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Dr. Ettinger’s Biofilm Protocol for Lyme and Gut Pathogens

A specific question has been asked a lot lately, as to what is my protocol for busting through Biofilm.  Most of these questions have been directed to me by those diagnosed with or think they may have H. pylori bacterial infection or Lyme’s Disease (See also: Biofilms of Borrelia burgdorferi And Clinical Implications for Chronic borreliosis by Alan B. MacDonald, MD).  The reason that I’ve put this “biofilm busting protocol” post together is because of this fact: the day I discovered how to handle biofilm in the human body, was the day that chronic conditions, from the sinus to the prostate, were no longer a ‘project’, so to speck, to handle.  I hope this information is helpful to you.

First a little background on – what is biofilm:


Fig. 1: The biofilm life cycle. 1: individual cells populate the surface. 2: extracellular polymeric substance (EPS) is produced and attachment becomes irreversible. 3 & 4: biofilm architecture develops and matures. 5: single cells are released from the biofilm.  Related PostBiofilm Basics and Quorum Sensing and Biofilm

Here is an excerpt from a Klaire Labs, product monograph, which is a basic primer on the topic (My additions are in RED) The National Institutes of Health (NIH) estimates that 60% of all human infections and 80% of refractory infections (def. unresponsive to medical treatment) are attributable to biofilm colonies.  I have seen this, most commonly, in cases I’ve worked-up, where the pathogen is: Chlamydia pneumoniae, Pseudomonas aeruginosa, Helicobacter pylori, [Lyme disease - Borrelia burgdorferi] and Candida albicans.

  • The protection conferred upon microorganisms by biofilm allows them to achieve a high level of antibiotic resistance, stealth and invisibility.
  • Biofilm not only provide a physical barrier to antimicrobial agents (pharmaceutical antibiotics) and host antibodies, but facilitate the exchange of antibiotic-resistant genetic material between organisms and may contain antibiotic-degrading (hydrolysing) enzymes such as b-lactamase, effectively neutralizing incoming antibiotic (b-lactam antibiotics) molecules.
  • In fact, biofilm communities can be 1000 times more resistant to antibiotics than free-floating bacteria.
  • The decreased growth rate of sessile microorganisms (def. Permanently attached to a substrate; not free to move about; “an attached oyster”) 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, and can almost single-handedly contribute to localized or systemic inflammatory reactions and delayed wound healing. “…. Once established, however, biofilm infections persist.  They are rarely resolved by host defense mechanisms, even in individuals with healthy innate and adaptive immune reactions.  Active host responses, such as invading neutrophils (the most abundant type of white blood cells in mammals and form an essential part of the innate immune system), can even be detrimental since those cells can cause collateral damage to neighboring healthy host tissue.  Biofilm infections respond only transiently to antibiotic therapy.” James Garth, PhD
  • Depending on the type of biofilm, one or more species of pathogens may be found embedded in the extracellular polymeric substance (def. Composed primarily of polysaccharides and can either stay attached to the cell’s outer surface, or be secreted into its growth medium).  Bacterial extracellular polymeric substance (EPS) maybe a carrier of, or may have heavy metals embedded in them, thus the indication for chelation w/EDTA. EDTA, ethylenediaminetetraacetic acid, is a chelating agent used to lower one’s body burden of heavy metals).

Pathogenic bacterial known to reside in biofilms include, but are not limited to: Borrelia burgdorferi (Lyme bacteria), Escherichia coli, Candida albicans (yeast and fungal mutation), Clostridium difficile (the most common cause of GI infection and a growing epidemic), Clostridium perfringens, Helicobacter pylori, Klebsiella pneumoniae, Legionella pneumophila, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella typhimurium, Staphylococcus aureus, Staphylococcus epidermidis, and Vibrio cholerae. Chlamydophila species such as Chlamydia pneumoniae don’t form biofilm, as they are intercellular, but may some how get accidentally get caught-up in them before entering a host cell. Here is a good video on Chlamydia and biofilm (Video [biofilm section 7:45 min. mark] – Dr. Wilmore Webley on C. pneumoniae & Biofilms).

The number of human diseases shown to be associated with biofilms is ever expanding and includes: chronic bacterial prostatitis, chronic rhinosinusitis (chronic sinus infections), 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 (causative) role of pathogenic mucosal biofilm in gastrointestinal diseases, such as Irritable Bowel Disorders (IBS): Crohn’s disease and ulcerative colitis.

S. aureus biofilm

S. aureus biofilm

Dr. Marcus Ettinger’s Biofilm Protocol: You can get help with any of these steps by going HERE.

A. Biofilm Busting Products. This is just a partial list of the products that can be used, and not all of these products will be, or should be, used at the same time. Additional nutraceuticals may be needed, based on each individuals unique situation.

