Exploring chronic disease
31 Oct 2007
Greg Blaney, MD, graduated from the University of Ottawa in 1974. Following internship at Edmonton General he joined a Community Health clinic in Ottawa. From 1987 to 1990 he was a teaching assistant in the College of Osteopathy of the CME program at Michigan State University, having trained in both conventional and manual medicine during the first two decades of his career. He went on to also gain competence in Acupuncture and Homotoxicology, was a medical advisor to the LaLeche league, the Childbirth Education Association, the RCMP and the Bank of Canada. He lectured in the University of Ottawa’s Residency program, and its Masters program in nutrition. Dr. Blaney is currently using Autoimmunity Research Foundation’s Marshall Protocol to save the lives of hundreds of patients with a wide variety of chronic inflammatory diseases.
Before learning about the Marshall Protocol my work had evolved into a chronic pain practice, where I focused on osteopathy and trigger point injections. Despite the fact that some people seemed to benefit somewhat from these therapies, I always had a certain group of patients with chronic symptoms that simply did not respond to anything I tried. I had one patient who was actually aggravated by most of these therapies and displayed multiple symptoms in different areas of her body that did not respond to treatment. At the same time, I was also treating a woman who had been diagnosed with Lyme disease ten years before becoming my patient, however her symptoms had gone into temporary remission. Although she had been told by another doctor that she was “cured”, when she was in a car accident, all of her Lyme symptoms returned. After being tested, she was once again positive for Lyme.
I started to investigate Lyme disease and it seemed very feasible that bacteria could be persisting in my patients who had tried everything but were not improving. I decided to attend the International Lyme and Associated Disease Society (ILADs) Conference where Dr. Marshall was scheduled to give a small presentation. Before listening to Dr. Marshall speak, I attended a talk about the standard ILADs treatment for chronic Lyme disease. Their advice was to give patients with chronic Lyme disease high-dose intravenous antibiotics. I wasn’t impressed by the approach because it seemed like administering antibiotics in this manner could have numerous toxic side effects. Now, I also realize that many of the antibiotics used by doctors that follow these recommendations actually foster the growth of L-form bacteria (the beta-lactam antibiotics). Furthermore, I wasn’t impressed with the data they had compiled about high-dose antibiotics and Lyme disease. In the long run, no patients actually seemed to be getting better.
In contrast, Dr. Marshall’s presentation seemed to make a lot more sense. He spoke about L-form bacteria and about how levels of the hormone/secosteroid “vitamin” D become dysregulated in people with inflammatory disease. At the time, I was suffering from quite a few ailments – cardiac arrythmia, low-level psoriasis, restless leg syndrome, general fatigue and some loss of cognitive function. When I came home from Dr. Marshall’s talk I decided to test my own vitamin D levels. My wife was suffering from chronic jaw and sinus problems so I tested her D levels as well.
Sure enough, both of us displayed dysregulated levels of the two vitamin D metabolites, 25-D and 1,25-D. Consequently, I decided that my wife and I should be guinea pigs and start the MP ourselves, which we did. After that point, I also started to check my patients’ D metabolite levels and test them for tick borne pathogens and Chlamydia. Nearly all of them displayed dysregulated levels of vitamin D and tested positive for different species of bacteria. When I looked at their bloodwork they also showed other markers of inflammation. I decided to start many of these patients on the MP.
I’ve had people with numerous inflammatory conditions do very well on the MP. I’ve had patients with arthritis, fibromyalgia, cardiovascular disorders, hypertension, Raynaud’s syndrome, Chronic Obstructive Pulmonary Disorder (COPD), chronic headaches and migraines, and other diseases respond very well. I’ve also had patients with mental afflictions such as obsessive compulsive disorder, anxiety disorders and depression do very well.
I’ve noticed that people with CFS are definitely able to recover as well, but it usually takes them a longer time to note signs of improvement – sometimes well into their second year on the treatment. I find that people with psoriatic arthritis also have severe immunopathology reactions. The people I find most challenging to treat with the MP are those with inflammatory bowel disorders. Not that the MP won’t work for them, but sometimes their immunopathology is hard to manage.
