This is a masterclass in systems biology. The real strength of the 'Metabolic Trap' lies in inducing metabolic inflexibility—by closing all compensatory pathways simultaneously, we leave the tumor with no room to adapt. From a data perspective, seeing Ivermectin as a 'bridge drug' that connects these axes is the missing link in many current protocols. Brilliant synthesis Paul.
I recently became a monthly donor to the Independent Medical Alliance, https://imahealth.org/. I assume this is a more cost efficient way to support your work.
Yes Thank You. The IMA artistically cut my salary as I was told I was not productive enough. Uggg And since I had all my medical credentials removed substack is the only way to generate some income. Thank You. Paul
Dear Dr. Marik, know there are so many people (including myself) that have nothing but respect for you and what you do. We’ve never met, but your recommendations have guided me (and anyone I could reach) through the Covid years. More recently, your repurposed medication research guided first me through breast cancer and now my husband through prostate cancer.
Not productive enough?! You are the most brilliant mind speaking and writing on cogent topics such as repurposed meds and cancer - particularly on this side of the scamdemic. Just wanted you to know you are esteemed and appreciated.
Great deep analysis of 1 of the 3 pillars of the new integrated åpproach. If you include the divinely led spiritual elements that are arguably the most critical pillar, you'd be onto something valuable. Also, consider free memberships and you'll be blessed.
Know which side you're choosing with Matthew 6:24.
Keep it all free, explain Malone's presence or the Lord (correct side of Matthew 6:24) will likely strike his judgement. Also know Judges 19:25-30, which is more than the 1st step towards wisdom, it's what he'll allow.
Sorry this is so long, but IAM DESPERATE!! Because I heard you speak in person at 2 of the FL globalcovidsummit seminars, I determined you were a man of unquestionable integrity, so I purchased your book Cancer Care (Kindle Version) before you made it free on the IMA website in pdf form. (I also gifted it at Christmas to the oncologist and nurse practitioner assigned to my hubby-that, and Amanda King's book.) I was able to search on drugs within the text of your book, reference the studies in order to share with my husband's oncologist, while he was undergoing chemotherapy. (Folfirinox 6 months) He was diagnosed with pancreatic cancer in June last year. He just turned 72. But he has a body and constitution of a much younger man, was rarely sick. He and I both got the Moderna jab (2 doses) in spring 2021. 😬😑 No boosters. His oncologist shot down any of the supplements and/or off label drugs I brought up during the chemo treatment. Hubby handled the chemo quite well, did not vomit, never required the prescribed anti-nausea meds, and recovered quite a bit, energy-wise, btw infusion cycles. Toward the 4th month he mentioned concern that the neuropathy symptoms, in both hands and feet, were lingering btw cycles, so oxaliplatin was reduced 20%, and then a subsequent additional 10% for the last 3 cycles. (After the fact, we believe we should have demanded MORE REDUCTION) He was really plagued but the numbness in the last 2 cycles and was told it would go away. No additional oxaliplatin reduction was implemented. What was the HUGE surprise to both of us, was the fact that the neuropathy has worsened after the chemo was finished.(12/26/25). He is devastated by this "surprise" development. He was given a 5-6 week hiatus from any treatment in preparation for 2 weeks of halcyon radiation of 2 spots : the pancreas tumor, and a tiny spot on the back of his liver, which scans during chemo showed to be gone, essentially. ("could not be appreciated") The other surprise is the "Pontius Pilate" attitude of this widely known Cancer Center in FL toward a condition they caused, but have NO treatment for. Hubby has turned down any further chemo, presses on through all the numbness in both his hands and feet (really up to his shins) to perform all daily tasks and beyond (fixing thigs, cutting grass, etc), only because he is/was extremely athletic up to now. (He played pickleball during all the chemo but the worsening of the neuropathy post chemo caused him to stop). Is there anyone anywhere addressing this horrible neuropathy issue???? I have been massaging his hands and feet with all kinds of my own natural applications from fig poultice, to castor oil combined with DMSO. He is fed up with doctors at this point (I don't blame him-I have looked into Astron Health and Leading Edge Clinic- both are online only and he is not convinced either could help him) and has applied a TENS machine, and vibration therapy, both without relief. I called a local acupuncturist, with whom there was a communication difficulty, and did not know about CIPN, specifically, but claimed to have helped chemo patients. I am desperate for WISE COUNSEL. Any thoughts, suggestions?
