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Foundation Staff
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Posted: Fri Oct 29th, 2004 16:13 |
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How to take a break from the Marshall Protocol
If you want to feel better for awhile or if you have a planned activity that requires you to feel better for awhile, an adjustment in medications may be all that is necessary.
If you've been on the MP long enough, you may want to take a break to provide you with an opportunity to assess your progress without the confusion of immune reaction symptoms.
However, some folks feel better when they stop antibiotic/s and some feel worse. If you have experimented with antibiotic dosing in the past, you have a better idea of how this will affect you.
Stopping Benicar is not recommened. Once you have reduced your vitamin D and allowed your immune system to recognize the pathogens with the Benicar blockade, it often, essentially, goes into "auto-pilot" mode and may keep on doing its job of killing pathogens even in the absence of antibiotics and Benicar. The Benicar blockade provides an anti-inflammatory effect that may be necessary to maintain tolerable symptoms.
Adjusting antibiotics
Regular doses of certain antibiotic (minocycline works this way) can be modulatory by reducing your immune response, bacterial killing and symptoms.
"We have to understand that what we have done is weakened the bacteria, allowing the immune system to kill them. But the same antibiotics that block the ability of the 70S bacterial ribosome to create proteins, and thus weaken them, also have a modulatory effect on the immune system itself. This has never been defined in any papers I have seen, but is likely when we consider that most of the antibiotics have come from a parasitic source - mino is just one step from a strep mutant, etc. It would be folly to assume they have no effect on the host.
The antibiotic/s modulate the ability of the immune system to kill the pathogens. Giving a more frequent (or regular) dose often reduces the killing, and folks who cease using the antibiotics sometimes have more, and less predictable, inflammation than when they were using the protocol." (may also affect blood test results)
..Trevor..
To take a break from the MP:
-decrease your antibiotic/s
-space out the antibiotic/s dosing
-or stop taking antibiotic/s completely
Continue the Benicar
Benicar provides a palliative anti-flammatory action that may be essential to maintain tolerable symptoms. Continue the Benicar blockade at 40mg every six to eight hours.
-Continue to avoid all forms of ingested Vitamin D.
-Take adequate precautions to avoid an increase in symptoms related to sun exposure. The light sensitivity is part of the healing process, and not due to the meds. However you adjust the protocol meds, you will still have the same degree of light sensitivity at that same stage of healing.
-If your special activity will entail an unavoidable increase in sun exposure, consider increasing the Benicar dosage to 40mg Q4H or 20mg Q2H....and plan for adequate rest. See How do I come off the MP and return to daylight?
Bacteria growth
The bacteria you are trying to kill are very slow growing, so an abstinence from the MP antibiotics for a few days or even weeks will not result in a significant increase in bacteria. If you are experiencing some symptoms of immunopathology, you are killing bacteria and making progress towards recovery.
What to do if your immune response continues
But once a reduction in vitamin D and the Benicar blockade have allowed the immune system to recognize the pathogens, it often, essentially, goes into "auto-pilot" mode and may keep on doing its job of killing pathogens even in the absence of antibiotics and Benicar.
"These days, in all my presentations to physicians, I make a point of helping them to understand that it is the immune system which is doing the germ-killing in the MP, not the drugs. They tend to make the mistake of focusing on the drugs. The problem is that even after you stop taking the Benicar (and abx), the immune system will keep killing the bacteria unmodulated for months." ..Trevor..
Stopping Benicar
"Benicar normalizes a number of actions of the innate immune system. If you stop taking Benicar, it is possible that once the palliative actions are removed, the immune-sensitizing actions might still be effective, with the body taking a while to switch off its recognition of the Th1 pathogens." ..Trevor..
As we recover and the innate immune system becomes more active, 1,25-D will recommence its role as VDR agonist. At some point the immunosuppressive action of Benicar (and it's ability to reduce symptoms) becomes dominant over its role in activation of the VDR (which is so critically important at the start of treatment).
So if stopping the Benicar means less activation of VDR, symptoms could be lessened; if stopping the Benicar means less immunosupression, symptoms could increase.
There is no method or technique to discontinue Benicar. Since it is not palliative unless the blockade is in place, it's okay to discontinue it without weaning. See Do I have to wean off Benicar?
Suggested med adjustments to discuss with your Doctor
It is important to choose a meds dosing and schedule at any point in time which will give symptoms that are manageable.
For some who stop the antibiotics altogether, immunopathology may continue. If that happens:
-Continue to take Benicar
-The minocycline dose/schedule can be adjusted to what is most comfortable for you individually.
Note: While taking Benicar, the maximum daily total minocycline recommended is 100mg. (you may take/require less)
Minocycline dosing options
-schedule can be extended or stopped if helpful to assess symptoms level rising or falling..