The patients that have the most spectacular initial responses to the MP are often those with severe headaches. I’ve had some patients whose headaches disappeared the moment they started Benicar. I’ve found that many patients with rheumatoid arthritis (RA) also show marked reduction in inflammation after just a few months of MP therapy. It’s easy to see these improvements because they are reflected in the patient’s bloodwork. For example, I can look for drops in C-reactive protein and sedimentation rate. At the moment I have an RA patient who is also being monitored by another rheumatologist. This doctor was initially skeptical of the MP, but I feel that when he sees how this particular patient’s bloodwork has improved, it will be easier for me to cajole him into mentioning this case in some of his papers. Hopefully he may also talk about the treatment with other patients. He just won’t be able to deny the signs of improvement.
Over the long run, what I’m usually most impressed with is the universal improvement in cognitive function that I see in nearly all my patients as they progress to later stages of the MP. The MP is such a safe way to improve mental function.
For one thing, ARB medications have been used in medicine for a long period of time and have not been shown to cause any significant adverse reactions. It is pretty much universally accepted that these medications are safe to use. In fact, at the moment, ARBs are being administered to some cancer patients at doses that are drastically higher than those used by the MP – around 800-1000 mg daily. The standard MP dose is 240 mg a day. Even at these high doses used in cancer, ARBs have not been shown to have any adverse side effects.
The MP antibiotics are taken in very low, pulsed, doses. There is no data showing that antibiotics taken in this manner pose any danger to the patient, and clinically no adverse events have been reported among patients taking antibiotics in this fashion. Some people mistakenly interpret changes in immunopathology as adverse events, without understanding that a rise in symptoms is a necessary part of the healing process.
For more on immunopathology see the Phase 1 Marshall Protocol guidelines.
All of them that are willing to do the treatment. It’s pretty amazing how many people out there are walking around with L-form bacteria and could be helped by the MP. When I tell patients about the Marshall Protocol I say, “This treatment is safe and effective, but you also have to be willing to deal with immunopathology and this is not a short-term process.” This makes some people shy away. Some are intent on searching for a quick fix. For example, I have a patient with back symptoms that I know are the result of inflammation, but he’s not interested in the MP because it requires such a commitment.
But when it comes down to it, I feel that MP will work for anyone who has a chronic condition, unless of course that condition is the result of a catastrophic injury. All chronic symptoms are the result of L-form and biofilm bacteria draining the ability of the immune system to function correctly. These bacteria are always percolating. The science behind the MP is extremely sound. Not that it can’t evolve and improve but I have no doubts about the treatment.
Since Benicar is marketed as a blood pressure lowering medication, many doctors don’t think outside the box and realize that it has other very important effects that allow it to reduce inflammation and stimulate the immune system. They resist the idea that patients can maintain a normal blood pressure while still taking the ARB.
Many doctors are also afraid that long-term use of antibiotics will lead to resistance. In reality this isn’t an issue. When antibiotics are pulsed, the concentration of the antibiotic in the tissues is always changing and there are different levels of antibiotic in the body at any one point in time. Because the level of antibiotic is never constant, it is impossible for bacteria to develop resistance mechanisms. The effectiveness of pulsing a substance in order to eliminate the ability of a pathogen to develop resistance has been demonstrated with pesticides. It has been found that disseminating pesticides in spurts rather than in a continuous fashion keeps the pathogens in crops from becoming resistant to the chemicals in the pesticide. Plus, we continue to find that when patients take minocycline, it continues to generate strong changes in immunopathology even after they have been taking the drug for many years.
I find that general practitioners are generally a little more open to the MP, but most of them feel they are too busy to actually sit down and fully read all the literature pertaining to the treatment. The MP is a very complex treatment so there’s a lot of research to be done if one is to understand it correctly. Specialists are difficult to convince because they tend to be rather narrow-minded. If the MP doesn’t invoke or make reference to something they have heard at a recent conference, they tend to ignore the possibility that it might work. It seems that many doctors are just hardwired to resist innovation and change.