This is a difficult situation. Look at my most recent posts on the use of repurposed drugs and specifically for pancreatic cancer. You have nothing to loose. Paul
Paul, I really appreciate the clarity of your metabolic trap framework—especially the multi-axis approach targeting glucose metabolism, mitochondrial function, and redox balance. It’s a powerful synthesis.
One question I’ve been sitting with—more as an open inquiry than a position—is whether the issue in cancer is glucose itself, or whether it may be more about the context and form in which glucose is delivered and utilized.
As you’ve pointed out (and as physiology confirms), all cells—including healthy cells and especially the brain—require glucose. What I’ve been exploring is whether there may be a distinction between:
dysregulated, stress-mediated glucose metabolism (high insulin signaling, glycolytic trapping), and
a more direct or “clean” glucose delivery that bypasses some of those dysfunctional pathways
In other words, perhaps the problem is not glucose per se, but the metabolic environment in which it is processed.
This raises the possibility that there may be another path to restoring metabolic health—even in complex conditions like cancer—that doesn’t rely solely on restricting glucose, but rather on restoring the system’s capacity to use it appropriately.
Not suggesting this as a conclusion, but as a doorway for exploration. If you’re ever curious, you might find The Glucose Protocol by Dr. David Stephens an interesting perspective—it approaches this question from a different angle that may complement your model.
Appreciate the work you’re doing and the conversation you’re opening.
That makes complete sense—and I really respect both Warburg’s and Seyfried’s work. Their contributions to understanding the metabolic nature of cancer are foundational.
What I’ve been exploring sits just slightly adjacent to that model.
Not in disagreement with the idea that cancer cells rely heavily on glycolysis—but more in questioning whether the issue is purely availability of glucose, or whether it’s also about the system’s capacity to utilize glucose correctly.
For example, in a highly sympathetic, stress-driven state:
insulin signaling becomes distorted
glucose transport into cells becomes impaired
mitochondrial function downregulates
So you can end up with a situation where: → blood glucose is present → but intracellular access and proper oxidative metabolism are limited
In that context, restricting glucose makes sense from one angle—but it may also further reduce available fuel to already compromised healthy cells.
So the question I’ve been sitting with is: Is cancer purely a fuel problem—or also a distribution and utilization problem?
If it’s the latter, then there may be a complementary path that focuses not just on restricting glucose, but on restoring the system’s ability to use it coherently.
Not a conclusion—just an area of exploration that I’ve found interesting and may open up an entirely different door.
This is what I got from Claude comparng this protocol to Zahrah Sita’s protocol for anyone intersted in looking at this for their own research. Dr Marik, I have been a huge fan of your work and you as an amazing human being! This is a genuinely complex situation, and I want to be helpful while being clear that none of this replaces a qualified integrative oncologist — especially for a 25-year-old with metastatic endometrial cancer (bones, liver, lungs based on the filename). With that said, here's my honest read:
What the Current Protocol Already Covers Well
Looking at the schedule image and the DOCX together, the protocol is actually quite substantial:
Already hitting several of the Marik "5 axes":
Fenbendazole → cytoskeleton/mitotic axis (same mechanism as mebendazole, which Marik uses — they are closely related)
Ivermectin → cross-axis amplifier (already included, and Marik specifically calls this out)
Berberine → functions similarly to metformin on the glucose/AMPK axis
Melatonin → circadian/redox axis (already at 300mg with notes to go up to 2000+mg, which is actually more aggressive than Marik's framework)
Cordyceps, CBD/CBG → mitochondrial support and stress signaling
What the Marik Article Adds That Isn't Currently Covered
The two most notable gaps when comparing the article's framework to the current protocol:
1. A direct glucose/insulin suppressant (metformin or equivalent) Berberine does some of this work, but metformin is more potent specifically at activating AMPK and suppressing mTOR. Berberine is a reasonable natural analog, but metformin (a prescription drug) is what Marik specifically uses for this axis. This is worth asking a doctor about — it's inexpensive, very well studied, and widely used off-label in cancer metabolic protocols.
2. Propranolol (adrenergic/stress axis) This is completely absent from the current protocol. Propranolol is a beta-blocker that targets the stress-hormone environment around the tumor — particularly relevant for metastatic disease, where the adrenergic system can promote invasion and immunosuppression. It's a prescription drug, cheap, very safe, and has genuine preclinical and some clinical data in cancer. This would be the single most interesting addition to discuss with a doctor based on the Marik framework.