  1. Monolaurin or Lauricidin [AKA Glyceryl laurate or glycerol monolaurate] (monolaurin information).
  2. Nattokinase (a potent oral fibrinolytic enzyme supplement) Some prefer Boluoke Lumbrokinase.
  3. InterFase Plus™ (broad-spectrum enzyme formula w/EDTA)
  4. NAC (N-Acetyl-Cysteine)
  5. Lactoferrin (I like Nutricillin by Ecological Formulas) Dr. Anju Usman of Illinois states, “Our bodies make proteins, transferrin and lactoferrin, which mop up iron and block the ability of biofilm to form,” she said. “But pathogenic bacteria secrete iron chelators to snatch up iron and thus compete with the transferrin and lactoferrin for what they need to survive.”
  6. Xylitol (sugar alcohol)
  7. Nutiva Extra-Virgin Coconut Oil (42-52% Medium Chain Fatty Acids [MCFA], lauric acid, by volume)
  8. Serrapeptase (a potent oral fibrinolytic enzyme supplement)
  9. Guaifenesin
  10. Turmeric, Neem oil, Reishi Mushroom
  11. BFB-1™ & BFB-2™
  12. Smilax officinalis
  13. Carbonized Bamboo

Updated 09 July 2013: I have been helping patients with H. pylori, a biofilm producing bacteria, for over 4 years now. In the beginning, eradicating this bug was very easy, in my opinion. As time progressed I noticed that the same protocol I had been using was becoming less and less effective – on first timers, not re-treatments. Medically there is no explanation for this, energetically there is, for me anyway, based on the research done by Rupert Sheldrake, PhD on Morphic Fields and Morphic Resonance. Please read about this theory for further clarification.

Because of this new shift in loss of effectiveness, in some patients, I have had to use more than one round of products or add more products to the protocol. The end result has always been eradication but it’s now taking more to achieve this result. Also, the people that are contacting me have undergone triple and quadruple therapies to no avail. This proves in my mind that biofilm and the bacterias that create them are learning to defend themselves more effectively.

My theory is that with the introduction of blogs, chat-rooms and websites devoted to H. pylori and biofilm, more and more people are self-treating. This self-treating is not killing the H. pylori or eliminating the biofilm but to the contrary, making them both stronger by building-up the biofilm defense. Every time a bacteria that produces a biofilm is unsuccessfully treated it becomes more resistant to the next protocol. When this is combined with the theory of Morphic Fields, it’s no wonder that H. pylori and biofilm eradication is becoming harder and harder to achieve. The point of all of this is that there is still effective treatment options available, it may just take a little more time and/or more products, allopathic and natural to get to the desired end result.

Lastly, I am not against self treating but the data out there on biofilm and H.pylori is not comprehensive enough for the layperson to be their own doctor and self-treat successfully. I have always advocated that if you want to get better with or at something, you need a coach who is an expert in that field or subject. There are times and places where self-help is good – biofilm and H. pylori treatment is not one of them. This is just my opinion.

Additional DataInterview with Dr. Cohen concerning biofilms and enzyme therapies (Nattokinase and Lumbrokinase) and Effect of xylitol on an in vitro model of oral biofilm (I have seen increased effectiveness since adding this to the protocol)

B. Avoid supplemental forms of: iron, magnesium and calcium during the biofilm protocol, as they may contribute to biofilm formation or increasing biofilm density, thus decreasing the overall effectiveness of the biofilm protocol.

C. Take a broad-spectrum probiotic and prebiotic.  I like Now Foods brand Probiotic-10.VSL-3 can also be used as well as Elaine Gotschall’s SCD™ yoghurt.  These products will help to crowd out the bad bacteria, and also help disrupt and replace biofilm colonies along the mucus membrane.

D. Specific additions based on condition (not a complete list):

  1. Candida albicansSF722* (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 – can’t make everyone happy.  I’ve used SF722 for over 15 years and it is amazing – never a problem!  *Do not take SF722 if you are allergic to fishADP by Biotics Research is also a dynamite product. There are many other amazing products that can be added to complement the SF722 and ADP.  It’s really a matter of how many pills someone wants/doesn’t want to take per day or the severity of one’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 (fluconazole), a prescription medication, is my personal preference, but Nizarol (ketoconazol) can also be used.  In Azole-resistant Candida albicans, lactoferrin must be added to either medication in order to increase their effectiveness.  There are certain B vitamins, minerals and amino acids that possesses synergistic properties and I find them indispensable when taking Diflucan (fluconazole), Nizarol (ketoconazole), and for supporting candida (yeast/fungal) treatment, and die-off symptoms.
  2. Chlamydia pneumonia, Klebsiella pneumoniae or Pseudomonas aeruginosa Pneumotrophin PMG by Standard Process, Inc. How it works.  I use this because it helps direct the body’s attention to the effected area and assists the body’s healing efforts to the lung, where it’s needed most.  Apex Energetics, H-PLR is also a mandatory addition. I also like to use OOrganik-15™ and Pneuma-Zyme™ by Biotics Research with some of my patients who manifest asthma, a chronic cough and/or emphysema like symptoms.
  3. H. pylori ProtocolHeartburn/gastritis/GERD or achlorhydria or H. pylori?
  4. Chronic bacterial prostatitis – Quercitin (600mg’s) and Bromelain (200mg’s) combination by Now Foods. Decreases inflammation and oxidant stress in the prostate while increasing local concentrations of beta-endorphins.  Apex Energetics, H-PLR is also a mandatory addition.

E. Certain dietary restrictions and additions will need to be taken.  These are determined on a case by case basis. After the desired result is achieved, there will need to be a rebuilding and regeneration protocol.  This is as important as eliminating the biofilm.

Important Note:

In order to receive protocol information or help, you must become a distance patient – Distance Patient Application. I truly do want to help all who are interested, but it’s finally gotten to the point where too many people want free advice, treatment plans, personalized protocols…. I’m a firm believer in fair-exchange and I feel I have done that by providing the information in this post.

I will help you and I can create a tailor-made protocol for your individual situation. Please contact our office for product prices and distance patient information (714) 639-4360(714) 639-4360.

