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

Important Note:

In order to receive protocol information or help, you will need to become a distance patient – Distance Patient Application. I truly do want to help any and 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 fill out the distance patient application (link above) or if you have questions about the program, please call me at 714-639-4360

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 to my Distance Patient Program/Application.

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.

DO NOT SELF TREAT! Please read my updated, update below.

  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

IMPORTANT; PLEASE READ: Updated, Update – 19 August 2014 (Original: 08 Aug 2013): I have been helping patients with H. pylori, a biofilm producing bacteria, for almost 7 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. There are now H. pylori strains that are now ‘multiple drug-resistant’. Medically there is no real explanation for this. Energetically there is a very good explanation, for me anyway, based on the research done by Rupert Sheldrake, PhD on Morphic Fields and Morphic Resonance. Please read about his 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, there are many people contacting me and letting me know that they have undergone triple and quadruple therapies to no avail. This proves in my mind that biofilm and the bacteria that create them are learning to defend themselves more effectively. They are adapting and mutating, genetically, to survive. Good for them and bad for us.

My theory is that with the introduction of hundreds 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 (Prevpac or Pylera) and/or natural to get to the desired end result – H. pylori and biofilm eradication.

Lastly, I am not against self treating per se. The issue is that the information, out on the web, on biofilm and H.pylori is not comprehensive or clear enough for the layperson to be their own doctor or to successfully self-treat. I have always advocated and promoted 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 , but 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 minerals, especially: iron, magnesium and calcium during the biofilm protocol, as they may contribute to biofilm formation or increase 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 or Biotics Research BioDof 7. VSL-3 can also be used (for a short period only) 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. Saccharomyces boulardii is another addition that will have positive benefits in any H. pylori, SIBO or Candida eradication protocol.

A recent meta-analysis involving 14 RCTs (1671 patients) evaluated the role of probiotics in H. pylori eradication [Tong et al. 2007]. In patients with H. pylori infection, probiotic supplementation improved eradication rates and reduced treatment-related side effects and individual symptoms [Tong et al. 2007]. In this meta-analysis, only one RCT evaluated S. boulardii and found that it decreased the risk of diarrhea when given concomitantly to patients receiving triple eradication therapy for H. pylori [Duman et al. 2005]. S. boulardii induces morphologic changes in H. pylori cells consistent with cellular damage [Vandenplas et al. 2009] and was shown to cause reduction in H. pylori colonization in infected children by 12% [Gotteland et al. 2005]. Of four RCTs testing S. boulardii in H. pylori infections, two were in children [Gotteland et al. 2005; Hurduc et al. 2009] and two in adults [Cindoruk et al. 2007; Cremonini et al. 2002]. Although there was no significant difference in H. pylori eradication between the S. boulardii and placebo groups, a significantly lower relative rate of AAD (16.1–25%) was observed. In a recent meta-analysis, the H. pylori eradication rate in the triple therapy group was 71% and increased significantly to 80% with S. boulardii supplementation [Szajewska et al. 2010]. Thus, S. boulardii may not be effective in eradicating H. pylori itself, but it is effective in reducing the side effects of the standard triple therapy (Prevpac).

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

  1. Candida albicansSF722* (10-Undecenoic Acid) 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 and Bromelain  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. Specific dietary restrictions and additions will need to be implemented.  These will 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.


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

  1. Michele,

    I apologize for the delay. My recommendation is the PrevPac combined with a tailored, biofilm-busting protocol. I can help you with that, but you would need to be an official patient for that. Nutritional supplements alone are no longer effective against H. pylori and I no longer recommend that approach. Here is a link to my distance patient program.

  2. Ghada,

    Most likely the reason behind the antibiotic failure is that your friend has a severe biofilm issue. Most people are not that bad. My biofilm-busting protocol combined with a PrevPac has been extremely effective with my patients. Nutritionals or PrevPac alone would not be my recommendation, as I too have seen many failures. Here is a link to my distance patient program if you would like my help.

  3. Mandy,

    There is a lot of stuff going on here. I would need a lot more data to do your situation justice. Here is a link to my distance patient program. I feel confident that I could help, we just have to do it right. As far as low free T3 goes, it could be a conversion issue in the liver, and you may need more selenium or your cortisol may be elevated and that will stop the conversion of T4 to T3. It may also just mean you need to start taking exogenous T3. I take GTA by Biotics Research. It’s T3. Thank you for the inquiry.

  4. Larissa,

    My recommendation is the PrevPac (2 antibiotics and an acid reducer) combined with a tailored, biofilm-busting protocol. I can help you with that, but you would need to be an official patient for that. I do Skype consultations or over the phone. Nutritional supplements alone are no longer effective against H. pylori and I no longer recommend that approach. Here is a link to my distance patient program.

