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	<title>AdvancedHealing.Com Journal &#187; Lyme Disease</title>
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	<description>An Orange, CA. Chiropractor &#38; 21st Century Medical Detective</description>
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		<title>Dr. Ettinger&#8217;s Biofilm Protocol for Lyme and Gut Pathogens</title>
		<link>http://www.advancedhealing.com/blog/2009/09/25/dr-ettingers-biofilm-protocol-for-lyme-and-gut-pathogens/</link>
		<comments>http://www.advancedhealing.com/blog/2009/09/25/dr-ettingers-biofilm-protocol-for-lyme-and-gut-pathogens/#comments</comments>
		<pubDate>Sat, 26 Sep 2009 01:07:24 +0000</pubDate>
		<dc:creator>Dr. Marcus Ettinger</dc:creator>
				<category><![CDATA[Biofilm]]></category>
		<category><![CDATA[Epstein Barr]]></category>
		<category><![CDATA[H. pylori]]></category>
		<category><![CDATA[Infection]]></category>
		<category><![CDATA[Lyme Disease]]></category>
		<category><![CDATA[Quorum Sensing]]></category>
		<category><![CDATA[Ulcerative Colitis]]></category>
		<category><![CDATA[Bacterial Prostatitis]]></category>
		<category><![CDATA[Biofilm Testing]]></category>
		<category><![CDATA[Borrelia burgdorferi]]></category>
		<category><![CDATA[Candida]]></category>
		<category><![CDATA[Chlamydia pneumonia]]></category>
		<category><![CDATA[extracellular polymeric substance]]></category>
		<category><![CDATA[Monolaurin]]></category>
		<category><![CDATA[sessile microorganisms]]></category>

		<guid isPermaLink="false">http://www.advancedhealing.com/blog/?p=159</guid>
		<description><![CDATA[The NIH est. 60% of all human infections and 80% of refractory inf., unresponsive to medical treatment, are attributable to biofilm colonies. Lyme, H. pylori]]></description>
			<content:encoded><![CDATA[<p style="text-align: justify;">A specific question has been asked a lot lately, as to what is my protocol for handling <a title="Biofilm Basics" href="http://www.advancedhealing.com/blog/2009/10/18/biofilm-basics/" target="_blank">Biofilm</a>.  Most of these questions have been directed to me by those diagnosed with or think they may have, Lyme disease or <a title="H. pylori bacteria" href="http://www.advancedhealing.com/blog/2009/09/13/heartburn-gastritis-gerd-achlorhydria-or-h-pylori/" target="_blank"><em>H. pylori</em> bacteria</a>.  The reason that I&#8217;ve put this &#8220;biofilm protocol&#8221; post together is because of this fact: the day I discovered how to handle biofilm in the body, was the day that chronic conditions were no longer a &#8216;project&#8217;, so to speck, to handle. I hope this information is helpful to you.</p>
<p style="text-align: justify;"><strong>First a little background on biofilm:</strong></p>
<p style="text-align: center;"><img class="aligncenter size-full wp-image-160" title="biofilm" src="http://www.advancedhealing.com/blog/wp-content/uploads/2009/09/biofilm.png" alt="biofilm" width="604" height="277" /></p>
<p style="text-align: justify;">Fig. 1: The biofilm life cycle. 1: individual cells populate the surface. 2: extracellular polymeric substance (EPS) is produced and attachment becomes irreversible. 3 &amp; 4: biofilm architecture develops and matures. 5: single cells are released from the biofilm. <strong>Related Post</strong> &#8211; <a title="Bofilm Basics" href="http://www.advancedhealing.com/blog/2009/10/18/biofilm-basics/" target="_blank">Biofilm Basics</a> and <a title="Quorum Sensing and Biofilm" href="http://www.advancedhealing.com/blog/2009/12/13/quorum-sensing-and-biofilm/" target="_blank">Quorum Sensing and Biofilm</a></p>
