Journal of Immunity

Vol 2 No 4 Oct-Dec 2004

Immune Restoration Handbook

(newly revised - 2nd edition)

Mark Konlee

The second edition of the Immune Restoration Handbook was co-authored by myself and Conrad LeBeau. After more than two months of working on revisions, it finally went to the printers on Nov 28th. Sometime between December 25th and New Years, we expect it back in printed form.

The book has a newly designed cover with a marble stone background. The chapters on the Adrenals, Thyroid and Complementary Therapies were substantially revised. The section on the Adrenals has updated information on the benefits of low-dose hydrocortisone for a wide range of health conditions. An expanded section has information on various ways of reducing and normalizing interleukin 6 levels and stimulating the adrenals to balance hormone production.

A promising low-cost protocol developed by Didi Ananda Rucira that has been used in Africa on AIDS patients with encouraging results has been included in the chapter on "Complementary Therapies."

Specialty Lab test for IL-6

Specialty Labs, 2211 Michigan Ave, Santa Monica, CA 90404 will test for Interleukin 6 levels. The Code for this test is 3828. Phone 310-828-6543 or 800-421-4449.

Anyone who has cancer, HIV, CFIDS, FM, Lyme, Candidiasis, hepatitis, intestinal dysbiosis and any other untreatable chronic health condition should test for IL-6 levels, IgA and active thyroid T3. This creates a starting point to develop and test immunological and hormonal treatments for these various conditions.

A Case Report - possible benefits of hydrocortisone and thyroid on CD4 counts and viral load in HIV+ patient

Miami, FL:

In the last issue of the Journal of Immunity we reported on a case of an HIV+ male (Bob) in Miami who began using 20 mg daily of hydrocortisone (tablet form) taken in the morning once a day. He also takes 25 mg of DHEA in the AM every day, one grain of thyroid daily plus 2 red clover caps twice a day. To this he has recently added 2 capsules of Black Cohosh daily as a source of hormone precursors.

Bob says he started this regimen around October 1st and about the same time stopped using his drug cocktail for treating HIV that consisted of Kaletra, Epivir and Viread. In the last week of September before starting his drug holiday (vacation), his CD4 count was 125 and his viral load for HIV was non-detectable. He had been on this drug combination for several months and his CD4 count had edged upwards very slowly while his condition with osteoporosis and bone pain had worsened.

After 6 weeks off the drugs and while using the hydrocortisone, thyroid and the other supplements, Bob reported less bone pain in this legs. For the first 3 weeks, Bob called about twice a week and said he was feeling great and felt almost normal. He had blood drawn for lab tests on November 18th, 2004. The day after the test, he started back on the drug cocktail at my urging. My concern was that because his CD4 count was low (125) and if the treatment failed, the CD4's could plummet downward leaving him more vulnerable to opportunistic infections. Around December 7th, Bob called with the results of the November 18th test and they were:

I said "interesting" and he said, "that's what I thought" He added: "I expected that if the hydrocortisone treatment failed completely that my viral load should have been over 80,000 and my CD4s would have been below 100. That is the least decline I would have expected if the treatment was having no benefits. Something unusual (beneficial) is happening here."

In the past 5 years, Bob has taken several drug vacations for weeks or months at a time and has tried about a dozen alternative combinations to the pharmaceutical drugs. The only two other OTC treatments that has shown some promise in stabilizing the CD4s and the viral load was high doses of plant based selenium (800 to 1200 mcg daily) and garlic retention enemas. However, even with these, after several months, Bob eventually had to get back on the drug cocktails when his CD4's continued their gradual decline. The reason he stopped the HIV drugs several times has always been due to their adverse effects.

For the time being, Bob has decided to stay on the 3 drug cocktail as well as the hydrocortisone treatment until the next lab test. Depending on the results and his CD4 counts, he will decide whether or not to take another drug vacation and only use the hydrocortisone and the other supplements.