Biofilm testing is also available through Fry Laboratories. 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.

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.

Infections of Interest: Borrelia (Lyme), Babesia, Bartonella, Anaplasma, Ehrlichia, Q-Fever (Coxiella), Toxoplasma, Rickettsia, Plasmodium, XMRV

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.

Additional data:

Effect of ciprofloxacin and N-acetylcysteine on bacterial adherence and biofilm formation on ureteral stent surfaces.

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99 Responses to “Dr. Ettinger’s Biofilm Protocol for Lyme and Gut Pathogens”

  1. Paula says:

    Hello Dr. Ettinger,

    Thank you for your response. Your explanation is very helpful in clearing up the details of your protocol for me.

    Cheers to wellness and good health.


  2. Ned,

    You are missing a few key ingredients to make the biofilm protocol effective. Also, getting the mercury out is important, if it is truly causing problems, but there are products that you should be on while undergoing the process. My recommendation would be to become a distance patient and use me as one of your coaches. This will save you a lot of time, money and effort. Getting on the exact protocol, for you, is very important will all you are doing and have going on. Here is a link to my “forms” page – Click on the Distance Patient Program Form for more details.

  3. Elaine says:

    Hi Dr. Ettinger,

    Could you tell me if bladderwrack tea is good for killing pylori? I am on the manuka honey right now- should I take them together? Am following on Amy Kings blog and discovered you there… If bladderwrack tea is good then will a couple of cups a day do the trick? And for how long?
    Am suffering from constant burning in my stomach and have been diagnosed with pylori last month through endoscopy..

    Thank you
    Elaine Bowyer

  4. Elaine says:

    Also, should I take extra virgin coconut oil for pylori? Also I have a hiatal hernia which I assume is giving me acid reflux

    Also should I take extra virgin coconut oil to help kill pylori?

    Thank you for your time

    Elaine Bowyer

  5. Elaine,

    There is only anecdotal evidence (Dr. Peter D’Adamo) that the fucose, found in Bladderwrack will “wash-away” the H. pylori. Personally I doubt it will have that effect. I am also not going to be recommending it to my patients. Manuka honey is also a mild, at best, treatment for the H. pylori bacteria. I wish I could tell you that this will work but I really don’t have much confidence in these two as treatments. Sorry.


    Dr. Ettinger

  6. Elaine,

    Extra virgin coconut oil, is just a piece of the puzzle, but by itself, or w/Manuka honey, or bladderwrack won’t do the trick. Again, sorry for being a downer.


    Dr. Marcus Ettinger

  7. tom washa says:

    Dear Dr. Ettinger,

    I am a retired fire fighter, EMT. Since retiring I have had 5 major operations on my legs, etc., I have taken much smoke, fire smoke plus all of the antibiotics from the operations. Now I have celiac disease and candida.

    Do you sell the products you are talking about? I have a hard time taking 10 different products, 3 to 6 times a day.
    Thanks, Tom

  8. Tom,

    I do. Please give me a call at 714-639-4360 to discuss the options.

    Dr. Ettinger

  9. Bev says:

    Dr. Ettinger:

    I have Morgellons Disease. I came down with it Sept. 2010. I have been on a holistic protocol, vegetarian diet, distilled H20 only, various supplements, alkaline forming diet, peroxide and Epsom salt baths every day, Manuka nasal and eye washes, tea tree oil diluted in Grape seed oil body washes, periodic colon cleanses, etc etc etc. I originally was treated for lyme’s by a Dermatologist with Doxycycline for one month with no effect. I discovered that my symptoms were indeed Morgellons after many hours on the internet doing research. I was a pre-med major.

    Recently an Internist treated me with Anti Fungal meds. It helped to some extent. She refused to continue treatment after two weeks with the explanation that it was toxic.
    My condition has improved but it is far from gone. They are primarily in my nose, eyes and on my face and upper back. I do not have major sores that are consistent with many other Morgellon sufferers. But I do have some eruptions caused by the exiting of sand like tiny granules from the areas mentioned. Especially in and around my eyes and on my face.

    Can you help me? Do you have a protocol for Morgellons?

    There is presently much information to support that the Morgellons organism is a genetically manipulated organism (GMO) created by a company that created an insecticide for crop dusting. I believe this company is situated in California. It is also documented that Morgellons is reaching pandemic proportions and is all over the world. But the majority of cases are in California, Florida and Texas.

    There is so much information on this subject now. I pour over new information every day.
    So, can you help me? If you can, I blog almost every day on a Morgellons Blog network and I will shout it to the world if you have the solution to eradicating it these miseries.

    Yes, I was exposed to black mold about 6 months before I came down with Morgellons. But, I also had a hip replacement about 10 months before I came down with Morgellons.

    How do we isolate the source? Right now I am interested in the solution.

    Please reply.

    Thank you. Bev

  10. Bev,

    In 22+ years of treating patients I have never treated anyone with Morgellon’s disease. I have been asked questions about it before and have done a little research over the years. The only advise I can give is very generic and based on what I might do if I had similar symptoms.