<p style="text-align: justify;">This is an excerpt from a Klaire Labs <a title="Monograph" href="http://www.protherainc.com/images/prod/monographs/K-INT%20&amp;%20K-INTP%20Monograph.pdf " target="_blank">product monograph</a> which is a basic primer on the topic (My additions are in <span style="color: #ff0000;">RED</span>) <span style="color: #800080;"><span style="color: #ff0000;">The National Institutes of Health estimates that</span></span><span style="color: #ff0000;"> </span>60% of all human infections and 80% of refractory infections<span style="color: #ff0000;"> (def.<em> unresponsive to medical treatment</em>)</span> are attributable to biofilm <span style="color: #ff0000;">colonies.  I have seen this, most commonly, in cases I&#8217;ve worked-up, where the pathogen is: C<em>hlamydia pneumoniae, Pseudomonas aeruginosa, Helicobacter pylori</em>, [Lyme disease - <em>Borrelia burgdorferi</em>] and <em>Candida albicans</em>. </span></p>
<ul>
<li style="text-align: justify;">The protection conferred upon microorganisms by biofilm allows them to achieve a high level of antibiotic resistance, <span style="color: #ff0000;">stealth and invisibility</span>.</li>
</ul>
<ul>
<li style="text-align: justify;">Biofilm not only provide a physical barrier to antimicrobial agents <span style="color: #ff0000;">(pharmaceutical antibiotics)</span> <span style="color: #ff0000;">and host antibodies</span>, but facilitate the exchange of antibiotic-resistant genetic material between organisms and may contain antibiotic-degrading (hydrolysing) enzymes such as <a title="Beta-Lactamase " href="http://en.wikipedia.org/wiki/Beta-lactamase" target="_blank">b-lactamase</a>, effectively neutralizing incoming antibiotic (<a title="beta-lactam antibiotics" href="http://en.wikipedia.org/wiki/Beta-lactam_antibiotic" target="_blank">b-lactam antibiotics</a>) molecules.</li>
</ul>
<ul>
<li style="text-align: justify;">In fact, biofilm communities can be 1000 times more resistant to antibiotics than free-floating bacteria.</li>
</ul>
<ul>
<li style="text-align: justify;">The decreased growth rate of sessile microorganisms <span style="color: #0000ff;"><span style="color: #ff0000;">(def. <em>Permanently attached to a substrate; not free to move about; &#8220;an attached oyster&#8221;</em>)</span> </span>also reduces their antibiotic susceptibility as most antimicrobial agents require rapid cell growth in order to effectively kill or inhibit the microbes.  Biofilm thus render pathogenic microorganisms enormously difficult to eradicate, <span style="color: #ff0000;">and can almost single-handedly contribute to  localized or systemic inflammatory reactions</span> <span style="color: #ff0000;">and delayed wound healing</span>.</li>
</ul>
<ul>
<li style="text-align: justify;">Depending on the type of biofilm, one or more species of pathogens may be found embedded in the extracellular polymeric substance <span style="color: #ff0000;">(def. <em>Composed primarily of polysaccharides and can either stay attached to the cell&#8217;s outer surface, or be secreted into its growth medium</em>)</span><span style="color: #0000ff;"><span style="color: #ff0000;">.  Bacterial extracellular polymeric substance (EPS) maybe a carrier of, or may have heavy metals embedded in them, thus the indication for chelation w/EDTA. </span></span><span style="color: #ff0000;"><em>EDTA, ethylenediaminetetraacetic acid, is a chelating agent used to lower one&#8217;s body burden of heavy metals</em></span><span style="color: #0000ff;"><span style="color: #ff0000;">).</span></span></li>
</ul>
<p style="text-align: justify;"><span style="color: #0000ff;"> </span></p>
