The Arthritis Trust of America’s Antibiotic Protocol
P. Anthony Chapdelaine, Jr., MD, MSPH
Executive Director and Secretary
The original mid-1980s Arthritis Trust of America antibiotic protocol for treating rheumatoid disease was developed by Gus Prosch, MD and several of the Foundation’s original physicians and scientists. The protocol can be found on pages 5 through 9 at http://arthritistrust.org/wp-content/uploads/2013/03/Wyburn-Mason-Treatment-for-Rheumatoid-Disease1.pdf. Note that substance 9 (rifampin) on page 5 was only used under exceptional circumstances and under close supervision. Dr. Prosch’s approach to using the protocol can be found on pages 3 and 4 at http://arthritistrust.org/wp-content/uploads/2013/03/Anti-amoebic-Treatment-for-Rheumatoid-Disease.pdf. The Foundation’s co-founder and first Executive Director summarized the protocol in the “How to Get Well” section, number 11 at http://arthritistrust.org/how-to-get-well/.
This protocol has helped cure or slow the progress of rheumatoid diseases such as rheumatoid arthritis for countless patients. In fact, the Foundation’s co-founder and Executive Director from 1982 until his death in late 2015 at almost 91 years-of-age, Perry A. Chapdelaine, Sr., tells how he halted his “galloping” arthritis within six weeks of using the original antibiotic protocol (metronidazole and allopurinol). As well, one of the founding physicians permanently cured his chronic rheumatoid arthritis and helped refine the Foundation’s protocol. (See: http://arthritistrust.org/wp-content/uploads/2013/03/Anti-amoebic-Treatment-for-Rheumatoid-Disease.pdf where Dr. Prosch also explains what the physicians learned early-on, that the initial Herxheimer arthritis “flare-up” exacerbation of symptoms was a good indicator that the treatment was working and should be continued until no further Herxheimer reactions occurred. Also see: http://arthritistrust.org/wp-content/uploads/2013/03/The-Herxheimer-Effect.pdf.) Usually, two or three repeat six-week antibiotic courses (trying different antibiotic combinations) are tried until a response plateau is reached or the Herxheimer reaction stops. It is considered better to not use the temporary low-dose prednisone to suppress the Herxheimer reaction unless it is too uncomfortable for the patient since the prednisone may mask the Herxheimer reaction. Usually, the patient can get by without the prednisone as the Herxheimer symptoms typically disappear quickly.
In the 1980s and 1990s the Foundation sponsored research which helped explain some of the reasons that the initial antimicrobial protocol worked, although most of the evidence came later in the form of clinical results. As the physicians and scientists gained experience using this protocol they realized that rheumatoid disease causation was multi-factorial. Sometimes the antibiotics were not enough. Sometimes minimizing or stopping the autoimmune inflammation required seemingly unrelated approaches: heavy metal chelation, elimination of dietary “allergens,” use of certain clinically-deficient nutrients or hormones. The connection between inflammation found in both rheumatoid disease and osteoarthritis became another concern and focus. For instance, one of our referral scientists (Rex Newnham, PhD) wrote extensively on using boron, which he said was deficient in the soil and food and particularly important in preventing protozoa and viruses (explaining its helpfulness in rheumatoid disease) and in repairing the damage from osteoarthritis – this was in the 1970s and 1980s, long before the present-day research confirming the same connection. (See: http://arthritistrust.org/wp-content/uploads/2013/03/Boron-and-Arthritis.pdf.)
In one of the Foundation’s earliest funded research projects Kwang Jeon, PhD of the University of Tennessee discovered that one of the reasons, besides its antimicrobial properties, that metronidazole – the first antibiotic used in the Arthritis Trust protocol – likely works is that it acts as a depressant to the macrophages which are releasing damaging byproducts as they try to “clean up” debris from organisms attacking the joint. Dr. Jeon also was able, for the first time, to culture macrophages taken from the synovial joint fluid and grow them continuously for more than a year. These two discoveries to this day are not known by the medical community. It was also discovered during this time that sufficient Lactobacillus acidophilus must be present in the gut to properly metabolize metronidazole to get the desired clinical effect, and that IV metronidazole did not work.
In recent years, Perry A. Chapdelaine, Sr. summarized the Foundation-supported laboratory research and the Foundation’s referral physicians’ clinical experiences in his article, “How to Get Well.” (See: http://arthritistrust.org/how-to-get-well/.) He presented, in broad strokes, most of what the Foundation’s physicians and scientists, over three-and-a-half decades, learned would work to eliminate rheumatoid disease, including additional insights into rheumatoid disease causations and the best approaches to stemming the inflammation.