For the past four months, Bob had also taken fish oil supplements that we reported earlier could also lower interleukin 6 levels. In November, he also added Holy Basil, 2 capsules daily, a herb that in stress tests on animals, preserved normal cortisol levels.

The IL-6 levels were not tested and that is something he plans to ask for, whether or not he will get it is another question since he is on SSD and testing for IL-6 is not a standard test approved by the government for measuring the effectivenss of an AIDS treatment protocol. We will continue to follow his case and report on the results.

Dec, 2004: I reached Al Plechner in Idaho where he recently retired from his veterinary practice of the past 35 years. We discussed everything from the pros and cons of synthetic steroids to natural hormones. While Al Plechner agreed that the most desirable hormones to use were the natural ones that are identical to those produced in the body, he indicated that he got some of his best results from methyl prednisolone (Medrol) a synthetic steroid that replaces cortisol. He said that Medrol caused no weight gain and that in some patients the hydrocortisone did. He said that in advanced cases of cancer the most important thing was to keep the patient alive and that is why he used a high dose of a slow released cortisol substitute like injectible Medrol. Later on when the cancer wis in remission, he uses oral hydrocortisone and thyroid to keep it that way.

Research has shown that hydrocortisone and synthetic substitutes like prednisolone and prednisone all have the effect of lowering interleukin 6 and TNF-a. Both of these effects improve Natural Killer cell function and CD8 cytotoxic lymphocyte activity that is critical for an effective immune response in treating cancer, AIDS and other chronic conditions of immune dysfunction. However, the synthetic steroids (E.G. prednisone etc.) are often overused and may eventually cause a number of adverse effects.

Thyroid supplementation helps in many ways. T3, the active form of thyroxin, increases the production of ATP and energy inside the cells and raises IgA levels, a key immunoglobulin needed for intestinal absorption of nutrients and medications and for mucosal immunity, cell-mediated immunity and to reduce food sensitivities and allergies. As IgA levels go up, IgE that is associated with allergies should go down.

I asked Plechner if there were any plants, seeds or herbs that contained natural hormones like cortisol or testosterone. He said he did not know the answer to this question and referred me to a compounding pharmacist, Wally Simons, of Madison, Wisconsin. Plechner said that hydrocortisone could be made from corn, soy or sesame seeds. He said that Wally had started the Women's International Pharmacy (a compounding pharmacy), and would be more knowledgeable in this arena and might have some answers.

On December 15th, I finally reached Wally Simons after several previous attempts had failed. He told me that as far as he knows, there is no human hormones that are naturally occurring in plants or seeds. He said one substance called diosgenin is a precursor chemical found in about 500 plants species that pharmaceutical companies use to make all the hormones produced by the Adrenal glands including pregnenolone, cortisol, DHEA, estrogen and testosterone to name a few. He said there are about 9 steps is converting diosgenin into hydrocortisone. He said Wild Mexican Yam is very abundant in diosgenin as is soy beans. He said the soy beans are cheaper and are now the usual source of diosgenin used to manufacture hydrocortisone.

I asked him if there were herbs, seeds and other nutrients that would increase the body's own production of cortisol and other natural hormones like DHEA and testosterone. He said there probably was but didn't know of any research in this area. I also asked him about cholesterol, the substance that like diosgenin provides the basic building blocks for all the hormones and inquired as to whether high (HDL) or low density cholesterol (LDL) was used by the adrenal glands to make the hormones. He said he did not know but thought the HDL was more likely the source. I told him I had observed significant drops in HDL in lab tests that I have seen from persons under chronic stress and I have observed that in persons HIV+ who have high levels of HDL's that their CD4 counts and viral loads remain stable.

This raises the next question: Can egg yolk lecithin help the adrenal glands produce more of the essential hormones we need to balance out the immune system? Remember Al-721 (egg yolk lecithin) from the 1980s? Egg yolk lecithin is available from soft boiled eggs or poached eggs of range fed or cage free chickens and could be a viable source of HDLs. Chickens that sit is a small cage and get no exercise are less likely to produce eggs with significant amounts of HDLs in them.

