Bacteriality — Exploring Chronic Disease

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About Bacteriality.com

In 1934, a German scientist named Emmy Klieneberger-Nobel discovered that the bacteria in her Petri dish had changed form and lost their cell walls in the process. Seventy years later, biomedical researcher Trevor Marshall created a model describing how these bacteria, along with intracellular bacteria and pathogens that live together inside protected communities called biofilms, might be able to cause chronic disease and dysregulate the immune system.

To date, there are over 50 known species of bacteria capable of transforming into the L-form, many of which have been implicated in a wide array of chronic diseases including sarcoidosis, Chronic Fatigue Syndrome, Lyme Disease, rheumatoid arthritis, Crohn’s disease and multiple sclerosis.

Similarly, in just a short period of time, researchers studying internal biofilms have already pegged them as the cause of numerous chronic infections and diseases, and the list of illnesses attributed to these bacterial colonies continues to grow rapidly. According to a recent public statement from the National Institutes of Health, more than 65% of all microbial infections are caused by biofilms.

Marshall has developed a treatment that colleagues have named the Marshall Protocol. Patients on the treatment take pulsed, low-dose antibiotics and Benicar, a medication which activates the immune system. The goal is to kill L-form, biofilm, and other latent bacteria that cannot be killed by standard antibiotic therapy. Hundreds of patients around the world with a variety of chronic diseases are using the treatment. Nearly all are reporting improvement and some claim complete resolution of symptoms.

Bacteriality.com delves into the fascinating and complex science underlying and related to Marshall’s work.

The present time is a watershed moment in medical research. Antiquated ideas like Koch’s postulates and the notion that many chronic diseases are “autoimmune” are quickly running their course. In their stead, some researchers are starting to make the connection between latent pathogens and disease, many of them casting their scientific gaze upon the Vitamin D Receptor (VDR), the fundamental receptor of the immune system. Microbiologists are increasingly starting to study how organisms interact in communities to cause disease in lieu of looking for a single organism in a disease state.

Thanks to rapid advances in technology, scientists can now detect human pathogens that are unable to be cultured in a Petri dish. This has lead to the realization that the microorganisms living inside and on humans (the human microbiome) outnumber human cells by approximately a factor of ten. Some scientists estimate only that 1% of bacteria are able to be cultured without advanced technology. This means that approximately 99% of the bacteria capable of inhabiting the human body are just starting to be characterized and identified by researchers – most of whom are affiliated with a global endeavor known as the Human Microbiome Project. The probability that many of these bacteria are pathogens that contribute to the development of inflammatory disease is extremely high.

Nevertheless, most of the research discussed on this site turns a lot of conventional medicine on its head, and the medical community, many of whose members are fixated on finding a purely genetic cause for all forms of disease, is painfully slow to warm to new insights. This is especially true in a world where powerful drug and supplement corporations stand to lose billions if chronically ill patients can now recover using a therapy that costs no more than a few dollars a day.

In 1982, Australian researchers Barry Marshall and Robin Warren discovered that ulcers, previously attributed to stress, are actually caused by H. pylori bacteria. When Marshall first put forth his research doctors walked out of his lectures, and he was shunned by many of his peers. Finally, Marshall actually swallowed H. pylori bacteria and developed an ulcer. It was only then, twenty years after his discovery, that the medical community and the public began to take him seriously.

A still shot from a video Dr. Andy Wright took of an infected blood cell.

Perhaps if we can understand and communicate Dr. Trevor Marshall’s research and that of other scientists investigating the human microbiome, it will not take decades for the medical community to embrace the notion that many inflammatory diseases are likely caused by a wide array of chronic bacteria.

For those who may be wondering, the image in the header is an illustration based on a video taken by British clinician Dr. Andy Wright. Dr. Wright used a Bradford Variable Projection High Resolution Microscope to view L-form bacteria in the blood of a patient with Chronic Fatigue Syndrome.

I would like to thank Dr. Joyce Waterhouse for her help with the editing process.

46 Responses for "About Bacteriality.com"

  1. Lynn Porteus August 19th, 2007 at 11:34 pm 1

    Well done Amy. Thanks for your insite and writing skills in producing such an understandable, valuable website. I will be sending my Dr you website address. I’m on the MP and follow your posts.

  2. John Dresser August 20th, 2007 at 9:56 am 2

    looks good Amy and Paul!

  3. JC Byron August 20th, 2007 at 4:17 pm 3

    Wow – lots of great stuff there. Wonderful job.

  4. Rico August 24th, 2007 at 8:22 pm 4

    Awesome, Amy. You sure put a lot of work into the articles and it paid off. Very good reading! Keep up the great work.

  5. Claire July 3rd, 2008 at 11:56 am 5

    Love your new website layout. Good job at staying a step ahead of the expanding nature of your site!

  6. Amy Proal July 3rd, 2008 at 2:08 pm 6

    Thanks Claire….Paul does a great job of staying on top of things and constantly updating features!

  7. Bill Sardi July 10th, 2008 at 6:34 am 7

    Nat Clin Pract Rheumatol. 2008 Jul 1. [Epub ahead of print] Links
    Control of autoimmune diseases by the vitamin D endocrine system.Adorini L, Penna G.
    L Adorini is Chief Scientific Officer at Intercept Pharmaceuticals, Corciano (Perugia).

    1,25-Dihydroxyvitamin D(3) [1,25(OH)(2)D(3)], the biologically active form of vitamin D(3), is a secosteroid hormone essential for bone and mineral homeostasis. It regulates the growth and differentiation of multiple cell types, and displays immunoregulatory and anti-inflammatory properties. Cells involved in innate and adaptive immune responses-including macrophages, dendritic cells, T cells and B cells-express the vitamin D receptor (VDR), and can both produce and respond to 1,25(OH)(2)D(3). The net effect of the vitamin D system on the immune response is an enhancement of innate immunity coupled with multifaceted regulation of adaptive immunity. Epidemiological evidence indicates a significant association between vitamin D deficiency and an increased incidence of several autoimmune diseases, and clarification of the physiological role of endogenous VDR agonists in the regulation of autoimmune responses will guide the development of pharmacological VDR agonists for use in the clinic. The antiproliferative, prodifferentiative, antibacterial, immunomodulatory and anti-inflammatory properties of synthetic VDR agonists could be exploited to treat a variety of autoimmune diseases, from rheumatoid arthritis to systemic lupus erythematosus, and possibly also multiple sclerosis, type 1 diabetes, inflammatory bowel diseases, and autoimmune prostatitis.