  5. Gemma Garner says:

    Hi Dr Ettinger, what a great source of information. I cannot believe there is so little available information on bio films especially considering what a threat they are. I am wondering if you have ever heard anything about bio films in cosmetic hylauronic acid fillers ( apparently they are the perfect breeding ground) yes this is the stuff of sci fi movies! I believe they will become more common as these fillers are used more and more. Most doctors will not even discuss the possibility of bio films and have no idea how to treat them.

    Love your blog, can’t believe you even quote one of my favourite authors Rupert Sheldrake!

    Best Regards

  6. gene says:

    I have bacterial prostititis (e-coli) which keeps recurring after courses of antibiotics (bactrim). My doctor may be recommending surgery if this keeps recurring.
    Do you have a protocol I could try before I go the surgery route?

  7. Gene, there are protocols that could be tried but I would need to know a lot more about you than just the fact that you have bacterial prostatitis. Here is a link to my distance patient program in case you are interested. Respectfully, Dr. Ettinger –

  8. Gemma, Thank you! Dr. Ettinger

  9. Cathy chahalis says:

    Thankyou very much for info. I am in the hospital with pseudomonas. This is relapse after sepsis with the same bug after being incubated after neck surgery at HSS in NY. I also have had question of Lyme disease for years after having chronic “rsd” for 20 yrs and too many problems with every organ of my body to write. I had 2 different tests from Fry lab and found to have tremendous amount of biofilm. I had the infected infusaport removed and a triple pic line was put in which within 5 days already clogged with Fibrogen and had to be “rotor routed”. I have been taking “boluke” before my triple antibiotic regimen (on my own with dr Zangs Allicin) and now after reading your article am even more convinced I did the right thing and maybe saved my life. I have been very sick for very long and would like to get rid of this biofilm once and for all. Any help would be greatly appreciated!!! Cathy chahalis

  10. Cathy, Yes you do have a few things going on. For now you may want to add-in Serrapeptase 80,000 units by AST Enzymes. This is more specific for your needs than Nattokinase or Lumbrokinase. 2 caps 2x/day on an empty stomach (30min before or 2 hours after food). 10% experience mild stomach distress if taken first thing in the morning. If this happens do the morning dose 2 hours after breakfast.

    When you get out we should schedule a distance patient consult. Let’s get you better! I wish you the best.

  11. mary sawyer says:

    I have had a horrible stomach condition which has exactly followed your description of biofilms and how they adapt. I have been to 15 doctors over 15 years and gone through every test or diet, and tried every OTC remedy anyone could think of. One test showed positive for pseudomonas aeruginosa. I’ve long known my condition is a bacteria because it has been knocked down by antibiotics, but nothing ever eradicates it, and it adapts to everything. It is now worse than ever. It’s burping gas that keeps me from being able to sleep at night because of the volume of gas that keeps coming and coming. None of the doctors I saw even seemed to know about biofilms, but all were content to eventually give up on me because nobody perceives gas as being all that serious. But this is making me old 20 years ahead of time! Do you know whom I should consult, since you say I shouldn’t self-medicate?

  12. Mary, Here is a link to my distance patient program in case you are interested. I have helped may people around the World with stories just like yours. Respectfully, Dr. Ettinger –

  13. Vera says:

    my dad has klebsiella pneumoniae in urine and has affected his prostate He cannot walk anymore .I was talking with a dr and she said to put him in hospital on Monday.She try to eradicate the Klebsiella with Imipenem drip but said the disease is chronic and created biofilms and is v hard to eradicate.I don’t know what to do to disrupt this biofilms..Anybody has any idea what treatment disrupt the klebsiella biofilms ? My dad is 86 yrs old.Thank you !

  14. Nicole Reid says:

    Hi doctor ettinger I was wondering what you would suggest o yake to remove biofilm from the intestines for parasites and how long I would need to yake them for any help would be greatly appreciated . Regards nicole

  15. Thank you for your question!

    This important note is located at the top of the post you commented on.

    Important Note:

    In order to receive protocol information or help, you will need to become a distance patient – Distance Patient Application. I truly do want to help any and 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 fill out the distance patient application (link above) or if you have questions about the program, please call me at 714-639-4360

    Here is a link to information on my Distance Patient Program.

  16. Ashley says:

    I’m interested in perhaps becoming a distance patient. However, I first wanted to know if you have any experience treating candida glabrata. I have been diagnosed with a glabrata vaginal yeast infection and have gone through some failed treatments. I know part of candida glabrata’s virulence is due its ability to create tough biofilms, so I was wondering if you have treated it in the past. Thanks!

  17. Ashley, I have treated a few patients with that. I would only feel comfortable with a protocol that also includes 200 mg’s a day of fluconazole (an MD would have to prescribe this). I don’t feel confident that a biofilm protocol combined with an antifungal protocol will get the job done, alone. If you are interested in a protocol that included fluconazole, please e-mail me directly at

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