    Monolaurin is an amazing base for most conditions that have a viral or bacterial component to them (2400mg’s/day would be the minimum dose, more may be needed per day). Vitamin D (6,000IU’s/day would be a starting dose and blood tests are needed to achieve a level between 70-90ng/mL). An enteric-coated, multi-strain probiotic is also a must. I would add a couple important antioxidants to help support any increased oxidative-stress going on: Alpha lipoic acid (1200mg’s/day, NAC (Now Foods brand only – 2 caps 2x/day). Iodoral (50mg’s a day for 3 months then 12.5mg’s/day thereafter). Lastly, I would make sure I had a good balance of EFA’s: Mollecularly distilled fish oil, organic flax seed oil, borage seed oil, and to emulsify all of it – non-GMO lecithin granules.

    Diet: I would avoid all gluten containing products, as well as cow’s milk products.

    Other things that may help: Transdermal magnesium oil, chlorella powder, IV vitamin C, low dose naltexone (LDN) and/or a biofilm protocol.

    I hope this is of some help.

    Dr. Marcus Ettinger


  11. Bev says:

    Dr. Ettinger:

    It appears that you have some very definitive ideas about how to get rid of these organisms.
    I would be willing to offer myself as a guinea pig if you create a daily diet (the what to’s and what not to eat regimen) and protocol of supplements for me to follow. I would also be quite willing to pay you for your time and supplies.
    What do you say about assisting me in this project?
    If it works, you have me to attest to the success of your efforts.
    I would even be willing to adjust the protocol if at first your original plan needed some refinement. Let us work on this project together and if you can come up with a solution, you would potentially have a great deal of clientele needs to meet. There are a lot of suffering people out there with Morgellons. Many have more serious issues than I am dealing with.
    I promise not to publish your protocol or any variety thereof.
    I will leave this up to you to offer to the universe.
    I realize and respect the fact that you have to make a living but you have also made it quite clear that you care. I Got it! You have integrity and so do I.
    You have the potential to help a lot of people out there and last estimated, there are about 30 thousand sufferers who have no where to turn. I read that it is at pandemic levels in the US. Apparently 90 something % is in the US mostly in California, Florida and Texas. I was living on the NJ shore when this happened to me.
    If you would agree to work with me, I will supply you with my medical information.
    I am quite healthy and do not consider myself a risk in any way.

    I await your reply.

  12. Barb says:


    Is your protocol effective for Babesia as well as Lymes ?

    Thanks !

  13. Al says:

    Dr Ettinger do you offer the testimg with Fry Labs? If so what is the cost? I am very interested in looking into biofilms. I am a CFS patient who had 13 amalgams removed about 15 years ago. Muy health improved after lots of time and work but plateaued about 5 years ago. I still really suffer with GI issues and sleep problems. I have sinus problems, joint and muscle pain that moves around, stay very tired most of the time. Doctors think I am in the early stages of an autoimmune disease. I have tested positive for XMRV by the WPI, CPN confirmed by Dr Stratton,H pylori, klebsiella, mycoplasma pneumoniae, and EBV. I would want to be tested before starting a detailed protocol because I know it would cause lots of issues as the biofilm breaks down before one would see improvements. I am willing to deal with the side effects only if I feel the end justifies the means. Thank you.

  14. Al,

    There is a 100% chance you have biofilm, so spending the money on validation would be a waste. If you still want testing, we can do it.

    It sounds like you have a lot going on and would benefit from knocking down some of the bugs living in your body. Making the bugs more susceptible to eradication by the body, innately and by natural or chemical agents, can only be achieved by reducing the biofilm that is housing and protecting theses bugs.

    Call to peruse this issue further (714) 639-4360.

  15. I feel it is, with a few adjustments in the nutritional supplements.

  16. Peter Bakor says:

    Dear Dr. Ettinger I would like to order Interfase Plus from you.Also I need advise for biofilm protocol.I was infected with chlamydia trachomatis 3 years ago.I am HLA B27 positive and I developed reactive arthritis.It is very serious and getting worst.Please advice how to remove chlamydia biofilm and therofore stop arthriris.I will pay you for a protocol please write me back to my email.I really need your help.Thanks

  17. Peter,

    I just received your post. Best advice is to become a distance patient. We can get your situation handled. Distance Patient Form

    Reiter’s “reactive” Arthritis – Testimonial

    I can also mail you the InterFase, but would rather do it as part of a protocol.


    Dr. Ettinger

  18. Pat Askert says:

    Hello Marcus

    May I congratulate you on a very informative article on your web site. Thank you for sharing this information.

    I am not sure if it is an oversight, but you may want to clarify the references to Lauric acid. I am probably telling you what you already know here. Monolaurin is a monoglyceride fat containing one molecule of Lauric acid and one molecule of glycerol. The vast majority of fats are composed of triglycerides (i.e. 3 fatty acid molecules bonded to one molecule of glycerol). In the case of Coconut oil, it contains triglycerides of Lauric acid and other fatty acids. It does not actually contain any ‘neat’ Lauric acid, or solitary Lauric acid molecules. Monolaurin is hugely more antimicrobial than trilaurin from what I’ve read and experienced. So monolaurin is likely to be more effective as an antimicrobial agent that coconut oil. However, coconut oil contains other fats and has other benefits. How effective monolaurin vs trilaurin is in terms of attacking bacterial biofilms I do not know. Do you know what the mechanism is? Do they dissolve into the biofilms as they are lipid soluble and kill the bacteria by their antimicrobial properties? Are they able to penetrate the biofilms?