  8. Amy Proal July 10th, 2008 at 8:56 am 8

    Hi Bill,

    Thanks for sharing an accurate description of the actions of 1,25-D. Of course, the vitamin D from supplements, food, and excessive sun exposure is converted into 25-D, not 1,25-D. 25-D is the secosteroid form of vitamin D that blocks the VDR. So it’s important to keep in mind that one cannot accelerate the activity of the VDR by consuming extra vitamin D or getting extra sun.

    However, Adorini and team have failed to consider the alternate hypothesis when it comes to the low levels of 25-D they observe in autoimmune disease – levels they link to “deficiency.” Marshall’s molecular data (recently published in BioEssays), which is backed day in and day out by clinical data obtained from our study, shows that a low 25-D is does not CAUSE autoimmune disease but is rather a RESULT of the disease process. As levels of 1,25-D rise in patients with inflammatory disease due to pathogen-induced blockage of the VDR, they naturally downregulate, through the Pregane Xenobiotic Receptor, a patient’s level of 25-D. So rather than serving as a sign of “deficiency”, low 25-D can actually be used as a marker to suggest that a person is infected with the chronic intracellular pathogens that cause autoimmune disease.

    Adorini and team should be happy to know that Dr. Marshall has already identified an excellent VDR agonist. It’s the ARB Benicar, which activates the receptor to just the right level in order to maintain an effective innate immune response, but not an over-exuberant innate immune response. Benicar is the medication patients on the Marshall Protocol take four times a day in order to prime their innate immune systems to effectively kill the Th1 pathogens.

    But it’s still good to hear that research teams are looking for even more potential VDR agonists.

    Best,

    Amy

  9. LJ August 26th, 2008 at 1:48 pm 9

    How do we donate to you? Your studies should be supported.

    LJ
    Chicago

  10. Amy Proal August 30th, 2008 at 7:42 pm 10

    Dear LJ,

    Sorry not to get back to you sooner. I have actually been having some discussions with the ARF board about donations. In any case, you can donate to ARF at the following site:
    http://autoimmunityresearch.org/

    Thank you very much for your generosity. I assure you your gift will be used as effectively as possible.

    Best,
    Amy

  11. Pato January 1st, 2009 at 1:03 pm 11

    Dear Amy,

    I am a molecular biologist in Buenos Aires, Argentina, and a PhD student at the same time. I am so (so soooo) gratefull for your work. Yesterday night, minutes before the new year to arrive, I had the luck to find your website by google, and if it was not for my family that wanted me to be in the celebration of the new year, I would have stayed the all night reading the information.

    I had the diagnosis of CFS last year, after four long years of going to different specialists and without any result, besides discarding possible illnesses. With the diagnosis of CFS, I started other treatments with very poor results, and using drugs that act on the nerve system, which I don’t like at all, but up to now it seemed it was my only choice.

    The information you present about the MP is so detailed, and I am happy that I could follow every slide of the Keynote presentation, since I learnt all these concepts at university. I’m very much anxious to start with the MP, because looking at my medical records (I keep a summery of every study and “hypothesis” of me feeling so bad) it all comes to place.

    I think finding your website was the best present for this Christmas and New Year for me, and I assure you I do not exagerate. During the last 4 years I’ve tried everything and sadly most of these things lack of coherence, but in my desperate wish to feel better, I would try them anyway.

    I will write to you soon, telling you how I am going with the MP. From Argentina, I say to you THANK YOU VERY MUCH again and I wish you a great 2009. Un abrazo grande (“a big hug”).

    Pato

  12. Amy Proal January 1st, 2009 at 2:44 pm 12

    Hi Pato,

    I am so glad you have found information about the MP and that this site has proven helpful in allowing you to understand the treatment!!

    I understand where you are coming from because I too saw many, many CFS doctors for 3 years before finding the MP. My health also only got worse while I used those treatments.

    I read about the MP on my birthday and for me it was the best birthday present I have ever had. As with you, I had a background in science and Dr. Marshall’s disease model simply made so much sense. Now the model has developed even more and I am very excited that I am able to help others understand it.

    If your doctors want to read any of Dr. Marshall’s peer reviewed papers or watch any of his recent Conference presentations on video they can be found at this link:

    http://mpkb.org/doku.php?id=home:publications:home

    You can also set up an account at http://www.curemyth1.org where you can ask questions about how to start the MP and they will be answered free of charge by patient advocates.

    If you start the treatment, please do write and let me know how it goes!

    Actualmente, te escribo de la Ciudad de Mexico donde estoy celabrado la Navidad y el Ano Nuevo con mi familia tambien. Aunque mi familia es de Mexico por tres anos no podia visitarla porque estube tan enferma con CFS que era impossible viajar en avion. Pero este ano siento tan mejor que hemos celebrado muchisimo juntos y tengo mucha energia. Debo esto a la MP y espero que el tratamiento empiece a mejorar tu CFS tambien hasta que tambien te sientas sano.

    Feliz ano nuevo!

    Amy

  13. avis January 11th, 2009 at 8:33 pm 13

    Hi Amy,

    As with Pato, I too discovered this site somewhere between Christmas and New Year’s day. This is the best Christmas present I’ve had in decades! I’ve been hunting for 37 years for me and for the last four years for my son and for years before that for my daughter. This is the most promising and sensible thing I’ve ever read having to do with my or my family’s health. It is clear that both of my children are TH1 affected, as are my husband and I. I actually believe that I was affected at birth, so last night I was extremely happy to discover your article on the communicable aspect of this. It just all fits now.

    My son started the protocol last night and will try to adjust as much as he can before he heads across the country to return to college in 6 days. Yesterday, one of my son’s many doctors e-mailed me his latest test results adding babesia and ehrlichia to his bartonella diagnosis, though we still cannot get a positive for lyme disease. Instead of reading up on these two additional forms of bacteria, I’ve simply assumed that the MP will take care of them, as well.