Published research indicates that in humans EXERCISE, oils high in monounsaturated fats (olive oil), green tea, niacin, Guggul and L-Carnitine will all increase the good HDL's. Will more HDLs increase adrenal output of cortisol and help normalize IL-6 and TNF levels?

Another question is where do plant steroids like diosgenin fit into this picture? Does diosgenin from Wild Mexican Yam and other sources cause the liver to produce more HDLs or does diosgenin work with HDL cholesterol to help the adrenal glands produce the essential hormones we need for normal metabolic and immune activity? Do these two compounds work separately to achieve the same end or do they work together?

Finally we have to ask how the adrenals that sit atop the kidneys can function normally if the kidneys are toxic and/or we are dehydrated? How can the kidneys function normally if the liver is toxic? Does recovery start with an effective detox program such as a short vegetable or fruit juice fast using raw foods? How about using Cilantro?

Note: Wally Simons can be reached at Women's Int'l Pharmacy at 800-699-8143, ext 100.

Specialty Labs web site at www.specialtylabs.com has an article on "Interleukin-6." IL-6 is an important cytokine to stimulate the B cells and thus antibody production and it is produced in the body by many types of cells including B cells, T cells, monocytes and hepatocytes. However, IL-6 is also produced by carcinomas, kaposi sarcoma cells, other sarcomas and melanomas and is elevated in Hodgkins disease. Specialty labs states that "neutralizing the effect of IL-6 may result in tumor regression. In recurrent breast cancer, IL-6 and IL-8 at the beginning of treatment are predictive indicators of response to therapy and prognosis; continuous elevation of IL-6 levels indicates poor prognosis in heavily pretreated patients. Combination therapy including agents that reduce IL-6 will become a new strategy for aggressively treating recurrent breast cancer."

Specialty labs also reports that "IL-6 was significantly elevated in 28 persons with acute myocardial infarction compared with 15 normal controls, a recent study suggests that IL-6 with its pro-inflammatory role, plays a key role in the pathogenesis of coronary artery disease. The amount of IL-6 produced is closely related to the severity of mycocardial dysfunction." Specialty Labs also reports that persons with the high plasma levels of IL-6 also have the highest mortality rates.

Natural hormones, while manufactured, have the same molecular structure as those produced within the body. Synthetic hormones like prednisone, prednisolone and others replace cortisol in bodily functions but usually have more side effects than their natural counterparts.

Cortef, a brand name of hydrocortisone, has been discontinued. Generic alternatives are available and usually come in 5, 10 or 20 mg tablets. Ask for a generic brand of "hydrocortisone" tablets. Your physician may know where to obtain them or check with a compounding pharmacy. For general use, 5 mg per 40 lbs of body weight would be a minimum to consider. A 160 lb person (160 divided by 40 = 4 x 5 = 20 mg hydrocortisone). Persons with advanced cancer and other serious conditions will usually need an injectable form of hydrocortisone to get results and they will need a higher dose initially. When IgA levels are below 60, the patient will not absorb the oral form which is why they will need an injectable form, at least for the first treatment.

When dietary supplements and drugs taken orally are not effective, it is often due to low IgA levels. This is something physicians need to check for, especially when the patient is not responding to the treatment. The use of natural thyroid will increase IgA (thyroxin induces IgA) levels after a few weeks and this will enable the intestines to once again absorb oral forms of hormones, drugs and dietary supplements.