3. Doxycycline (mitochondrial axis) The protocol targets mitochondria somewhat through Cordyceps and ivermectin, but doxycycline (an antibiotic) is Marik's specific mitochondrial stressor — it hits cancer stem cells in a way the others don't. Requires a prescription but is commonly available.
What's Already Strong in the Current Protocol That Marik Doesn't Emphasize
The current protocol actually goes beyond Marik in several areas:
DIM is highly specific and smart for endometrial cancer (hormone-driven cancer, estrogen metabolism matters enormously)
Modified Citrus Pectin for anti-metastatic properties
Akkermansia for gut/immune axis
TUDCA for liver protection — critical given liver metastasis
Iodine + Selenium — thyroid/endocrine support relevant to hormonal cancer
Practical Summary
If I were mapping priorities from the Marik article onto what's missing:
Ask about Propranolol — most accessible addition, addresses adrenergic axis, has real data
Ask about Metformin — would strengthen the glucose axis beyond what berberine alone does
Ask about Doxycycline — low-cost antibiotic with mitochondrial/stem cell rationale
All three are prescription drugs, inexpensive, and have established safety profiles — exactly the kind of thing an integrative oncologist or open-minded physician could evaluate for someone in this situation. The framework in the Marik article doesn't replace what's already being done; it would layer on top of it.
The protocol she's on is already one of the more comprehensive alternative/integrative approaches I've seen. The Marik article's main contribution here is the propranolol angle, which is genuinely absent and has a reasonable rationale for metastatic disease.
It would be decent to mention that your knowledge is based on 30 years of research by Dr Thomas Seyfried… author of : Cancer As A Metabolic Disease. (John Wiley and Sons,2012)
This is a masterclass in systems biology. The real strength of the 'Metabolic Trap' lies in inducing metabolic inflexibility—by closing all compensatory pathways simultaneously, we leave the tumor with no room to adapt. From a data perspective, seeing Ivermectin as a 'bridge drug' that connects these axes is the missing link in many current protocols. Brilliant synthesis Paul.
Thanks my friend
So great to see you here, Dr. Marik
Thank You, Dr. Marik. I have forwarded this to 2 friends who are engaging this approach, and will include it in my next blog post.
Excellent summary! Often times the best strategy is a shotgun approach.
Masterclass indeed!
Thank you Dr. Marik!!!
Loved this article, Doc. Well done.
Thanks..more to come
This is excellent!
I recently became a monthly donor to the Independent Medical Alliance, https://imahealth.org/. I assume this is a more cost efficient way to support your work.
Yes Thank You. The IMA artistically cut my salary as I was told I was not productive enough. Uggg And since I had all my medical credentials removed substack is the only way to generate some income. Thank You. Paul
I see, I will fix that, Subscribe to your Substack.
Dear Dr. Marik, know there are so many people (including myself) that have nothing but respect for you and what you do. We’ve never met, but your recommendations have guided me (and anyone I could reach) through the Covid years. More recently, your repurposed medication research guided first me through breast cancer and now my husband through prostate cancer.
Not productive enough?! You are the most brilliant mind speaking and writing on cogent topics such as repurposed meds and cancer - particularly on this side of the scamdemic. Just wanted you to know you are esteemed and appreciated.
:( didn’t you start the group?? I’m so sorry. Makes me not want to read their articles.
Yes. Hostile board.
Sorry to hear that.
Great deep analysis of 1 of the 3 pillars of the new integrated åpproach. If you include the divinely led spiritual elements that are arguably the most critical pillar, you'd be onto something valuable. Also, consider free memberships and you'll be blessed.
https://TurboVancer.org has it all including some of yout divinely led free articles.
Know which side you're choosing with Matthew 6:24.
Keep it all free, explain Malone's presence or the Lord (correct side of Matthew 6:24) will likely strike his judgement. Also know Judges 19:25-30, which is more than the 1st step towards wisdom, it's what he'll allow.
Thank you, Dr. Marik. Also for more you are doing to help my family member.
Very good article indeed..