<p>Pathogenic bacterial known to reside in biofilms include, but are not limited to: <em>Borrelia burgdorferi <span style="color: #ff0000;">(</span></em><span style="color: #ff0000;">Lyme bacteria</span><em><span style="color: #ff0000;">)</span>, Escherichia coli, Candida albicans <span style="color: #ff0000;">(</span></em><span style="color: #ff0000;">yeast and fungal mutation)</span><em>, Clostridium difficile, Clostridium perfringens, <strong>Helicobacter pylori</strong>, Klebsiella pneumoniae, Legionella pneumophila, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella typhimurium, Staphylococcus aureus, Staphylococcus epidermidis, and Vibrio cholerae. </em>The number of human diseases shown to be associated with biofilms is ever expanding and includes: <strong>chronic bacterial prostatitis</strong>, <strong>chronic rhinosinusitis</strong> <span style="color: #ff0000;">(chronic sinus infections)</span>, cystic fibrosis pneumonia, infective endocarditis, periodontitis, recurrent otitis media, and virtually all device and implant related infections.  Strong evidence is also beginning to emerge for an etiologic <span style="color: #ff0000;">(causative)</span> role of pathogenic mucosal biofilm in gastrointestinal diseases, <span style="color: #ff0000;">such as Irritable Bowel Disorders (IBS): Crohn&#8217;s disease and ulcerative colitis.</span></p>
<div id="attachment_162" class="wp-caption aligncenter" style="width: 310px"><img class="size-medium wp-image-162" title="S. aureus biofilm" src="http://www.advancedhealing.com/blog/wp-content/uploads/2009/09/S.-aureus-biofilm-300x201.jpg" alt="S. aureus biofilm" width="300" height="201" /><p class="wp-caption-text">S. aureus biofilm</p></div>
<p style="text-align: justify;"><strong>Dr. Marcus Ettinger&#8217;s Biofilm Protocol</strong> &#8211; Only the eradication phase is presented here.  There is a pre,   post and toxin reduction step as well.  You can get help with any of these steps &#8211; <a title="Distance Patient Program" href="http://www.advancedhealing.com/images/pdf/distance_patient_program.pdf  " target="_blank">HERE</a></p>
<p style="text-align: justify;"><strong><span style="color: #0000ff;">A.</span></strong> Products (<span style="color: #ff0000;"><span style="color: #000000;">mandatory products in</span> red</span><span style="color: #000000;">).</span><strong><span style="color: #ff0000;"> </span></strong><span style="color: #000000;">These are ONLY the basics. Additional nutraceuticals may be needed, based on each individuals unique situation</span>.</p>
<ol>
<li style="text-align: justify;"><span style="color: #ff0000;"><strong>Monolaurin</strong><span style="color: #000000;"> [</span></span><span style="color: #000000;">AKA Glyceryl laurate or glycerol monolaurate] </span><span style="color: #ff0000;"><strong> </strong><span style="color: #000000;">(<a title="Monolaurin Information" href="http://www.advancedhealing.com/blog/2010/08/16/antiviral-antibacterial-actions-of-monolaurin-and-lauric-acid/" target="_blank">monolaurin information</a>)</span><strong> or Lauricidin</strong></span></li>
<li style="text-align: justify;"><strong>Nutiva Extra-Virgin Coconut Oil</strong> (42-52% Medium Chain Fatty Acids [MCFA], lauric acid, by volume)</li>
<li style="text-align: justify;"><span style="color: #ff0000;"><strong>Nattokinase</strong></span> (a potent fibrinolytic enzyme) I like this better than Lumbrokinase.</li>
<li style="text-align: justify;"><span style="color: #ff0000;"><strong>InterFase Plus™</strong></span> (broad-spectrum enzyme formula w/EDTA)</li>
<li style="text-align: justify;"><strong>Serrapeptase</strong> (a potent fibrinolytic enzyme)</li>
<li style="text-align: justify;"><strong><span style="color: #ff0000;">Vitamin C</span></strong> (ascorbic acid &#8211; Not buffered, as most of these contain metals)</li>
<li style="text-align: justify;"><span style="color: #ff0000;"><strong>NAC</strong></span> (N-Acetyl-Cysteine)</li>
<li style="text-align: justify;"><strong><span style="color: #ff0000;">Lactoferrin</span></strong> (specifically Nutricillin by Ecological Formulas) <em>Dr. Anju Usman of Illinois states, &#8220;Our bodies make proteins, transferrin and lactoferrin, which mop up iron and block the ability of biofilm to form,&#8221; she said. &#8220;But pathogenic bacteria secrete iron chelators to snatch up iron and thus compete with the transferrin and lactoferrin for what they need to survive.&#8221;</em></li>
</ol>