    We, too, have tried every possible intervention available. Many have been reasonable palliative measures but nothing has even hinted at a cure. I am a health psychologist and have told a number of people in my practice about the MP, stressing, however, to look at your site in order to get the science in a well organized and clear manner. I so appreciate what you’re doing and am awaiting my d- metabolite test results, and expect to be following soon enough. (You can imagine just how much vitamin D we have been on.)

    I start this year with abundant hope. Thank you so much.

    Avis

  14. Amy Proal January 13th, 2009 at 11:30 am 14

    Hi Avis,

    Thanks for writing. Again, I’m glad that Bacteriality has been a helpful reference for you. It’s true – so many disparate aspects related to chronic disease suddenly come together with an understanding of Dr. Marshall’s model.

    There’s something very exciting to me about starting the Marshall Protocol as a young person and ridding yourself of the bacteria that have passed around my family and caused suffering for so long (at least there was for me!). I’m so glad that your son is already on the Protocol. Make sure he knows that if he’s away at college and wants advice about how to dose his antibiotics or advice on any other MP-related issue he can ask his questions at http://www.curemyth1.org (Th1 refers to bacteria, hence the name). The patient advocates on the site answer questions about the MP free of charge.

    You are right not to stress about his Lyme diagnosis. Despite what most Lyme doctors believe, Lyme is caused by a great variety of bacteria besides Borellia, all of which don’t show up on conventional blood tests. Instead of searching for a diagnosis that will inevitably lead him to the MP anyway, it is fair to assume that since he has symptoms of unknown cause, he harbors these pathogens and they will indeed be targeted by the MP.

    I believe I was also sick at birth and the disease slowly crept up on me as my infection finally spread greatly during my early twenties. It was great to start the MP and begin to experience symptoms as a manifestation of improvement rather than as simply a sign that I was getting sicker. I hope you whole family can eventually benefit from the treatment and I wish you all the best.

    Amy

  15. stephanie January 22nd, 2009 at 11:42 am 15

    How do you suggest testing for this?

  16. Amy Proal January 24th, 2009 at 6:58 pm 16

    Hi Stephanie,

    Right now, the gold standard is the therapeutic probe. You can also test your D metabolites as described here.

    Best,
    Amy

  17. stella voisey February 27th, 2009 at 1:23 pm 17

    dear Amy Proal

    Did you have thyroid and adrenal replacement when you went on MP?

  18. Amy Proal March 3rd, 2009 at 7:05 pm 18

    Hi Stella,

    Before starting the MP I had very low levels of both thyroid and adrenal hormone. I was taking both T3/T4 supplements and armour thyroid. I stopped all three medications when I started the MP. Once one the MP, Benicar, which is taken 4X daily, goes a long way in re-stabilizing the body’s hormonal pathways. I guess that worked for me because I didn’t feel any need to take the medicines anymore when I was on the MP. To tell you the truth through, I’m not sure if they were doing anything before I started the MP, it was was hard to tell.

    All I can tell you definitively is that my recent hormone tests show that all my hormone levels have returned to a healthy range. So the MP did succeed in taking away my potential need for thyroid/adrenal supplements.

    Best,

    Amy

  19. Dr. Matthew Hertert March 26th, 2009 at 2:36 pm 19

    Amy-
    Thanks so much for your work here. I am a physician who teaches at two Universities and does a lot of public speaking. I have been referring people, particularly folks and families facing chronic illness, to your site more and more recently. I think our major (individual) health challenges today are 1) sedentary lifestyle, 2) commerce-driven changes to nutrition value of food and our eating habits, 3) changes in our electromagnetic spectrum, 4) the flood of chemicals assuaging us via food, fabric and environment, and 5) biofilms (which I used to have a much longer descriptor for before I found your site).
    Bless you and thank you for this work and for making it so accessible to laypeople.

  20. Amy Proal March 26th, 2009 at 2:44 pm 20

    Dear Dr. Hertert,

    Thank you for your kind comments! I’m so glad that you are open to new ideas about treatment. I can tell how much you genuinely care about your patients. I hope to write more articles in the coming month and address even more topics.

    Take care!

    Amy

  21. Nour March 31st, 2009 at 11:37 am 21

    Hi Amy! Good WORK.
    I live in Reston virginia out of Washingto DC can you refer me to a doctor or list of doctors that are famlair with Marshll Protocal. thank you.

  22. Amy Proal April 1st, 2009 at 4:48 pm 22

    Hi Nour,

    Thanks! Glad you like my work!

    You may be able to find a doctor in the DC area by posting at the following website:

    http://www.curemyth1.org (Th1 refers to diseases caused by bacteria, hence the name) The patient advocates on the site, who are volunteers, will give you a list of doctors with MP patients in DC free of charge. If there are no MP doctors in DC taking new patients, you may want to ask for the list of MP doctors in Maryland of Virginia if you are willing to drive a while to see a doctor.

    Hopefully you can find a doctor on one of those lists. If not, you could consider flying once to see a good MP doctor in another state. Many of them will let you conduct all your subsequent visits over the phone.

    Or, you may want to talk to your current doctor or look for an open-minded doctor in DC and convince them to put you on the treatment. If you do, be sure to show the doctor this list of Dr. Marshall and team’s published papers and conference abstracts:

    http://mpkb.org/doku.php/home#publications_presentations

    Good luck!

    Amy

  23. james tallant April 2nd, 2009 at 4:17 pm 23

    Hi, Can I start by saying , that I wish everyone out there with this horrible desease. the best of luck, from the bottom of my heart.
    I am from the U.K. and my wife suffered from sarcoid for just over seven years. the doctors here said there was no cure, and she died from the desease on the 22 of december 2007. I had just read about the protocol a short time, before my wifes death, and I did’nt have the time left to set anything up over here. so you see, there are people dying over here. it would be great if some of you people could contact the medical proffession over here, and make them aware of your progress, and maybe help set up advice for people here. good luck to you all

  24. Amy Proal April 7th, 2009 at 12:27 pm 24

    Hi James.

    I’m so sorry about your wife. Day in and day out I try to communicate on this site the reality that sarcoidosis is a serious and deadly illness.

    We are making our best effort to communicate our research on sarcoidosis and other similar disease to the international scientific community.