It’s also hard for some doctors to accept the idea that the patient must avoid vitamin D. But I feel these concerns will become less frequent as more doctors realize that we’re telling patients to avoid a hormone/secosteroid, not a vitamin. We need to stop referring to “vitamin D” as a vitamin. I tell my patients, “What would you say if I told you to add testosterone to your food? You would tell me I’m crazy!” Adding “vitamin” D to the food supply is as ridiculous as telling the public to take large amounts of any other hormone. If you ingest massive amounts of any hormone or steroid it’s clearly going to throw off the body’s natural state of homeostasis. I have to say it boggles my mind that when molecular biologists have clearly recognized that vitamin D is not a vitamin doctors are still thinking of it as a nutrient rather than a hormone/secosteroid.
The hardest concept for people to grasp is that of the immunopathology reaction – the fact that a rise in intensity of symptoms is not a sign that the disease process is advancing, but a reflection that the immune system is active and killing bacteria. We have been hardwired to equate symptoms with disease, but what many people do not realize is that all disease symptoms are the result of an immune system response. If a person gets infected with a virus, the rise in symptoms they display is not caused by the virus, but the response of the immune system to the virus. Once on the MP, some patients report intense exacerbation of symptoms, severe lightheadedness, or profound fatigue, and are convinced that they are getting sicker. I have to assure them that what they are feeling is the natural result of their immune systems dealing with toxins, cellular debris and the remains of dead bacteria. Europeans are usually more open to the idea, but North Americans have really been brainwashed to equate symptoms with disease. In cases where people have trouble grasping this concept, the biggest hurdle is to get them through the first phase of the treatment when the immunopathology is often strongest. If I have any dropouts, they come from this group – the people who can’t intellectually grasp the idea that they need to feel worse before they get better.
Well, about 20-25 percent, maybe less, all of them during the first phase of the treatment. People with CFS are often impatient because in most cases even after they’ve done the protocol for over a year they feel just as symptomatic as they did at the start. It isn’t until well into the second year that they begin to note improvement. They do improve, but it takes them longer to get better than patients with other diseases. The CFS people also get a lot of slack from other doctors who don’t understand that they need to hang in for longer periods of time before noting improvement. Some patients also lack family support and find it difficult to push forward with the treatment when those around them don’t understand why they are experiencing temporary rises in symptoms. Those who are supported by family and friends do much better. One of the things I believe we should focus on is how to better educate family members about the treatment so that they can provide a better support network.
Some patients with mental illness also prove to be challenging cases because they need to take quite a few medications in order to manage their symptoms and these medications often interfere with the ability of the immune system to function correctly. Also, many of their family members are not willing to put up with the rise in psychological symptoms that results from the immune system reaction.
I believe that there will finally be recognition of the fact that bacteria do not manifest themselves in the manner in which we are taught in medical school. Doctors will accept that when acute infections are treated, the bacteria causing the disease doesn’t necessary clear, but can mutate into forms that can persist in the body for long periods of time. Then, they will recognize that these persistent bacterial infections are a major medical problem. Perhaps this will lead to further research into how these bacteria will respond to other antibiotics. Maybe new antibiotics will be created to target these pathogens. This reality is already starting to infiltrate mainstream medicine as studies are coming out showing that adult asthma seems to be the result of bacteria that have persisted in the throat since childhood. The same thing can be said for chronic lung infections, chronic bladder infections and well, most chronic conditions.
I also believe there will be an emphasis on further research into the ways that ARBs can be used to regulate the immune system. Finally, I feel there will be recognition of how bacteria can affect the body’s enzyme systems. This will finally move the focus of medical research away from genetics and towards the reality that bacteria are instead able to directly affect the function of the body’s receptors. Rather than looking at how to turn on and off genes, we can look at how the receptors that control and activate the genome are affected by the presence of L-form bacteria and other substances. Dr. Marshall has already shown that the inflammatory process can dysregulate the thyroid receptors, the glucocorticoid receptors and many of the other nuclear receptors. Armed with a better understanding of how the body achieves homeostasis, we can modify the receptor response in order to restore an organism’s ability to go into normal self-regulatory function. Perhaps we can use this information to develop new therapies.
There will also be a revolution in concept that will move doctors away from trying to reduce or suppress the end products of an illness. Instead they will learn how to manage the disease process itself. For example, right now it is believed that high blood pressure can damage blood vessels. But high blood pressure is just the end product of an inflammatory response generated by bacteria in the vessels. Rather than trying to use medications to lower the patient’s blood pressure directly (which is what we do now), we can go after the pathogens that are causing a patient’s blood pressure to rise in the first place and actually cure the illness.