<p style="text-align: justify;"><span style="color: #0000ff;"><strong>B.</strong></span> Avoid supplemental forms of: magnesium, iron and calcium during the biofilm protocol, as they may contribute to  biofilm formation or decrease the effectiveness of the biofilm protocol.</p>
<p style="text-align: justify;"><span style="color: #0000ff;"><strong>C.</strong></span> Take a broad-spectrum probiotic and prebiotic.  I like the combination of Now Foods brand <span style="color: #ff0000;"><strong>Probiotic-10</strong></span><span style="color: #ff0000;"> </span> and their <span style="color: #ff0000;"><strong>Probiotic Defense Powder </strong><span style="color: #000000;">(contains gluten)</span></span>.  These products will help to crowd out the bad bacteria, and also help disrupt and replace biofilm colonies along the mucus membrane.</p>
<p style="text-align: justify;"><span style="color: #0000ff;"><strong>D</strong></span>. Specific additions based on condition (not a complete list):</p>
<ol>
<li style="text-align: justify;"> <strong>Candida</strong> <strong>albicans</strong> &#8211; <a title="SF722" href="http://www.thorne.com/Products/Gastrointestinal-Health/General_GI_Support/prd~SF722.jsp" target="_blank">SF722</a><strong>*</strong> (10-Undecenoic Acid  50 mg) Thorne Research. This is as close as you can get to a medication and still be a natural substance.  There are a few chat rooms blasting this product, based on who knows what &#8211; can&#8217;t make everyone happy.  I&#8217;ve used SF722 for over 15 years and it is amazing &#8211; never a problem!  <span style="text-decoration: underline;"><strong>*</strong>Do not take SF722 if you are allergic to fish</span>. There are many other amazing products that can be added to complement the SF722. It&#8217;s really a matter of how many pills someone wants/doesn&#8217;t want to take per day or the severity of one&#8217;s condition, that will determine, if or which, additional products will be added. If the Candida albicans overgrowth is severe, has not responded to holistic methods or has mutated into its more virulent hyphal form/fungal infection (nails, underarms, groin or skin); Diflucan (<a title="Fluconazole" href="http://en.wikipedia.org/wiki/Fluconazole" target="_blank">fluconazole</a>), a prescription medication, is my personal preference, but Nizarol (<a title="Ketoconazol" href="http://en.wikipedia.org/wiki/Ketoconazole" target="_blank">ketoconazol</a>) can also be used. In Azole-resistant Candida albicans, lactoferrin must be added to either medication in order to increase their effectiveness. There is a certain B vitamin, mineral and amino acid that possesses synergistic qualities and I find them indispensable when taking Diflucan (fluconazole), Nizarol (ketoconazole) or for supporting candida die-off symptoms.</li>
<li style="text-align: justify;"><span style="color: #000000;"><strong>Chlamydia pneumonia, </strong></span> <strong>Klebsiella pneumoniae</strong><span style="color: #000000;"><strong> </strong> or </span><strong>Pseudomonas aeruginosa</strong><span style="color: #000000;"> <em> &#8211; </em></span>Pneumotrophin PMG<span style="color: #000000;"> by Standard Process, Inc. <a title="Pneumotrphin PMG" href="http://www.standardprocess.com/display/displayFile.aspx?docid=154&amp;filename=/Public/Lit/TabSheets/pneumotrophinpmg6900.pdf" target="_blank">How it works</a>.  I use this because it helps direct the body&#8217;s attention and healing efforts to the lung, where it&#8217;s needed most. Apex Energetics, H-PLR is also a mandatory addition. </span>I also like to use <a title="OOganik-15 Biotics Research" href="http://www.bioticsresearch.com/node/1656" target="_blank">OOrganik-15™ </a>and <a title="Pneuma-Zyme Biotics Research" href="http://www.bioticsresearch.com/node/1657" target="_blank">Pneuma-Zyme™</a> by Biotics Research with some of my patients who manifest asthma, a chronic cough and/or emphysema like symptoms.     <span style="color: #000000;"> </span></li>