    This coming week Dr. Marshall will be giving a speech in Prague where physicians from the UK will surely be in attendance.

    He also recently gave the keynote speech at the Conference of the Gene in China where numerous researchers from England were also present.

    He is also in contact with a man from the UK who runs a non-profit organization that supports new medical treatments. They are working together to spread work about the MP in the UK.

    This will all still take time but I believe there will definitely be increased acceptance of the MP in the UK in the coming years.

    Again, I’m sorry about your wife. I hope that other patients, who have been incorrectly told by their doctors that sarcoidosis is “no big deal” will read about her story and realize they need to act now to treat their disease.

    All the best,

    Amy

  25. Greg Horner May 7th, 2009 at 8:11 am 25

    Amy,

    Dr Marshall said in Feb, “There is a special issue upcoming in Annals called “Frontiers in Autoimmunity.” The three papers will be in that. I suspect that the two Autoimmunity Reviews papers will hit Pubmed within a month, they tend to pre-publish pretty quickly on the internet.”

    Is there any way to get a copy of these papers?

    Thanks,
    Greg

  26. Amy Proal May 7th, 2009 at 2:02 pm 26

    Hi Greg,

    You’re right – the Autoimmunity Reviews papers were published much more quickly than the Annals papers. We think the Autoimmunity Reviews papers should appear in PubMed any day now. But you can read them already. They are the first papers listed at the following link:

    http://mpkb.org/doku.php#publications_presentations

    At the same link you can find the abstracts for the Annals papers. Unfortunately, the full text of the papers won’t be ready until September. I guess the abstracts are better than nothing!

    Thanks for your interest and hope this helps!

    Amy

  27. Caroline Rhodes May 8th, 2009 at 9:44 am 27

    Dear Amy,
    Thank you for increasing global awareness of the MP.
    It’s wonderful to access all this information via the web.
    Thanks again,
    Caroline

  28. elizabeth allan June 9th, 2009 at 12:17 am 28

    Hello Amy,

    I am on Phase 2, just starting, for cfs/hashimoto’s/depression/dyspnea/antibodies to rickettsia. I was wondering if you have your own interview of how you got through the MP.

    I am having a tough time with the fatigue/depression herx particularily with the self-doubt “is this really going to work”. Having had cfs for 22 years, and having tried so many things, I guess I have doubts. Do you know of any MPers who have had something similar for a long time as well that I could write to.

    Thanks so much.

    elizabeth

  29. Amy Proal June 9th, 2009 at 11:38 am 29

    Hi Elizabeth,

    I’m glad you are on the MP! I think the feelings of doubt you have about the MP are normal, especially after having been sick for so long. I can’t predict the future, but I am confident that you will respond to the treatment. There were long periods of time at the beginning of the MP where all I felt was immnopathology and could not yet sense any improvement. It took over a year for me to feel that my body was becoming more resilient. But before then I could still sense that my symptoms were no longer random. Instead, they would largely respond to increases in the antibiotics and changes in Benicar dosing. I hope you can at least sense how the MP drugs affect your symptoms because if you do, you can be more confident that ever that your symptoms are largely immunopathology – a sign of bacterial die-off that will lead you to wellness in the end.

    In terms of finding others who have your same diagnoses and are also on the MP, have you posted yet on the the website http://www.curemyth1.org? (Th1 refers to diseases caused by bacteria, hence the name). The patient advocates on the site may be able to put you in touch with other people on the MP. Also, you can look at other members profiles and see what diseases they are recovering from. Then you can contact them via private message if you become a member of the site (that simply involves registering by creating a name and password.)

    I definitely want to write about my intense struggle with CFS and fibromyalgia – from the days when I was bedridden to the place I have reached now where I have a life again. Sometimes I try to start writing the story. It seems so long and there are so many details I want to mention. I’m working on how to condense the story in my head and write it when I feel most inspired and, of course, have the time! So hopefully, yes, I will have a piece sooner than later about myself.

    All the best as you continue to recover with the MP.

    Best,

    Amy

  30. Chris Mavraedis July 21st, 2009 at 4:48 am 30

    Amy, Thanks for your wonderfully insightful videos and writings on the MP! I am having neurological problems that I initially thought were caused by too much aspartame consumption. But I have been off the aspartame for almost a year now and my symptoms are getting worse. The latest possible diagnosis is that I may have PLS or Primary Lateral Sclerosis a more benign type of ALS! I am considering going on the MP and your website is an excellent source of information on the protocol. I have seen on the website for the MP that ALS is difficult to treat with the MP due to it’s quick progression. But, I have possibly the much slower progressing PLS. Do you think that PLS would be treated by the MP? Thanks for your assistance in advance!

    Chris Mavraedis

  31. Paul Albert July 23rd, 2009 at 10:58 am 31

    Hi Chris,

    This is Paul. I am helping Amy answer her questions. The most valid way to tell if you’re a good candidate for the MP is a therapeutic probe:
    http://mpkb.org/doku.php/home:starting:therapeutic_probe

    So long as you can generate an immunopathological reaction, you know that the treatment can potentially work for you.

    Best,
    Paul

  32. Jen July 29th, 2009 at 4:22 pm 32

    Hello,

    I’m looking into doing the MP to help with a few very serious health problems. I’m wondering if anyone has been cured by this long term protocol? By cured, I mean no longer has to take antibiotics and is living healthy. I am also wondering if, while on the program, you are still able to go to work and function? Thank you in advance for responding to my inquiry. I’m in a very scary and frustrating time in my life due to these health issues.

    Jen.

  33. Paul Albert August 2nd, 2009 at 8:10 am 33

    Hi Jen,

    We have a Knowledge Base article that address the length of the MP:
    http://mpkb.org/doku.php/home:patients:mp_duration

    In later stages of the MP, a number of people including myself for example become insensitive to antibiotics so they just drop them.

    It is possible to work while doing the MP. There’s a lot of issues but the main one is how sick you are from the outset.

    Hope this helps.

    Best,
    Paul

  34. Amy Proal August 2nd, 2009 at 4:53 pm 34

    Hi Jen,

    If you want to get feedback from more people, recommend also posting your same question at http://www.curemyth1.org – a site Autoimmunity Research Foundation has created where people starting the MP can get advice from patient advocates and people who have been on the MP for longer periods of time.

