneet hänen ohjeidensa mukaisesti Benicar-lääkityksen. Jotkut ovat sanoneet oireidensa helpottaneen huomattavasti jo muutaman tunnin kuluttua lääkkeen ottamisesta.

Tässä tietoa Marshallin ohjeista. Ohjeet on annettu sarkoidoosia sairastaville, joten se ei välttämättä kaikin osin ole sama borrelioosia sairastaville (esim. useat borrelioosia sairastavista eivät tule huonompaan kuntoon auringonvalossa). Sarkoidoosin tavoin borrelioosia pidetään Th1 sairautena. ARB (esim Benicar) estää tulehduksia aiheuttavien sytokiinien tuotannon estämällä Angiotensin II tyyppi I reseptorit. Sen seurauksena TNF alfan vapautuminen estyy. Artikkelin mukaan lääke auttaa hyödyntämään antibiootteja paremmin. Esim. sellaiset henkilöt jotka saavat vakavia herxheimer reaktioita saattavat kärsiä tulehduksellisista kudosvaurioista. Benicar estää näiden vaurioiden synnyn. Artikkeli antaa paljon ajattelemisen aihetta.


HOW TO START THE MARSHALL PROTOCOL

The First Three Months
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http://www.sarcinfo.com/phase1.pdf

5. Begin taking Benicar 40mg every eight hours (every six hours is preferable) to interrupt the inflammatory cycle and reduce the severity of potential Herxheimer reactions (For example; 6am, 2pm,10pm or 6am, noon, 6pm, midnight) Benicar/Olmetec (Olmesartan/ Medoxomil) is the only ARB that works properly so ask your doctor to write 'no substitutions' on the prescription. You should not take a Benicar/diuretic combination-check the bottle to make sure the label does NOT include the
words 'hydrochlorothiazide' or 'HCT'. If you live in a country where Benicar is not yet available, ask on the SarcInfo phorum about how you might legally import Benicar. Continue to monitor your blood pressure and symptoms to reassure your doctor that the expected, mild hypotensive side effect of Benicar is not affecting you adversely.

You MUST use Benicar when you are on the Marshall Protocol.

Benicar blocks the production of all inflammatory cytokines by blocking the Angiotensin II Type I receptors. This inhibits the release of TNF alpha from the sarcoidosis Th1 immune reaction and also has a profound, direct effect on the actual intra-cellular bacteria. Benicar is a CRITICAL component of the Marshall Protocol. Without it, the immune system may not be able to use the antibiotics to kill the bacteria. This is evident in those patients taking antibiotics who do not experience a Herxheimer reaction until they take Benicar. Other patients experiencing severe Herxheimer reactions may suffer tissue damage from the inflammatory reaction without the protection that Benciar provides. For these reasons, we cannot endorse the use of this guideline unless Benicar is prescibed at the recommended dosages. The success of this treatment plan is vitally dependant on using these antibiotics with Benicar.

6. If you are taking Prednisone, work with your doctor to begin or to continue the weaning process.

Antibiotics will not be effective while you are taking steroids to suppress your immune system. Benicar will help greatly with this weaning process. If you are taking Methotrexate, it is also important to wean from this medication as it is an an antibiotic of the DHFR antagonist class, and it will interfere with your antibiotic therapy.

7. After at least one week of taking Benicar at the correct dosage, begin taking minocycline (do not substitute with doxycycline, only minocycline kills the microbes of sarcoidosis). Start at no more than 25mg every other day. If you have weaned down to 8mg of Prednisone a day you may begin
minocycline- but continue weaning until the process is complete. Continue the Benicar every eight hours. Be alert for the Herxheimer reaction. This is an increase in your present sarcoidosis symptoms or a return of your previous sarcoidosis symptoms that is caused by endotoxins being released by the dying bacteria. Your Herxheimer reaction will be unique to your sarcoidosis systemic involvement. Some patients get muscle pains, others experience increased fatigue or shortness of breath, etc.. It typically begins 1-24 hrs after your minocycline dose and usually dissipates 1-48 hrs before your next antibiotic dose. If you find that the herxheimer shock is too severe, do not take the next scheduled dose of antibiotic and increase your Benicar frequency to as much as every four hours to make sure the Herxheimer shock does not get worse. Do not hesitate to seek medical attention if you think you are in trouble.