<li style="text-align: justify;"><span style="color: #000000;"><strong>H. pylori</strong> &#8211; <a title="H. Pylori Protocol" href="http://www.advancedhealing.com/blog/2009/09/13/heartburn-gastritis-gerd-achlorhydria-or-h-pylori/" target="_blank">Complete write-up on another post</a>.</span></li>
<li style="text-align: justify;"><strong>Chronic bacterial prostatitis</strong><span style="color: #000000;"> &#8211; Quercitin (600mg&#8217;s) </span><span style="color: #000000;">and Bromelain (200mg&#8217;s) <a title="Quercitin/Bromelain Combo" href="http://www.nowfoods.com/Products/ProductsAlphabetically/M003365.htm" target="_blank">combination by Now Foods</a>. </span>Decreases inflammation and oxidant stress in the prostate while increasing local concentrations of beta-endorphins. Apex Energetics, H-PLR is also a mandatory addition.</li>
</ol>
<p><strong><span style="color: #0000ff;">E. </span></strong>Certain dietary restrictions and additions will need to be taken. These are determined on a case by case basis.</p>
<h2 style="text-align: justify;"><span style="color: #000000;">Important  Note:</span></h2>
<h2 style="text-align: justify;"><span style="color: #ff0000;">All dosages  will be provided if you purchase some or all of  your &#8220;biofilm protocol&#8221; products through  my office. I truly do want to help all who are interested, but it&#8217;s finally  gotten to the point where too many people want free advice and an  increasing amount of my time, and then buy all of their products  elsewhere. I am a firm  believer in fair exchange  and I feel I have  done that by providing the information in this post.</span></h2>
<h2 style="text-align: justify;"><span style="color: #ff0000;">I also offer  tailor made protocols for your individual situation, please contact our  office for product prices and distance patient information <span style="color: #000000;">(714) 639-4360.&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p></span></span></h2>
<p style="text-align: justify;"><strong>Biofilm testing is also available through <a title="Biofilm Testing at Fry Labs" href="http://www.frylabs.com/" target="_blank">Fry Laboratories</a>.</strong> Fry Laboratories, L.L.C. is an independent clinical diagnostic and research laboratory located in Scottsdale, Arizona. We are committed to understanding chronic diseases and contributing to their cure through advancements in diagnostics and basic science research with emphasis on chronic inflammatory diseases, vector-borne diseases, and their intersection. Our clinical diagnostic laboratory offers general and targeted immunology services in conjunction with standard and cutting edge infectious disease detection and identification technologies. Our signature services include microscopy for visual identification and quantification of a wide range of blood-borne pathogens, co-infection serology, biofilm detection, and genus wide molecular detection technology with sequencing for individualized species and/or strain identification. We participate in both CAP and API quality control programs and provide worldwide testing service.</p>
<p style="text-align: justify;">Diseases of Interest: Chronic Fatigue Syndrome, Fibromyalgia, Gulf War Veterans Illness, Chronic Lyme Disease, ALS (Lou Gehrig’s Disease), Parkinson’s Disease, Multiple Sclerosis, Autism, Lupus, Ulcerative Colitis, Scleroderma, Rheumatoid Arthritis, Osteoarthritis, Crohn’s Disease.</p>
<p style="text-align: justify;">Infections of Interest: Borrelia (Lyme), Babesia, Bartonella, Anaplasma, Ehrlichia, Q-Fever (Coxiella), Toxoplasma, Rickettsia, Plasmodium, XMRV</p>
<p style="text-align: justify;">Important: This post is not a substitute for medical advise or treatment and is for informational purposes only. Please consult with a physician before starting any nutritional or biofilm protocol on your own.</p>
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