    Lauricidin is a brand of Monolaurin, so I presume you were referring to Ecological Formulas’ Monolaurin in the above instance. I don’t know which is better quality, but Lauricidin is in pellet form whereas EF’s Monolaurin comes in capsule form. I had two of my practitioners muscle test Lauricidin on me, at various times, and at no point did it test positively on me! I still used it though lol

    You mentioned Nutricillin above, by Ecological Formulas. This contains Olive Leaf Extract (OLE) which has been referenced by others (e.g. Dr Klinghardt) as being able to break up biofilms to some degree. Nutricillin also contains other helpful ingredients here such as Lactoferrin, Colostrum and Lysozyme. The Lactoferrin I understand helps to bind with iron in the biofilms and remove them. Do you know what the mechanism of OLE is in the context of biofilms? I’ve already read that Grapefruit Seed Extract (GSE) is anti-biofilm, but perhaps not to the extent of OLE.

    Although Klaire Labs’ Interfase Plus contains EDTA, the standard Interfase product contains significant more enzymes per capsule, so I’m not sure which is going to be ‘better’. However, I have various oral EDTA supplements already so I think Interfase may be a better option in the short term. I am going to try both out. Have you heard of Dr Neidermaier’s Regulat? Dr Klinghardt highly rates it, more than Nattokinase or Serrapeptase, but it may depend on the individual. I’ve personally not noticed THAT much difference from Regulat so far but will be comparing it to the other enzyme formulas. Nowhere really tells us what the exact ingredients are however.

    You recommend ascorbic acid. Everyone seems to recommend a different type of Vit C. Straight Vit C will of course be acidic, especially if one is taking high dosages, and can lead to the ‘runs’. Do you see any benefit in taking buffered Vit C in terms of its buffering capacity (to help buffer acidic byproducts of breaking down biofims) and being able to tolerate higher dosages without too much intestinal irritation?

    On a final note, do you believe there are significant differences between the basic biofilm protocol supplements when it comes to tackling fungal or bacterial biofilms? You have listed some additional antimicrobial agents and enzyme formulas, but in terms of the initial list in section A…

    Also, as some of our beneficial flora form ‘good’ biofilms, these will to some degree be disrupted by such a protocol I would expect – but less than the ‘bad’ biofilms?

    Any comments you might have would be greatly appreciated!

    Thanks again for all the information and wishing you a Happy New Year!



  19. Pat, Thank you and your are welcome.

    Here is the clarification on Monolaurin. Right where I mention Monolaurin I have a kink to a post I wrote in August of 2010, “Antiviral and Antibacterial Actions of Monolaurin and Lauric Acid”. Please check that out.

    As for coconut oil, it just supplies the precursor ingredient in bulk. The body will work it’s magic and make tons of wonderful monolaurin.

    Lauricidin and Ecological Formulas Monolaurin work just as well in my experience. I used Monolaurin for years and now I’m using Lauricidin, due to it being cheaper per dose. I’m using 1 tsp 3x/day with most patients.

    About Nutricillin: The two most potent ingredients in Nutricillin are Lactoferrin and lysozyme. Lactoferrin being hands down the main active ingredient. The others play an important, synergistic role. As far as olive leaf extract goes, I’m not quite sure where that fits in. It could be because of its antioxidant polyphenols and Oleuropein. I have read PubMed articles where olive leaf extract have been useful as a bactericidal compound but I have not read any credible data where it was tested as a compound used to breakdown biofilm. I’m still a fan of OLE. Another not on Lactoferrin: “azole” resistant candida/fungal infections become treatable with the additio0n of lactoferrin. I recommend a combination of Nytsatin, Fluconazole, Nuticillin and monolaurin for systemic infections. I’s a bomb and works every time.

    Interfase and Interfase Plus can bot be used and still achieve a good result. I usually use the Plus version first and then switch to the regular version. The EDTA in the beginning helps to weaken the biofilm by removing the iron and calcium. There is just enough EDTA in there to work on the stomach but not enough to have any major systemic benefit, unless taken over an extended period of time. Those with chronic lung infections, Chlamydia pneumonia, Klebsiella pneumoniae or Pseudomonas aeruginosa, will benefit from long term use.

    Regulat: I love Regulat and use it to rehabilitate the blood terrain. It is not so much a treatment as it is a foundation builder. It just makes everything else I give a patient work better. It’s like mending unfertile soil. It can in some instances take up to two years to rahab soil to yield proper crops. With products like Regulat you cut that time down to weeks or a few months. Sea salt is anothe product I use for this task but in this case it’s used as an electrolyte builder.

    Ascorbic acid: At doses of just a gram or two a day should have not adverse effects on even the most sensitive digestive system. I don’t like buffered because it will contain calcium or magnesium, which we want to avoid in excess.

    Biofilm differences (the good, the bad, the ugly): As far as I have seen in treating hundreds of biofilm patients, biofilm is biofilm – period. Any addition I add is purely synergistic to the main protocol. Taking a broad-spectrum probiotic during the protocol will handle any disruption to the native bacterial colonies.


    Dr. Marcus Ettinger

  20. Jason says:

    Good stuff Doc. I’ve read through all of this and really appreciate it.

    Have you heard of Cistus Tea or Plasmanex1?
    Dr K in Wash St likes these for Biofilms.

  21. Jason,

    Cistus Tea seams to work only on oral biofilm. See link below. I personally like
    Biotene Gum or Biotene PBF Oral Rinse for reduction of oral biofilm. The
    advantage to Biotene is that it can be bought at Walmart, Walgreens or Rite Aid.