8. Increase the (every other day) minocycline slowly by 25mg increments. Allow a week or more between increased doses to make sure your Herxheimer reaction is not more than you wish to tolerate. Do not try to 'speed up' therapy by using a higher dose of minocycline than the minimum needed to give you Herxheimer. These are very slow growing bacteria and there is no need to hurry. The dose of antibiotic that you can tolerate may change (both up and down) during the course of therapy.

Continue to take the Benicar 40mg at least every eight hours because it is a prophylactic, not a palliative medication. Although minocycline is reported to be less likely to cause yeast infections than the other tetracyclines, it is advisable to take a daily quality probiotic such as Lactobacillus acidophilus and bifidus capsules.

9. Once your bacterial load is significantly reduced as indicated by little or no Herxheimer reaction from taking 100mg of minocycline every other day, other antibiotics will be carefully added to continue the bacteriocidal effectiveness. Because the addition of another antibiotic can cause severe Herxheimer reactions, it is imperative that a cautious, detailed ramping protocol be followed. When you are at this stage, which typically takes at least three months, consult your doctor and ask for further instructions on the SarcInfo phorum.

10. Just as Tuberculosis takes 1-2 years to cure, antibiotic therapy often takes a year or more to induce remission in sarcoidosis. Remission is indicated by resolution of symptoms, absence of Herxheimer reaction and a return of the bloodwork inflammatory markers ACE, CRP, Triglycerides, and Alkaline Phosphatase to the low end of normal. The % Lymphocytes should increase, back into the normal range. The 1,25-D should be between 25 and 35 pg/ml measured over (at least) a 6 months interval. Signs of inflammation on Xrays, CT and MRI Imaging should be resolved.

11. Less intense antibiotic therapy is recommended for the same period of time it took to induce remission. Continued use of Benicar may be desirable to take advantage of its anti-inflammatory benefits. Periodic antibiotic dosing may be necessary indefinitely to maintain low mycoplasma levels and to avoid a sarcoidosis relapse. When the time comes for others to have their annual flu vaccination you should spend a week or two killing any new CWD bacteria which have entered your body during that year.

References

[1] Available Papers for Physicians

a. Marshall TG, Marshall FE: Sarcoidosis succumbs to antibiotics - implications for autoimmune

disease. Autoimmunity Reviews, in press, doi10.1016/j.autrev.2003.10.001

Available from URL http://dx.doi.org/10.1016/j.autrev.2003.10.001 Accessed Nov 19, 2003

b. Marshall TG, Marshall FE Antibiotics in Sarcoidosis - Reflections on the First Year. JOIMR 2003;1

(3)2 Available from http://www.joimr.org/phorum/read.php?f=2&i=38&t=38

c. Cantwell AR Bacteria in Sarcoidosis and a Rationale for Antibiotic Therapy in this Disease.

JOIMR 2003;1(5)1 Available from http: //www.joimr.org/phorum/read.php?f=2&i=48&t=48

d. Marshall TG, Marshall FE The Science Points to Angiotensin II and 1,25-dihydroxyvitamin D.

JOIMR 2003;1(2)3 Available from http://www.chestjournal.org/cgi/eletters/123/1/18

e. Marshall TG, Marshall FE New Treatments Emerge as Sarcoidosis Yields Up its Secrets. Clinmed

2003 Jan 27;2003010001 Available from http//clinmed.netprints.org/cgi/content/full/2003010001

f. Dosing Issues When Using Minocin/Minocycline to Treat Sarcoidosis.

Available from http://www.sarcinfo.com/minocin.htm

h. Vitamin D and Calcium in Sarcoidosis.

Available from http://www.sarcinfo.com/calcium.htm

h. Mangin M Observations of Jarisch-Herxheimer Reaction in Sarcoidosis Patients JOIMR 2004;2(1)

1 Available from http://www.joimr.org/phorum/read.php?f=2&i=51&t=51