An example is the African woman (looking for help for a friend with Ankylosing Spondylitis) who used Perry Chapdelaine, Sr.’s suggestion to look for and treat for organisms common to the friend’s geographical area and eliminate the body’s burden of immune triggers and depressants. (See our website links: “How to Get Well” Item 5 http://arthritistrust.org/how-to-get-well/ and “Newsletters Spring 2005” http://arthritistrust.org/wp-content/uploads/2013/06/2005Spring.pdf.) Ultimately, this required that the woman help the man get medical treatment for a parasite (schistosomiasis) while supporting the man’s immune system and eliminating toxins (heavy metal and pesticide exposures), all of which finally resulted in a cure. There is no one-size-fits-all approach to inflammation (which is now accepted as the pathophysiology behind heart disease, cancer, rheumatoid disease, and most chronic medical problems). The issue is always how to help the patient discover, and eliminate or control, the reasons for the inflammation. There are hundreds of articles, historical letters and references (many giving the clinical or research basis behind the Foundation’s protocols and recommendations) at http://arthritistrust.org/what-we-stand-for/ and at http://arthritistrust.org/articles-miscellaneous-and-historical/. (One example is the finding that allopurinol, used for preventing uric acid buildup in gout, and in the correct dose part of the original Foundation antibiotic protocol, also has viral-static, antiamebic, antibacterial, and antiparasitic properties!) These articles and letters detail other substances or methods that can be tried for resistant autoimmune cases.
Additionally, to quiet-down the “trigger points” that seem to exacerbate nerve signals and thus contribute to ongoing joint destruction, two of the founding physicians (Dr. Paul Pybus of South Africa and Dr. Gus Prosch of Birmingham, Alabama) developed and refined a method for injecting a dilute depo-steroid and lidocaine solution into these points, the solution remaining in that area and dampening the inflammation, which then relaxed the nerve excitation reflex feedback which had been causing a “clamping” effect that was destroying the joint. (See Intraneural Injections for Rheumatoid Arthritis and Osteoarthritis & Control of Pain in Arthritis of the Knee by Anthony DiFabio and Dr. Pybus at http://arthritistrust.org/books-and-pamphlets/, and Dr. Prosch’s “Lecture on Intraneural Injections” at http://arthritistrust.org/wp-content/uploads/2013/03/GusProschLecture2-1987.pdf.)
My own decade of clinical experience in using the Arthritis Trust of America’s protocols and principles confirmed their validity. As well, I found a variety of “etiologies” some of which, although briefly mentioned in passing by the Foundation’s physicians and scientists were not emphasized since no patient’s history is exactly the same as another patient’s. Solving inflammatory problems requires detective work on the parts of both physician and patient; requires trial-and-error (since each patient is his/her own “experiment”) by following a protocol and then moving to the next “lead” if no results are forthcoming; and requires patience and persistence. Sometimes, several contributing factors must be eliminated or minimized to effect a helpful result (i.e., one must determine and then reverse the factors which upset the “tipping point” at which the body’s burden to exposures overwhelms the immune system). Genetic inheritance (HLA factors) may predispose toward how a patient reacts to one or more exposures, but in the Foundation’s experience it is rarely the sole “cause” of any chronic disease.
To illustrate: a patient came to see me after a year’s progression of severe and rapidly-crippling rheumatoid arthritis, responding only slightly to our Foundation’s antibiotic protocol. I tried other measures, including compounding clotrimazole capsules which sometimes worked when metronidazole failed to make a difference. I worked with her for over half-a-year trying different natural anti-inflammatory substances (which did help a little), measured a hundred item panel each of IgE and IgG food allergies or sensitivities, as well as the live white blood cell (lymphocyte) response to several-hundred food and chemical substances. She had clinically significant reactions to a number of foods and chemicals which we eliminated from her diet for several months. This helped somewhat in stopping her symptoms, but not completely. A dentist removed her mercury fillings, after which the mercury (and other heavy metals) which, once it had been removed, we found at high levels by a chelation-challenge test were orally chelated over a three month period. But it turned out, much to my surprise when I tried using it based on anecdotal evidence, that the major impact to halting her rheumatoid arthritis progression was by using MSM (methylsulfonylmethyl) crystals mixed in water. She titrated the dose every few days by increasing it until she found the maximum dose her body required to minimize inflammation without causing her diarrhea (since one of the effects of MSM is to increase peristalsis, making it useful for chronic constipation). After all our work, we did not “cure” her rheumatoid arthritis, but we found that as long as she takes the MSM daily, and avoids certain foods (which she can only eat on occasion) such as bananas, tomatoes or tomato paste, hot chili peppers, pumpkin and a few others, her arthritis is well-controlled. If she has dietary indiscretion (usually too many meals containing one of her reacting foods or chemicals), she will have a “flare,” but always improves after a few days by avoiding the offending substance. She also regularly takes capsules of concentrated bioabsorbable curcumin and other natural anti-inflammatory herbs or vitamins.