    Effects of Cistus-tea on bacterial colonization and enzyme activities of the in
    situ pellicle –

    Plasmanex1: Plasmanex1 does not breakdown biofilm by itself but will assist in
    the process when used with other products and its not easy for the average
    consumer to locate. A more readily available, like product is either nattokinase
    or serrapeptase. Both decrease blood viscosity through reduction of fibrinogen
    just like Plasmanex1.

    I hope this helps.


    Dr. Marcus Ettinger, B.Sc., D.C.

  22. Jason says:

    Yes that does help – thanks

    My last question is in regards to the EDTA in Interfase Plus (I’m sure this has been beat to death)…

    You mentioned it’s a small amount of EDTA. Do you have the exact amount?
    Is there something we can do to safely replenish calcium levels while taking EDTA, without feeding more biofilms?
    I worry about hypocalcium and kidney stones too

  23. Jason,

    I don’t know the amount of EDTA as it is not listed on the label. I do know it’s a small amount.

    No disrespect here but calcium loss is really a non-issue. The EDTA will be working predominately in the stomach and the loss will be in mcg’s not grams. Also, the formation of kidney stones has more to do with magnesium deficiency then it will ever have to do with calcium deficiency.

    I will call you tomorrow after 1:00pm PST


    Dr. Marcus Ettinger

  24. Monica says:

    Dear Doctor,

    I have been taking Interfase Plus for 2 weeks now. I am on a protocol to combat my possible parasites. I think I may be having side effects from the Interfase as my parasite symptoms have been as bad or worse while on this regimen. I am scared that I have been misdiagnosed, wondering if the protocol could be giving me such side effects which are the same as my worst symptoms of why I am being treated.

    I am taking 2 Interfase/day, 4 Tinidizol, 4 Berberine, probiotics, Bentonite. I have been looking all over the internet for some kind of answers. I am scared that I will never get better. I am unemployed and don’t have the stamina to do what I need to do.

    When I had my first round of protocol in December I had 2 weeks of feeling great and remembered what “normal” is for the first time in a year. Now on the second round – higher dosage of Interfase. I am sick as a dog – same as the original symptoms.

    Please help with some kind of assurance. Any comments?

    Thank you!!!


  25. elise says:

    Dr. Ettinger,

    About how long does it take to eradicate biofilms (get rid of infection) on your protocol?

    Is it absolutely neccessary to be off magnesium, calcium and iron? (which is why I ask how long to rid oneself of the biofilms). I have extreme insomnia and can not sleep more than a few hours without these supplements.
    My particular ailment involves the gut..loose stools after intravenous antibiotics/c-section, so I dont seem to be absorbing nutrients.

    Thank you kindly,

  26. Monica,

    The protocol you are on, if you have parasites (protozoa), should handle the problem. Having the correct diagnosis is very important though because the medication can potentially create negative GI symptoms.

    I don’t know anything about your case so it’s hard for me to comment more about your situation.


    Dr. Marcus Ettinger

  27. Elise,

    Usually 44-66 days and yes it’s very important to stay off mineral supplements, especially iron. If you have to take magnesium then try transdermal magnesium. It can be found by looking-up magnesium oil on Google. Try a combo of potassium citrate (orally) and rubbing on magnesium oil. Rub on and let sit for 1 minute and wipe off with a damp wash cloth.


    Dr. Marcus Ettinger

  28. elise says:

    thank you Dr. Ettinger for your response, and advice.

  29. Judy says:

    Dr. Ettinger,

    Can yeast get so out of control that it can possible take over many parts of the body, esp. the skin and cause biofilm to grow over/in/around the skin?

    Also, can yeast get to be systemic anc grow hyphae fromm a human body?

    I have been to allergists and they did the skin testing but also drew blood for the yeast. I was told I have an allergy to mold, yeast, and gluten and that I have a STRONG allergy to yeast. The Dr. put me on Nystatin with 12 refills. I did not feel the Nystatin was helping.

    I am working with 2 Drs. now because I have to take Warfarin for the rest of my life and I wanted to try Diflucan, which increases the affects of warfarin. In Dec. of 2010 I was diagnosed with DVT and PE. I was on Warfarin for a year and they did an ultrasound on my leg and all clots were gone. Also did a D-dimer and results were 200. So I was then taken off warfarin. 1 month later I had to go to urgent care because I had such terrible shortness of breath. I now had DVT again and a huge blood clot in each lung. Did a CT Scan on my lungs and a D-dimer which was now 9,000. Would recurrent PE and now bilateral, come back that quickly? Is it possible that biofilm could have something to do with this?

    I respect your answers and know I gave you alot here and it is hard to answer all without actually seeing a person. General answers would be deeply appreciated.

    I have been battling biofilm on my skin with an enzyme formula containing Cellulase, Hemicellulase, Glucose Oxidase, and Xylanase. It does help to remove it but I want it completely gone.


  30. Judy,

    Biofilm, as far as I know and have researched, will not grow on the skin. Here is where biofilm can be found on the body: mucous membranes, surgical implants/catheters and wounds.

    Yeast can be systemic and mutate into a fungal form.

    As far as DVT goes, I would have your sed rate and CRP tested to see if there is a chronic inflammatory state going on in your body. If so, I recommend astaxanthin, high gamma fraction vitamin E, Nattokinase (fibrinolytic enzyme), alpha lipoic acid, MSM, magnesium, quercitin and other bioflavonoids, resveratrol – to start. This may sound like a lot but it isn’t.

