Exploring chronic disease
9 Aug 2008
The actor and comedian Bernie Mac died today, and it was because of sarcoidosis. Preliminary news reports say otherwise. A statement by Mac’s publicist, who very likely got it on authority from his doctors, said that it was the “complications due to pneumonia” which ended his life. Mac had suffered from the disease sarcoidosis for 20 some years.
Pneumonia is a lung disease, and the lungs of a patient with sarcoidosis are greatly weakened by the chronic intraphagocytic metagenomic bacteria that cause the illness. Though it is truly a deadly disease, Mac expressed little concern, publicly at least, about sarcoidosis. Mac was likely convinced by his doctors that sarcoidosis could be successfully kept at bay by high doses of immunosuppressants. In one statement, Mac said his sarcoidosis had “gone into remission” around 2005.
The evidence says that sarcoidosis doesn’t go away. The 2003 NIH ACCESS study followed 215 sarcoidosis patients for two years. Two years is the period during which it is sometimes mistakenly thought that the disease can go into remission. NIH ACCESS found that measures of sarcoidosis severity remained unchanged over the two-year period, despite the fact that many patients were using corticosteroids and other immunosuppressive drugs– and despite the fact that the study’s authors went to great lengths to equivocate about what their data really meant.
In fact, in the NIH ACCESS study there were no documented cases of spontaneous remission. Even in the positive-sounding “improved” category for clinical markers, the percentages described were at best “improved”, not “better” and certainly not “cured.” The study also concluded that most patients with persistent sarcoidosis at two years were “unlikely to have resolution of the illness” and that “end-stage pulmonary sarcoidosis usually develops over one or two decades.”
In simple terms, the study found that not one patient recovered over a two year period, and that any patient to remain ill with sarcoidosis for two years is likely to die from the disease over the following ten to twenty years.
When asked, Mac’s publicist indicated his pneumonia was unrelated to his sarcoidosis, but those of us who know better realize that the opposite is true. Many of the chronic bacterial species that cause sarcoidosis create substances that block the Vitamin D Receptor – a fundamental receptor that controls many components of the innate immune response including transcription of the bulk of the body’s antimicrobial peptides.
Mac’s choice to be treated with the “first-line treatment” for sarcoidosis – immunosuppressants including prednisone no doubt – was doubly unfortunate. Doing so inactivates the innate immune system, which allows a heavier load of VDR-dysregulating bacteria to accumulate… which, in turn, further inactivates the innate immune system. In such a state of disrepair, the immune system has little recourse in its fight against an otherwise easily dispatched strain of pneumonia.
Clearly, Mac’s doctors incorrectly faulted an overactive immune response for the disease. Without being too dramatic, it’s also clear their ignorance had deadly repercussions.
Mac’s story is Exhibit A that sarcoidosis is deadly. Also, it is an apt example of how mortality associated with sarcoidosis goes underreported in cases where opportunistic infections are erroneously attributed to be the cause of death. According to much of the medical community, Mac’s sarcoidosis was in remission and an unrelated case of pneumonia was the cause of death. No wonder statistics on sarcoidosis and death are inaccurate. If a patient succumbs to a co-infection directly related to the sarcoidosis disease process the co-infection is blamed rather than sarcoidosis itself.
A look back to Mac’s comments about sarcoidosis in 2005 show just how uninformed he was about his disease.
Four years ago, Mac announced to the public that he had sarcoidosis, communicating through his publicist that he had been dealing with the disease since his 20s.
Yet, he contended, “I’ve had sarcoidosis since 1983, and it has not altered or limited my lifestyle. No one knows where sarcoidosis comes from or where it starts, and there’s no known cause for this condition that affects primarily minorities.”
Despite this blithe statement, the actor was promptly hospitalized after completing work on Ocean’s Twelve and filming on the fourth season of The Bernie Mac Show was subsequently delayed.
Initially, a Fox representative said Mac was merely taking a self-imposed hiatus because he was suffering from exhaustion, brought on by a heavy work schedule. But the network later said Mac was suffering from pneumonia. In fact, his publicist finally admitted that he “had double pneumonia which weakened his lungs and his entire immune system, and the sarcoidosis symptoms became pronounced.”
The same publicist was quick to point out that sarcoidosis is a “treatable illness and not deadly.” In his statement, Mac says, “I still walk, play basketball and do normal things…. Since sarcoidosis hasn’t slowed me down, then it shouldn’t be a concern for others.”
While Mac’s death is certainly tragic, a second tragedy is the misinformation he and his publicists repeated. Perhaps he was forced to pretend that he was feeling well despite his sarcoidosis symptoms so that he would not be asked to give up any movie roles or sitcom appearances.
But anyone familiar with sarcoidosis knows that Mac must have been suffering greatly from the illness, and his case of “double pneumonia” in 2005 makes it obvious how ill he really was. Mac could have done a service to the community by communicating the actual seriousness of his disease to the public, but instead he made the mistake of accepting the statements of his doctors as an accurate depiction of sarcoidosis.
How long will it take before sarcoidosis is given full credit for the deadly disease that it is? More importantly though, how long will it take for the breadth of the medical world to finally acknowledge that the cure for sarcoidosis exists and has already cured people? It’s disturbing that ever since biomedical researcher Trevor Marshall published the landmark papers “Sarcoidosis and Antibiotics: Reflections on the First Year” in 2003 and “Sarcoidosis Succumbs to Antibiotics” in 2004, physicians and the FDA have been privy to the scientific knowledge that allows sarcoidosis to be treated correctly. Yet, as in Mac’s case, they continue to turn to conventional dogma when treating the disease in place of embracing the paradigm shifts necessary to understand the illness at the molecular level. One thing is for sure – if Bernie Mac had been treated with the Marshall Protocol he would be alive and well today.
Even those people who have yet to understand the potential of the Marshall Protocol should at least be forced to admit that the standard treatment for sarcoidosis – the ample use of corticosteroids that weaken immune function – puts patients in a place where they can easily succumb to infections. So Mac’s death makes it clear that conventional treatment for sarcoidosis is not only ineffective but also quite dangerous and even life threatening.
We also can hope that while tragic, Mac’s death may at least cause the medical community and the public to raise an eyebrow about the fact that attempts to deny the seriousness of sarcoidosis do little to stop the disease from taking lives.
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.