    Hang in there,

    Amy

  35. Amy Proal August 16th, 2009 at 6:59 pm 35

    Hi Tanja,

    I’m glad your sister went to the “peak states” session, because it might show that she’s willing to consider some other options for therapy. My Mom is a yoga instructor, and I think meditation can be very helpful. However, when it comes to serious chronic diseases like schizophrenia, my personal experience is that mind-altering therapies can only take a person so far. That’s why, ultimately, I would hope your sister would look into the MP, considering that, at this time, it is also a different approach to treating her disease than the standard recommendations she has gotten from her doctors thus far.

    As you know, I don’t want to take a position on vaccines, but I’m very glad your two-year old daughter sounds so healthy.

    I don’t have a deep knowledge of parasites. I know that parasites are more common in areas with contaminated water and in countries with less rigorous food inspection. Still, I’m sure it’s possible to acquire some parasites in the developed world. According to our disease model, bacteria facilitate the survival of parasites rather than vise versa.

    We have found that is chronic bacteria which dysregulate the immune response, and it is under these conditions which parasites may find it most easy to take hold. This means that by eliminating the bacteria which cause immune dysregulation, there would be a much greater chance that parasite would have a harder time surviving. So, I still think that getting rid of chronic pathogenic bacteria would be important for anyone who has a parasite. That said, I don’t know much about parasite flushes or if a therapy like that would have a positive effect.

    Take care,
    Amy

  36. Wen Zhen September 5th, 2009 at 6:29 am 36

    Dear Amy:
    I’m a graduate student from the Department of Operative Dentistry, West China College of Stomatology, Sichuan University, Chengdu, China. I am still studying at school to finish my master degree next year and working on the microbiology in the field of the relationship between the L-form bacteria and systematic diseases for nearly 2 years. I just found this website today after reading a review—Bacterial L-Forms — together written byE. J. Allan,C. Hoischen,and J. Gumpert. I can’t help but want to leave this message right away to express how inspring this is for me before I totally navigate the whole web. Not before long, I am kind of depressed about working on the L-form as the relevant research and reference in this area seemed not so abundent and compelling,especially in stomatology and too many times of my expereimental failures also turned me back. Through it all, I’ve came so far and the more I spend time with this unique micro-life, the more I love it and get to know it. And now I just discover more and more scientists are paying attention to the L-forms and I believe with more active researchers working on it, there will be a breakthough in life science. As for me, I am going to try my best to pursue the advance studies in the future.
    Truly Yours Wen Zhen, Zhang
    P.s: Is a trial set out in West China Hospital with your research team? I haven’t heard of it.Which department you are going to collaborate with? Perhaps it’s the department of clinical medicine. I have the intership, working in the West China Hospital, but the Department of Operative Dentistry.
    Anyway, I would love to give you some helps if you come here.

  37. Amy Proal September 9th, 2009 at 9:21 pm 37

    Hi Wen Zhen,

    Wow! I can’t believe you are working at West China Hospital and studying L-form bacteria!! That’s quite a coincidence. I wish you had written me last week because I was in Chengdu last week and for a week or so before that. Over the last week I’ve been in Australia which is why I haven’t written back to your comment more quickly.

    Our trial is moving forward and we are working with researchers in the rheumatology department. That is because the first trial we are doing will test the Marshall Protocol on patients with ankylosing spondylitis.

    However if you read through the material on this site you’ll see that we believe L-form bacteria and other bacteria (including biofilm bacteria) play a causative role in a wide array of diseases. So I definitely think that you are doing research on a fascinating topic!

    I’ve heard that it’s definitely very difficult to culture L-forms so I can understand why some of your experiments might have failed. But if you say you’re becoming more familiar with the L-form I think that’s wonderful and that your studies will make a serious contribution to medicine.

    Perhaps you could help out with our trial at West China Hospital. I will email you privately in a few days with more details. At the very least you could meet the research team. Also next time I come back to Chengdu (hopefully in a few months) we have to meet!

    I like Chengdu a lot. The food is very spicy though and I have trouble eating spicy food so my meal options are a bit limited. I’ve seen the pandas twice and gone to most of the main sights in Chengdu. I also sang Karaoke at ATT with students from the rheumatology department. It was really fun!

    Hopefully we’ll keep in touch and I’ll write you privately soon.

    Best,

    Amy

  38. Wen Zhen September 12th, 2009 at 9:24 pm 38

    Dear Amy:
    I’m very delighted to see your reply finally, but what a pity we couldn’t meet each other in Chengdu right away. I really want to see you as soon as possible. We must be having a lot of topics to talk about.

    My thesis advisor was just preparing to recruit more students to make a research team focusing on L-form bacteria. By then, I will be a member in that research team since I was the one working in this field at first and kept this research coming so far. Although I made a bare contribution to it, at least we’ve had a start. I havn’t went to lab for nearly three months because I was busy writting my Master’s thesis as well as dealing with a number of papers for application to persue a PhD position abroad. But sooner or later,I’ll continue my research again. Before that, I have to finish all my paper work as I know once the experiment set out, there’s no recess.

    Watching your Web makes me feel my deficiency in this area and there are so much more I have to learn if I really want to go on the research. I think maybe I don’t have the ability you expected to help your trial, but if any, I would try my best to do it. After all,it’s very nice to know you online and hope we will see each other someday.

    Truly yours,

    Wen Zhen

    P.s: I’m also not a local here, so what you went through is pretty the same to me.

  39. Heather Beckett October 30th, 2009 at 8:16 am 39

    Any, I am a fellow CFS sufferer , have got 25 months behind me on the MP, still in phase 2, modified phase 2, as Zith caused intolerable IP . I have followed your progress with much interest over the past 2 years, esp the China presentations, so excellent and understandable , I have sent to family and friends.

    Is there a chapter 3 yet to your Journey towards Complete Recovery from CFS ….?