Yes absolutely. My own health has recovered to a point where I see signs of age reversal. My eyesight has improved, my hearing has improved, and my cognitive function is better than ever. After I exercise I feel invigorated – the way I used to feel when I was young, rather than drained. There is no doubt that the MP can have a significant effect on a patient’s longevity. Experts in the field of immunology are increasingly pointing to the fact that the aging of the immune system is a main factor influencing longevity. As people grow older, their immune systems are forced to deal with higher bacterial loads, which in turns means they have to manage a greater inflammatory response. The MP downregulates this inflammatory response, restoring the agility of the immune system, which significantly affects the aging process.
That means that I’m going to be greedy about staying on antibiotics until I’ve reaped every possible benefit of the MP. Come this Christmas I will have been on the MP for three years. All my symptoms are gone and I feel completely healthy. Except for one small issue. I still have occasional tinnitus. Some days it’s completely gone, but other days it’s still at about 20% of where it used to be. I’m staying on antibiotics until this issue is completely gone. I can see myself staying on antibiotics for at least another six months, maybe even a year. I have no concerns about staying on them for a longer period of time. Some of the symptoms that I suffered from before the MP started when I was only 5-6 years old, so I had been sick for over 50 years. I have no intellectual concerns about spending 4-5 years on medications in order to reverse disease symptoms that had manifested over such a longer period of time, especially since I know how slowly L-form bacteria grow and how they can become dormant for periods of time. I also feel there are simply no adverse reactions or negative side effects that I need to worry about while taking the MP medications. It’s an extremely safe approach.
It’s sometimes problematic when a patient is also being monitored by other doctors and they are being given incorrect advice about managing the MP medications. That’s why I strongly feel that before putting patients on the MP, doctors should do the treatment themselves. That way they get a good idea of what their patients will experience and are later able to reassure and guide them much more effectively. For example, when a patient comes to see me during the early stages of the treatment I’ll ask, “Is your jaw sore?”, “Do you feel…?” And they’ll say, “Yeah!, yeah!, that’s exactly what I feel!” Then I can assure them that I also experienced those symptoms and say, “well, what you’re feeling is completely normal.”
I think we should continue to work on creating resources that allow the patient to become better at learning how to dose their antibiotics and manage the treatment on their own. Rather than having to ask questions about how to proceed or requiring advice from doctors and the board staff, they can learn to manage and understand their reactions – to be able to say, “Oh, I’ll take an extra Benicar”, or “Oh, I’ll space my antibiotics out to three days rather than two.” The treatment works best when patients are able to intuitively manage their own body responses in this manner.
Doctors should take the time to really understand the science behind the Marshall Protocol. That way they will recognize that 99% of the time the changes observed in their patients, or fluctuations in lab results are the result of immunopathology and not cause for concern. Otherwise they will often incorrectly infer that changes in bloodwork are somehow due to toxicity from the medications. Severe immunopathology reactions are not a sign that something is going wrong, but only a reflection of the fact that the treatment is actually working too effectively. By sitting down and reading about the MP in depth, they will also develop a greater confidence in the safety of the treatment, so that instead of freaking out when a patient’s kidney function temporarily drops, and often blaming Benicar for the situation, they will realize that decreased kidney function is just a result of immunopathology in the kidneys that can be managed. There is simply no evidence that Benicar can affect kidney function – there are even patients on dialysis that take Benicar. It’s also important to learn how to counsel patients during flares in which their immunopathology may kick in very strongly in order to help them manage their antibiotics and keep the reaction under control.
Another thing doctors should understand is that in the case of nearly every patient, immunopathology occurs in the brain. This means that during much of the treatment, patients are not thinking properly and have psychological issues. These mental reactions should not cause doctors to question the stability of the patient, but instead it should be understood that every patient will experience a certain level of confusion, anxiety and neurological symptoms while on the MP.
Amy Proal graduated from Georgetown University in 2005 with a degree in biology. While at Georgetown, she wrote her senior thesis on Chronic Fatigue Syndrome and the Marshall Protocol.