Hydrocortisone and other natural hormones are made available in any strength through a compounding pharmacy. To locate a compounding Pharmacist, contact

Int'l Academy of Compounding Pharmacists (IACP), PO Box 1365, Sugarland, TX 77487 800-927-4227 or Fax 281-495-0602. Their web site is http://www.iacprx.org and they can provide you with a list of local compounding pharmacists. Natural hormones are also available through www.womensinternational.com. 800-279-5708

If you cannot afford a prescription for hydrocortisone, you can obtain some benefits from a 1% hydrocortisone cream that is available over-the-counter at your local drug store. In a 1% hydrocortisone cream, there is about 20 mg of hydrocortisone in 1/2 teaspoon. Massage about 1/2 teaspoon daily in the morning on your skin or joints. It may be debatable as to how much is actually absorbed systemically, but some is, and enough to give noticeable results. Some published studies claiming that the hormone is not absorbed through the skin to have systemic effects are, in my opinion, wrong. One should always assume that any substance that is applied to the skin and disappears within the skin is absorbed completely. The liver gets the ultimate job of removing all these substances, toxic or benign. Unfortunately, this list includes everything from soaps to gasoline to toxic chemicals used to remove paint and varnish, glues, epoxy, etc. etc.

Some published reports say that hydrocortisone is not absorbed through the skin into the blood for a systemic effect and cite lab tests to back their position. However, contrary to their tests, logic begs to know where the hydrocortisone goes once it has been massaged into the skin. Does it come back out of the skin? It certainly does not go back into the tube from whence it came.

There are many reasons why a test for blood levels of this hormone might fail to detect an increase in cortisol. One is the time of the test from the skin application - too soon or too late may not give accurate results. Two is that the test might have measured cortisone instead unbound cortisol and three is that the body may adjust downwards its production of cortisol when it detects free cortisol circulating in the blood.

It is important to remember that cortisol and cortisone are not the same thing. Cortisol is the active form of the hormone while cortisone is the bound, oxidized or inactive form of the hormone.

Note: To avoid interfering with the circadian cycle, use hydrocortisone cream or tablets only in the morning. If too much is absorbed, it may cause excessive mental activity and keep you awake at night. Then you will know it is time to back off the treatment and retest the cortisol levels.

The million dollar question that I am trying to find the answer to is to locate the foods or herbs a person can consume to promote the normal production of adrenal hormones needed to balance the immune system and to feel great. Countless searches I have placed at the National Library of Medicine (NLM) have turned up only fragments of information that add only small pieces to this puzzle and not enough to fill the mosaic of a landscape. This mission would be easier if I could but find Aladdin's Magic Lamp or the Holy Grail.

One is not likely to find either of these mythical items through an internet search or a garage sale. Rather, we must summon from within us the wisdom, intuition and good judgment to separate the wheat from the chaff in the information blizzard of our times. Many people read this newsletter hoping to find answers to personal health issues that affect them. Some of those answers are here but more are needed as the process of sifting and winnowing continues.

Urine, herbs and plant steroids. Morning urine contains free cortisol. Some alternative physicians have successfully treated cancer by injecting the patients own urine back into their body. Some people drink a glass of their own urine daily for its health benefits. For those who cannot get past the thought or the taste, some people have reported benefits from a urine retention enema. Urine can also be absorbed topically when applied to the skin.

Diosgenin is a plant steroid precursor to Cortisol that can be found in Wild Yam. Some manufacturers claim that wild yam has progesterone in it but fail to cite any research to spport this statement. Black Cohosh and Yucca also contain plant steroids. Black cohosh products have been sold to millions of women in Europe as a treatment for PMS. Black Cohosh has also been reported by Louise Tenny in "Todays Herbal Health" to lower blood pressure. Black Cohosh, Yucca and Red Clover all have been used in in herbal medicine to treat cancer. Are the effectiveness of these 3 herbs in treating cancer due to their ability to raise cortisol levels that lower IL-6 or do the plant steroids (sterols) directly lower the IL-6 without being first converted into cortisol?

Ginseng may contain precursors to testosterone or nitric acid that enhances the sex drive. Licorice root is reported to elevate cortisol but also blood pressure so must be used in small doses or not at all. Holy Basil has been studied in mice induced under stress and has been found to protect and maintain normal cortisol levels. Other herbs with sterols in them are Saw Palmetto and Pygeum, both of which are used to treat BPH.