-A single dose of mino 25mg may be enough to slow immune response symptoms.(or 50mg if on higher doses)
-or mino dose can be decreased and continued (lowest recommended is 25mg)
-if the immune system response is dampened by taking a mino dose, a lower dose taken more often may be effective. See Why and when do you recommend taking minocycline frequently?
The dosing most suitable is individual to each and may need to be adjusted as necessary.
Members in phase 2 or 3
If your immune system response doesn't stop by stopping the antibiotic/s, you may find it better to continue the 2nd and/or 3rd antibiotic/s dosing at the last comfortable level while adjusting mino to reduce symptoms (see above).
To resume the MP
-If you have been off Benicar as well: Take the Benicar alone for a few days to see if you have any intolerable adjustment symptoms and then resume minocycline.
-If you took a break from antibiotics for just a day or two, you can resume at the previous dose.
-If the break was longer, restart antibiotics at a lower dose to assess symptoms as tolerable, to avoid a strong immune system reaction.
* Please check with Board Staff regarding your individual situation whenever you are unsure.
Scroll down for members' experiences
Last edited on Sat Aug 23rd, 2008 19:56 by Foundation Staff
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Foundation Staff
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Posted: Sun Oct 9th, 2005 01:16 |
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(filelink)
Personal experiences with an antibiotics break
See Tell me about your break
-Those of us who take ABX breaks continue to take Benicar. It usually reduces inflammatory disease symptoms and you can see how you feel without the Herxheimer reactions.
-When you've been on the MP long enough to have killed plenty of bugs, Dr Marshall encourages you to take a break from the meds for a while, just to prove to yourself that you really are getting better. It's a revelation! After a couple of weeks you have to remind yourself what it was like to be so ill.  ~Julia
Sometimes the immunopathology will take weeks or months to decline during a break, but when it does, the patient may realize how much bacterial killing has occurred and the progress they have made due to the MP.
-At the end of a month, I was still herxing and not able to much more than I had before, so I made a decision to stay on break until I felt somewhat rehabilitated. At 50 days I was feeling much better...
...Although this break has lasted 70+ days, ¦way longer than I ever anticipated, ¦it has been an eye-opening experience. I actually got to the point of feeling great, and the last two weeks were the best of all¦..BETTER THAN ANY TIME IN THE LAST 25 YEARS. I did not need naps, and could go literally all day with just a 45 minute rest in the afternoon. I had the exhilarating feeling of dancing or flying. It felt like time travel to a past where I was well and energetic. ~Shrnhml (May 1st 2006)
-I may be seeing a pattern here for my individualized implementation of the MP. Having no help, all household maintenance is up to me. I can go only so long without catching up. I seem to be in a pretty constant mental and physical herx while taking the MP meds, so nothing gets done. Maybe 8 to 10 months on and then a month or so off (to restore order) will be my pattern. ~Shrnhml (May 2nd 2007)
Dr Marshall wrote: Having improved morale is oh so important when you have to get through the difficult patches of recovery. A little bit of herx-holiday every few months is something I strongly suggest to the Docs who call me.
John McDonald wrote: The break was very nice. When I am in the midst of herxing my emotions tell me that I have always been herxing, always will, with no end in sight. I know many of us have that psychological response. Taking this break has been a morale booster.
IVAL has a break
Gary's Experience ..
-I believe this was a very good way for me to take a mini-break (dropping back to previously tolerable dose of "last abx" added) ..... as the herxing dropped waaaayy down (to a point I barely noticed any herxing at all and that was only in passing) ~ Robertrr
Individual Pace Joyce Waterhouse, Ph.D.
I'm eager to get well. How can I speed up my progress on the MP?
If you stop the MP prematurely
The MP can't create new inflammation because it can't make bacteria appear where there weren't any bacteria before. When we get new symptoms that we haven't had before, surely it's because the MP is exposing more bacteria in places we didn't realise we had them.
Now, if we didn't do the MP, these hidden bacteria would not remain hidden for ever. Eventually they would multiply to the point where they would reveal themselves in new symptoms. So, if one stops the MP prematurely, not only will the 'new' symptoms remain and worsen, but also further new symptoms will gradually develop, just as they would have done if one had never done any MP.
For example, I was not aware of any heart trouble with my sarc. But on Phase 1 of the MP I had a couple of scary episodes that felt like heart pain. If I hadn't been on the MP, the bacteria affecting my heart would be freely multiplying year by year until the time that my heart might be seriously weakened and I would be in grave danger.
What I'm saying (rather long-windedly!) is, if you stop the MP, you don't go into a stationary state exactly the same as you are now - you continue to deteriorate. You don't tread water, you drown. ~Julia
See also
Benicar forever?
Words of Encouragement
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