I saw several patients whose “rheumatoid arthritis” did not improve no matter what we tried. I finally tested them comprehensively (not the usual inaccurate “screening” test) for what our state health department and the local medical university “authorities” said did not exist in Tennessee: Borrelia burgdorferi – Lyme Disease spirochete. These patients all had extensive infections by this spirochete that were causing their “rheumatoid arthritis” inflammation and joint destruction, as well as other symptoms and signs such as “brain fog” from the organisms invading the cerebral tissue. Resolution of their arthritis symptoms depended on how many years these patients had been infected and their response to the multiple antibiotics and natural anti-parasitic substances used to try to “eliminate” (or “control” – since evidence exists that they may be never totally eliminated) the organisms. One of our Foundation’s scientist advisors (Lida Mattman, PhD) was a world authority on pleomorphic cell-wall-deficient organisms (and literally “wrote the book” on these). She was also a friend. Decades ago, through her research and that of her PhD students, she showed that antibiotics, the immune system, and other factors will often simply change bacteria or other pathogens (such as spirochetes like Borrelia) into a “cell-wall-deficient” (pleomorphic) form which cannot be detected by the usual lab tests, cannot be detected or destroyed by the immune system, cannot be touched by the usual antibiotics which created them in the first place, and eventually would come out of “hiding” and revert to their prior form once they were no longer being hunted or poisoned. This accounts for many of the supposed “reinfections” physicians encounter, which are actually incomplete elimination of the organism as it enters a cell-wall-deficient stage with its later recurrence. To this day this fact is not recognized or studied by the medical establishment. (There is a Swedish doctor who developed a light microscope more powerful by orders-of-magnitude than any available in the world who has shown through his microscopy – both still photos and movies – Borellia in its cell-wall-deficient phase as well in other phases, such as a “string of pearls,” all of which contribute to the incredible difficulty inherent in eliminating that spirochete organism.)
I treated a couple women with “rheumatoid arthritis” diagnoses who responded best to balancing their out-of-range ovarian hormones, and there is at least one physician-lay group advocating this issue as a major contributor to rheumatoid disease.
I treated patients who had infections with Rickettsial infections (Ehrlichia, Anaplasma, Rocky Mountain Spotted Fever etc.) whose “autoimmune” arthritis cleared after eliminating those infections.
There is evidence that “gouty arthritis” is a sequelae to “ubiquiton” which is a substance excreted by a Mycoplasma bacterium. (Remember that the antimicrobial Allopurinol, used for uric acid control, is used during the first stage of the Foundation’s antibiotic protocol.)
It is understandable why a patient becomes discouraged by the lengthy, and sometimes difficult, process of investigation into the etiology of their “rheumatoid disease” inflammation. This investigation requires dedication and work on the patient’s part which may be too expensive, too complicated, or too “overwhelming” without proper support. It is understandable why this process can be equally frustrating for the physician who lacks either the training about the processes behind the body’s overloaded immune response to inflammatory insults – generally from multiple causes – or does not have the staff or time to spend with the patient to figure out the reason(s) behind the autoimmune response, or is unable to interest the patient in trying out different approaches.
So, the place to start is with education. The physician and patient should, at least, read and be familiar with the principles outlined in the Foundation’s “How to Get Well” section at http://arthritistrust.org/how-to-get-well/.
Regarding the Foundation’s antibiotic protocol, Perry Chapdelaine, Sr., in the “Letters and Answers” section http://arthritistrust.org/letters-and-answers/ answered one patient this way:
It’s not clear as to whether you were given insufficient medication over time, or whether your doctor went through our complete medical recommendations.
With the proper protocol, while it’s true that about 50% of those who try the Wyburn-Mason treatment alone get well, we’ve since learned that there are many other factors that must be explored. We’ve all been negatively conditioned to pop a pill to solve a health problem. This works fine for symptom relief, but usually not for serious health problems that actually involve many factors (causes) at the same time.
Please go back to our website and read the article “How to Get Well,” and you’ll understand better what you’ve got to do.
Dr. Prosch used to switch from one of our recommended drugs to another for a second or third trial, for example, from metronidazole to clotrimazole, or tinidazole, also from allopurinol to furazolidone. The problem is this: if your RD is primarily a condition of antigen/antibody complexes that you’ve developed a sensitivity to, no one knows specifically which microorganisms cause the difficulty. So, by trying one broad spectrum set of drugs and then another, one covers a broader range.