Plant sterols may be precursors to Pregnenolone, Cortisol, DHEA and other adrenal hormones. However, research to confirm this is nonexistent in this area. Other sources of sterols are Brown Rice bran and unrefined (black) Sesame seeds or oil, Avocados and most other raw unprocessed seeds and nuts especially sunflower seeds, peanuts, pumpkin seeds, seafood, buckwheat and barley.

1. The Immune System Cure, Bouic and Vanderhaeghe; published by Prentice Hall, Canada

In the book "The Immune System Cure" by Lorna Vanderhaeghe and Patrick Bouic, the authors report that plant sterols, beta-sitosterol, campesterol and stigmasterol can alleviate inflammation from interleukin-6 and tnf-alpha in persons with rheumatoid arthritis. These plant sterols also called plant steroids exist in hundreds of foods but especially rice bran, sesame seeds, buckwheat, scallops, clams, oysters, crab, shrimp, salmon, haddock and other seafoods. Lessor amounts exist in nearly all whole grains and seeds. Moducare, a product endorsed by the authors as source of sterols gets its ingredients from soy bean oil. Sterolins are cofactors that come along with the plant sterols.

On the "Con" side of this book, there is a lack of specific clinical data that establishes a specific dosage of these plant sterols or Moducare to a specific decline in IL-6 and TNF in a specified number of patients. Although several patients with chronic fatigue syndrome have used Moducare and have told me over the years that they felt better, I am not convinced of the degree of efficacy until some hard data surfaces. Having used both Moducare and Hydrocortisone in the past, I have the impression that 10 mgs of hydrocortisone daily has been more effective for me personally in relieving fatigue than 3 Moducare capsules I took daily for several weeks. (Kyolic is now distributing Moducare in health food stores). People should try out both Moducare and hydrocortisone at different times and decide what what works best for them.

I have also personally found that one-half teaspoon of a 1% hydrocortisone (Anti-itch) cream massaged into the skin daily to have about the same benefits as 10 mg of hydrocortisone taken orally.

Presently, there is insufficient research on whether on not a combination of certain herbs with hormone precursors combined with seeds and plants with plant sterols will normalize adrenal production of cortisol and the other adrenal hormones and eliminate the need for hydrocortisone supplementation.

As for interleukin-6 inhibitors, I have listed 10 or more and they are published in this journal (Vol 2, No 2, 2004). However, no one should assume that they will match the effectiveness of hydrocortisone. More research is needed in this arena.

For the past 2 years, regular mercury thermometers for taking one's temperature under the armpit for basal temperature or under the tongue have been banned from sale in the marketplace as unsafe. This is ironic as dentists are still allowed to place mercury amalgam fillings in our mouths that come in direct contact with our teeth and bone structure while a thermometer with mercury encased in glass is considered too dangerous to place in our mouth.

Worldwide, mercury poisoning is now adversely affecting hundreds of millions of people. Most of the mercury polluting our air and water is coming from coal fired electricity generating plants. While hydroelectric and wind power is where the money should be placed, instead we find billions of dollars are being spent to promote the air polluting coal dynasty dinosaurs under the ruse that they will environmentally friendly in another 10 or 15 years. "Silent spring" is fast approaching.

When the mercury shakedown thermometers were discontinued about two years ago, the only alternatives available were the digital thermometers that basically were not designed for under the armpit basal temperature testing.

Last week I found at a local Walgreens store a shakedown thermometer that does not use mercury but instead uses a environmentally safe substance called "Galinstan." The Mercury-Free oral thermometer is manufactured in Germany by Geratherm A.G.. It is distributed in the US by R.G.. Medical Diagnostics in Southfield, Michigan. It cost only $6. If you cannot find one at a local drugstore, go to the web site www.rgmd.com to locate a distributor and a local supplier.