Dr. Marik,
Sorry this is so long, but IAM DESPERATE!! Because I heard you speak in person at 2 of the FL globalcovidsummit seminars, I determined you were a man of unquestionable integrity, so I purchased your book Cancer Care (Kindle Version) before you made it free on the IMA website in pdf form. (I also gifted it at Christmas to the oncologist and nurse practitioner assigned to my hubby-that, and Amanda King's book.) I was able to search on drugs within the text of your book, reference the studies in order to share with my husband's oncologist, while he was undergoing chemotherapy. (Folfirinox 6 months) He was diagnosed with pancreatic cancer in June last year. He just turned 72. But he has a body and constitution of a much younger man, was rarely sick. He and I both got the Moderna jab (2 doses) in spring 2021. 😬😑 No boosters. His oncologist shot down any of the supplements and/or off label drugs I brought up during the chemo treatment. Hubby handled the chemo quite well, did not vomit, never required the prescribed anti-nausea meds, and recovered quite a bit, energy-wise, btw infusion cycles. Toward the 4th month he mentioned concern that the neuropathy symptoms, in both hands and feet, were lingering btw cycles, so oxaliplatin was reduced 20%, and then a subsequent additional 10% for the last 3 cycles. (After the fact, we believe we should have demanded MORE REDUCTION) He was really plagued but the numbness in the last 2 cycles and was told it would go away. No additional oxaliplatin reduction was implemented. What was the HUGE surprise to both of us, was the fact that the neuropathy has worsened after the chemo was finished.(12/26/25). He is devastated by this "surprise" development. He was given a 5-6 week hiatus from any treatment in preparation for 2 weeks of halcyon radiation of 2 spots : the pancreas tumor, and a tiny spot on the back of his liver, which scans during chemo showed to be gone, essentially. ("could not be appreciated") The other surprise is the "Pontius Pilate" attitude of this widely known Cancer Center in FL toward a condition they caused, but have NO treatment for. Hubby has turned down any further chemo, presses on through all the numbness in both his hands and feet (really up to his shins) to perform all daily tasks and beyond (fixing thigs, cutting grass, etc), only because he is/was extremely athletic up to now. (He played pickleball during all the chemo but the worsening of the neuropathy post chemo caused him to stop). Is there anyone anywhere addressing this horrible neuropathy issue???? I have been massaging his hands and feet with all kinds of my own natural applications from fig poultice, to castor oil combined with DMSO. He is fed up with doctors at this point (I don't blame him-I have looked into Astron Health and Leading Edge Clinic- both are online only and he is not convinced either could help him) and has applied a TENS machine, and vibration therapy, both without relief. I called a local acupuncturist, with whom there was a communication difficulty, and did not know about CIPN, specifically, but claimed to have helped chemo patients. I am desperate for WISE COUNSEL. Any thoughts, suggestions?
This is a difficult situation. Look at my most recent posts on the use of repurposed drugs and specifically for pancreatic cancer. You have nothing to loose. Paul
Paul, I really appreciate the clarity of your metabolic trap framework—especially the multi-axis approach targeting glucose metabolism, mitochondrial function, and redox balance. It’s a powerful synthesis.
One question I’ve been sitting with—more as an open inquiry than a position—is whether the issue in cancer is glucose itself, or whether it may be more about the context and form in which glucose is delivered and utilized.
As you’ve pointed out (and as physiology confirms), all cells—including healthy cells and especially the brain—require glucose. What I’ve been exploring is whether there may be a distinction between:
dysregulated, stress-mediated glucose metabolism (high insulin signaling, glycolytic trapping), and
a more direct or “clean” glucose delivery that bypasses some of those dysfunctional pathways
In other words, perhaps the problem is not glucose per se, but the metabolic environment in which it is processed.
This raises the possibility that there may be another path to restoring metabolic health—even in complex conditions like cancer—that doesn’t rely solely on restricting glucose, but rather on restoring the system’s capacity to use it appropriately.
Not suggesting this as a conclusion, but as a doorway for exploration. If you’re ever curious, you might find The Glucose Protocol by Dr. David Stephens an interesting perspective—it approaches this question from a different angle that may complement your model.
Appreciate the work you’re doing and the conversation you’re opening.
I will get the book that you suggested Paul
Thanks. That’s an interesting perspective. I dont know. I follow the work of Otto Warburg and Tom Seyfried.
That makes complete sense—and I really respect both Warburg’s and Seyfried’s work. Their contributions to understanding the metabolic nature of cancer are foundational.
What I’ve been exploring sits just slightly adjacent to that model.
Not in disagreement with the idea that cancer cells rely heavily on glycolysis—but more in questioning whether the issue is purely availability of glucose, or whether it’s also about the system’s capacity to utilize glucose correctly.