    You are functioning, travelling, no Noirs (that I see),, you give me hope!!!! I have been super photosensitive, 2 years on MP and not tolerating much daylight yet. Since I am probably twice your age…I have quite a load of CWDs
    with much appreciation
    Heather Beckett, Canada

  40. Amy Proal November 1st, 2009 at 1:41 pm 40

    Hi Heather,

    I’m in graduate school now getting my PhD. I’m really busy writing other stuff these days. I would like to write a Part III to my recovery from CFS, but it always seems to be put on the backburner. So, I’ve tried to make people aware of my improvements through my actions rather than my words including pictures of trips, etc. Although it has improved, I still struggle with photosensitivity. I usually take off my glasses when photographed, but I do typically wear them in the bright sun.

    I assume you’re aware that the thinking has a shifted quite a bit in terms of the mentality surrounding recovery and the MP. Whereas Dr. Marshall once advocated that people needed to get Phase III in order to beat their disease, various case histories have suggested that patients can remain on Phase II or even Benicar alone and still recover tremendously.

    So, I hope if you haven’t already, you will begin to see some improvement in the coming year. I’m glad you’re sticking with the MP. Thank you for your kind comments about my talks and presentations. I have some more coming up that I’m eager to work on.

    Take care and at some point, I hope to write Part III.

    Best,
    Amy

  41. Ian Cameron November 10th, 2009 at 10:09 pm 41

    Hi Amy,

    Has the MP undergone a clinical double blind study to test its effectiveness to heal/cure autoimmune diseases? Have studies of the MP been published in any scientific or medical journal?

    Thanks and regards,
    Ian

  42. Paul Albert November 12th, 2009 at 5:55 pm 42

    Hi Ian,

    Here are our list of papers and presentations:
    http://mpkb.org/doku.php/home:publications

    And here is our 2008 survey:
    http://mpkb.org/doku.php/home:publications:mp2008_survey

    Also, we do have a clinical trial in the works:
    http://bacteriality.com/2009/07/22/wch/

    Best,
    Paul

  43. Paul Albert November 12th, 2009 at 6:33 pm 43

    Hi Bill,

    1. I believe the number we use these days is lower than 32 ng/ml. Lately, we’ve been talking about <20. Though there are certainly others, I think the main reason that figure is used because that is the amount of 25-D in patients who don't supplement with vitamin D:
    http://mpkb.org/doku.php/home:pathogenesis:vitamind
    http://mpkb.org/doku.php/home:tests:25d

    Keep in mind that 1,25-D levels are often elevated in patients sick with chronic disease – something you don't hear too much about from the pro-supplementation crowd.

    2. We address many of these questions here:
    http://bacteriality.com/2009/08/10/iom/
    http://mpkb.org/doku.php/home:othertreatments:sunshine
    http://mpkb.org/doku.php/home:pathogenesis:vitamind:latitude
    http://mpkb.org/doku.php/home:pathogenesis:vitamind:observational_bias

    3. There are *some* long-term studies on vitamin D intake :
    http://mpkb.org/doku.php/home:pathogenesis:vitamind:longterm

    As for the relative lack of data supporting our claims, we are not the ones making the non-conservative recommendation to supplement with a secosteroid.

    4. Once again, see here:
    http://bacteriality.com/2009/08/10/iom/

    5. The problem with historical efforts to understand which level 25-D is immunosuppressive is that these studies often need to account for 1,25-D. Short-term administration of vitamin D can raise levels of 25-D and increase VDR activity but only because some of that 25-D is converted into 1,25-D. There's a lot to explain here. Read some of the MPKB articles I linked to above to get more on our explanation for this.

    6. What kind of market exists for the MP? Currently, no one associated with ARF receives a salary. I can assure you that there is *no* money made in any other way. For example, ARF does not make any money when patients buy special glasses from NoIR Medical. Anyone who is making money off the MP is not associated with ARF. So… at this point, the compensation is all psychological.

    I think it would be great if the Foundation could pay Dr. Marshall a salary. Maybe that will happen in time…. That said, there are better ways to make money than convincing doctors and researchers that several of their key assumptions about chronic disease are incorrect.

    By the way, here's an introduction to the MP:
    http://mpkb.org/doku.php/home:patients:protocol_overview

    The MPKB is still a work in progress, but there is some helpful stuff there.

    Best,
    Paul

  44. Bill Kelleher November 14th, 2009 at 4:22 pm 44

    Paul- Thank you for your reply, but I was a bit put off by your email to me:

    “Author: Paul Albert
    Comment:
    Bill,

    Let me get this straight – you posted your book-length comment in three places??? Not cool.

    Well, anyway I responded to one of them here:
    http://bacteriality.com/about-2/

    Paul”

    Not cool? I’m trying to find answers for my sister who is very ill. I figured the more places I posted, the more information and perspectives I might get. Perhaps you could be more welcoming. I don’t have a dog in this fight (and fight it seems to be judging by what I’ve seen on occasion from both sides).

    Also, I don’t see my original post here for others to read, so it will be hard for them to follow your responses to me.

    I have some genuine, sincere, objective questions and I need straight forward, compassionate answers.

    First, to your point on no salaries being paid to anyone including Dr. Marshall, that is all well and good for now, I am sure you are aware that Dr. Marshall has a US Patent application for his protocol.

    “As for the relative lack of data supporting our claims, we are not the ones making the non-conservative recommendation to supplement with a secosteroid.”

    1. Not all cholecalciferol is converted to 25D. Some is stored. Cholecalciferol is not a secosteroid (at least I don’t think, correct me if I am wrong, it is a pre-hormone, 25D is a secosteroid after cholecalciferol is converted).

    2. If your recommended level for MP people to get below is 32ng/ml, this is not what I have seen on the forums. I have seen people well under 20, even 10-12 or lower. If it is not your intention for people to go this low then there needs to be better information. If it is intended for people to go this low, I would say this is not a “conservative” recommendation– just as you say the pro-D side, I belive there is a general lack of data supporting people avoiding D until their levels are in the low teens or lower. The only data you have supporting this is ‘in silica’. This is far from ideal data to base recommendations on.

    Another common theme I see in MP anecdotes is the ‘IP’ reactions that used to be referred to as ‘herx’ reactions. It seems any adverse effects from this treatment are all attributred to these ‘IP’ reactions, almost encouraging the patient that the treatment is working and to move forward, and rarely if ever attributed to side effects of medication like the high and frequent dosing of Benicar– ARB’s are known to cause low aldosterone levels, especially at higher doses and this can produce many of hte same symptoms that are being classified as ‘IP’ reactions.

