I. Background
Arthritis has been known to exist since prehistoric times. Over 37,000,000 people are currently suffering from some form of rheumatic disease, resulting in tens of billions of dollars in health care costs and lost productivity. This protocol provides the means of returning these people to an active, productive life through the safe and effective use of low dose antibiotics.
II. Disease Mechanism
This protocol views inflammatory rheumatism as a persistent, cell-mediated hypersensitivity created by long exposure to antigen (toxins) derived from a hidden or invisible microbial source (i.e., mycoplasma or closely related bacterial L forms). It appears that mycoplasma produce their effect in man by creating a cell-mediated response resulting from long-standing cellular parasitism with gradual sensitization of the host through intermittent antigen release from the cells. The therapeutic focus must be on eliminating mycoplasma.
It is suggested that mycoplasma enter joint tissue when the cellular immunity is weak and remain as parasites for many years. Over time, the body produces antibodies, which represent the defense mechanism of the cells, against the mycoplasma. Eventually, the antibodies begin to increase in concentration in the tissues surrounding the cells that are infected. Finally, when the concentration become sufficiently high, the stage is set for a reaction to occur between the two forces: the extra-cellular antibodies and the intra-cellular mycoplasma.
The beginning of the disease in the clinical sense is when the two forces are thrown together by injury, stress, barometer alterations, or other environmental factors. The initial reaction is one of inflammation in the spaces between the cells and this rapidly extends to produce hot, swollen, tender joints and painful surrounding soft tissues. This inflammatory reaction is designed to keep the infectious process from spreading. Unfortunately, it also becomes a barrier to the entry of more of the body's defense forces. This helps account for the chronic, unrelenting nature of the disease process.
The Hypersensitivity State
The body's immune system is not so easily tricked, however. Various immune cells create a large supply of mycoplasma specific antibody, ready to used the next time that the mycoplasma and its antigen become exposed. Hence, a "hypersensitive state" develops. This state also accounts for the high degree of localization of mycoplasma foci.
A delicate balance exists, until something disturbs it from either side, causing the next wave of infection or inflammation. As a result, it is not desirable to use standard anti-microbial therapy. High doses of antibiotic can kill too many mycoplasmas at once, causing them to release excess antigen, while any surviving remnants burrow themselves further inside the body's joints and soft tissue.
The primary objective of treatment is the suppression of antigen production while avoiding the sudden release of excess antigen and delayed drug sensitivity to over-medication. Effective treatment utilizes relatively low dose medication, interrupted dosing, and long-term treatment.
In all microbial hypersensitivity states, the causative agent virtually goes underground as the tissue reactivity becomes manifest. Thus, in the highly reactive state, very little anti-microbial medication is needed to further control the disease. And if too much is given, the body begins to react against the medicine itself and defeats the purpose of the treatment. This is the main reason for the intermittent treatment.
Treating the Microbial Cause
The fundamental treatment goal in the induction of a sustained remission is to control and suppress antigen production. The final objective is the ultimate elimination of the microbial agent. In the primary objective, the suppression of antigen production, dosage needs to be tailored to the individual patient. Medication may need to be reduced to the minimum, such as minocycline, 50 mg. once or twice a week, gradually increasing according to patient tolerance.
An important guideline in successful treatment has been the avoidance of over-medication with paradoxical worsening. Too much medication can cause a delayed hypersensitive reaction to the drug itself and induce a flare of the arthritis with the development of symptoms closely mimicking the disease (Herxheimer Reaction). The Herxheimer flare is the first indication that the antibiotic is reaching its target, and therefore considered a good sign. A therapeutic balance can be readily reestablished by the temporary interruption of the treatment for a week and then restarting at the same low dose.
Disease Characteristics
The toxic substances, as well as toxins from organism die-off characteristically present in inflamed tissues, escape into the blood stream and are transported to the liver where they are destroyed. As they pass through the system, they react at the point of greatest antigen accumulation and may affect the body in a devastating fashion because of their persistence:
In the bone marrow, these toxic materials interfere with formation of blood and therefore anemia is commonly observed in severe rheumatoid arthritis and cannot be corrected until the disease has improved
In the central nervous system these toxins promote depression, inability to concentrate, loss of memory, loss of interest in one's vocational effort, mental irritability and seizures
In the muscular system these toxins are responsible for excessive fatigue and persistent weakness which is difficult to overcome by physical means
In the endocrine system gland functions are depressed
There is an effect upon the digestive system and many other basic physiological processes
Every organ system may be involved at one time or another
Patients who experience severe symptom onset, which then rapidly subsides without residual change, and who have recurrent, similar episodes, seem to be less likely to develop destructive joint changes than patients in whom the onset is gradual with smoldering involvement. In the course of time, through the continuity of antimycoplasma treatment, there is a gradual reduction in inflammation and symptoms generally diminish.