    Diet is just as important. I would get your triglycerides around 100, glucose around 88 and urine pH between 6.5 and 7. Eating a plant based diet will also help. Don’t worry so much about the sugar in fruit as it’s mainly fructose. You want to stay off all starch!

    This is a good start. Let me know what changes occur.

    Dr. Ettinger

  31. Pat Askert says:

    Hi Marcus, thank you very much for your response.

    That’s quite a lot of Monolaurin – depends what other antimicrobials one is taking of course as they act cumulatively/synergistically. I guess it’s just a case of working one’s way up to the dosage. I saw your Monolaurin article before but it never clicked that its ‘non-ionic surfactant’ properties would make it good at dissolving biofilms, but effectively acting as an antimicrobial detergent! :-D Good stuff!

    Regulat – I’m still not 100% clear on why/how it works – if it is its enzyme content, its peptide/amino acid content, its vitamin content, it’s acidophilus content or its (indirect) alkalising action that provides the benefits and exactly what the biochemical benefits are.

    Ascorbic acid – I am sure you have heard of people making liposomal Vitamin C but putting C powder into an ultrasonic cleaner along with water, lecithin and baking soda. Then taking it orally in small dosages. It is reputedly better absorbed than taking the C straight. Do you have any opinions on that please?

    @ Jason – Klaire Labs’ Interfase Plus – contains 250mg of enzyme blend and 125g of EDTA, a total of 375mg. 2 capsules is thus 500mg of enyzmes plus 250mg of EDTA. I don’t notice any uptake of EDTA into the blood and my kidneys are quite sensitive to EDTA. Interfase contains 500mg of enzyme blend per capsule.

    All the best


  32. Pat Askert says:

    Hi again Marcus

    Forgot to ask…Do you have any opinion of Apolactoferrin? The type of Lactoferrin that is unbound to Iron. I would expect it to be more effective at removing Iron from biofilms that bound Lactoferrin. Most manufacturers do not state what type they use and one can only assume they use bound Lactoferrin. The only source of Apolactoferrin I found was by Life Extension.

    I would assume that ordinary Lactoferrin is better for getting iron into the blood and cells.

    Do you have an opinion on the recently discovered mosquito-borne protozoan Protomyxzoa rheumatica (a.k.a. FL1953 – by Dr Stephen Fry of Fry Labs)? It is supposedly lipid-loving and strongly biofilm forming. There is very little information on it to date so we don’t know how widespread it is. I am sure you are familiar with it as you already recommend Fry Labs for biofilm testing using their advanced stain.




  33. Pat,

    There is VERY limited data about the benefit of apolactoferrin over lactoferrin. I personally feel Life Extension has an in with the company that produces the Apo version. I don’t know for sure but that is my hunch. Personally, I will keep using Nutricillin by Ecological Formulas. It has worked for me over the years so I know I can trust its effectiveness.

    As far as Protomyxzoa (FL1953) goes, I’m going to sit back and watch this fight play-out a little more before I jump-in on this one. You’ve got the vested interests; the real Lyme patients; the, “I have Lyme, but don’t really have Lyme people”; the chronic fatigue syndrome (I have a legitimate problem but can’t figure what it is) patients; and the Morgellon’s patients… all grasping at straws here or a rope to hold on to as their ship slowly sinks into the dark, cold abyss.

    At the end of the day I put my faith in nature. Food can either be a medicine or a poison. What we put into or not into the body dictates, for the most part, our current and future state of health.

    There is a lot more to this but I don’t feel like writing a book now. If you want to call and chat some time, please feel free. In fact we should do a post together. Call me at 714-639-4360

    Dr. Marcus Ettinger

  34. Judy DeLorenzo says:

    I have been fighting chronic Lyme for many years. Around the same time I became stricken with Lyme, I started to develop lipomas. Do you think the lipomas are actually biofilm deposits?

  35. Susan Peters says:

    Dear Dr. Ettinger, I am a very long standing Neuro Lyme Patient. I am currently experiencing a bad relapse, and am on ANtibiotics for Sero Negative Bartonella, and Neuro Lyme. I have a god LLMD in LA, BUT he is NOT addressing the Biofilm issue, and after reading your work on Biofilms, I am wondering if I am beating a “Dead Horse” at this point. I am 65 and have Medicare…….Do you take Medicare. ALSO, can you BUST open Biofilms at the same time as takin antibiotics. OR do you HAVE to bust open the biofilms FIRST and THEN take Antimicrobials. I live in La Verne and would love to see you if you take Medicare. God Bless, SUsan Peters

  36. Viki says:

    Hi Dr. Ettinger,

    just needed to know have you ever had experience with Crest Syndrome/Scleroderma? is there a special diet that i should also follow besides your protocol?
    God Bless!

  37. Judy,

    I know we talked but I just wanted to post this response to possibly help others. I do not feel that lipomas are affiliated with biofilm in any way. A lipoma is a benign tumor composed of adipose tissue. There are a couple possibilities to their development. One is a gene, HMG I-C, that’s related to obesity and the other may be due to Metabolic Syndrome and Insulin Resistance. No matter the cause, I suggest going on a low-glycemic, non-reactive diet. That means no: starch, beans or dairy. Check out for more data on this (go to the FAQ section). I would also recommend phosphatidylcholine. It’s primarily found in Lecithin. I suggest 2 tbsp of Non-GMO lecithin granules mixed in a protein shake or in Greek yogurt.