For example, in a highly sympathetic, stress-driven state:
insulin signaling becomes distorted
glucose transport into cells becomes impaired
mitochondrial function downregulates
So you can end up with a situation where: → blood glucose is present → but intracellular access and proper oxidative metabolism are limited
In that context, restricting glucose makes sense from one angle—but it may also further reduce available fuel to already compromised healthy cells.
So the question I’ve been sitting with is: Is cancer purely a fuel problem—or also a distribution and utilization problem?
If it’s the latter, then there may be a complementary path that focuses not just on restricting glucose, but on restoring the system’s ability to use it coherently.
Not a conclusion—just an area of exploration that I’ve found interesting and may open up an entirely different door.
This is what I got from Claude comparng this protocol to Zahrah Sita’s protocol for anyone intersted in looking at this for their own research. Dr Marik, I have been a huge fan of your work and you as an amazing human being! This is a genuinely complex situation, and I want to be helpful while being clear that none of this replaces a qualified integrative oncologist — especially for a 25-year-old with metastatic endometrial cancer (bones, liver, lungs based on the filename). With that said, here's my honest read:
What the Current Protocol Already Covers Well
Looking at the schedule image and the DOCX together, the protocol is actually quite substantial:
Already hitting several of the Marik "5 axes":
Fenbendazole → cytoskeleton/mitotic axis (same mechanism as mebendazole, which Marik uses — they are closely related)
Ivermectin → cross-axis amplifier (already included, and Marik specifically calls this out)
Berberine → functions similarly to metformin on the glucose/AMPK axis
Melatonin → circadian/redox axis (already at 300mg with notes to go up to 2000+mg, which is actually more aggressive than Marik's framework)
Cordyceps, CBD/CBG → mitochondrial support and stress signaling
What the Marik Article Adds That Isn't Currently Covered
The two most notable gaps when comparing the article's framework to the current protocol:
1. A direct glucose/insulin suppressant (metformin or equivalent) Berberine does some of this work, but metformin is more potent specifically at activating AMPK and suppressing mTOR. Berberine is a reasonable natural analog, but metformin (a prescription drug) is what Marik specifically uses for this axis. This is worth asking a doctor about — it's inexpensive, very well studied, and widely used off-label in cancer metabolic protocols.
2. Propranolol (adrenergic/stress axis) This is completely absent from the current protocol. Propranolol is a beta-blocker that targets the stress-hormone environment around the tumor — particularly relevant for metastatic disease, where the adrenergic system can promote invasion and immunosuppression. It's a prescription drug, cheap, very safe, and has genuine preclinical and some clinical data in cancer. This would be the single most interesting addition to discuss with a doctor based on the Marik framework.
3. Doxycycline (mitochondrial axis) The protocol targets mitochondria somewhat through Cordyceps and ivermectin, but doxycycline (an antibiotic) is Marik's specific mitochondrial stressor — it hits cancer stem cells in a way the others don't. Requires a prescription but is commonly available.
What's Already Strong in the Current Protocol That Marik Doesn't Emphasize
The current protocol actually goes beyond Marik in several areas:
DIM is highly specific and smart for endometrial cancer (hormone-driven cancer, estrogen metabolism matters enormously)
Modified Citrus Pectin for anti-metastatic properties
Akkermansia for gut/immune axis
TUDCA for liver protection — critical given liver metastasis
Iodine + Selenium — thyroid/endocrine support relevant to hormonal cancer
Practical Summary
If I were mapping priorities from the Marik article onto what's missing:
Ask about Propranolol — most accessible addition, addresses adrenergic axis, has real data
Ask about Metformin — would strengthen the glucose axis beyond what berberine alone does
Ask about Doxycycline — low-cost antibiotic with mitochondrial/stem cell rationale
All three are prescription drugs, inexpensive, and have established safety profiles — exactly the kind of thing an integrative oncologist or open-minded physician could evaluate for someone in this situation. The framework in the Marik article doesn't replace what's already being done; it would layer on top of it.
The protocol she's on is already one of the more comprehensive alternative/integrative approaches I've seen. The Marik article's main contribution here is the propranolol angle, which is genuinely absent and has a reasonable rationale for metastatic disease.
Excellent , I appreciate the mechanisms on a cellular level. What do you feel about baby aspirin?
I cover this in a later post. It seems the only role of ASA is prevention of colorectal cancer/polyps
Thank you
It would be decent to mention that your knowledge is based on 30 years of research by Dr Thomas Seyfried… author of : Cancer As A Metabolic Disease. (John Wiley and Sons,2012)
I have mentioned Dr Seyfried in earlier posts..