    Maybe the pro-D side doesn’t have as long term data as you would like, but there certainly are some long term studies. The MP has none. At least not that I am aware of. No long term, randomized, controlled trials, just anecdotes. I do not doubt that some people are getting better, but no one, not even you, Amy Proal or even Trevor Marshall can tell me or anyone else exactly why. Is it perhaps the Benicar alone? Is it the long term dosing of antibiotics alone? As some people are on MP for years, with multiple variable like changes in diet, awareness of health, fitness, etc., you simply cannot say for sure what is helping them. You have no in vitro, much less in vivo data to prove any part of the MP protocol theory. No data besides ‘in silica’ to prove Benicar activates the VDR, and likewise to prove 25D is immunosuppressive.

    Further, correct me if I am wrong, but I believe that your reference range for 1,25D is outdated at 45 for the upper limit. It seems more current lab tests and studies show this to be closer to 60-65pg/ml.

    Also, I’ve not seen any evidence in your protocol testing recommendations that takes into account the effect of calcium, PTH, Phosphate and others on 1,25D levels.

    Correct me if I am wrong, but the studies I’ve seen show that levels of 25D below 20ng/ml tend to cause marked increases in PTH, which can precipitate bone loss.

    To get back to a point I alluded to earlier. I’ve not seen sufficient evidence from your MP information that 25D or other inactive forms can effect the function of the VDR. Here are some references I found to support the opposite:

    http://www.ncbi.nlm.nih.gov/pubmed/9398723?dopt=Abstract

    These are on the binding affinity of 25D compared to 1,25D, one showing 25D’s is at least 500x lower than 1,25D’s binding affinity for the VDR:

    http://www.ncbi.nlm.nih.gov/pubmed/1084355?dopt=Abstract

    I’ve heard reports of even 1000x lower, but I am still searching for an adequate reference.

    To be fair, I had the common sense thought that 25D levels are many times higher in the serum versus 1,25D, given that 25D levels are measured in ng/ml and 1,25D levels are measured in pg/ml, and perhaps the relative abundance of 25D to 1,25D might overcome this binding deficit. However, when I explored this angle, it seems that 25D has a higher tendency to remain protein bound in the serum versus 1,25D by a nearly 10-fold amount. So given that ng are 1000x a pg, and for a mathematical example a person had a 25D level of 40ng/ml and 1,25 level of 40pg/ml, ther ewold be 1000x more 25D; however, if 25D is roughly 10x more protein bound versus 1,25D, this would theoretically leave 100x as much free 25D than 1,25D, with 1,25D having at least a 500x affinity for the VDR– I think the 1,25D wins here.

    Further, I found a study on sarcoidosis where they bound radioactive 1,25D to VDR receptors on T cells. They found that 25D was not able to displace the radioactive 1,25D but that non-radioactive 1,25D was able to displace it:

    http://www.ncbi.nlm.nih.gov/pubmed/1646583?dopt=AbstractPlus

    I cannot seem to find one study that demonstrates that 25D affects the VDR and inhibits 1,25D’s ability to turn it on. Further, correct me if I am wrong because I am just learning about all of this, but from what I have read and understand so far about the relationship between 25D and PTH, if 25D did block the activity of 1,25D on the VDR, then wouldn’t PTH levels increase? Rather, it seems that the higher 25D goes, PTH is decreased.

    What I would believe is if you had a study in human volunteers that took baseline 25D, 1,25D, PTH, Calcium, and antimicrobial peptide levels at baseline, then randomized and groups to receive D supplementation at a level targeted to get 25D levels into the 40-60ng/ml range. Perhaps a placebo group, and a group for D-avoidance targeting low 25D levels and see what happens to antimicrobial peptide production and perhaps other immune markers. This would show if low 25D would indeed boost immune response, allowing 1,25D to activate the VDR, or perhaps show that increased 25D levels decrease AMP production or other immune markers.

    Also, to allude to an earlier point, to prove MP works, you need studies with multiple arms– perhaps a benicar only arm, a low D only arm, low D + abx, Benicar + abx, Benicar + low D, Benicar + low D + abx, etc., etc. Perhaps Benicar and abx is enough? Perhaps low D is harmful long term? (You have no long term data, certainly no where near the number of years as some of the D-supplementation studies). MP and D-Avoidance simply have not been around long enough to bear out an potential long term health effects.

    Now, after all this, this is not to say I am going to go out an gob down oodles of cholecalciferol, but I don’t think I’m going to recommend my sister starve herself of sun exposure or dietary D intake either.

    I also don’t mean to be at all hostile, though your email to me certainly seemed to be. I am just a brother who loves his sister very much and would genuinely like to help her. I am looking for conrete answers, and any information or clarification you can provde me on the points I have made here will be most helpful. I appreciate your time and that of the other volunteers on this and other sites.

  45. Bill Kelleher November 14th, 2009 at 4:27 pm 45

    Sorry if this is a duplicate, not sure if the first one posted:

    Paul- Thank you for your reply, but I was a bit put off by your email to me:

    “Author: Paul Albert
    Comment:
    Bill,

    Let me get this straight – you posted your book-length comment in three places??? Not cool.

    Well, anyway I responded to one of them here:
    http://bacteriality.com/about-2/

    Paul”

    Not cool? I’m trying to find answers for my sister who is very ill. I figured the more places I posted, the more information and perspectives I might get. Perhaps you could be more welcoming. I don’t have a dog in this fight (and fight it seems to be judging by what I’ve seen on occasion from both sides).

    Also, I don’t see my original post here for others to read, so it will be hard for them to follow your responses to me.

    I have some genuine, sincere, objective questions and I need straight forward, compassionate answers.

    “As for the relative lack of data supporting our claims, we are not the ones making the non-conservative recommendation to supplement with a secosteroid.”

    1. Not all cholecalciferol is converted to 25D. Some is stored. Cholecalciferol is not a secosteroid (at least I don’t think, correct me if I am wrong, it is a pre-hormone, 25D is a secosteroid after cholecalciferol is converted).