    I hope this helps.


    Dr. Marcus Ettinger

  38. Susan,

    First off, I am sorry but I’m not a Medicare provider. You can call our office and we will let you know our fees. Secondly, following my biofilm protocol while on antibiotics is the best time. I feel that the protocol works synergistically with pharmaceutical and natural antibiotics and antifungals.

    Take care,

    Dr. Ettinger

  39. Viki,

    I have treated 2 patients with scleroderma. I have also treated many with lupus, MS, Myasthenia gravis, RA and many other auto immune conditions. I have had good to great success with my patients. The key factors are how far along the condition has progressed and how willing the patient is to follow my recommendations. If I get someone who will do what I say and is on the treatable side of disease’s tipping-point, we can have amazing results. I would need to speak with you to get more details before I can make a specific recommendation. You can call me any time – 714-639-4360

    I would love to have the opportunity to help you.


    Dr. Ettinger

  40. Andy Gonzales says:

    Greetings Dr. Ettinger,

    I found this page via a search on biofilms as I have chronic lyme. I had been on antibiotics for a while and they became, more or less, ineffective. I started to take stronger herbal antibiotics which produced a strong herx for a short time and they seem to have become ineffective also.

    Therefor, a logical assumption would be to address biofilms. Your protocol looks good… I would be interested to know if you sell the whole group of necessary supplements (less the more common things like vitamin C / Coconut oil) and how much a month’s supply might cost…

    Thanks and I appreciate the information.

  41. Bikram says:

    Hello, Dr. Ettinger

    In your protocol, did you took all the supplements at once ((namely Monolaurin,
    Nattokinase (a potent fibrinolytic enzyme) ,InterFase Plus™ (broad-spectrum enzyme formula w/EDTA), Serrapeptase (a potent fibrinolytic enzyme)
    Vitamin C (ascorbic acid – Not buffered, as most of these contain metals)
    NAC (N-Acetyl-Cysteine), Lactoferrin)).

    please advise if i understood your protocol and based on that planning my own protocol for h pylori infection (with very mild symptons like excessive saliva as i tested +ve for h plyori 3 months ago ) as listed below:
    step 1 : biofilm deattachment using Monolaurin, NAC, Lactoferrin and InterFase Plus w EDTA.
    step2: antibacterial attack using oregano oil , mastci gum and broccolli supplements combined with VSL3 probiotic
    step 3 : maintenance dose of monolaurin and mastic gum and other supplements like brocooli from chapter.

    My symptoms are very mild because(exessive saliva) i think i’ve started monolaurin and mastic gum with probiotics after antibiotics course and also taking cabbage and other juices every alternative day.

    Also want to ask can i start whey protein shakes as i have stop my exercise after h pylori came +ve. I’m currently waiting for my second test.

    I’m thinking result will be positive because i still have excessive saliva symptom. Considering i still got h pylori is it possible start on whey protein and weight exercise.

    Lastly please advise me on above protocol.


  42. Bikram, I can help you with your protocol. Please go here to find-out how – Distance Patient Application Form

    Dr. Ettinger

  43. Andy,

    Please call my office and we can discuss what products you want – 714-639-4360.

    Dr. Ettinger

  44. Jeremy says:

    Dr. Ettinger,

    How long does it typically take to clear up a biofilm issue. I’m sure this is a range and a difficult question to answer, but can you give an idea of how long it takes to clear biofilm and then how long it takes to heal the gut lining. Thank you.

  45. Jeremy,

    It depends on the area, what bacteria are contributing to the biofilm formation, and what protocol/products you are using. It can be a matter of a couple of weeks to many months.

    Dr. Marcus Ettinger

  46. Selma says:

    Hello Doctor
    My mother took a stool test and just found out today her h pylori and another parasite she had is gone. Does this mean the bio film is gone as well? She is thinking to take monolaurin, SF722, and probiotics first thing morning time as a preventative measure. Do you think that is necessary or is probiotic sufficient enough.

  47. Selma,

    The biofilm associated with the H. pylori is gone. This is all I can say about that question.

    SF722 is mainly for yeast/fungus and is not recommended to take, just to take. Monolaurin and a probiotic can be taken indefinitely. I would also recommend taking a digestive enzyme with HCl (hydrochloric acid) too – one with each meal.


    Dr. Ettinger

  48. Rina says:

    Hi. I have been doing a biofilm protocol using Saccharomyces per a doctor I am seeing. I have been chealating for several months now for lead, mercury & other heavy metals. I have noticed that since starting the Interfase Plus & Saccharomyces, I have been having unbearable muscle spasms throughout my body-so intense that they can misallign my spine, causing me to practically live at the chiropractor’s office. Am I missing some important nutrient? Or is this a side effect? I cannot tolerate most probiotics as they cause me severe bloating and intolerable gas. I am intolerant to gluten & dairy. I wanted to try the VSL you recommended but I see it may contain dairy. Any other suggestions? Thanks, Rina

  49. Rina,

    The Interfase also grabs-on to good minerals as well. If you are already low in magnesium, calcium and or potassium, you will not want to be on Interfase. You will want to talk with the doctor that has you on the Interfase to determine you options. I do offer distance patient consulting, if interested.

    Also, If you can’t tolerate probiotics you will, most likely, not be able to handle the VSL#3. There maybe some products that may may you more tollerant but I would need to know more about you and your case.

    I hope this helps some.


    Dr. Marcus Ettinger

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