Aga, M. et all and 17 other Japanese researchers studied the effects of Chinese parsley (Coriandrum Sativum), otherwise known a Cilantro, on lead deposits in mice. The researchers report:

"The preventive effect of Chinese parsley (Coriandrum Sativum) on lead deposition was investigated in male ICR mice given lead (1000 ppm) as lead acetate trihydrate in drinking water for 32 days. Administration of Chinese parsley to mice by gastric intubation was performed for 25 days from day 7 after the start of lead exposure up to the end of the experiment. "

They report that "Administration of Chinese parsley significantly decreased lead deposition in the femur and severe lead-induced injury in the kidneys. In addition, urinary excretion of delta-aminolevulinic acid (ALA) which is known to increase with lead intake was significantly decreased after administration of Chinese parsley."

They added: These results suggest that Chinese parsley has suppressive activity on lead deposition, probably resulting from the chelation of lead by some substances contained in Chinese parsley. (1)

In an earlier published study, Omura and Beckman report that "In the spring of 1995, use of Chinese parsley for successful elimination of Hg (mercury) deposits existing in various organs of the first author as the result of the decay of radioactive Thallium 201 injected for cardiac SPECT, was accidentally discovered after eating Vietnamese soup, which happened to contain Chinese parsley, also called cilantro. We also found Chinese parsley accelerates the excretion of Hg, Pb, and A1 from the body though the urine." (2)

The researchers found that antibiotic therapy for a herpes infection was successful only after the Cilantro treatment. They concluded that the heavy metals somehow protected the herpes virus.

1. Preventive effect of Coriandrum sativum (Chinese parsley) on localized lead deposition in ICR mice. J Ethnopharmacol. 2001 Oct;77(2-3):203-8.

2. Role of mercury (Hg) in resistant infections & effective treatment of Chlamydia trachomatis and Herpes family viral infections (and potential treatment for cancer) by removing localized Hg deposits with Chinese parsley and delivering effective antibiotics using various drug uptake enhancement methods. Authors: Omura, Y; Beckman, S L. Acupunct Electrother Res. 1995 Aug-Dec;20(3-4):195-229.

It should be noted that lead, mercury, aluminum and other heavy metals are strong inducers of interleukin-6 and other TH2 cytokines. Heavy metal toxicity is likely to prevent recovery from HIV/AID, chronic fatigue syndrome, cancer, candidiasis, herpes and other chronic infections that do not respond to treatment.

One or two tablespoons of fresh cilantro daily sprinkled in salsa, over a salad or in soup should be helpful in reducing heavy metals and IL-6. Cilantro in tablets or capsules is also available. Monitor (lab tests) for heavy metals before and after using Cilantro to determine its effectiveness.

Dear Mark,

Hope you are well. Did I give you this recipe?

The sisters working in one of the poorest slums in Nairobi are integrating the "Great Health Naturally" (derived from Immune Restoration Handbook) into their program. These PLAs are the poorest of the poor. They put 40 patients on the following items and within a month 70% of the patients started gaining weight (up to 2-3 kgs), slept better, small odd pains receded, skin cleared and so on. They are taking:

Hot Stuff (African Tonic), was invented in order to simplify the delivery of the protocol to poor patients. It's delicious. Try it.

Increases appetite, encourages weight gain, help internal acid-alkaline balance, helps give a better sleep, raises and balances body temperature.

PS: In addition to the African tonic, Didi has HIV+ patients drink one or two cups of Neem Leaf tea daily.

I was very pleased to learn that information from the Immune Restoration Handbook has been helping people living in mud huts in Nairobi, Kenya, who are suffering from AIDS and many other conditions. However, without the direct hands-on efforts of Sister (Didi) Ananda Rucira and her volunteers, none of this would have been possible. She is truly doing God's work here on Earth and deserves our prayers, gratitude and support.

I am starting on the 28 page annual report which will include reprints from the last three Journals of Immunity and a few new articles. We will print 15000 copies to be mailed or given away. Your support and prayers will help us carry on this effort. Wishing each of you a belated Merry Christmas and a Happy and Healthy New Years.