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For many physicians, corticosteroids, of which glucocorticoids are one kind, are a first-line treatment for a number of diseases, including multiple sclerosis, sarcoidosis, lupus, and rheumatoid arthritis. Research shows that any kind of short-term symptomatic improvement from corticosteroid use does not last, and that over the longer term, use of the drugs can have adverse consequences, including a litany of side effects. Ther term corticosteroids refers to a family of drugs that includes synthetic drugs, such as prednisolone, and natural ones such as cortisol, ­an adrenal hormone which is found naturally in the body. Corticosteroids include mineralocorticoids, which affect salt and water retention, and glucocorticoids, which affect protein, fat, and carbohydrate metabolism.
Corticosteroids can be administered by injection, topically, nasally, orally, or via eye drops.
Because they suppress the innate immune response and do significant long-term damage, all corticosteroids and hormonal steroids are contraindicated and must be discontinued before beginning the Marshall Protocol (MP). Patients with chronic disease may find that while taking corticosteroids, both symptoms and markers of the disease, including X-rays, liver enzymes, etc., may temporarily decrease.
Even if the dose of corticosteroids is continually increased over time, the sheer amount of toxins that the bacteria generate will, at some point, become uncontrollable. Corticosteroids act on a host of nuclear receptors, activating some and inactivating others.
Whether nuclear receptors are active or inactive is important because they control, and, when modulated, can upset everything from immune response to energy metabolism. The function of the glucocorticoid receptor (GCR) is not fully known, as mice who are bred without it do not survive gestation. The body exquisitely balances the endogenous production of its steroid hormones in a manner which cannot be mimicked with endogenous drugs.
Fibrosis, which is not stopped by steroids, encases bacterial pathogens in collagen, from which they will eventually begin to break free. The long-term use of steroids promotes parasitization of the more dense organs, rather than just soft-tissue in the lungs.
There are no studies which show that steroids improve long-term prognosis in the treatment of illness.


The 2003 NIH ACCESS study2), the largest and most ambitious to date, validates that these drugs are ineffective for sarcoidosis patients, even for a time period as short as two years. Table 3 in the paper shows how, for the majority of patients, markers of the disease process remained unchanged. Oral steroids improved the chest X-ray and a global score of CXR, symptoms and spirometry over 3-24 months.
Relapse… rarely occurred in patients who had not been treated with corticosteroids in the past. Whether taking injectable or inhaled corticosteroids, children are particularly susceptible to the negative long-term effects of the drugs. Am I suffering treatment-induced diseases or damage as a result of taking high-dose steroids? Am I familiar with reports indicating that corticosteroids do not halt the advancement of sarcoidosis?
Do I realize that withdrawal from corticosteroids causes relapse of disease symptoms that may be worse than the original symptoms? While on the MP, limited use of sniffed, inhaled or topical steroids is allowed for intolerable symptoms of nasal congestion, shortness of breath or itching if management of MP medications fails to dampen immunopathology symptoms. MP patients should consult with their health care practitioners to devise a plan to substitute other medication for symptom relief, if possible, or to discontinue the use of the steroid product as soon as the acute inflammation is under control. Corticosteroids suppress the innate immune response, which provides some patients with temporary symptom palliation but also allows chronic pathogens to proliferate. Though synthetic and natural corticosteroids are both potent anti-inflammatory compounds, the synthetics exert a stronger effect. MP patients are strongly discouraged from using any of these corticosteroid forms because they are absorbed systemically and are, to some degree, immunosuppressive.
As damaging as they are, the abrupt discontinuation of corticosteroids can cause serious harm. This is due to the short-lived decrease in inflammation as well as the fact that pathogens are not being killed.


For example, cortisol has an affinity for the glucocorticoid receptor, and aldoesterone has an affinity for the mineralocorticoid receptor. The problem with viewing cortisol or any other hormone as a supplement is that it acts as a steroid rather than a replacement. By way of example, hydrocortisone alters operation of the VDR, thyroid-alpha, thyroid-beta, glucocorticoid, mineralcorticoid and too many other alterations for me to detail. There is every reason to believe that a longer-term study as well as one looking at dose would further demonstrate how corticosteroids are worse than ineffective – they're dangerous. The striking difference in relapse rate between treated and untreated patients suggests that patients with disease that would later be severe and protracted were almost unerringly identified early in their course.
Also, being a health care worker at the time of SARS infection more than tripled the risk of psychiatric morbidities at follow-up.
For their own safety, patients on the Marshall Protocol (MP) must wean off of them as opposed to discontinuing them outright. MP patients currently taking corticosteroids should consult with their physicians to slowly wean off the drugs. The bacteria multiply in the tissues without any hindrance once the corticosteroids have shut down the body's immune reaction. Corticosteroids also bind to other key receptors including the Vitamin D Receptor, PPAR-alpha, PPAR-gamma, and others. A more comprehensive paper would also have examined the range of negative side effects associated with coriticosteroid use. There are limited data beyond two years to indicate whether oral steroids have any modifying effect on long-term disease progression. Members of the MP study site are advised not to begin steroid withdrawal without first discontinuing antibiotics and consulting with our support community.



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