    2. If your recommended level for MP people to get below is 32ng/ml, this is not what I have seen on the forums. I have seen people well under 20, even 10-12 or lower. If it is not your intention for people to go this low then there needs to be better information. If it is intended for people to go this low, I would say this is not a “conservative” recommendation– just as you say the pro-D side, I belive there is a general lack of data supporting people avoiding D until their levels are in the low teens or lower. The only data you have supporting this is ‘in silica’. This is far from ideal data to base recommendations on.

    Another common theme I see in MP anecdotes is the ‘IP’ reactions that used to be referred to as ‘herx’ reactions. It seems any adverse effects from this treatment are all attributred to these ‘IP’ reactions, almost encouraging the patient that the treatment is working and to move forward, and rarely if ever attributed to side effects of medication like the high and frequent dosing of Benicar– ARB’s are known to cause low aldosterone levels, especially at higher doses and this can produce many of hte same symptoms that are being classified as ‘IP’.

    Maybe the pro-D side doesn’t have as long term data as you would like, but there certainly are some long term studies. The MP has none. At least not that I am aware of. No long term, randomized, controlled trials, just anecdotes. I do not doubt that some people are getting better, but no one, not even you, Amy Proal or even Trevor Marshall can tell me or anyone else exactly why. Is it perhaps the Benicar alone? Is it the long term dosing of antibiotics alone? As some people are on MP for years, with multiple variable like changes in diet, awareness of health, fitness, etc., you simply cannot say for sure what is helping them. You have no in vitro, much less in vivo data to prove any part of the MP protocol theory. No data besides ‘in silica’ to prove Benicar activates the VDR, and likewise to prove 25D is immunosuppressive.

    Further, correct me if I am wrong, but I believe that your reference range for 1,25D is outdated at 45 for the upper limit. It seems more current lab tests and studies show this to be closer to 60-65.

    Also, I’ve not seen any evidence in your protocol testing recommendations that takes into account the effect of calcium, PTH, Phosphate and others on 1,25D levels.

    Correct me if I am wrong, but the studies I’ve seen show that levels of 25D below 20ng/ml tend to cause marked increases in PTH, which can precipitate bone loss.

    To get back to a point I alluded to earlier. I’ve not seen sufficient evidence from your MP information that 25D or other inactive forms can effect the function of the VDR. Here are some references I found to support the opposite:

    http://www.ncbi.nlm.nih.gov/pubmed/9398723?dopt=Abstract

    These are on the binding affinity of 25D compared to 1,25D, one showing 25D’s is at least 500x lower than 1,25D’s binding affinity for the VDR:

    http://www.ncbi.nlm.nih.gov/pubmed/1084355?dopt=Abstract

    I’ve heard reports of even 1000x lower, but I am still searching for an adequate reference.

    To be fair, I had the common sense thought that 25D levels are many times higher in the serum versus 1,25D, given that 25D levels are measured in ng/ml and 1,25D levels are measured in pg/ml, and perhaps the relative abundance of 25D to 1,25D might overcome this binding deficit. However, when I explored this angle, it seems that 25D has a higher tendency to remain protein bound in the serum versus 1,25D by a nearly 10-fold amount.

    Further, I found a study on sarcoidosis where they bound radioactive 1,25D to VDR receptors on T cells. They found that 25D was not able to displace the radioactive 1,25D but that non-radioactive 1,25D was able to displace it:

    http://www.ncbi.nlm.nih.gov/pubmed/1646583?dopt=AbstractPlus

    I cannot seem to find one study that demonstrates that 25D affects the VDR and inhibits 1,25D’s ability to turn it on. Further, correct me if I am wrong because I am just learning about all of this, but from what I have read and understand so far about the relationship between 25D and PTH, if 25D did block the activity of 1,25D on the VDR, then wouldn’t PTH levels increase? Rather, it seems that the higher 25D goes, PTH is decreased.

    What I would believe is if you had a study in human volunteers that took baseline 25D, 1,25D, PTH, Calcium, and antimicrobial peptide levels at baseline, then randomized and groups to receive D supplementation at a level targeted to get 25D levels into the 40-60ng/ml range. A placebo group, and a group for D-avoidance targeting low 25D levels and see what happens to antimicrobial peptide production and perhaps other immune markers. This would show id low 25D would indeed boost immune response, allowing 1,25D to active the VDR, or perhaps show that increased 25D levels decrease AMP production or other immune markers.

    Also, to allude to an earlier point, to prove MP works, you need studies with multiple arms– perhaps a benicar only arm, a low D only arm, low D + abx, Benicar + abx, etc., etc. Perhaps Benicar and abx is enough? Perhaps low D is harmful long term? (You have no long term data, certainly no where near the number of years as some of the D-supplementation studies). MP and D-Avoidance simply have not been around long enough to bear out an potential long term health effects.

    Now, after all this, this is not to say I am going to go out an gob down oodles of cholecalciferol, but I don’t think I’m going to recommend my sister starve herself of sun exposure or dietary D intake either.

    I also don’t mean to be at all hostile, though your email to me certainly was. I am just a brother who loves his sister very much and would genuinely like to help her. I am looking fo conrete answers, and any information or clarification you can provde me on the points I have made here will be most helpful. I appreciate your time and that of the other volunteers on this and other sites.

  46. Amy Proal November 14th, 2009 at 4:41 pm 46

    Hi Bill,

    I understand that you are trying to help your sister and that’s very admirable. However, right now I am in graduate school and extremely busy. I have kept the comment sections open on this site so that I can answer people who ask one or two questions but I simply don’t have the time to spend hours discussing your concerns.

    Since we are a non-profit organization in which nobody gets paid we have very limited resources and time. Most of the people who start the MP seem to get most of the info they need by using our Knowledgbase, reading our publications, and using http://www.curemyth1.org to meet other people on the treatment and ask them about progress and concerns. If you feel that these resources do not offer you enough information about the MP to recommend the treatment to your sister then perhaps she should seek out another treatment option at this time. Maybe in the future we will have the resources to provide more individualized counseling.

    Best,

    Amy


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Patient Interviews

About Amy Proal

Amy and Zeus

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.

Amy has spoken at several international conferences and authored several peer-reviewed papers on the intersection of bacteria and chronic disease.

If you have questions about the MP, please visit CureMyTh1.org where volunteer patient advocates will answer your questions. Another good resource is the MP Knowledge Base, which is scheduled to be completed within the next year.

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